In-depth study of personality disorders in first-admission patients with substance use disorders
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
BMC Psychiatry 2012, 12:180 doi:10.1186/1471-244X-12-180Published: 29 October 2012
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.
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.
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.
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.