Section of Psychiatric Epidemiology, Institute & Department of Psychiatry (LIM-23), University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
Department of Social Medicine, Federal University of Espirito Santo, Vitoria, ES, Brazil.
PLoS One. 2021 Mar 23;16(3):e0248403. doi: 10.1371/journal.pone.0248403. eCollection 2021.
Alcohol Use Disorders are frequently comorbid with personality disorders. However, the heterogeneity of the prevalence estimates is high, and most data come from high income countries. Our aim is to estimate the prevalence and association between alcohol use outcomes and the three DSM-5 clusters of personality disorders in a representative sample of the São Paulo Metropolitan Area.
A representative household sample of 2,942 adults was interviewed using the WHO Composite International Diagnostic Interview and the International Personality Disorder Examination Screening Questionnaire. Lifetime PD diagnoses were multiply imputed, and AUD diagnoses were obtained using DSM-5 criteria. We conducted cross-tabulations and logistic regression to estimate the associations between AUDs and PDs.
Our study did not find significant associations of PDs with heavy drinking patterns or mild AUD. Cluster B PD respondents tended to show the highest conditional prevalence estimates of most alcohol use patterns and AUD, including its severity subtypes. When alcohol outcomes were regressed on all PD Clusters simultaneously, with adjustment for sex and age, only cluster B was significantly associated with past-year alcohol use (OR 3.0), regular drinking (OR 3.2), and AUDs (OR 8.5), especially moderate and severe cases of alcohol use disorders (OR 9.7 and 16.6, respectively). These associations between Cluster B PDs and these alcohol outcomes were shown to be independent of other PD Clusters and individuals´ sex and age.
The main finding of our study is that AUDs are highly comorbid with PDs. The presence of Cluster B PDs significantly increases the odds of alcohol consumption and disorders and of more severe forms of AUDs. Considering the local context of poor treatment provision, more specific prevention and intervention strategies should be directed to this population.
酒精使用障碍常与人格障碍共病。然而，患病率的异质性很高，而且大多数数据来自高收入国家。我们的目的是在圣保罗大都市区的代表性样本中，估计酒精使用结果与 DSM-5 人格障碍三个聚类之间的患病率和关联。
采用世界卫生组织复合国际诊断访谈和国际人格障碍检查筛选问卷，对 2942 名成年人进行了代表性家庭抽样调查。使用多重插补法对终身 PD 诊断进行了估计，并使用 DSM-5 标准获得了 AUD 诊断。我们进行了交叉表和逻辑回归分析，以估计 AUD 和 PD 之间的关联。
我们的研究没有发现 PD 与重度饮酒模式或轻度 AUD 之间存在显著关联。B 群人格障碍受访者倾向于表现出大多数酒精使用模式和 AUD 的最高条件患病率估计值，包括其严重程度亚型。当将酒精结果回归到所有 PD 聚类时，同时调整性别和年龄，只有 B 聚类与过去一年的酒精使用（OR 3.0）、规律饮酒（OR 3.2）和 AUD（OR 8.5）显著相关，特别是中度和重度酒精使用障碍（OR 9.7 和 16.6）。B 群人格障碍与这些酒精结果之间的关联独立于其他 PD 聚类和个体的性别和年龄。
我们研究的主要发现是 AUD 与 PD 高度共病。B 群人格障碍的存在显著增加了酒精消耗和障碍以及更严重形式的 AUD 的可能性。考虑到当地治疗服务匮乏的情况，应针对该人群制定更具体的预防和干预策略。
