Substance abuse patterns and their association with psychopathology and type of hostility in male patients with borderline and antisocial personality disorder

The aim of this study was to investigate the prevalence of substance use disorder in young adult patients with borderline personality disorder (BPD) and antisocial personality disorder (APD) and to ascertain the specific substances each of these groups choose to abuse. An additional aim was to assess whether alcohol and drug abuse in the patients related to their psychopathology and hostility. The study subjects were 41 hospitalized patients with BPD and 44 hospitalized patients with APD. The diagnoses of personality disorders and substance use disorders were made using DSM-III criteria. Psychopathology patterns were assessed using the Brief psychiatric Rating Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety inventory Hostility was assessed using the Hostility and Direction of Hostility Questionnaire. Abuse of one or more substances was reported by 76% of BPD patients and 95% of APD patients. There was no difference between the two groups in terms of alcohol abuse, but certain substances (such as benzodiazepines, anticholinergics, cannabis, and opioids) were abused more than twice as often by APD patients versus BPD patients. APD patients were more likely than BPD patients to be multiusers. In BPD patients, the number of substances abused showed a negative association with depression, while in APD patients it was positively related to state anxiety. In both patient groups, there was no correlation of the number of abused substances with the degree of extroverted or introverted hostility. Copyright (C) 1999 by W.B. Saunders Company