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M. Pacini, I. Maremmani, PISA-SIA - Vol. 7, Giugno 2001, num.2
Testo Bibliografia Summary Riassunto Indice
Il problema della personalità
tossicofilica nella patogenesi del Disturbo da Uso di Sostanze Psicoattive.
Revisione della Letteratura e recenti acquisizioni
The issue of toxicophilic personality in the pathogenesis of Psychoactive
Substance Use Disorder.
A review of literature and recent advances
It remains unsolved whether a personality setting exists that can specifically
predict drug addiction. Addiction was first singled out in DSM axis II as a
form of personality disorder consisting in proneness to substance and alcohol
abuse; and later reconsidered as a DSM-IV axis I clinical condition. Nevertheless,
substance abuse still appears on the axis II as a symptom of significant diagnostic
weight for borderline and antisocial personality disorders.The self medication hypothesis showed to fit part of the cases of addiction with regard to the mechanism supporting the development of regular use of substances. However, such a theoretical model does not provide with pathogenetic explanations for all the different stages of the natural history of the illness.
In this paper we submit the hypothesis that bipolar spectrum plays an important role in the pathogenesis of addictive disorders. The basis of this hypothesis derives in part from the epidemiological studies of mood disorders and affective temperaments in drug addicts, in part from the existing clinical similarities between bipolar spectrum and dramatic cluster of the personality disorders, particularly borderline personality disorder. In fact the relationships between borderline personality disorder and drug abuse are well known.
Bipolar spectrum is involved in the development of risk behaviour, in which we can include the first contact with the substances of abuse. In other words, addiction would be the product of risk behaviour, a symptom of bipolar spectrum and of the reward properties of the substance of abuse .