Evaluation des troubles de personnalité des patients alcooliques - Division d'abus de substances

• Unité de recherche: OFSP
• Numéro de projet: 98.000724

Mots-clé (Allemand)

Alkohol
Persönlichkeit alkoholabhängiger Patienten
Alkoholmissbrauch
Alkoholabhängigkeit

Mots-clé (Anglais)

Alcohol
alcholic patients
opiate addicts
methadone
personality disorder
psychiatric diagnosis

Mots-clé (Français)

alcool
personnalité des patients alcooliques
abus de substances

Description succincte (Anglais)

Assessment of the prevalence of psychiatric diagnosis including personality disorder among alcoholic patients and former opiate addicts in methadone maintenance treatmentin different outpatient units of the Substance Abuse Division in Geneva.

Objectifs du projet (Anglais)

1) To determine the prevalence of personality disorders among alcoholic patients followed at the "Unité d'Alcoologie" of the Substance Abuse Division in Geneva
2) To assess a correlation between the presence of personality disorders and anxiety or depressive syndromes among alcoholics followed at the "Unité d'Alcoologie" of the Substance Abuse Division in Geneva
3) To assess the correlation between anxiety or depressive syndromes, personality disorders and results of treatment for alcoholism
4) To determine the prevalence of personality disorders among drug addicts followed in methadone maintenance treatment at the "Unité de Toxicodépendances" of the Substance Abuse Division in Geneva, and compare those with and without a concurrent alcohol problem
5) To improve the quality of psychiatric diagnosis in our Division and to test a Five-step Mental Health Approach including the use of the ICD-10 symptom checklist plus a serie of severity rating scales for the assessment of mental health among patients followed at the Substance Abuse Division.

Résumé des résultats (Abstract) (Anglais)

In this study, the prevalence of psychiatric diagnosis including personality disorder was assessed among 101 alcoholic patients and 226 former opiate addicts in methadone maintenance treatment, all followed in different outpatient units of the Substance Abuse Division in Geneva. A mental health assessment protocol with validated diagnostic and screening instruments was proposed, including the ICD-10 symptom checklist plus series of severity rating scales. Overall, 70 % of alcoholic patients, and 68% of drug addicts were diagnosed with at least one personality disorder. Among patients with harmful use of or dependence on alcohol as principal ICD-10 diagnosis, the Cluster C and particularly anxious type of personality disorder was most frequently diagnosed, whereas among those with harmful use of or dependence to drugs (heroin principally) as principal ICD-10 diagnosis, the Cluster B and particularly emotionally unstable type of personality disorder was most prevalent. The type of personality disorder is an important determinant for the type of substance principally and the number of substances abused. One third of patients in methadone maintenance treatment present a harmful use of or dependence on alcohol. Type and number of personality disorders play a role in the outcome (drug problem, severity of mood and anxiety disorders ) of the substance abuse treatment. The treatment of substance abusers with a personality disorder especially those with Cluster B or multiple personality disorders require an integrated approach combining substance abuse, axe I and axe II disorders treatment. New therapeutic strategies for dual diagnosis patients should be developed, tested and evaluated.

Mise en oeuvre et application (Français)

1. Rapport oral sur l'avancement des travaux: 01.03.1999
2. Recueil des données: 01.08.1999
3. Rapport intermédiaire par écrit: 01.08.1999
4. Saisie et vérification des données: 01.09.1999
5. Analyse des données: 31.10.1999
6. Rapport final et son résumé: 31.12.1999