Prevalence of personality disorder in alcohol and drug services and associated comorbidity
Prevalence of personality disorder in alcohol and drug services and associated comorbidity
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DOI：
10.1111/j.1360-0443.2004.00813.x
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发表时间：
2004-10-01
期刊：
影响因子：
6
通讯作者：
Weaver, T
中科院分区：
文献类型：
--
作者：
Bowden-Jones, O;Iqbal, MZ;Weaver, T
目的比较酗酒和吸毒人群中人格障碍的患病率，并特别关注其对精神病理和服务特征的影响。设计横断面调查。在英国四个城市中心设置三个酒精和四个药物服务。从目前的治疗人群中随机抽取216名药物服务患者和64名酒精服务患者。治疗人口普查记录了人口统计学和诊断数据。患者访谈使用快速人格评估表（PAS-Q）评估存在集群类型和人格障碍的严重程度。其他精神病理采用综合精神病理评定量表（CPRS）进行测量。病例记录审计使用OPCRIT时间表和有关社会发病率的数据记录精神病性精神病理。结果药物服务人员人格障碍患病率为37%，酒精服务人员人格障碍患病率为53%。严重程度和群集的分布在两个样本之间有显著差异。在两个样本中，人格障碍的严重程度与精神病理之间存在显著的关联。与群集B和C相关的发病率水平相似。与PAS-Q相比，临床诊断人格障碍的特异性高，敏感性低。结论：在酒精和药物服务人群中，人格障碍与精神病理和社会发病率的显著增加有关，并随着人格障碍严重程度的增加而恶化。尽管如此，临床工作人员很难识别出人格障碍。PAS-Q可作为药物滥用人群的临床评估工具，用于人格障碍患者的早期识别和管理。
Aims To compare the prevalence of personality disorder in alcohol and drug populations with special attention to its impact on psychopathology and service characteristics.Design Cross-sectional survey.Setting Three alcohol and four drug services in four urban UK centres.Participants Two hundred and sixteen drug and 64 alcohol service patients randomly sampled from current treatment populations.Measurements A treatment population census recorded demographic and diagnostic data. Patient interviews assessed the presence cluster type and, severity of personality disorder using the Quick Personality Assessment Schedule (PAS-Q). Other psychopathology was measured using the Comprehensive Psychopathological Rating Scale (CPRS). A case-note audit recorded psychotic psychopathology using the OPCRIT schedule and data regarding social morbidity.Findings The overall prevalence of personality disorder was 37% in the drug service sample and 53% in the alcohol service sample. The distribution of severity and clusters differed markedly between the two samples. There was a significant association between the severity of personality disorder and psychopathology in both samples. Levels of morbidity associated with clusters B and C were similar. Clinical diagnosis of personality disorder showed high specificity but low sensitivity when compared to PAS-Q.Conclusions In both alcohol and drug service populations, personality disorder is associated with significantly increased rates of psychopathology and social morbidity that worsens with increasing severity of the disorder. Despite this, personality disorder is poorly identified by clinical staff. The PAS-Q may be useful as a clinical assessment tool in the substance misuse population for the early identification and management of patients with personality disorder.