Positive association of personal distress with testosterone in opiate-addicted patients

Abstract

Clinical studies report that substance addictions are associated with sociocognitive impairments. Regarding opiate-addicted patients, the few existing studies point to deficits in empathic abilities. Previous research suggests that testosterone might be a relevant biomarker of these impairments. The authors aimed to investigate whether opiate-addicted patients show specific impairments in emotional (empathic concern, personal distress) and cognitive empathy compared to healthy controls. Furthermore, the authors aimed to assess possible associations of testosterone levels with impaired empathic abilities in the patients' group. In this cross-sectional study, 27 opiate-addicted, diacetylmorphine-maintained patients (21 males, age mean 41.67 years, standard deviation 8.814) and 31 healthy controls (23 males, age mean 40.77 years, standard deviation 8.401) matched in age, sex, and educational level were examined. Cognitive and emotional empathy were measured via the German version of the Interpersonal Reactivity Index and salivary testosterone levels were assessed. The authors found higher personal distress scores (p < 0.01, d = 0.817) and higher testosterone (p < 0.001, d = 1.093) in the patients' group compared to controls. Moreover, a positive correlation was found between testosterone and personal distress among the patients' group (r = 0.399, p < 0.05). Opiate-addicted patients show specific impairments in emotional empathy, namely higher personal distress, which has clinical implications regarding social cognition rehabilitation and relapse prevention. The current data point toward testosterone as a possible biomarker for these sociocognitive impairments and suggest that high personal distress and high testosterone during withdrawal are possible markers for severe opiate addiction.

Impaired empathy and increased anger following social exclusion in non-intoxicated opioid users

“…The finding of lower emotional empathy in the nonintoxicated users partially replicates previous research suggesting impaired empathy among drug users (Ferrari et al 2014;Kroll et al 2018aKroll et al , 2018bMaurage et al 2011;Preller et al 2014) and opioid users specifically (Kroll et al 2018a;Stange et al 2017;Tomei et al 2017), but crucially highlighted that acutely intoxicated opioid users show intact emotional empathy compared to controls. This was contrary to our initial prediction that empathy would be lowest within the intoxicated user group.…”

“…Impairments in emotional empathy have been observed in drug users generally (Ferrari et al 2014), alcohol users (Maurage et al 2011) and stimulant users (Kroll et al 2018a(Kroll et al , 2018bPreller et al 2014). Two studies with chronic opioid users have similarly reported impairments in emotional empathy using a subjective questionnaire among methadoneand diacetylmorphine-maintained individuals (Stange et al 2017;Tomei et al 2017) but a further study failed to replicate these findings (Kroll et al 2018a). The ability to empathise can be affected by situational factors including psychosocial stress, affective state, and socioeconomic status (Kanske et al 2017), where acute opioid intoxication state may also be important to understand impairments in empathy within the context of wider social stress.…”

“…We aimed to examine both the acute and long-term effects of opioids in people prescribed an opioid substitution medication (OSM), by testing people intoxicated with OSM at the time of testing, and people who had not taken their medication for at least 12 hours. Based on previous research showing deficits in empathy in opioid users, we hypothesised that both of the opioid user groups would show impairments in empathy; however, given evidence that opioid intoxication is associated with impaired emotional empathy (Stange et al 2017;Tomei et al 2017), we predicted that emotional empathy would be most impaired in the intoxicated group. Secondly, we hypothesised that the intoxicated user group would have a dampened response to social exclusionbased on the analgesic effects of opioids and the assertion that physical and social pain are related.…”

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

“…The IRI has been used in many trials related to social cognition (427) (e.g., 329, 427–429) and neurophysiological studies (430, 431), in combination with MRI data (432–437), and appears to be predictive of performance on other tasks of social cognition (438–440). Atypical scores may arise in association with schizotypy (441), schizophrenia (256, 442–448), epilepsy (449, 450), ASD (156), Huntington’s disease (183, 184), Tourette syndrome (183), Alzheimer’s disease and mild cognitive impairment (451), frontotemporal dementia (452–454), post-traumatic stress disorder (455, 456), attention deficit-hyperactivity disorder (393), anorexia nervosa (457), Parkinson’s disease (458, 459), depression (273), traumatic brain injury (460), aphasia (461), multiple sclerosis (462), complex regional pain (463), and substance misuse (464). No significant difference to controls have also been found in other samples of patients with substance misuse (25, 26, 465), schizophrenia (466), first-episode psychosis (467), and first-degree relatives of patients with schizophrenia (468, 469).…”