title: Premorbid Personality Disorders in Male Schizophrenic Patients with or without Comorbid Substance Use Disorder: Is Dual Diagnosis Mediated by Personality Disorder?
abstract: BACKGROUND
  Although substance abuse is an important clinical problem in schizophrenic patients, very little evidence explains why these patients use drugs and alcohol. This study therefore aimed to examine whether premorbid personality disorders affect substance abuse.
  
  
  METHODS
  The sample included 40 male schizophrenic patients with and 40 male schizophrenic patients without substance use disorder comorbidity who had applied to Ankara Numune Research and Training Hospital. Each participant and a family member were interviewed in a structured clinical interview that addressed premorbid personality disorders.
  
  
  RESULTS
  Altogether, 32 patients (80%) in the group with comorbidity and 28 (70%) in the group without comorbidity had a premorbid personality disorder. Antisocial (35% vs. 0%; p<.001) and borderline (37.5% vs. 5%; p=.001) personality disorders were more often detected in the group with comorbidity, while avoidant (10% vs. 35%; p=.014) and obsessive-compulsive (0% vs. 15%; p=.026) personality disorders were less frequently found in this group. Comparing the group with comorbidity with premorbid personality types, schizophrenic patients with premorbid antisocial personality disorder were more frequently unemployed and hospitalized as well as had an earlier onset age of schizophrenia (p=.034, p=.038 and p=.035, respectively). Schizophrenic patients with premorbid borderline personality disorder had a significantly earlier onset age of substance use (19±5; p=.028).
  
  
  CONCLUSIONS
  Schizophrenic patients with substance use comorbidity variously differ from those without comorbidity and some of these differences may be associated with premorbid personality disorders.
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Altunsoy
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Şafak Yalçın
authors.initials: ŞY
authors.lastname: Şahiner
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Cingi Külük
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Tuncer
authors.initials: T
authors.lastname: Okay
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Ulusoy Kaymak
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Aydemir
authors.affiliation: Clinic of Psychiatry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Göka
keywords: Comorbidity; personality disorder; schizophrenia; substance abuse