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Substance use disorder and personality disorder
Kenneth J Sher1, Timothy J Trull
1Department of Psychological Sciences, University of Missouri-Columbia and the Missouri Alcoholism Research Center at the University of Missouri-Columbia, 200 South Seventh Street, Columbia, MO 65211, USA. SherK@missouri.edu
Current Psychiatry Reports
|January 30, 2002
Summary
Personality disorders (PDs) and substance use disorders (SUDs) frequently co-occur. This review highlights common mechanisms and clinical implications, focusing on antisocial and borderline personality disorders, and other prevalent PDs in SUD populations.
Area of Science:
- Psychiatry
- Clinical Psychology
- Addiction Medicine
Background:
- High comorbidity exists between personality disorders (PDs) and substance use disorders (SUDs) in general and clinical populations.
- Antisocial personality disorder (ASPD) and borderline personality disorder (BPD) are frequently comorbid with SUDs, presenting significant clinical challenges.
- Other PDs, including avoidant and paranoid PD, are also prevalent in individuals with SUDs.
Purpose of the Study:
- To review the existing literature on the comorbidity of PDs and SUDs.
- To explore potential mechanisms underlying this comorbidity.
- To discuss the clinical implications of co-occurring PDs and SUDs.
Main Methods:
- Literature review of studies documenting PD-SUD comorbidity.
- Analysis of research on common etiologic processes for specific PDs and SUDs.
- Examination of clinical implications and challenges associated with comorbid PDs and SUDs.
Main Results:
- Significant comorbidity rates between various PDs and SUDs are well-documented.
- ASPD and BPD show particularly high rates of co-occurrence with SUDs.
- Shared etiologic factors are increasingly identified for specific PD-SUD combinations.
Conclusions:
- The frequent co-occurrence of PDs and SUDs necessitates integrated treatment approaches.
- Understanding shared mechanisms can inform more effective prevention and intervention strategies.
- Clinical practice must address the complexity of comorbid PDs and SUDs, including less commonly studied PDs.