[Premorbid psychological status in heroin abusers: impact of treatment compliance]

Heroin abusers who performed two "prefrontal" psychological tests (WCST and Delayed Alternation test--DIAT) with unusual amount of perseverative responses, reached i.v. doses of 0.5-1.0 g of heroin per day during the first year of heroin intake and continued out-patient treatment after discharge from hospital. Patients with "ideal" performance on two tests injected 0.1-0.3 g of heroin per day during the first year of heroin intake and stopped treatment after discharge, sometimes returned for treatment after several months of remission because of relapse. The latter patient group had lower verbal intelligence in comparison with education-matched normal controls. Percent of normal controls who made unusually many perseverative responses on WCST was the same as in the patient group (chi 2 = 5.5, p = 0.24).

a) Performance of WCST and partially DAT can characterise of premorbid psychological status in heroin abusers; b) premorbid dysfunction of prefrontal cortex that mediates perseverative responses to WCST and DAT may contribute to drug abusing severity; c) low verbal intelligence may poorly influence treatment compliance in heroin abusers.