Prevalence and Determinants of Personality Disorders in a Clinical Sample of Alcohol-, Drug-, and Dual-Dependent Patients

Abstract

The present study compares the prevalence rates of 12 personality disorders (PDs) among patients with alcohol, drug, and dual dependence through chi-square tests and analyses of variance. It further investigates possible predictors of these PDs through multiple linear regression analyses. Data were gathered in 2007–2008 among 274 patients admitted to intensive, residential substance abuse treatment programs in Belgium, using the ADP-IV (Assessment of DSM-IV Personality Disorders), the EuropASI (European version of the Addiction Severity Index), and the MINI (Mini International Neuropsychiatric Interview). The analyses showed that drug- and dual-dependent patients have higher PD prevalence rates than alcohol-dependent patients. The severity, but not the nature of the dependence, appears as an important predictor for personality pathology.

RÉSUMÉ

Prévalence et facteurs déterminants des troubles de la personnalité au sein d'un échantillon clinique de patients présentant une dépendance à l'alcool, à la drogue ou une double dépendance

La présente étude compare les taux de prévalence de douze troubles de la personnalité (TP) DSM-IV chez des patients souffrant d'une dépendance à l'alcool, à la drogue ou d'une double dépendance, à l'aide de tests du khi-carré et d'analyses de la variance. Elle étudie les variables sociodémographiques et liées aux substances (nature et gravité) ainsi que les possibles variables explicatives de ces douze TP au moyen de multiples analyses de régression linéaire. Les données ont été rassemblées en 2007 et 2008 à l'aide du questionnaire ADP-IV (Assessment of DSM Personality Disorders IV), de l’European Addiction Severity Index (EuropAsi) et du Mini International Neuropsychiatric Interview, auprès de 274 patients admis en Belgique dans des programmes résidentiels intensifs de traitement de la toxicomanie.

RESUMEN

Prevalencia y determinantes de trastornos de la personalidad en una muestra clínica de pacientes con dependencia del alcohol, de las drogas y dual

El presente estudio compara las tasas de prevalencia de doce trastornos de la personalidad (TP) DSM-IV en pacientes con dependencia del alcohol, de las drogas o dual mediante pruebas de ji-cuadrado y análisis de la varianza, e investiga las variables sociodemográficas y relacionadas con las sustancias (naturaleza y gravedad) como posibles predictores de estos doce TP mediante análisis de regresión lineal múltiple. Los datos fueron obtenidos en 2007 y 2008 de 274 pacientes incluidos en programas residenciales intensivos de tratamiento por abuso de sustancias llevados a cabo en Bélgica, a través del cuestionario ADP-IV (Assessment of DSM Personality Disorders IV), el European Addiction Severity Index (EuropASI) y la Mini International Neuropsychiatric Interview (MINI).

Keywords :

• substance dependence
• dual diagnosis
• alcohol addiction
• drug addiction
• personality disorder
• polydrug use
• dual dependence

THE AUTHORS

Kathy Colpaert, M.Ed., is a research and teaching assistant at the Department of Orthopedagogics (Ghent University, Belgium). Her main research interests include substance abuse epidemiology and health services research. In her Ph.D. study, she focuses on the relation between addiction severity, psychiatric comorbidity, and quality of life of substance abusers in intensive residential treatment.

Wouter Vanderplasschen, Ph.D., is lecturer at the Department of Orthopedagogics (Ghent University, Belgium). His main research topics are substance misuse, case management, treatment methods, special needs groups, and evaluation of treatment.

Jessica De Maeyer, Ph.D., currently works as a post-doctoral researcher at the Department of Orthopedagogics (Ghent University, Belgium). In her Ph.D. dissertation, she studied the quality of life of opiate-dependent individuals after methadone maintenance treatment. Her main research interests include quality of life, harm reduction, outreach and strengths-based interventions, and support to individuals suffering from dependency problems and vulnerable groups in general.

Eric Broekaert, Ph.D., is a professor in Orthopedagogics (Special Education) at Ghent University in Belgium. He has a long experience in the field of substance abuse treatment and research, both nationally and internationally. Prof. Broekaert founded the first TC (‘De Kiem”) in Belgium. He is the Chairman of the Orthopedagogical Observation and Treatment Centre, a school for children with emotional and behavioral problems. He is also Chairman of the European Workshop on Drug Policy Oriented Research and cofounder and Honorary Vice President of the European Federation of Therapeutic Communities. He is actively involved in a variety of national and international research projects on substance abuse treatment. He has authored numerous scientific publications and is coeditor of the Therapeutic Communities: The International Journal for Therapeutic and Supportive Organizations.

Filip De Fruyt, Ph.D., is appointed as professor in Differential Psychology and Personality Assessment at Ghent University in Belgium. His research expands a broad domain, including adaptive and maladaptive traits, their structure and development, cross-cultural manifestations of personality, and applied personality psychology. He has been the secretary for six years and is a current member of the Executive Board of the European Association of Personality Psychology (EAPP). He served as associate editor of the European Journal of Personality from 2000 to 2004 and is still consulting editor of the European Journal of Personality, the International Journal of Selection and Assessment, the Review of Work and Organizational Psychology, and the Journal of Personality and Social Psychology (section Personality Processes and Individual Differences). He has (co-)authored more than 90 papers in a broad range of leading international academic journals.