Prevalence and Pattern of Personality Disorders and Psychiatric Comorbidities Among Patients With Substance Use...

Background Substance use disorders (SUDs) frequently coexist with personality disorders (PDs), contributing to poorer treatment adherence, relapse, and clinical outcomes. Their coexistence with other psychiatric comorbidities further complicates management and highlights the need for comprehensive assessment. However, data regarding the prevalence and pattern of PDs among patients with SUDs in Indian tertiary care settings remain limited. This study aimed to determine the prevalence and pattern of PDs and personality traits among patients with SUDs, evaluate associated psychiatric comorbidities, and examine their relationship with different types of substance use. Methods A hospital-based cross-sectional study was conducted in the Department of Psychiatry, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, over a nine-month period from 01 October 2025 to 30 June 2026. A total of 200 consecutive patients aged 18 to 60 years who fulfilled the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) criteria for SUD and were admitted to the de-addiction ward were enrolled. Sociodemographic and clinical information was collected using a structured psychiatric interview proforma. PDs and personality traits were assessed using the International Personality Disorder Examination (IPDE). Psychiatric comorbidities were evaluated through detailed clinical interviews, mental status examination, and standardized rating scales including the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Yale Brown Obsessive Compulsive Scale, and Young Mania Rating Scale, whenever clinically indicated. Results The mean age of the participants was 30.55 ± 6.40 years. Alcohol and opioid use were the most common substances, each accounting for 30.0% of cases, followed by multiple substance use (24.0%) and cannabis use (16.0%). Personality traits were identified in 27.5% of participants, while 20.5% met the diagnostic criteria for a PD. Dissocial and impulsive PDs were the most prevalent, each observed in 5.5% of participants. Cluster B PDs constituted the largest group (12.5%), followed by Cluster C (4.5%) and Cluster A (3.5%). Psychiatric comorbidity was present in 6.5% of participants, with depression (3.0%) being the most frequent, followed by anxiety (2.0%), obsessive-compulsive disorder (1.0%), and mania (0.5%). No statistically significant association was found between the type of substance used and the presence of PD (χ² = 1.069, p = 0.785). No statistically significant association was observed between substance type and PD clusters using the Fisher-Freeman-Halton exact test (exact two-sided p = 0.976). Conclusion PDs were present in one-fifth of patients with SUDs, with dissocial and impulsive PDs being the most frequently observed individual diagnoses. Cluster B was the most frequently observed PD cluster in this inpatient SUD population. No significant association was found between the type of substance used and either the presence of PD or the distribution of PD clusters. Routine assessment of personality pathology and psychiatric comorbidities may support individualized clinical management.