Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out

Susmita Pandey,1,2 Ingeborg Bolstad,1 Lars Lien,1,3 Jørgen G Bramness1,4,5 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Departm...

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Main Authors: Pandey S, Bolstad I, Lien L, Bramness JG
Format: Article
Language:English
Published: Dove Medical Press 2021-04-01
Series:Substance Abuse and Rehabilitation
Subjects:
Online Access:https://www.dovepress.com/antisocial-personality-disorder-among-patients-in-treatment-for-alcoho-peer-reviewed-fulltext-article-SAR
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author Pandey S
Bolstad I
Lien L
Bramness JG
author_facet Pandey S
Bolstad I
Lien L
Bramness JG
author_sort Pandey S
collection DOAJ
description Susmita Pandey,1,2 Ingeborg Bolstad,1 Lars Lien,1,3 Jørgen G Bramness1,4,5 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Department of Health and Social Science, Innlandet University of Applied Science, Elverum, Norway; 4Department of Clinical Medicine, UiT – Norway’s Arctic University, Tromsø, Norway; 5Norwegian Institute of Public Health, Oslo, NorwayCorrespondence: Susmita Pandey Email susmita.research@gmail.comBackground: Patients with alcohol use disorders (AUD) vary significantly in many clinically important characteristics making them a heterogenous group. AUD patients with comorbid antisocial personality disorder (ASPD) form an important sub-group, and studies indicate that these patients may have poorer treatment outcomes. Therefore, we aimed to investigate the characteristics of AUD inpatients with comorbid ASPD and identify predictors of early relapse or treatment drop-out in these patients.Methods: In a longitudinal study of AUD patients (n = 113; 30 females; aged 27 to 72 years) in treatment at three residential rehabilitation clinics in Norway, we used interviews and self-report questionnaires to collect data on alcohol use, mental health, and trauma experience. In addition, we assessed biochemical parameters. The patients were followed up at 6 weeks to identify early relapse or drop-out.Results: Prevalence of ASPD among AUD patients was 15%. AUD patients with comorbid ASPD were exclusively male, of younger age, and reported more childhood trauma, and adult attention-deficit-hyperactivity-disorder symptoms. They reported more hazardous drinking behavior and more often had dependence on substances in addition to alcohol. The presence of ASPD did not predict early relapse or drop-out. However, early relapse or drop-out in ASPD patients was associated with childhood and adult trauma, younger age of drinking debut, and higher baseline prolactin levels.Conclusion: AUD patients with ASPD had different clinical characteristics to other AUD patients and they had specific predictors of early relapse or drop-out. Our findings indicate that the early relapse or drop-out among AUD patients with ASPD may be attributed to environmental and possibly biological vulnerability. However, further studies with larger sample size are warranted to confirm these preliminary associations.Keywords: alcohol use disorder, antisocial personality disorder, relapse, drop-out
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spelling doaj.art-9907772feac04e87848ab2e91358f2fe2022-12-21T22:50:08ZengDove Medical PressSubstance Abuse and Rehabilitation1179-84672021-04-01Volume 12112264061Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-OutPandey SBolstad ILien LBramness JGSusmita Pandey,1,2 Ingeborg Bolstad,1 Lars Lien,1,3 Jørgen G Bramness1,4,5 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Department of Health and Social Science, Innlandet University of Applied Science, Elverum, Norway; 4Department of Clinical Medicine, UiT – Norway’s Arctic University, Tromsø, Norway; 5Norwegian Institute of Public Health, Oslo, NorwayCorrespondence: Susmita Pandey Email susmita.research@gmail.comBackground: Patients with alcohol use disorders (AUD) vary significantly in many clinically important characteristics making them a heterogenous group. AUD patients with comorbid antisocial personality disorder (ASPD) form an important sub-group, and studies indicate that these patients may have poorer treatment outcomes. Therefore, we aimed to investigate the characteristics of AUD inpatients with comorbid ASPD and identify predictors of early relapse or treatment drop-out in these patients.Methods: In a longitudinal study of AUD patients (n = 113; 30 females; aged 27 to 72 years) in treatment at three residential rehabilitation clinics in Norway, we used interviews and self-report questionnaires to collect data on alcohol use, mental health, and trauma experience. In addition, we assessed biochemical parameters. The patients were followed up at 6 weeks to identify early relapse or drop-out.Results: Prevalence of ASPD among AUD patients was 15%. AUD patients with comorbid ASPD were exclusively male, of younger age, and reported more childhood trauma, and adult attention-deficit-hyperactivity-disorder symptoms. They reported more hazardous drinking behavior and more often had dependence on substances in addition to alcohol. The presence of ASPD did not predict early relapse or drop-out. However, early relapse or drop-out in ASPD patients was associated with childhood and adult trauma, younger age of drinking debut, and higher baseline prolactin levels.Conclusion: AUD patients with ASPD had different clinical characteristics to other AUD patients and they had specific predictors of early relapse or drop-out. Our findings indicate that the early relapse or drop-out among AUD patients with ASPD may be attributed to environmental and possibly biological vulnerability. However, further studies with larger sample size are warranted to confirm these preliminary associations.Keywords: alcohol use disorder, antisocial personality disorder, relapse, drop-outhttps://www.dovepress.com/antisocial-personality-disorder-among-patients-in-treatment-for-alcoho-peer-reviewed-fulltext-article-SARalcohol use disorderantisocial personality disorderrelapsedrop-out
spellingShingle Pandey S
Bolstad I
Lien L
Bramness JG
Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out
Substance Abuse and Rehabilitation
alcohol use disorder
antisocial personality disorder
relapse
drop-out
title Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out
title_full Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out
title_fullStr Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out
title_full_unstemmed Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out
title_short Antisocial Personality Disorder Among Patients in Treatment for Alcohol Use Disorder (AUD): Characteristics and Predictors of Early Relapse or Drop-Out
title_sort antisocial personality disorder among patients in treatment for alcohol use disorder aud characteristics and predictors of early relapse or drop out
topic alcohol use disorder
antisocial personality disorder
relapse
drop-out
url https://www.dovepress.com/antisocial-personality-disorder-among-patients-in-treatment-for-alcoho-peer-reviewed-fulltext-article-SAR
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