A systematic assessment of the comorbidity of DSM-III-R personality disorders in alcoholic outpatients

Nurnberg, H. George; Rifkin, Arthur; Doddi, Seshagiri

doi:10.1016/0010-440x(93)90073-d

Cited by 49 publications

(40 citation statements)

References 41 publications

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“…However, Cluster B PDs appear to be particularly prevalent among alcoholics, 2,3,[5][6][7]10,11,13 with both ASPD and BPD overrepresented in this population. 1,6,8,11,[21][22][23][24] In turn, alcohol use disorders are highly prevalent among people with Cluster B PDs. In the NESARC, alcohol use disorders were more frequently encountered among the 2 Cluster B PDs studied (in 28.7 % of people with ASPD and in 29.1% of those with histrionic PD) than those with other types of PDs.…”

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confidence: 99%

Personality Disorders among Alcoholic Outpatients: Prevalence and Course in Treatment

2010

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Objective: To determine the prevalence of concurrent personality disorders (PDs) among alcoholic men and women seeking outpatient treatment, and to examine their effect on the course of alcohol treatment. Method:Patients with alcohol use disorders (n = 165) were assessed by clinical and semi-structured interviews, as well as self-report scales, to measure levels of psychological distress, impulsivity, social functioning, and addiction severity at treatment intake. PD diagnoses were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Personality Disorder (SCID-II). Course in treatment was monitored prospectively for 12 weeks. Results:Using the results of the SCID-II (n = 138), the sample was divided into 3 groups-that is, no PD 41% (n = 57), Cluster B PD 32% (n = 44), and other PD 27% (n = 37). The 3 groups did not differ in their alcohol use severity at intake. However, the Cluster B PD group achieved alcohol milestones at a younger age. Subjects with a PD had more severe psychological and social problems at intake. The Cluster B PD group showed significantly higher levels of impulsivity at intake, greater likelihood of early treatment dropout, and quicker times to first slip and to relapse. Conclusions:This study supports the high prevalence of concurrent PDs, particularly Cluster B PDs, among treatment-seeking alcoholics. The relation between observed high levels of impulsivity and worse course in early alcohol treatment among people with a Cluster B PD merits further investigation.Can J Psychiatry. 2010;55(2):65-73. Clinical Implications· Among our outpatient treatment-seeking alcoholic sample, 59% had a PD, underscoring the importance of screening for this comorbidity. · Cluster B PDs were especially prevalent in our sample population (32%) and showed significantly higher levels of impulsivity at intake. · Subjects with Cluster B PD showed significantly poorer course in early alcohol treatment, confirming the clinical experience of difficulty engaging this population into treatment. Limitations· Our findings are not generalizable to alcohol use disorders as a whole, given that subjects were treatment-seeking outpatients with no comorbid drug dependence. · We were unable to examine outcomes for 20% of our sample owing to attrition, refusal to attend follow-up interviews, or missing data. · The current sample size limits our ability to further examine the complex relation between Cluster B PD and impulsivity, and their impact on alcoholism.

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Personality Disorders among Alcoholic Outpatients: Prevalence and Course in Treatment

2010

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“…Los resultados obtenidos indican que el 62,8% de la muestra (es decir, 2 de cada 3 alcohólicos) presenta, al menos, un trastorno de personalidad (el 64,1% de los hombres y el 58,8% de las mujeres). Estos resultados coinciden con los obtenidos en otras investigaciones que también señalan una tasa elevada de trastornos de personalidad en el alcoholismo (De Jong et al, 1993;Nurnberg et al, 1993). Esta cifra tan elevada es preocupante, ya que los programas habituales de intervención clínica con alcohólicos no contemplan, en su mayor parte, la existencia de trastornos de personalidad.…”

Section: Conclusionesunclassified

“…Sin embargo, los resultados obtenidos en las diferentes investigaciones llevadas a cabo en el ámbito del alcoholismo arrojan unos resultados muy heterogéneos, con una amplia variabilidad en la tasa de comorbilidad encontrada. En concreto, la tasa de alteraciones de personalidad que se ha observado en este tipo de pacientes oscila entre el 30% en algunos estudios (Driessen, Veltrup, Wetterling, John y Dilling, 1998; Pettinati, Pierce, Belden y Meyers, 1999) y el 80% en otros (De Jong, Van den Brink, Harteveld y Van der Wielen, 1993;Nurnberg, Rifkin y Doddi, 1993). El tipo de muestra utilizado -pacientes internos o ambulatorios, centros públicos o privados, etc.-y la diversidad de instrumentos de evaluación empleados, no es ajeno a ello.…”

Section: Introductionunclassified

“…En algunos estudios destaca el trastorno antisocial de la personalidad (Morgenstern, Lagenbucher, Labouvie y Miller, 1997), mientras que en otros es el histriónico (De Jong et al, 1993), el paranoide (Nurnberg et al, 1993), el narcisista (Pettinati et al, 1999) o, incluso, el no especificado (Driessen et al, 1998).…”

Section: Introductionunclassified

“…De Jong et al, 1993;Nurnberg, 1993). La constatación de este hecho, pone en duda la operatividad de la propia clasificación de los trastornos de personalidad.…”

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Trastornos de personalidad en alcohólicos : un estudio descriptivo

Montalvo¹,

González²,

López-Goñi³

et al. 2002

RPPC

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En este artículo se lleva a cabo una descripción de los trastornos de personalidad que aparecen con mayor frecuencia en el alcoholismo. Para ello, se cuenta con una muestra de 70 pacientes alcohólicos, que cumplimentan el MCMI-II en el transcurso de la evaluación pretratamiento. Los resultados muestran que el 62,8% de los pacientes presenta, al menos, un trastorno de personalidad. Más en concreto, el trastorno de mayor prevalencia es el pasivo-agresivo (34,1%), seguido del trastorno antisocial (20,4%) y del trastorno por dependencia (20,4%). Asimismo, se compara la prevalencia de los trastornos de personalidad en función del sexo y del abuso añadido de otras sustancias. Los resultados obtenidos en estas variables muestran la existencia de diferencias significativas. Por último, se comentan las implicaciones de este estudio para la prác-tica clínica y para las investigaciones futuras.Palabras clave: Alcoholismo, trastornos de personalidad, comorbilidad. Personality disorders in alcoholics: a descriptiva studyIn this paper, the most frequent personality disorders related to alcoholism are described. A sample of 70 alcoholic patients who answered the MCMI-II in the course of pretreatment assessment was selected. According to results, the 62,8% of them showed at least one personality disorder. The most prevalent ones were the passive-aggressive (34,1%), the antisocial (20,4%) and the dependent (20,4%). Furthermore, the prevalence of personality disorders according to gender and abuse of other substances was compared. Results obtained with these variables showed the existence of significant differences. Finally, implications of this study for clinical practice and futura research in this field are commented upon.

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Co-occurrence of 12-Month Alcohol and Drug Use Disorders and PersonalityDisorders in the United States

Grant¹,

Stinson²,

Dawson³

et al. 2004

Arch Gen Psychiatry

598

286

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A systematic assessment of the comorbidity of DSM-III-R personality disorders in alcoholic outpatients

Cited by 49 publications

References 41 publications

Personality Disorders among Alcoholic Outpatients: Prevalence and Course in Treatment

Personality Disorders among Alcoholic Outpatients: Prevalence and Course in Treatment

Trastornos de personalidad en alcohólicos : un estudio descriptivo

Co-occurrence of 12-Month Alcohol and Drug Use Disorders and PersonalityDisorders in the United States

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