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.
Drug Alcohol Depend. 2010 Apr 1;108(1-2):141-5. doi: 10.1016/j.drugalcdep.2009.12.004. Epub 2010 Jan 15.
This study examined the prevalence of nicotine dependence (ND) and its associations with DSM-IV personality disorders (PDs) among current smokers (n=7078), controlling for sociodemographic characteristics and comorbid Axis I and II disorders. Data were derived from a nationally representative sample of the U.S. population. Although all PDs were significantly associated with ND when sociodemographic factors were controlled, only schizotypal, borderline, narcissistic and obsessive-compulsive PDs were associated with ND after adding controls for Axis I and other Axis II disorders. These associations remained significant after controlling for degree of smoking exposure. The results suggest that both shared and PD-specific pathogenetic factors underlie these PD-ND associations. Implications are also discussed in terms of the relationship between personality features of schizotypal, borderline, narcissistic and obsessive-compulsive PDs and the self-medication hypothesis and the role of neurotransmission.
本研究调查了当前吸烟者(n=7078)中尼古丁依赖(ND)的流行情况及其与 DSM-IV 人格障碍(PD)的关联,同时控制了社会人口统计学特征以及共患的轴 I 和轴 II 障碍。数据来自美国人群的全国代表性样本。尽管在控制社会人口统计学因素后,所有 PD 都与 ND 显著相关,但在添加轴 I 和其他轴 II 障碍的对照后,只有精神分裂型、边缘型、自恋型和强迫型 PD 与 ND 相关。在控制吸烟程度后,这些关联仍然显著。研究结果表明,这些 PD-ND 关联既存在共同的发病机制因素,也存在 PD 特异性的发病机制因素。还讨论了这些 PD 与精神分裂型、边缘型、自恋型和强迫型 PD 的人格特征与自我治疗假说以及神经递质传递之间关系的意义。