Comorbidity of personality disorders with alcohol abuse

There is high comorbidity of alcohol dependence with mood, anxiety, substance abuse and personality disorders. Personality disorders, in particular, are considered to be an important contributing and/or predisposing factor in the pathogenesis, clinical course and treatment outcome of alcohol dependence. According to clinical and epidemiological studies, the prevalence of personality disorders in alcoholism ranges from as low as 22-40% to as high as 58-78%. The literature has focused primarily on antisocial and borderline personality disorders; however, almost the whole spectrum of personality disorders can be encountered in alcohol dependence, such as the dependent, avoidant, paranoid and others. A number of factors, such as sampling methods, diagnostic criteria used or assessment procedures applied, may explain this wide variation. The quest of a distinct 'alcoholic personality' dates from the first half of the 20th century but failed to reveal consistent and strong substantiation. However, renewed efforts provided evidence for the importance of impulsivity/ disinhibition and neuroticism/negative affectivity in the development of alcohol dependence; the role of other personality traits such as extraversion/sociability is still unclear. These findings led to a number of typologies, some of the most popular and influential being those of Cloninger, Babor, and Lesch.