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Open Access Highly Accessed Research article

In-depth study of personality disorders in first-admission patients with substance use disorders

Anne-Marit Langås12*, Ulrik Fredrik Malt234 and Stein Opjordsmoen35

Author Affiliations

1 Vestre Viken Hospital Trust, Division of Mental Health and Addiction, Department of Mental Health Research and Development, P.O. Box 135, Lier, NO-3401, Norway

2 Norwegian Research Network on Mood Disorders (NORMOOD), Oslo, Norway

3 University of Oslo, Institute of Clinical Medicine, Oslo, Norway

4 Division of Surgery and Clinical Neuroscience, Dept of Neuropsychiatry and Psychosomatic Medicine, Oslo University Hospital, Oslo, Norway

5 Division of Mental Health and Addiction, Dept of Research and Development, Oslo University Hospital, Oslo, Norway

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BMC Psychiatry 2012, 12:180  doi:10.1186/1471-244X-12-180

Published: 29 October 2012

Abstract

Background

Assessment of comorbid personality disorders (PDs) in patients with substance use disorders (SUDs) is challenging due to symptom overlap, additional mental and physical disorders, and limitations of the assessment methods. Our in-depth study applied methods to overcome these difficulties.

Method

A complete catchment area sample of 61 consecutively admitted patients with SUDs, with no previous history of specialized treatment (addiction clinics, psychiatry) were studied, addressing PDs and associated clinical and demographic variables. The thorough assessments included the Psychiatric Research Interview for Substance and Mental Disorders and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders.

Results

Forty-six percent of the SUD patients had at least one PD (16% antisocial [males only]; 13% borderline; and 8% paranoid, avoidant, and obsessive-compulsive, respectively). Cluster C disorders were as prevalent as Cluster B disorders. SUD patients with PDs were younger at the onset of their first SUD and at admission; used more illicit drugs; had more anxiety disorders, particularly social phobia; had more severe depressive symptoms; were more distressed; and less often attended work or school.

Conclusion

The psychiatric comorbidity and symptom load of SUD patients with PDs differed from those of SUD patients without PDs, suggesting different treatment needs, and stressing the value of the assessment of PDs in SUD patients.

Keywords:
Substance use disorder; Personality disorder; Comorbidity; Treatment-naïve; Catchment area