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Personality disorder and alcohol treatment outcome: systematic review and meta-analysis
Giles M Newton-Howes1, James A Foulds2, Nicola H Guy2
1Giles M. Newton-Howes, MRCPsych, Department of Psychological Medicine, University of Otago, Wellington; James A. Foulds, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch; Nicola H. Guy, MMedSci, Department of Psychological Medicine, University of Otago, Wellington; Joseph M. Boden, PhD, Christchurch Health and Development Study, Roger T. Mulder, FRANZCP, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Giles.newton-howes@otago.ac.nz.
Abstract:
BackgroundPersonality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes.AimsTo determine the size and direction of the association between personality disorder and the outcome of treatment for AUD.MethodWe conducted a systematic review and meta-analysis of randomised trials and longitudinal studies.ResultsPersonality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall.ConclusionsCurrent evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area.