Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
VA Connecticut Healthcare System, West Haven, CT, USA.
Transl Psychiatry. 2024 Aug 28;14(1):346. doi: 10.1038/s41398-024-03054-z.
There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there is limited information on the specific patterns of association of ASPD with SUD severity and specific SUD diagnostic criteria. We investigated the association of alcohol, cannabis, cocaine, opioid, and tobacco use disorders (AUD, CanUD, CocUD, OUD, and TUD, respectively) in 1660 individuals with ASPD and 6640 controls matched by sex (24% female), age, and racial/ethnic background in a sample ascertained for addiction-related traits. Generalized linear regressions were used to test ASPD with respect to the five DSM-5 SUD diagnoses, their severity (i.e., mild, moderate, severe), and their diagnostic criteria. We found that ASPD is associated with the diagnosis and severity of AUD (Odds Ratio, ORs = 1.89 and 1.25), CanUD (ORs = 2.13 and 1.32), and TUD (ORs = 1.50 and 1.21) (ps < 0.003). Of the specific diagnostic criteria, the "hazardous use" criterion showed the strongest association with ASPD across the five SUDs investigated (from OR = 1.88 to OR = 1.37). However, when criteria of different SUDs were included in the same model, ASPD was independently associated only with TUD "hazardous use" and CocUD "attempts to quit". Attempting to quit cocaine was inversely related to the presence of ASPD and remained significant (OR = 0.57, 95% confidence interval = 0.36-0.89) after controlling for interactive effects with sex. The current work provides novel insights into ASPD-SUD comorbidity, supporting the existence of different SUD patterns among individuals affected by ASPD.
物质使用障碍（SUD）患者中反社会人格障碍（ASPD）的患病率很高。然而，关于 ASPD 与 SUD 严重程度和特定 SUD 诊断标准的具体关联模式的信息有限。我们在一个确定与成瘾相关特征的样本中，调查了 1660 名 ASPD 患者和 6640 名性别（24%为女性）、年龄和种族/族裔背景相匹配的对照者中酒精、大麻、可卡因、阿片类药物和烟草使用障碍（AUD、CanUD、CocUD、OUD 和 TUD）的关联。使用广义线性回归来测试 ASPD 与 DSM-5 中的五个 SUD 诊断、其严重程度（即轻度、中度、重度）和其诊断标准的关系。我们发现，ASPD 与 AUD（比值比，ORs = 1.89 和 1.25）、CanUD（ORs = 2.13 和 1.32）和 TUD（ORs = 1.50 和 1.21）的诊断和严重程度有关（p < 0.003）。在五个研究的 SUD 中，特定诊断标准中，“有害使用”标准与 ASPD 的关联最强（OR = 1.88 到 OR = 1.37）。然而，当不同 SUD 的标准包含在同一个模型中时，ASPD 仅与 TUD 的“有害使用”和 CocUD 的“尝试戒断”独立相关。尝试戒断可卡因与 ASPD 的存在呈负相关，且在控制了与性别交互作用后仍有显著意义（OR = 0.57，95%置信区间 = 0.36-0.89）。目前的工作为 ASPD-SUD 共病提供了新的见解，支持了受 ASPD 影响的个体中存在不同的 SUD 模式。
