The impact of personality disorders on alcohol-use outcomes in a pharmacotherapy trial for alcohol dependence and comorbid Axis I disorders.
Although antisocial and borderline personality disorders frequently co-occur with alcohol dependence and other Axis I disorders, their effect on alcohol use outcomes in context of pharmacotherapy remains unclear. Patients with Major Axis I disorders, including alcohol dependence, and diagnosis of antisocial (ASPD) or borderline personality disorder (BPD) were enrolled in a 12-week medication trial for treatment of their alcohol dependence. Everyone was randomized to one of four cells: naltrexone alone, placebo alone, open label disulfiram and naltrexone, or open label disulfiram and placebo. Outcome measures included scales for alcohol use and craving. Data were analyzed comparing patients with ASPD vs. those without, and patients with BPD vs. those without. Diagnosis of personality disorder did not adversely affect alcohol outcomes, and patients with ASPD or BPD did not have a poorer response to medication than patients without diagnosis of ASPD or BPD. The findings suggest that naltrexone and disulfiram can be safely and effectively used with patients who have comorbid diagnoses of Axis I and Axis II disorders.
Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut, USA. Elizabeth.Ralevski@yale.edu
Elizabeth
E
Ralevski
Samuel
S
Ball
Charla
C
Nich
Diana
D
Limoncelli
Ismene
I
Petrakis
D000328:Adult; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D000987:Antisocial Personality Disorder / Q000453:epidemiology / Q000523:psychology; D016739:Behavior, Addictive / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004221:Disulfiram / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010349:Patient Compliance; D010554:Personality Disorders / Q000453:epidemiology* / Q000523:psychology; D010919:Placebos; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome
D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D010919:Placebos; D009271:Naltrexone; D004221:Disulfiram