Coexistence between personality disorders and substance use disorder. Madrid study about prevalence of dual pathology.

INTRODUCTION: Personality disorders (PD) and substance use disorders (SUD) have a high prevalence and an important health and socioeconomic impact so, it is interesting to study the relationship between them. The objectives of the study are: to compare the prevalence of SUD between patients with and without diagnosis of PD, to analyze if any PD is related to the SUD, and if a specific PD is associated with a specific SUD. MATERIAL AND METHODS: Cross-sectional study in 837 patients from centers of attention to drug addiction and mental health in Madrid, Spain. The Mini International Neuropsychiatric Interview (MINI) and the Personality Diagnostic Questionnaire-4+ (PDQ4+) are used to detect mental disorder and PD, respectively. RESULTS: SUD is significantly higher in antisocial PD (p<0.01); sedative (p<0.01) and alcohol (p<0.05) use disorder in borderline PD; cocaine (p<0.05) and alcohol (p<0.01) use disorder in paranoid PD; and alcohol use disorder in histrionic PD (p<0.01). The SUD for cocaine is lower in obsessive- compulsive PD (p<0.05) and depressive PD (p<0.01). There is a positive correlation between the number of PD of a subject and the number of SUD that it presents. The risk of an alcohol [OR of 1,08 CI (1,01-1,16)] or sedatives [OR of 1,08 CI (1,001-1,17)] use disorders increases if an individual presents more than one type of PD. CONCLUSIONS: There is not differences of SUD prevalence between PD and not PD groups. We found an association between SUD and PD of cluster B (antisocial, borderline and histrionic) and also with paranoid PD. The SUD are more common among man with the exception of sedatives.

Personality patterns of people with medically refractory epilepsy - Does the epileptogenic zone matter?

OBJECTIVES: The aims of this study were to determine the rate of dysfunctional personality patterns before and after epilepsy surgery, their types, and the importance of the epileptogenic zone in a sample of people with refractory epilepsy. METHODS: We conducted an ambispective observational study, including refractory epilepsy surgery candidates. Demographic, psychiatric, and neurological data were recorded. Evaluation of personality was made using the Millon Clinical Multiaxial Inventory-II (MCMI-II). Presurgical predictors of personality patterns were determined using a linear regression model. The proportion of patients with dysfunctional personality patterns, before and after surgery, was compared using the Mcnemar's test. Then a generalized estimating equation model was performed to include predictors of changes in this rate. RESULTS: One hundred and ninety-nine participants were included. Seventy percent had a dysfunctional personality pattern before surgery. After surgery, this percentage dropped to 58%. The difference was statistically significant after adjusting for potential confounders (p = 0.013). The most common types were Cluster C personality patterns. Temporal epileptogenic zone was a significant predictor of higher scores of the Avoidant (Coef. 11.8; Confidence Interval (CI) -0.59 23.7; p = 0.051) and Compulsive (Coef. 9.55; CI 2.48 16.6; p = 0.008) personality patterns and lower scores of Histrionic (Coef. -11.4; CI -21.2 -1.55; p = 0.024) and Antisocial (Coef. -8.4; CI -15.6 -1.25; p = 0.022) personality patterns, compared to extratemporal epileptogenic zone. CONCLUSION: People with refractory epilepsy have high rates of dysfunctional personality patterns. These patterns differ according to the epileptogenic zone.

Enfermedad psicógena masiva. Reporte de tres episodios no recientes / Massive Psychogenic Disease. A report of three not recent episodes

Episodios de enfermedad psicógena masiva han ocurrido en entornos sociales diferentes, en todo el mundo, a lo largo de la historia de la humanidad. Cada vez los profesionales de la salud participan más en su atención y solución. Este trabajo presenta tres "casos" catalogados como tales, que el autor tuvo la oportunidad de asistir. Se realizan comentarios en cada uno de ellos y se actualizan conceptos sobre esta condición, que se expresa por los más variados síntomas en un grupo de personas ante un estrés intenso por supuestas amenazas, aunque no exista una razón física o ambiental para que se enfermen. Genera marcada tensión tanto en pacientes como en facultativos y en el público. Los médicos, y el personal sanitario en general, deben estar preparados para su adecuado diagnóstico y conducta a seguir.

Episodes of massive psychogenic disease have occurred in different social contexts, worldwide, throughout history. Every time health professionals participate more in their attention and solution. This work presents three ¨cases¨ classified as such, which the author had the opportunity to attend. There are, in this work comments, about each of them and concepts about this condition are updated; which is expressed by the most varied symptoms in a group of people facing intense stress due to supposed threatening even though there is no physical or environmental reason to get sick. It generates a marked tension in patients and doctors so as in the general public. Doctors and sanitary personnel should be prepared for its adequate diagnosis and conduct to follow.

Gender differences in the prevalence and impact factors of hysterical tendencies in adolescents from three eastern Chinese provinces.

BACKGROUND: Few studies have attempted to compare the differences in the prevalence and impact factors of hysterical tendencies (HTs) in adolescents. Thus, the aim of this study was to examine gender differences in the prevalence and impact factors of adolescents' HTs across three eastern Chinese provinces (Anhui, Jiangsu, and Zhejiang). METHODS: A multicenter, school-based, cross-sectional study was conducted in three provinces (Anhui, Jiangsu, and Zhejiang) in China in 2014. The sample included 10,131 middle-school students aged 13-18 years who were randomly selected using a multiphase, stratified, cluster sampling technique. A two-stage appraisal procedure was used to determine the adolescents' HTs. We also designed a multicenter, school-based, case control (1329 cases with 2661 control individuals) study to collect data on the common factors affecting this population using a common protocol and questionnaire. RESULTS: An overall positive rate of HTs among adolescents across the three eastern Chinese provinces studied was found at 13.1% (95% confidence interval (CI) 12.5-13.8%), at 14.5% (95% CI 13.3-15.7%) for females, and at 12.2% (95% CI 11.1-13.4%) for males. Gender-stratified, multiple conditional regression analyses revealed that superstitious beliefs pertaining to life, somatotype, teacher-student satisfaction, and family achievement orientation were significantly linked to HTs only in males, while left-behind adolescents, emotional and social adaptation, teacher-student support, family cohesion, and the Hospital Anxiety and Depression Scale - depression scores were significantly associated with female HTs only. The models indicated that of all the independent variables studied, family medical history was the strongest impact factor for both male HTs (adjusted matched odds ratio (amOR) = 2.92, 95% CI = 1.84-4.86) and female HTs (amOR = 2.74, 95% CI = 1.59-4.98). CONCLUSIONS: HTs are prevalent among adolescents in the three eastern Chinese provinces studied. Gender differences in the prevalence and impact factors of HTs are significant in adolescents, and HTs seem to affect more females than males. Therefore, sex-specific intervention programs against HTs in adolescents should be considered to reduce HT prevalence in adolescents by modifying influential social, school, and family factors.

Perfil psicosocial y sobrevaloracion en lumbalgias crónicas. importancia de las pruebas de biomecanica y valoración psiquiátrica / Psychosocial profile and overvaluation in chronic back pain. importance of biomechanic test and psychiatric evaluation

Introducción: La detección de la simulación se fundamenta en distintas fuentes de información (Exploración física, Pruebas médicas, Evaluación psiquiátrica, Pruebas biomecánicas). A mayor inconsistencias más posibilidades de sobrevaloración. Objetivos: Demostrar que los resultados inconsistentes en pruebas biomecánicas y Test de personalidad (SIMS, PAI, MMPI-2, MCMI-III), se corresponden con un perfil de personalidad característico (somatizador, histriónico, hipocondríaco). Material y Métodos: SUJETOS: 70 pacientes valorados en MAZ por lumbalgia crónica. METODO: determinación de fiabilidad en Valoración Biomecánica (Ned Lumbal) + Entrevista Psiquiátrica Estructurada + fiabilidad en Test de personalidad (MMPI-2, MCMI-III, PAI, SIMS). Resultados y Conclusiones:1) Los pacientes poco fiables muestran significativamente más rasgos de personalidad somatizadora, hipocondríaca e histriónica. 2) no diferencias significativas en pacientes con trastornos adaptativos ansioso-depresivos. 3) alta correlación entre pruebas biomecánicas y de personalidad. Conclusiones: Confirmamos un mayor perfil de personalidad premorbida (somatizador, hipocondríaco e histriónico) y sobrevaloración en lumbalgia crónicas empleando pruebas biomecánicas/psiquiátricas (AU)

Introduction: The detection of the simulation is based on different information sources (physical examination, medical tests, psychiatric evaluation, biomechanical tests). To major inconsistencies more possibilities of overvaluation. Objective:To demonstrate that inconsistent results in Biomechanical tests (Ned-Lumbar) and Personality tests (SIMS, PAI, MMPI-2, MCMI-III) correspond to a characteristic personality profile (somatization, histrionic, hypochondriac). Material and Method: SUBJECTS: 70 patients with chronic back pain valued by MAZ. METHOD: To determinate the reliability in Biomechanical Assessment (Ned Lumbal) + Structured Psychiatric Interview + Personality test (MMPI-2, MCMI-III, PAI, SIMS). Results: 1) Patients with few reliability have a personality profile of somatization, hypochondriac or histrionic statistically significant. 2) No significant differences in patients with adaptative anxiety-depressive disorders. 3) High correlation between biomechanical and personality test. Conclusions:It is confirmed a mayor profile of premorbid personality (somatization, hypochondriac and histrionic) and an overvaluation in chronic back pain using biomechanical and psychiatric tests (AU)

Paternal malparenting and offspring personality disorders: Mediating effect of early maladaptive schemas.

OBJECTIVE: To examine the mediating role of maladaptive schemas between permissive/authoritarian parenting by fathers and personality disorders, including histrionic, antisocial, narcissistic and depressive attitudes among adults. METHODS: This cross-sectional study was conducted at the University of Sargodha, Sargodha, Pakistan, and comprised university students. Data was collected by administering the parental authority questionnaire, the young schema questionnaire and the personality diagnostic questionnaire. SPSS 23 was used for data analysis. The study was completed in one year. It was started from June 2014 and ended in June 2015. RESULTS: Of the 200 participants who were handed the questionnaires, 100(50%) returned it fully filled up. Of them, 87(87%) were women and 13(13%) were men. All scales had greater than 0.70 alpha reliability coefficients. The values of skewness for all scales ranged from 0.10 to 0.86.Permissive parenting style had positive correlation with histrionic (p<0.05), narcissistic (p<0.05) and antisocial personality disorders (p<0.01). Authoritarian parenting had positive correlation with early maladaptive schemas (p<0.01) and depressive personality disorder (p<0.05). CONCLUSIONS: Both permissive and authoritarian parenting styles led to personality disorders among offspring in the adult phase of their lives.

Comorbidity of personality disorders in mood disorders: a meta-analytic review of 122 studies from 1988 to 2010.

BACKGROUND: A meta-analysis was conducted to identify the proportions of comorbid personality disorders (PD) in mood disorders. METHODS: We found 122 empirical papers published in the period 1980-2010 on participants having mood disorders in addition to a comorbid PD. Mood disorders were classified as bipolar disorders (BD), major depressive disorders (MDD) and dysthymic disorders (DYS). Several moderators were coded as well. RESULTS: The risk of having at least one comorbid PD (any PD) was high across all three mood disorders (BD=.42, MDD=.45), but highest in DYS (.60). Cluster B and C PDs were most frequent in BD, while cluster C PDs dominated in MDD and DYS. Among the specific PDs, the paranoid (.11 versus .07/.05), borderline (.16 versus .14/.13), histrionic (.10 versus .06/.06) and obsessive-compulsive (.18 versus .09/.12) PDs occurred more frequently in BD versus MDD/DYS, whereas the avoidant PD (.22 versus .12/.16) was most frequent in DYS versus BD/MDD. Moderator analyses showed higher comorbidity when diagnoses were based on questionnaires versus clinical interviews, DSM-III-R versus DSM-IV, more women were included or the duration of the disorder was longer. Age of onset yielded mixed results. LIMITATIONS: Blind rating of diagnoses was recorded, but was employed in too few studies to be usable as an indication of diagnostic validity. CONCLUSIONS: Personality disorders are common in mood disorders. Implications of the identified moderators as well as the new DSM-5 diagnostic system are considered.

Measuring IPDE-SQ personality disorder prevalence in pre-sentence and early-stage prison populations, with sub-type estimates.

Understanding the prevalence and type of personality disorder within prison systems allows for the effective targeting of resources to implement strategies to alleviate symptoms, manage behaviour and attempt to reduce re-offending. This study aimed to determine the prevalence of personality disorder (PD) traits within a local urban high-turnover adult male prison with a remand/recently sentenced population in London, UK. The International Personality Disorder Examination - Screening Questionnaire (IPDE-SQ) self-administered questionnaire (ICD-10 version) was completed by 283 prisoners (42% completion rate). 77% of respondents reached the threshold for one or more PDs. The most common PD types were Paranoid PD (44.5%), Anankastic PD (40.3%), Schizoid PD (35%) and Dissocial PD (25.8%). These results confirm and extend existing knowledge regarding the prevalence of PD in prison populations into a high-turnover, urban, remand population. The stark comparison with community samples indicates that a more equitable standard of service delivery within the criminal justice system, focussing on preventive and early intervention services, is now required.

Cluster B maladaptive personality traits in Spanish adolescents.

INTRODUCCTION: The prevalence and expression of Cluster B personality disorders during adolescence have been poorly analyzed. The main aim of this research was to analyze the rate of Cluster B maladaptive personality traits in Spanish adolescents. We also examined dimensional structure underlying the influence of sex and age in its phenotypic expression, was also examined. METHOD: The sample consisted of a total of 1440 participants (Mean=15.9 years, SD=1.2). The self-reporting questionnaire used was the Personality Diagnostic Questionnaire-4 + (PDQ-4 +). RESULTS: Maladaptative «dramatic¼ or «erratic¼ personality traits are common among adolescents, particularly antisocial and borderline facets. Using the PDQ-4+ cut-off points, 20.3% of the sample submitted had a Cluster B personality disorder. The analysis of the internal structure of the Cluster B items of the PDQ-4 + yielded a factorial solution centred on three interrelated factors, including: Antisocial, Borderline and Histrionic/Narcissistic. There were differences by gender in the subscales of Cluster B, but not in function of age. CONCLUSIONS: These data yield new insights that improve the understanding of the Cluster B personality disorders and traits in this sector of the population. Future studies should use measurement tools that take into account the concern, conviction and distress associated with such experiences.

Jaqueca asociada a trastorno de conversión (jaqueca de Babinski). Análisis de una serie de 43 casos / Migraine associated with conversion symptoms (Babinski's migraine): evaluation of a series of 43 cases

Introducción: En 1890 el neurólogo francés Babinski describió como migraine ophthalmique hystérique o jaqueca oftálmica histérica, cuatro casos de cefalea asociada a síntomas visuales y trastornos histéricos. Desde entonces esta asociación ha sido raramente descrita, aunque la frecuencia, posiblemente elevada de acuerdo con descripciones anteriores, está por establecer. Este trabajo recupera la descripción de Babinski e intenta rehabilitar el síndrome descubierto por el semiólogo francés en la relativamente alta frecuencia de este tipo de pacientes observada en un hospital público. Asimismo, se especula sobre los motivos del olvido de esta descripción. Método: El estudio presenta una serie de 43 casos de jaqueca, la gran mayoría compatibles con jaqueca de tipo basilar de acuerdo con los criterios IHS, asociados a síntomas de conversión. El diagnóstico de trastorno de conversión (histeria) se basa en los criterios establecidos por el DSM-IV. Resultados: Todos los pacientes mostraron una o más manifestaciones de histeria durante las crisis de jaqueca, y algunos en los intervalos. Se discuten los detalles de las cefaleas, de los síntomas asociados y de las manifestaciones histéricas. La mayoría de los pacientes mejoró con medicación antijaquecosa. La alteración de la conciencia pudo haber contribuido al desencadenamiento de los síntomas histéricos. Conclusiones: La jaqueca basilar asociada a trastorno de conversión descrita de forma sistematizada por Babinski no es una entidad rara. Cuadros similares se han descrito a lo largo de la historia de la medicina. El silencio durante el último siglo sobre la entidad se debe posiblemente a la dificultad histórica en definir de forma apropiada los trastornos de conversión. La jaqueca de Babinski es una entidad bien establecida y debe ser recuperada para el clínico (AU)

Background: In 1890 four cases of headache associated with visual symptoms and hysterical disorder were described by the French neurologist Babinski as migraine ophthalmique hystérique, or hysterical ophthalmic migraine. Since that time this association has seldom been described, and the possibly high frequency previously reported still remains to be established. This paper has reused Babinski's description and it tries to rehabilitate the syndrome described by the French semiologist across the relatively frequent experience of this type of patients in a public hospital. Also it analyzes the reason of the oblivion of his description.Method: This study presents a series of 43 cases of headache of the migraine type associated with other symptoms, most consistent with basilar-type migraine according to IHS criteria. Diagnosis of conversion disorder (hysteria) was grounded in the criteria set forth in the DSM-IV. Results: All patients exhibited one or more manifestations of hysteria (conversion symptoms) during migraine attacks, and some did in the intervals between attacks as well. Details of the headaches, associated symptoms, and hysterical manifestations are discussed. Most patients improved with antimigraine medication. Altered consciousness may have contributed to the onset of hysterical symptoms. Conclusions: The basilar type migraine associated with conversion symptoms described of systematized form by Babinski, it is not a rare entity. Similar pictures have been described along the history of the medicine. The later silence possibly is due to the historical difficulty in defining accurately the conversión disorders. The Babinski's migraine is a certain well entity and must be recovered for the clinic (AU)

Is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, histrionic personality disorder category a valid construct?

PURPOSE: The study investigated crucial aspects of the construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) histrionic personality disorder (HPD) category. MATERIAL AND METHODS: The study included 2289 patients from the Norwegian Network of Psychotherapeutic Day Hospitals. Construct validity was assessed by means of prevalence, comorbidity with other personality disorders, internal consistency among HPD criteria, severity indices, as well as factor analyses. RESULTS: The prevalence of HPD was very low (0.4 %). The comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. The internal consistency was low. The criteria seemed to form 2 separate clusters: the first contained exhibitionistic and attention-seeking traits and the other contained impressionistic traits. CONCLUSION: The results indicated poor construct validity of the HPD category. Different options for the future of the category are discussed. The authors suggest the HPD category to be deleted from the DSM system. However, the clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism.

Trastornos de personalidad en fumadores y no fumadores de la población general / Personality disorders in smokers and nonsmokers of general population

El objetivo de este estudio fue evaluar y comparar la presencia de trastornos de la personalidad en una muestra de 202 fumadores que acuden a un tratamiento psicológico para dejar de fumar y de 211 no fumadores de la población general. Se utilizó el “Inventario clínico multiaxial de Millon-II” (MCMI-II; Millon, 1997). Los resultados muestran que los fumadores puntúan significativamente más que los no fumadores en la escala fóbica, la escala histriónica y la escala pasivo-agresiva. En cambio, los no fumadores destacan en la escala compulsiva. Se encontró que los fumadores puntúan más que los no fumadores en la escala de ansiedad, en la escala histeriforme y en la escala de neurosis depresiva, así como en la escala de sinceridad y de alteración. Esta relación se mantuvo una vez controlado el efecto del sexo y la edad de los sujetos. Concluimos que ciertos tipos de trastornos de la personalidad sí son más frecuentes en población fumadora, en concreto, el histriónico, el fóbico y el pasivo-agresivo. Los restantes subtipos necesitarían de una mayor investigación (AU)

The aim of the study was to assess and compare the presence of personality disorders in a sample of 202 smokers who underwent psychological treatment to stop smoking and a sample of 211 nonsmokers from the general population. For the evaluation of the personality disorders we used the Spanish version of the Millon Clinical Multiaxial Inventory-II (MCMI-II; Millon, 1997). The results show that smokers obtain higher scores than nonsmokers in the phobic scale, the histrionic scale and the passive - aggressive scale. On the other hand, nonsmokers score higher in the compulsive scale. We found that smokers score higher than nonsmokers in anxiety scale, in somatoform scale and in dysthymic disorder, as well as in sincerity and in alteration scales. This relationship was kept after controlling the effect of the gender and age of the subjects. We concluded that some personality disorders, in particular, the histrionic, the avoidant, and the passive-aggressive, are more frequent in smokers. Future research is needed for the other subtypes

Trastornos de la conducta alimentaria y la personalidad. Un estudio con el MCMI-II / Eating behaviour disorders and personality. A study using MCMI-II

ObjetivoEstudiar las características de personalidad en pacientes con trastornos alimentarios y la influencia de dichas características y ciertos síndromes clínicos en la evolución de esos trastornos, especialmente cuando cursan durante más de 7 años.DiseñoEstudio de comorbilidad mediante prueba diagnóstica.EmplazamientoPacientes ambulatorios en unidad de trastornos alimentarios.Participantes147 pacientes con trastornos alimentarios, en tratamiento ambulatorio, con peso normal. Media de edad, 22,24 años.IntervencionesValoración de personalidad y síndromes clínicos mediante el Inventario de Millon (MCMI-II).Mediciones principalesMedias en las escalas de personalidad y síndromes clínicos; determinación de prevalencia mediante una tasa-base >84.ResultadosEn pacientes con anorexia se detecta al menos un trastorno de personalidad en el 25,33%; en bulimia nerviosa llega al 30,44% y en el trastorno por atracón al 32,13%. En formas purgativas la prevalencia es del 31,07% y en no purgativas, del 24,75%. En la anorexia el trastorno obsesivo es el más frecuente (39,77%); en bulimia lo es el trastorno histriónico (46,66%); en las formas purgativas, el trastorno dependiente (46,15%), y en no purgativas, el obsesivo (35,36%). Considerando las puntuaciones medias, resultan significativamente más elevadas en pacientes con bulimia para el trastorno histriónico (p<0,05). En estos pacientes también se observa más sintomatología histeriforme (p<0,01) e hipomanía (p<0,05). Finalmente, en pacientes con más de 7 años de evolución se recoge más ansiedad (p<0,05), neurosis depresiva (p<0,05) y abuso de alcohol (p<0,01).ConclusionesValorar los estilos de personalidad y síndromes clínicos asociados a los trastornos alimentarios parece de suma importancia terapéutica y pronóstica(AU)

ObjectiveTo study the personality characteristics in patients with eating behaviour disorders and the influence of these characteristics, and certain clinical syndromes on the progress of these disorders, particularly when they have lasted more than seven years.DesignStudy of comorbidity using a diagnostic test.SettingEating behaviour disorders unit outpatients.ParticipantsA total of 147 patients with eating behaviour disorders being treated as outpatients. They were of normal weight, with a mean age of 22.24 years.InterventionsAssessment of personality and clinical syndromes using the Millon Clinical Multiaxial Inventory (MCMI-II).Main measurementsMeans of the personality and clinical syndromes scales and determination of prevalence using a rate-base >84.ResultsAt least one personality disorder was detected in 25.33% of patients with anorexia, 30.44% with bulimia nervosa and 32.13% with binge-eating disorder. In the purgative and non-purgative forms the prevalence was 31.07% and 24.75%, respectively. An obsessive disorder is more common in anorexia (39.77%); a histrionic disorder in bulimia (46.66%); a dependent disorder in the purgative forms (46.15%), and an obsessive one in the no-purgative forms (35.36%). As regards the mean scores, they were significantly higher in patients with bulimia for the histrionic disorder (P<.05). More hysterical type symptoms and hypomania were also observed in these patients (P<.01 and P<.05, respectively). Finally, the patients who had suffered the disorder for more than seven years registered more anxiety (P<.05), depressive neurosis (P<.05) and alcohol abuse (P<.01).ConclusionsTo assess personality styles and clinical syndromes associated with eating behaviour disorders can be an important therapeutic and prognostic tool(AU)

Assessment and emergency management of suicidality in personality disorders.

This article examines the association between suicidal behavior and personality disorders. It updates the review of epidemiological evidence for the association between suicidal behavior and suicide in individuals who have a personality disorder diagnosis, particularly in borderline personality disorder (BPD). The second part of the article presents new empirical evidence that characterizes suicidal behavior in patients who have BPD, specifically examining patient characteristics that differentiate patients who have BPD with a history of high versus low lethality suicide attempts. Finally, the article discusses the approach to a patient who has BPD and presents to the emergency department because of an increased risk of suicide.

Borderline personality and substance use in women.

The association between borderline personality disorder (BPD) and substance use disorder (SUD) was examined in a predominantly psychiatric (77.6%) sample of 232 women. BPD proved to be a significant predictor of a lifetime diagnosis of SUD across four different categories: any SUD (including alcohol); alcohol use; drug use; and heroin, cocaine, or poly-substance use. BPD continued to be a predictor of SUD even when the effects of other cluster B and all cluster C PDs were controlled statistically. Antisocial personality disorder generally yielded larger odds ratios than BPD and emerged as a partial mediator of the relation between BPD and SUD. Histrionic PD was the only other PD that showed meaningful relations with SUD.

Comorbilidad del alcoholismo con los trastornos de personalidad / Co-morbidity between alcoholism and personality disorders

En este texto se lleva a cabo una revisión de los estudios realizados hasta la fecha en relación con la comorbilidad de los trastornos de personalidad con el alcoholismo. Los resultados obtenidos en las diferentes investigaciones no son concluyentes. La tasa de prevalencia de los trastornos de personalidad en los alcohólicos es muy heterogénea, con una amplia variabilidad de unos estudios a otros. Sin embargo, se observa una cierta tendencia a los trastornos de personalidad del grupo B (antisocial, principalmente). Por último se comentan las implicaciones de este estudio para la investigación y para la práctica clínica (AU)

The aim of this paper is to review the current knowledge about the comorbidity between alcoholism and personality disorders. Attempts to draw a specific profile of alcoholics are not conclusive. Prevalence of personality disorders in alcoholics is very heterogeneous, and a great variability is observed across all the studies carried out. There is a trend to find a higher proportion of alcoholics within the cluster B category (mainly, antisocial). Lastly, implications of this kind of studies for future research and clinical practice are discussed (AU)

What dimensions underlie cluster B personality disorders?

This report presents a conceptual model of the relationships between personality dimensions and the four personality disorders listed in the B cluster on axis II. The hypothesis will be developed that while impulsivity is the common dimension underlying all four disorders, differences between the categories reflect the severity of impulsive traits, interactions with other personality dimensions, the effects of gender, and the influence of culture. Clinical and research implications of the model are then described.

DSM-III-R axis II comorbidity in dysthymia and major depression.

OBJECTIVE: Dysthymia is generally believed to be associated with a high rate of DSM-III-R axis II comorbidity. However, it is unclear whether this rate is higher than that for other axis I disorders, how many dysthymic patients have personality disorders, and what the most common co-occurring axis II conditions are. METHOD: Ninety-seven outpatients with early-on-set dysthymia and 45 with episodic major depression were administered structured diagnostic interviews for axis I and II disorders. In addition, knowledgeable informants were independently interviewed about axis II conditions in the patients. RESULTS: A significantly greater proportion of dysthymic patients (60%) than patients with episodic major depression (18%) met criteria for a personality disorder. The most common axis II conditions among dysthymic patients were borderline, histrionic, and avoidant personality disorder. Informants' reports yielded similar results. CONCLUSIONS: These data indicate that early-onset dysthymia is associated with significantly greater axis II comorbidity than episodic major depression. Further work is necessary to elucidate the processes underlying this association.