Personality disorders and substance use disorders: a narrative review

Abstract

Background: Personality factors have always been considered to play an important role in the etiology of substance-related disorders. Psychopathologic factors underlying an individual's personality structure have a major role in his or her tendency to use substances. This comorbidity can have an adverse effect on seeking and complying with treatment. Objective: This review provides the comorbidity of personality disorders and substance use disorders (SUD). Methods: In this report which was conducted in 2016, authors gathered data from different journals issued in print or electronic versions. These journals were indexed in Web of Science (Thomson Reuters), PubMed, Scopus, Google Scholar, ProQuest, Science Direct, Scientific Information Database (SID) and Magiran. A comprehensive search was done using keywords "Comorbidity", "Personality disorders" and "Substance use disorders". The research investigated in this review was conducted from January 1995 to 2016. Results: Comorbidity of borderline personality disorder, antisocial personality and diagnostic and therapeutic considerations are the most well-known problems in personality disorder. In dealing with these patients special attention should be paid to their safety, suicidal and homicidal thoughts Conclusion: It should be noted that an early diagnosis of comorbid personality disorder would lead to an adjusted expectancy from treatment, and adoption of long-term treatments for these patients

Birds of a Feather Flock Together: Concurrent Personality Disorders and Substance Use Disorders

“…Sher and Trull 16 suggest that these 2 conditions commonly share risk factors (childhood trauma and family conflict), and the appearance and persistence of 1 increases the likelihood and persistence of the other. 20…”

“…Dunn 21 found that participants in his study, with low-sensory registration and sensory-avoidant patterns, tended to abuse depressant substances to avoid their emotions (particularly anger) and tone down emotional distress experienced by individuals with PDs. 20,22 Participants with sensory-seeking patterns showed a tendency to abuse stimulants, which can be linked to their influence on the nervous system through encouraging euphoric experiences. People with high levels of impulsivity and interest in short-term rewards can be prone to develop SUDs.…”

“…The use of these substances likely further impairs their sensory processing, whereas abstinence and awareness of how they process sensory information can enable more adaptive responses to meet sensory needs. 20,24 In addition, accessing and using substances once dependent may promote antisocial behaviors to maintain use even though much of this potentially dissipate with sobriety. As a result, it is important to consider the presentation of the SUD when contemplating PDs diagnosis.…”

“…34 Diagnoses of PDs are typically given when symptoms have evidently subsisted pre-SUD and do not wane following a few months after withdrawal and abstinence. 20 For this reason, it is important to re-evaluate over time to observe emerging patterns for a PD (recurrent interpersonal problems, boundary testing, loaded personal histories, and so forth) and monitor clinician countertransference.…”

“…As a person must meet 5 of 9 criteria to receive a BPD diagnosis with 1 criterion being specifically related in part to substance abuse, the probability of having a SUD is greatly increased. Sher and Trull 16 suggest that these 2 conditions commonly share risk factors (childhood trauma and family conflict), and the appearance and persistence of 1 increases the likelihood and persistence of the other 20 …”