Grant Bridget F, Stinson Frederick S, Dawson Deborah A, Chou S Patricia, Ruan W June, Pickering Roger P
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA.
Arch Gen Psychiatry. 2004 Apr;61(4):361-8. doi: 10.1001/archpsyc.61.4.361.
Very little information is available on the co-occurrence of different personality disorders (PDs) and alcohol and drug use disorders in the US population.
To present national data on sex differences in the co-occurrence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol and drug use disorders and 7 of the 10 DSM-IV PDs.
Face-to-face interviews conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43 093).
The United States and the District of Columbia, including Alaska and Hawaii.
Household and group-quarters residents, aged 18 years and older.
Among individuals with a current alcohol use disorder, 28.6% (95% confidence interval [CI], 26.7-30.6) had at least 1 PD, whereas 47.7% (95% CI, 43.9-51.6) of those with a current drug use disorder had at least 1 PD. Further, 16.4% (95% CI, 15.1-17.6) of individuals with at least 1 PD had a current alcohol use disorder and 6.5% (95% CI, 5.7-7.3) had a current drug use disorder. Associations between PDs and alcohol and drug use disorders were overwhelmingly positive and significant (P <.05). Overall, alcohol use disorders were most strongly related to antisocial (odds ratio [OR], 4.8; 95% CI, 4.1-5.6), histrionic (OR, 4.7; 95% CI, 3.8-5.8), and dependent (OR, 3.0; 95% CI, 1.9-4.8) PDs. Drug use disorders also were more highly associated with antisocial (OR, 11.8; 95% CI, 9.7-14.3), histrionic (OR, 8.0; 95% CI, 6.0-10.7), and dependent (OR, 11.6; 95% CI, 7.1-19.1) PDs. Associations between obsessive-compulsive, histrionic, schizoid, and antisocial PDs and specific alcohol and drug use disorders were significantly stronger (P <.04) among women than men, whereas the association between dependent PD and drug dependence was significantly greater (P <.04) among men than women.
The co-occurrence of PDs with alcohol and drug use disorders is pervasive in the US population. Results highlight the need for further research on the underlying structure of these disorders and the treatment implications of these disorders when comorbid.
关于美国人群中不同人格障碍（PDs）与酒精和药物使用障碍共现的信息非常少。
呈现关于《精神疾病诊断与统计手册》第四版（DSM-IV）酒精和药物使用障碍与10种DSM-IV人格障碍中的7种共现的性别差异的全国性数据。
在2001 - 2002年全国酒精及相关状况流行病学调查中进行的面对面访谈（N = 43093）。
美国及哥伦比亚特区，包括阿拉斯加和夏威夷。
年龄在18岁及以上的家庭和集体居住场所居民。
在当前患有酒精使用障碍的个体中，28.6%（95%置信区间[CI]，26.7 - 30.6）至少患有一种人格障碍，而在当前患有药物使用障碍的个体中，47.7%（95%CI，43.9 - 51.6）至少患有一种人格障碍。此外，至少患有一种人格障碍的个体中，16.4%（95%CI，15.1 - 17.6）当前患有酒精使用障碍，6.5%（95%CI，5.7 - 7.3）当前患有药物使用障碍。人格障碍与酒精和药物使用障碍之间的关联绝大多数为正向且显著（P <.05）。总体而言，酒精使用障碍与反社会型（优势比[OR]，4.8；95%CI，4.1 - 5.6）、表演型（OR，4.7；95%CI，3.8 - 5.8）和依赖型（OR，3.0；95%CI，1.9 - 4.8）人格障碍的相关性最强。药物使用障碍也与反社会型（OR，11.8；95%CI，9.7 - 14.3）、表演型（OR，8.0；95%CI，6.0 - 10.7）和依赖型（OR；11.6；95%CI，7.1 - 19.1）人格障碍的相关性更高。强迫型、表演型、分裂样和反社会型人格障碍与特定酒精和药物使用障碍之间的关联在女性中比男性显著更强（P <.04），而依赖型人格障碍与药物依赖之间的关联在男性中比女性显著更强（P <.04）。
人格障碍与酒精和药物使用障碍在美国人群中共现很普遍。结果凸显了对这些障碍的潜在结构以及共病时这些障碍的治疗意义进行进一步研究的必要性。
