TY  - JOUR
T1  - PErsonality disorders and the 3-year course of alcohol, drug, and nicotine use disorders
AU  - Hasin D, Fenton MC, Skodol A, et al
Y1  - 2011/11/01
N1  - 10.1001/archgenpsychiatry.2011.136
JO  - Archives of General Psychiatry
SP  - 1158
EP  - 1167
VL  - 68
IS  - 11
N2  - Context 
                  Little is known about the role of a broad range of personality disorders in the course of substance use disorder (SUD) and whether these differ by substance. The existing literature focuses mostly on antisocial personality disorder and does not come to clear conclusions.Objective 
                  To determine the association between the 10 DSM-IV personality disorders and the persistence of common SUDs in a 3-year prospective study of a national sample.Design 
                  Data were drawn from participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had alcohol dependence (n = 1172), cannabis use disorder (n = 454), or nicotine dependence (n = 4017) at baseline and who were reinterviewed 3 years later. Control variables included demographic characteristics, family history of substance disorders, baseline Axis I disorders and treatment status, and prior SUD duration.Main Outcome Measure 
                  Persistent SUD, defined as meeting full criteria for the relevant SUD throughout the 3-year follow-up period.Results 
                  Persistent SUD was found among 30.1% of participants with alcohol dependence, 30.8% with cannabis use disorder, and 56.6% with nicotine dependence at baseline. Axis I disorders did not have strong or consistent associations with persistent SUD. In contrast, antisocial personality disorder was significantly associated with persistent alcohol, cannabis, and nicotine use disorders (adjusted odds ratios, 2.46-3.51), as was borderline personality disorder (adjusted odds ratios, 2.04-2.78) and schizotypal personality disorder (adjusted odds ratios, 1.65-5.90). Narcissistic, schizoid, and obsessive-compulsive personality disorders were less consistently associated with SUD persistence.Conclusions 
                  The consistent findings on the association of antisocial, borderline, and schizotypal personality disorders with persistent SUD indicates the importance of these personality disorders in understanding the course of SUD. Future studies should examine dimensional representations of personality disorders and the role of specific components of these disorders, biological and environmental contributors to these relationships, and potential applications of these findings to treatment development.
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2011.136
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2011.136
ER  -