Background
Substance use disorders
(SUDs) constitute a major health problem and are associated with an extensive
psychiatric comorbidity. Personality disorders (PDs) and SUDs commonly
co-occur. Comorbid PD is characterized by more severe addiction problems and by
an unfavorable clinical outcome. The present study investigated the prevalence
of SUDs, PDs and common Axis I disorders in a sample of adolescent outpatients.
We also investigated the association between PDs and SUDs, and how this
association was influenced by adjustment for other Axis I disorders, age and
gender.
Methods
The sample consisted of
153 adolescents, aged 14–17 years, who were referred to a non-specialized
mental health outpatient clinic with a defined catchment area. SUDs and other
Axis I conditions were assessed using the mini international neuropsychiatric
interview. PDs were assessed using the structured interview for DSM-IV
personality.
Results
18.3 % of the
adolescents screened positive for a SUD, with no significant gender difference.
There was a highly significant association between number of PD symptoms and
having one or more SUDs; this relationship was practically unchanged by
adjustment for gender, age and presence of Axis I disorders. For boys, no
significant associations between SUDs and specific PDs, conduct disorder (CD)
or attention deficit hyperactivity disorder (ADHD) were found. For girls, there
were significant associations between SUD and BPD, negativistic PD, more than
one PD, CD and ADHD.
Conclusions
We found no significant
gender difference in the prevalence of SUD in a sample of adolescents referred
to a general mental health outpatient clinic. The association between number of
PD symptoms and having one or more SUDs was practically unchanged by adjustment
for gender, age and presence of one or more Axis I disorders, which suggested
that having an increased number of PD symptoms in itself may constitute a risk
factor for developing SUDs in adolescence. The association in girls between
SUDs and PDs, CD and ADHD raises the question if adolescent girls suffering
from these conditions may be especially at risk for developing SUDs. In
clinical settings, they should therefore be monitored with particular diligence
with regard to their use of psychoactive substances.
Below: PD symptoms in adolescents
with SUD and other Axis I disorders. PD Symptoms any
PD criteria meeting a score of 1,2 or 3 when measured with the SIDP-IV; SUD substance
use disorders; alcohol and/or drug abuse or dependence. Alcohol alcohol
abuse or dependence; CannabisCannabis abuse or dependence; Anxiety anxiety
disorders, simple phobias, generalized anxiety disorder, panic disorder,
agoraphobia, social phobia and post-traumatic stress disorder; Mood mood
disorders, dysthymia and major depressive episode; CD conduct
disorder; ADHDattention deficit hyperactivity disorder. **
p < 0.05
Full article at: http://goo.gl/szh4O2
Department for
Child and Adolescent Mental Health (The Nic Waal Institute), Lovisenberg
Diakonale Hospital, Oslo, Norway
Department of
Psychology, University of Oslo, Oslo, Norway
Centre for Child
and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
Norwegian Centre
for Violence and Traumatic Stress Studies, Oslo, Norway
Vestfold Hospital
Trust, Tønsberg, Norway
Institute of
Clinical Medicine, University of Oslo, Oslo, Norway
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