Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
BACKGROUND
Very little information is available on the co-occurrence of different personality disorders (PDs) and alcohol and drug use disorders in the US population.


OBJECTIVE
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.


METHODS
Face-to-face interviews conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43 093).


METHODS
The United States and the District of Columbia, including Alaska and Hawaii.


METHODS
Household and group-quarters residents, aged 18 years and older.


RESULTS
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.


CONCLUSIONS
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.
Grant
Bridget F
BF
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA. bgrant@willco.niaaa.nih.gov
Stinson
Frederick S
FS
Dawson
Deborah A
DA
Chou
S Patricia
SP
Ruan
W June
WJ
Pickering
Roger P
RP
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D010554:Personality Disorders / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology