Very little information is available on the co-occurrence of different
personality disorders (PDs) and alcohol and drug use disorders in the US population.
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.
Face-to-face interviews conducted in the 2001-2002 National Epidemiologic
Survey on Alcohol and Related Conditions (N = 43 093).
The United States and the District of Columbia, including Alaska and
Household and group-quarters residents, aged 18 years and older.
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.
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.