The prevalence of comorbid alcohol use disorder in the presence of personality disorder: Systematic review and explanatory modelling

Abstract

Comorbid personality disorder (PD) worsens outcome in mental state disorders; however, the proportion of people with PD who have an alcohol use disorder (AUD) is poorly described. A systematic review of the literature for studies reporting on AUD in those with PD was completed. Lifetime prevalence figures were meta-analysed using multilevel models, accounting for type of PD and population examined. Sixteen unique studies contributed data to the analysis. PD type accounted for most of the heterogeneity in lifetime AUD prevalence. People with antisocial PD had the highest lifetime AUD prevalence, at 76.7%, followed by those with borderline PD at 52.2%, while those with other forms of PD, or undifferentiated PD, had a prevalence of 38.9%. Lifetime AUD prevalence was not significantly higher in clinical compared with population samples. The majority of people with PD experience an AUD at some time in the life course. This has clinical screening and management implications. Copyright © 2018 John Wiley & Sons, Ltd.

Psychiatric comorbidities in alcohol use disorder

“…Although only antisocial personality disorder has been consistently classified within the externalising domain, 67,68 borderline personality disorder also commonly co-occurs with alcohol use disorder. 17 Individuals with antisocial personality disorder engage in aggressive and abusive relationships, lack empathy, engage in risk taking, lie, and manipulate; whereas individuals with borderline personality disorder engage in risk-taking behaviour and have intense relationships, distorted self-image, and suicidal behaviour. A 1995 review indicated a median prevalence of antisocial personality disorder of 18% and borderline personality disorder of 21%, in people with alcohol use disorder (table).…”

“…18 In a 2018 meta-analysis, however, the lifetime prevalence of alcohol use disorder was 77% in people with antisocial personality disorder, 52% in people with borderline personality disorder, and 39% in people with other personality disorders (including combined or undifferentiated personality disorder). 17 In a 2012-13 US epidemiological study, the odds for antisocial personality disorder were 1•7 in individuals with moderate lifetime alcohol use disorder and 2•4 in individuals with severe lifetime alcohol use disorder, and the odds for borderline personality disorder were 1•5 in individuals with moderate lifetime alcohol use disorder and 2•5 in individuals with severe lifetime alcohol use disorder. 1 The excess prevalence of alcohol use disorder in people with personality disorders, and vice versa, is particularly challenging in the context of treatment, mainly because of the lower retention of people with personality disorders in alcohol use disorder treatments.…”

Psychiatric Co-Morbidity in Alcohol and Drug-Dependence: A Case Control Study

“…26 Additionally, only antisocial personality condition has been regularly classified within the externalizing domain, 67,68 borderline personality conditions also frequently co occurs with alcohol usage condition. 27 Subjects with antisocial personality issues involve in violent and abusive associations, lack of empathy, involve in risk taking and manipulative behavior; whereas subjects with borderline personality issues involve in risk taking behavior and have intense behavior, distorted selfi mage, and suicidal conduct. A 1995 review showed a median incidence of antisocial personality issue of 18% and borderline personality issue of 21%, in subjects with alcohol dependence.…”

The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

“…Women with personality disorder have recently been described as "high risk" caregivers in order to explain the complex interaction between their psychological and interpersonal functioning, and their relationship and social difficulties [29]. There are higher rates of risk-taking behavior that impact the fetus, such as drug and alcohol misuse [30], increased rates of smoking in pregnancy [25], and poor nutrition. Troubled relationships, including domestic violence, may also lead to negative birth outcomes for the baby in relation to preterm birth, lower appearance, pulse, grimace, activity, and respiration (APGAR) scores, and lower birth weight [31].…”