Psychiatric Comorbidity and Personality Structure in Patients with Polyvalent Addiction

Abstract

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). Sampling and Method: 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. Conclusion: 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. Limitation: small sample size.

Metacognitive Interpersonal Therapy for Co‐Occurrent Avoidant Personality Disorder and Substance Abuse

“…Many patients suffer from a combination of personality disorders (PDs) and substance abuse (SA; Morken, Karterud, & Arefjord, ). The co‐occurrence between these two conditions is extremely common, with PD being present in up to 90% of people with polyvalent addiction (Rentrop, Zilker, Lederle, Birkhofer, & Hörz, ). Further, the presence of PD predicts the transition from substance use to substance use disorder (Lev‐Ran, Le Foll, McKenzie, George, & Rehm, ).…”

Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment

“…Also, like other studies of people with opiate dependence, almost all participants had a psychiatric or personality disorder (Applebaum et al, 2010; Cacciola et al, 1996; Carpentier et al, 2009; Haro et al, 2004; Rentrop et al, 2014; Teplin et al, 2004). As hypothesized, psychiatric and personality disorders predicted having a smoking cessation goal and ever making a quit attempt, even when considering demographic variables.…”

“…Psychiatric and personality disorders are known to be prevalent among people with opiate dependence and are associated with smoking cessation difficulty in other populations (Cacciola, Rutherford, Alterman, McKay, & Snider, 1996; Carpentier et al, 2009; Donald, Chartrand, & Bolton, 2013; Goodwin, Pagura, Spiwak, Lemeshow, & Sareen, 2011; Haro et al, 2004; Rentrop, Zilker, Lederle, Birkhofer, & Horz, 2014; Smith, Mazure, & McKee, 2014; Teplin, O'Connell, Daiter, & Varenbut, 2004); however, these factors have not been investigated among people in opiate dependence treatment who smoke. To elucidate how psychiatric and personality disorders could impede smoking cessation in people with opiate dependence and determine specific psychiatric disorders and personality traits that could be targets for intervention to improve smoking cessation treatment for individuals with opiate dependence who smoke, we evaluated the relationships between psychiatric disorders, personality disorders, and individual personality disorder facets (i.e., traits) and smoking cessation goals and quit attempts among these individuals.…”

“…Most people in opiate dependence treatment have a psychiatric or personality disorder (Cacciola et al, 1996; Carpentier et al, 2009; Haro et al, 2004; Rentrop et al, 2014; Teplin et al, 2004). Mood disorders (25-60%), anxiety disorders (22%-46%), posttraumatic stress disorder (27%-52%), antisocial personality disorder (26%-75%), and borderline personality disorder (18%-51%) are the most common among those in opiate dependence treatment (Applebaum et al, 2010; Batki, Canfield, & Ploutz-Snyder, 2011; Carpentier et al, 2009; Craig, 2000; Darke, Kaye, & Finlay-Jones, 1998; Darke et al, 2007; Darke, Williamson, Ross, Teesson, & Lynskey, 2004; Himelhoch et al, 2012; Mackesy-Amiti, Donenberg, & Ouellet, 2012; Mason et al, 1998; Mills, Teesson, Darke, Ross, & Lynskey, 2004; Ross et al, 2005; Savant et al, 2013; Villagonzalo et al, 2011).…”

Mentalization And Personality Organization In Heroin Addicted Patients : A Narrative Analysis

“…The lowest difference is observed in the scale Coping and rigidity (mean: 38.53 in the control group in comparison to 22.47 in the clinical group, p < .01). Rentrop et al (2014) have conducted a study dealing with the levels of personality organization based on the STIPO in a group of polydrug-using opiate-dependent patients. It fits well to the present work: 90% of the patients had at least one axis II disorder, and 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.…”