Association of personality disorders with Type A and Type B alcoholics

Personality disorders frequently occur as comorbid disorder in alcohol-dependent subjects. Antisocial personality was described as an important characteristic in Cloninger's Type 2 and Babor's Type B subjects. The impact of other personality disorders on these alcoholism typologies, their pathogenesis and prognosis is, however, still unclear. The present study investigated the prevalence of personality disorders in 237 (194 males) detoxified alcohol-dependent patients after subtyping this sample according to Babor's Type A/B following the criteria suggested by Schuckit et al. (1995). Personality disorders were assessed with the SCID-II (DSM-IV). In all, 160 patients (68 %) could be classified as Type A, and 77 (32 %) as Type B. Type B subjects were younger, had an earlier onset,more alcohol intake and a more severe course of alcohol dependence. Type B patients had significantly more often any cluster A and B personality disorder, and significantly specifically more often a borderline, antisocial and avoidant personality disorder. There were no statistical differences concerning the other personality disorders. In summary, the Type A/B dichotomy using the criteria of Schuckit et al. (1995) was replicated successfully. Differences concerning cluster B personality disorder prevalence of Type B subjects demonstrated that these subjects are significantly more often affected from borderline and antisocial personality disorder. The impact of other personality disorders does not play a substantial role in subtyping alcoholics.