Personality disorders in drug abusers: prevalence and their association with AXIS I disorders as predictors of treatment retention.

A sample of 226 drug-dependent individuals consecutively admitted to treatment in the major therapeutic programmes in Greece were assessed at intake with the EuropASI and SCL-90-R. At 4 to 6 weeks, 173 who were continuing treatment were reassessed with the SCL-90-R and interviewed with the SCID-R and the CIDI. Mean age of the subjects was 28 years, and 82.3% were male. Heroin was the main substance of abuse for the large majority (89.8%). Prevalence of AXIS II personality disorders (PD) was 59.5% and the majority (61.2%) had more than one PD. Cluster B was diagnosed in almost half of the subjects (48.6%), Antisocial Personality Disorder (APD) being the most prevalent (33.5%) type of PD. Subjects with APD had an earlier age of initiation of illicit drug use than those without. Subjects with a PD had twice the odds of having a comorbid AXIS I diagnosis and three times the odds of having a mood disorder than those without a PD. SCL-90-R assessments showed that psychiatric symptoms were significantly reduced in the period between intake and the fourth week in treatment. Somatization, Depression and Anxiety symptoms were however less reduced in subjects with a PD than in those without PD. Dropping out from treatment was more strongly predicted by AXIS I than AXIS II disorders, with an increased probability of dropping out in the presence of current mood disorders, whereas current anxiety disorder predicted treatment retention.