Antisocial Personality Disorder and depression in relation to alcoholism: a community-based sample

Antisocial Personality Disorder (ASPD) and depression frequently co-occur with alcoholism. This study examined the relationship between the presence of ASPD or depression and the course and severity of alcoholism.

Alcoholic men (n = 207), recruited from a community-based sample, the Minnesota Twin-Family Study (MTFS), were categorized according to comorbid diagnoses into the following four groups: alcoholics with ASPD (n = 25), alcoholics with depression (n = 24), alcoholics with neither ASPD nor depression, but who were allowed to have additional psychopathology (n = 130) and alcoholics with no other psychiatric diagnoses (n = 28). The four diagnostic subgroups were compared on alcohol and drug use, alcohol-related problems and personality dimensions.

ASPD was associated with an earlier age of first intoxication, a more chronic and severe course of alcoholism, more social consequences of drinking and higher levels of drug use. On the whole, depression was associated with a less severe course of alcoholism. Alcoholics with depression and alcoholics with ASPD had higher negative emotionality, and alcoholics with ASPD had lower constraint scores on the Multidimensional Personality Questionnaire.

These findings, derived from a community-based sample, indicate the importance of assessing comorbidity among alcoholics and confirm the association of ASPD with a more severe and chronic course of alcoholism and with higher likelihood of drug abuse.