Nordholm Dorte, Nielsen Bent
Department of Psychiatry, Odense University Hospital, Odense C, Denmark.
Eur Addict Res. 2007;13(4):222-9. doi: 10.1159/000104885.
The aim of the present study was firstly to describe the characteristics of alcoholic outpatients (A) suffering from co-morbid personality disorder (PD) of either the cluster B (A+PDB) or cluster C (A+PDC) type. Secondly, to investigate the effect of various kinds of treatment to be able to single out the most beneficial therapy. Thirdly, to identify the most beneficial treatment. The patients were offered the following outpatient treatments: cognitive behaviour therapy, family therapy and supportive consultations. The material consisted of 363 patients who started psychosocial treatment at the outpatient alcohol clinic at Odense University Hospital, Denmark. It was possible to re-interview 276 (76%) patients 1 year after onset of treatment. Of the 363 patients, 87% were alcohol-dependent (ICD-10) and 34% fulfilled the ICD-10-R criteria for PDs. The basic interviews focused on the seven main areas of the Addiction Severity Index. A+PDC had significantly more serious medical problems than A-PD, while the A+PDB group had significantly more employment, drug use and social problems than the A-PD. As for psychiatric status, A-PD had significantly different scores compared with A+PDB and A+PDC. A+PDB were younger and had a longer history of alcohol abuse than A-PD and A+PDC. After treatment there was no significance between the patients with and without PD concerning alcohol outcome and psychosocial outcome. The significance of co-morbid PD for the prognosis of alcohol abusers may be overestimated. Our results indicate that A+PD can be treated as successfully as other patients in an outpatient alcohol clinic can.
本研究的目的,首先是描述患有共病性人格障碍(PD)的B簇(A+PDB)或C簇(A+PDC)型酒精门诊患者(A)的特征。其次,调查各种治疗方法的效果,以便选出最有益的疗法。第三,确定最有益的治疗方法。为患者提供了以下门诊治疗:认知行为疗法、家庭疗法和支持性咨询。研究材料包括363名在丹麦欧登塞大学医院酒精门诊开始接受心理社会治疗的患者。治疗开始1年后,对其中276名(76%)患者进行再次访谈成为可能。在这363名患者中,87%为酒精依赖(ICD-10),34%符合PD的ICD-10-R标准。基础访谈聚焦于成瘾严重程度指数的七个主要领域。A+PDC组的医疗问题比A-PD组严重得多,而A+PDB组在就业、药物使用和社会问题方面比A-PD组严重得多。在精神状态方面,A-PD与A+PDB组和A+PDC组的得分有显著差异。A+PDB组比A-PD组和A+PDC组更年轻,酒精滥用史更长。治疗后,有无PD的患者在酒精治疗结果和心理社会治疗结果方面没有显著差异。共病性PD对酒精滥用者预后的重要性可能被高估了。我们的结果表明,A+PD在门诊酒精诊所的治疗效果与其他患者一样成功。