Co-occurrence of 12-Month Alcohol and Drug Use Disorders and PersonalityDisorders in the United States

TLDR

Very little information is available on the co‑occurrence of personality disorders and alcohol and drug use disorders in the US population. The study aims to present national data on sex differences in the co‑occurrence of DSM‑IV alcohol and drug use disorders and seven of the ten DSM‑IV personality disorders. Face‑to‑face interviews were conducted in the 2001‑2002 National Epidemiologic Survey on Alcohol and Related Conditions with 43,093 adults aged 18 and older across the United States and the District of Columbia. Among adults with alcohol use disorder, 28.6% had at least one personality disorder, while 47.7% of those with drug use disorder had a personality disorder; antisocial, histrionic, and dependent personality disorders were most strongly associated with alcohol and drug use disorders (odds ratios 3.0–11.8), and the co‑occurrence was pervasive across sexes.

Abstract

Very little information is available on the co-occurrence of different personality disorders (PDs) and alcohol and drug use disorders in the US population.To present national data on sex differences in the co-occurrence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol and drug use disorders and 7 of the 10 DSM-IV PDs.Face-to-face interviews conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43 093).The United States and the District of Columbia, including Alaska and Hawaii.Household and group-quarters residents, aged 18 years and older.Among individuals with a current alcohol use disorder, 28.6% (95% confidence interval [CI], 26.7-30.6) had at least 1 PD, whereas 47.7% (95% CI, 43.9-51.6) of those with a current drug use disorder had at least 1 PD. Further, 16.4% (95% CI, 15.1-17.6) of individuals with at least 1 PD had a current alcohol use disorder and 6.5% (95% CI, 5.7-7.3) had a current drug use disorder. Associations between PDs and alcohol and drug use disorders were overwhelmingly positive and significant (P <.05). Overall, alcohol use disorders were most strongly related to antisocial (odds ratio [OR], 4.8; 95% CI, 4.1-5.6), histrionic (OR, 4.7; 95% CI, 3.8-5.8), and dependent (OR, 3.0; 95% CI, 1.9-4.8) PDs. Drug use disorders also were more highly associated with antisocial (OR, 11.8; 95% CI, 9.7-14.3), histrionic (OR, 8.0; 95% CI, 6.0-10.7), and dependent (OR, 11.6; 95% CI, 7.1-19.1) PDs. Associations between obsessive-compulsive, histrionic, schizoid, and antisocial PDs and specific alcohol and drug use disorders were significantly stronger (P <.04) among women than men, whereas the association between dependent PD and drug dependence was significantly greater (P <.04) among men than women.The co-occurrence of PDs with alcohol and drug use disorders is pervasive in the US population. Results highlight the need for further research on the underlying structure of these disorders and the treatment implications of these disorders when comorbid.