Axis II comorbidity in substance abusers

Am J Psychiatry. 1991 Jan;148(1):118-20. doi: 10.1176/ajp.148.1.118.

Abstract

Objective: To assess the complex relationship between substance abuse and personality disorders, the authors determined the prevalence of personality disorders in a group of middle-class substance abusers and compared the subjects who had personality disorders with those who did not.

Method: The subjects were drawn from patients consecutively admitted to an inpatient substance abuse program in a private psychiatric hospital; they were the first 100 who agreed to participate. Substance dependence was diagnosed according to DSM-III-R, and the patients were assessed with the Structured Clinical Interview for DSM-III-R Personality Disorders, Alcohol Use Inventory, MMPI, Health and Daily Living Form, Shipley Institute of Living Scale, and measures of chemical use and life satisfaction.

Results: Of the 100 substance abusers, 57 had personality disorders. These patients differed significantly from the 43 patients without personality disorders in several ways: they had greater involvement with illegal drugs, had different patterns of alcohol use, had greater psychopathology, were less satisfied with their lives, and were more impulsive, isolated, and depressed.

Conclusions: Because of the marked differences between the substance abusers with and without personality disorders, a uniform approach to substance abuse treatment may be inadequate.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Alcoholism / classification
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology
  • Comorbidity
  • Female
  • Humans
  • MMPI
  • Male
  • Personality Disorders / classification
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology*
  • Personality Inventory
  • Psychiatric Status Rating Scales
  • Substance-Related Disorders / classification
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Texas / epidemiology