Background: Co-morbid personality disorders are common in substance dependent patients, and personality disorders are associated with worse clinical outcomes, worse retention and compliance, and alliance problems. The whole range of personality disorders is present in substance dependent patients, and antisocial personality disorder is particularly common. However, clinical strategies must vary strongly across disorders. Objectives: To test the clinical effectiveness of a full personality disorder assessment and individual feedback to patient and caseworker, against screening for axis I disorders alone. Methods: A randomized clinical trial of consecutively admitted patients to a central intake unit for illicit drug use disorders is carried out. Patients are randomized after their first intake interview to either limited (axis I only) or full (axis I and II) assessment. The axis I screening includes anxiety or depression, drug and alcohol dependence, attention deficit hyperactivity disorder, and current level of functioning. The axis II disorder includes a semi-structured interview for personality disorders. Outcomes include global functioning (Work and Social Adjustment Scale), substance use outcomes (Opiate Treatment Index), and symptoms (Kessler 6) at 3 and 6 months follow-up. Patients in both groups receive a similar amount of contact with research interviewers. Results: The preliminary results of the study are presented, including patients´ perception of the research interview and feedback, and outcomes of the first 30 patients randomized. We present clinical examples of patients with antisocial, borderline and narcissistic personality disorders.
Society for Psychotherapy Research. Book of Abstracts, 2008, p. 96-97
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Society for Psychotherapy Research, 39th International Meeting, 2008