Personality disorders among alcoholic outpatients: prevalence and course in treatment.
OBJECTIVE
To determine the prevalence of concurrent personality disorders (PDs) among alcoholic men and women seeking outpatient treatment, and to examine their effect on the course of alcohol treatment.


METHODS
Patients with alcohol use disorders (n = 165) were assessed by clinical and semi-structured interviews, as well as self-report scales, to measure levels of psychological distress, impulsivity, social functioning, and addiction severity at treatment intake. PD diagnoses were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Personality Disorder (SCID-II). Course in treatment was monitored prospectively for 12 weeks.


RESULTS
Using the results of the SCID-II (n = 138), the sample was divided into 3 groups-that is, no PD 41% (n = 57), Cluster B PD 32% (n = 44), and other PD 27% (n = 37). The 3 groups did not differ in their alcohol use severity at intake. However, the Cluster B PD group achieved alcohol milestones at a younger age. Subjects with a PD had more severe psychological and social problems at intake. The Cluster B PD group showed significantly higher levels of impulsivity at intake, greater likelihood of early treatment dropout, and quicker times to first slip and to relapse.


CONCLUSIONS
This study supports the high prevalence of concurrent PDs, particularly Cluster B PDs, among treatment-seeking alcoholics. The relation between observed high levels of impulsivity and worse course in early alcohol treatment among people with a Cluster B PD merits further investigation.
Zikos
Eugenia
E
Department of Psychiatry, McGill University Health Centre, 1025 Pine Avenue West, Montreal, Quebec. eugenia.zikos@mail.mcgill.ca
Gill
Kathryn J
KJ
Charney
Dara A
DA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010352:Patient Dropouts / Q000523:psychology*; D010554:Personality Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012931:Social Environment; D055815:Young Adult