Psychiatric comorbidity and personality structure in patients with polyvalent addiction.
BACKGROUND
This study focuses on the systematic psychiatric evaluation of polydrug-using opiate-dependent patients, using the standard DSM-IV diagnostic interviews and a new psychodynamic instrument operationalizing personality organization (Structured Interview of Personality Organization, STIPO).


METHODS
50 patients were interviewed with the Structured Clinical Interview for DSM-IV Disorders (SCID) I and II and the STIPO by two independent researchers at a detoxification treatment unit.


RESULTS
According to the SCID I and II, all patients had at least one axis I disorder, 90% at least one axis II disorder. A correspondence was found between STIPO and SCID results, in that more pathology in the SCID coincided with more severity in the STIPO. According to the STIPO, 100% of the patients were located at the level of borderline personality organization, indicating identity pathology according to Kernberg's model.


CONCLUSIONS
Given the fact that comorbid psychiatric disorders compromise the outcome of detoxification and dehabituation treatments, it is highly relevant to diagnose these disorders and to assess underlying personality pathology. While the evidence of psychosocial treatments in addiction therapy is still weak, the integration of syndrome-tailored treatment modules may help improve the treatment of patients with this chronically relapsing condition.


CONCLUSIONS
small sample size.
Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany.
Michael
M
Rentrop
Thomas
T
Zilker
Alice
A
Lederle
Andreas
A
Birkhofer
Susanne
S
Hörz
D000328:Adult; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000453:epidemiology*; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D010551:Personality; D010552:Personality Assessment; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology