AimsEvaluation of the efficacy and safety of slow-release oral morphine (SROM) compared with methadone for detoxification from methadone and SROM maintenance treatment.DesignRandomized, double-blind, double-dummy, comparative multi-centre study with parallel groups.SettingThree psychiatric hospitals in Austria specializing in in-patient detoxification.ParticipantsMale and female opioid dependents (age > 18 years) willing to undergo detoxification from maintenance therapy in order to reach abstinence.InterventionsAbstinence was reached from maintenance treatment by tapered dose reduction of either SROM or methadone over a period of 16 days.MeasurementsEfficacy analyses were based on the number of patients per treatment group completing the study, as well as on the control of signs and symptoms of withdrawal [measured using Short Opioid Withdrawal Scale (SOWS)] and suppression of opiate craving. In addition, self-reported somatic and psychic symptoms (measured using Symptom Checklist SCL-90-R) were monitored.FindingsOf the 208 patients enrolled into the study, 202 were eligible for analysis (SROM: n = 102, methadone: n = 100). Completion rates were 51% in the SROM group and 49% in the methadone group [difference between groups: 2%; 95% confidence interval (CI): −12% to 16%]. The rate of discontinuation in the study was high mainly because of patients voluntarily withdrawing from treatment. No statistically significant differences between treatment groups were found in terms of signs and symptoms of opiate withdrawal, craving for opiates or self-reported symptoms. SROM and methadone were both well tolerated.ConclusionsDetoxification from maintenance treatment with tapered dose reduction of SROM is non-inferior to methadone.

Three versions (22-item, 10-item, and 7-item) of the social support questionnaire (F-SOZU) were psychometrically evaluated in two clinical and three non-clinical Austrian samples. The distribution of sum scores in all three versions was negatively skewed; means on the item-level were in the upper region of the five-point scale (M > 4.0) in all non-clinical samples. Internal consistency estimates were found to be satisfying for the total test scores (alpha > 0.85). The 10-item and the 7-item forms correlated highly with the 22-item form total score (r > 0.90). Principal components analysis supported a one dimensional solution in all forms. The discussion focuses on the problem of the highly skewed test scores. It is also argued that the use of the 7-item version might be preferable and more efficient if the researcher is only interested in obtaining a global score for perceived social support.

Although the Suicide Intent Scale (SIS) is a widely used instrument in research on suicidal behavior, comparative research on the latent structure of the SIS has been neglected. To determine whether a general factor model of the SIS is supported, alternative factor models of the SIS were evaluated comparatively in 11 clinical samples. The SIS was applied as part of a structured clinical interview to patients after an episode of non-fatal suicidal behavior. The samples were drawn from 11 study centers within the frame of the WHO/EURO multicenter study on suicidal behavior. Three different two-factor and two three-factor models of the SIS were examined in each sample using principal component analysis with orthogonal Procrustes rotation. The factorial structure of the 'subjective part' of the SIS (items 9-14) was strongly supported, whereas an acceptable model fit for the 'objective part' was not found. Possible future revisions of 'objective' SIS items may be worth consideration. As a limitation, the results of the study might not generalize to other samples that use different definitions of non-fatal suicidal behavior.

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The factor structure of the Beck Depression Inventory (BDI) is still controversial. The present study attempted to replicate a general two-factor model (cognitive-affective and somatic factors) of the BDI with a confirmatory Procrustes rotation procedure in two clinical samples of patients being treated for alcohol dependence (N₁ = 243, N₂ = 148) and one clinical sample of patients admitted to an acute psychiatric ward because of an act of deliberate self-harm (N₃ = 144). In addition, due to the neglect of gender-specific analysis in factor-analytic studies of the BDI, the two-factor model was tested for males and females separately. The results did not support the validity of the two-factor model in the total samples. Gender-specific findings indicated a better fit of the model in male samples. Possible implications of a gender-specific factor structure of the BDI are discussed.