Download PDF
Fortschr Neurol Psychiatr 2015; 83(10): 544-554
DOI: 10.1055/s-0041-107984
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Persönlichkeitsstörungen und Sucht: Systematische Literaturübersicht zu Epidemiologie, Verlauf und Behandlung

A Systematic Review of Personality Disorders and Addiction: Epidemiology, Course and Treatment
S. Euler
1   Universitäre Psychiatrische Kliniken (UPK), Universität Basel
,
D. Sollberger
2   Zentrum für Spezifische Psychotherapie und Psychosomatik, Psychiatrie Baselland, Liestal
,
K. Bader
1   Universitäre Psychiatrische Kliniken (UPK), Universität Basel
,
U. E. Lang
1   Universitäre Psychiatrische Kliniken (UPK), Universität Basel
,
M. Walter
1   Universitäre Psychiatrische Kliniken (UPK), Universität Basel
› Author Affiliations
Further Information

Publication History

02 July 2015

20 October 2015

Publication Date:
20 November 2015 (online)

    Permissions and Reprints

Zusammenfassung

Ziel: Dieser Artikel gibt eine systematische Übersicht über den aktuellen Forschungsstand zur Komorbidität von Persönlichkeitsstörungen und Suchterkrankungen inklusive der nicht-stoffgebundenen Abhängigkeiten.

Methode: Systematische Literaturübersicht.

Ergebnis: Persönlichkeitsstörungen und Substanzabhängigkeiten zeigen hohe Komorbiditätsraten, die sich auch für die nicht-stoffgebundenen Süchte (Verhaltenssüchte) nachweisen lassen. Die größte Evidenz liegt für die Komorbidität mit der Borderline-Persönlichkeitsstörung vor. Für die Behandlung von Doppeldiagnosen haben sich bisher drei psychotherapeutische Verfahren empirisch als wirksam erwiesen. Pharmakologische Behandlungsansätze sind bisher kaum untersucht worden.

Schlussfolgerung: Für die Doppeldiagnose ist die methodenintegrative Psychotherapie die Behandlungsmethode der Wahl, wobei v. a. im Bereich der Komorbidität von Persönlichkeitsstörungen und Verhaltenssüchten Forschungsbedarf besteht.

Abstract

Aim: This paper provides a systematic overview of the comorbidity of personality and addictive disorders including behavioural addictions.

Method: Systematic review.

Results: Personality disorders and substance-related addictions show high comorbidity rates. This is equally true of behavioural addictions. Most empirical research is on comorbidity with borderline personality disorder. For treatment of individuals with dual diagnoses, three psychotherapies have been demonstrated to be effective. Pharmacotherapeutic approaches have hardly been investigated.

Conclusion: Methodologically integrative treatment represents therapy of choice for patients with dual diagnoses. Comorbidity of personality disorders and behavioural addictions needs further investigation.

Schlüsselwörter

Persönlichkeitsstörung - Substanzabhängigkeit - Verhaltenssucht - Komorbidität - Doppeldiagnose - DSM-5

Key words

personality disorder - substance use disorder - behavioural addiction - comorbidity - dual diagnosis - DSM-5
 

  • Literatur

  • 1 Kessler RC. The epidemiology of dual diagnosis. Biol Psychiatry 2004; 56: 730-737
    CrossrefPubMedGoogle Scholar
  • 2 Walter M, Gouzoulis-Mayfrank E (Hrsg). Psychische Störungen und Suchterkrankungen. Diagnostik und Behandlung von Doppeldiagnosen. Stuttgart: Kohlhammer; 2014
    Google Scholar
  • 3 Dom G, Moggi F. Co-occuring Addictive and Psychiatric Disorders. Heidelberg: Springer; 2015
    Google Scholar
  • 4 Verheul R. Co-morbidity of personality disorders in individuals with substance use disorders. Eur Psychiatry 2001; 16: 274-282
    CrossrefPubMedGoogle Scholar
  • 5 Grant BF, Stinson FS, Dawson DA et al. Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 2004; 61: 361-368
    CrossrefPubMedGoogle Scholar
  • 6 Walter M, Dürsteler KM, Petitjean SA et al. Psychosoziale Behandlungen bei Suchterkrankungen. Fortschr Neurol Psychiatr 2015; 83: 201-210
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Preuss U, Koller G, Barnow S et al. Suicidal behavior in alcohol-dependent subjects: the role of personality disorders. Alcoholism: Clin Exp Res 2006; 30: 866-877
    CrossrefPubMedGoogle Scholar
  • 8 Walter M, Dammann G. Abhängigkeitserkrankungen und Persönlichkeitsstörungen: Eine aktuelle Übersicht aus neurobiologischer und psychodynamischer Perspektive. Psychotherapeut 2012; 57: 425-233
    CrossrefPubMedGoogle Scholar
  • 9 Sher KJ, Trull TJ. Substance use disorder and personality disorder. Curr Psychiatry Rep 2002; 4: 25-29
    CrossrefPubMedGoogle Scholar
  • 10 Walter M, Gunderson JG, Zanarini MC et al. New onsets of substance use disorders in borderline personality disorder over seven years of follow-ups. Addiction 2009; 204: 97-103
    PubMedGoogle Scholar
  • 11 Odlaug BL, Schreiber LRN, Grant JE. Personality disorders and dimensions in pathological gambling. J Pers Disord 2012; 26: 381-392
    CrossrefPubMedGoogle Scholar
  • 12 Mishra S, Lalumière ML, Morgan M et al. An examination of the relationship between gambling and antisocial behavior. J Gambl Stud 2011; 27: 409-426
    CrossrefPubMedGoogle Scholar
  • 13 Kiefer F, Fauth-Buhler M, Heinz A et al. Neurobiologische Grundlagen der Verhaltenssüchte. Nervenarzt 2013; 84: 557-562
    CrossrefPubMedGoogle Scholar
  • 14 Grant JE, Chamberlain SR. Impulsive action and impulsive choice across substance and behavioral addictions: cause or consequence?. Addict Behav 2014; 39: 1632-1639
    CrossrefPubMedGoogle Scholar
  • 15 van den Bosch LM, Verheul R. Patients with addiction and personality disorder: Treatment outcomes and clinical implications. Curr Opin Psychiatry 2007; 20: 67-71
    CrossrefPubMedGoogle Scholar
  • 16 Kienast T, Foerster J. Psychotherapy of personality disorders and concomitant substance dependence. Curr Opin Psychiatry 2008; 21: 619-624
    CrossrefPubMedGoogle Scholar
  • 17 Kienast T, Stoffers J, Bermpohl F et al. Borderline personality disorder and comorbid addiction: epidemiology and treatment. Dtsch Arztebl Int 2014; 111: 280-286
    PubMedGoogle Scholar
  • 18 Pennay A, Cameron J, Reichert T et al. A systematic review of interventions for co-occuring substande use disorder and borderline personality disorder. J Subst Abuse 2011; 41: 363-373
    PubMedGoogle Scholar
  • 19 Gianoli MO, Jane JS, O'Brien E et al. Treatment for comorbid borderline personality disorder and alcohol use disorders: a review of the evidence and future recommendations. Exp Clin Psychopharmacol 2012; 20: 333-344
    CrossrefPubMedGoogle Scholar
  • 20 Lee NK, Cameron J, Jenner L. A systematic review of interventions for co-occurring substance use and borderline personality disorders. Alcohol Rev DOI: 10.1111/dar.12267.
    PubMedGoogle Scholar
  • 21 Tomko RL, Trull TJ, Wood PK et al. Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. J Pers Disord 2014; 28: 734-750
    CrossrefPubMedGoogle Scholar
  • 22 Verheul R, Van den Bosch LM, Koeter MW et al. Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. Br J Psychiatry 2003; 182: 135-140
    CrossrefPubMedGoogle Scholar
  • 23 Rounsaville BJ, Kranzler HR, Ball S et al. Personality disorders in substance abusers: relation to substance use. J Nerv Ment Dis 1998; 186: 87-95
    CrossrefPubMedGoogle Scholar
  • 24 Stinson FS, Dawson DA, Goldstein RB et al. Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008; 69: 1033-1045
    CrossrefPubMedGoogle Scholar
  • 25 Black DW, Belsare G, Schlosser S. Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior. J Clin Psychiatry 1999; 60: 839-844
    CrossrefPubMedGoogle Scholar
  • 26 Odlaug BL, Schreiber LR, Grant JE. Personality disorders and dimensions in pathological gambling. J Pers Disord 2012; 26: 381-392
    CrossrefPubMedGoogle Scholar
  • 27 American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-5. 5. Aufl. Washington, D.C.: American Psychiatric Publishing; 2013
    Google Scholar
  • 28 Walter M. Personality Disorder and Addiction. In: Dom G, Moggi F. Co-occuring Addictive and Psychiatric Disorders. Heidelberg: Springer; 2015: 137-148
    Google Scholar
  • 29 Coid J, Yang M, Tyrer P et al. Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 2006; 188: 423-431
    Google Scholar
  • 30 Kernberg OF, Michels R. Borderline Personality Disorder. Editorial. Am J Psychiatry 2009; 166: 505-508
    Google Scholar
  • 31 Gunderson JG, Weinberg I, Choi-Kain L. Borderline personality disorder. Focus 2013; 11: 129-145
    CrossrefPubMedGoogle Scholar
  • 32 Gunderson JG, Stout RL, McGlashan TH et al. Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study. Arch Gen Psychiat 2011; 68: 827-837
    CrossrefPubMedGoogle Scholar
  • 33 Zanarini MC, Frankenburg FR, Reich DB et al. The subsyndromal phenomenology of borderline personality disorder: a 10-year follow-up study. Am J Psychiatry 2007; 164: 929-935
    Google Scholar
  • 34 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text rev. Washington, DC: American Psychiatric Association; 2001
    Google Scholar
  • 35 Krueger RF, Derringer J, Markon KE et al. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychol Med 2012; 42: 1879-1890
    CrossrefPubMedGoogle Scholar
  • 36 Herpertz S. Was bringt das DSM-V Neues zur Klassifikation der Persönlichkeitsstörungen?. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 2011; 59: 261-266
    CrossrefPubMedGoogle Scholar
  • 37 Zimmermann J, Benecke C, Bender DS et al. Persönlichkeitsdiagnostik im DSM-5. Psychotherapeut 2013; 58: 455-465
    CrossrefPubMedGoogle Scholar
  • 38 Linehan MM. Dialectical Behavioral Therapy of Borderline Personality Disorder. New York: Guilford; 1993
    Google Scholar
  • 39 Bateman A, Fonagy P. Psychotherapy for Borderline Personality Disorder: Mentalization Based Treatment. London: Oxford University Press; 2004
    CrossrefGoogle Scholar
  • 40 Young J, Weisshaar ME, Klosko JS. Schema Therapy: A Practitioner's Guide. New York: Guilford; 2006
    Google Scholar
  • 41 Clarkin JF, Yeomans FE, Kernberg OF. Psychotherapy of borderline personality disorder. Focusing on object relations. Arlington: American Psychiatric Publishing; 2006
    Google Scholar
  • 42 Stoffers JM, Völlm BA, Rücker G et al. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev DOI: 10.1002/14651858.CD005652.
    PubMedGoogle Scholar
  • 43 Sollberger D, Walter M. Psychotherapie der Borderline-Persönlichkeitsstörung: Gemeinsamkeiten und Differenzen evidenzbasierter störungsspezifischer Behandlungen. Fortschr Neurol Psychiatr 2010; 78: 698-708
    Google Scholar
  • 44 Paris J. Effectiveness of different psychotherapy approaches in the treatment of borderline personality disorder. Curr Psychiatry Rep 2010; 12: 56-60
    CrossrefPubMedGoogle Scholar
  • 45 Lana F, Fernández-San Martín MI. To what extent are specific psychotherapies for borderline personality disorders efficacious? A systematic review of published randomised controlled trials. Actas Esp Psiquiatr 2013; 41: 242-252
    PubMedGoogle Scholar
  • 46 Burmeister K, Höschel K, von Auer AK et al. Dialectical Behavior Therapy (DBT)-developments and empirical evidence. Psychiatr Prax 2014; 41: 242-249
    Article in Thieme ConnectPubMedGoogle Scholar
  • 47 Euler S, Schultz-Venrath U. Theorie und Praxis der Mentalisierungsbasierten Therapie (MBT) bei der Borderline-Persönlichkeitsstörung. PSYCHup2date 2014; 8: 393-407
    PubMedGoogle Scholar
  • 48 Jacob GA, Bernstein D, Lieb K et al. Schematherapie mit dem Moduskonzept bei Persönlichkeitsstörungen. Psychiatrie und Psychotherapie up2date 2009; 3: 105-119
    Article in Thieme ConnectPubMedGoogle Scholar
  • 49 Martius P. Psychodynamische übertragungsfokussierte Psychotherapie für Patienten mit schweren Persönlichkeitsstörungen. Schweiz Archiv Neurol Psychiat 2012; 163: 171-178
    PubMedGoogle Scholar
  • 50 Dixon-Gordon KL, Turner BJ, Chapman AL. Psychotherapy for personality disorders. Int Rev Psychiatry 2011; 23: 282-302
    CrossrefPubMedGoogle Scholar
  • 51 Walter M, Sollberger D, Euler S. Persönlichkeitsstörungen und Sucht. Stuttgart: Kohlhammer; 2015. Im Druck
    Google Scholar
  • 52 Bamelis LL, Evers SM, Spinhoven P et al. Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. Am J Psychiatry 2014; 171: 305-322
    Google Scholar
  • 53 Herpertz SC, Zanarini M, Schulz CS et al. WFSBP Task Force on Personality Disorders. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of personality disorders. World J Biol Psychiatry 2007; 8: 212-244
    CrossrefPubMedGoogle Scholar
  • 54 Lieb K, Völlm B, Rücker G et al. Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials. Br J Psychiatry 2010; 196: 4-12
    CrossrefPubMedGoogle Scholar
  • 55 Renneberg B, Schmitz B, Doering St et al. Behandlungsleitlinie Persönlichkeitsstörungen. Psychotherapeut 2010; 4: 339-354
    PubMedGoogle Scholar
  • 56 Ripoll LH, Triebwasser J, Siever LJ. Evidence-based pharmacotherapy for personality disorders. Focus 2013; 11: 225-248
    CrossrefPubMedGoogle Scholar
  • 57 World Health Organization. International Classification of Diseases. Geneva: World Health Organization; 2015 10th version (ICD-10).
    PubMedGoogle Scholar
  • 58 Heinz A, Friedel E. DSM-5: wichtige Änderungen im Bereich der Suchterkrankungen. Der Nervenarzt 2014; 85: 571-577
    CrossrefPubMedGoogle Scholar
  • 59 Dutra L, Stathopoulou G, Basden SL et al. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry 2008; 165: 179-187
    Google Scholar
  • 60 Kiluk BD, Carroll KM. New developments in behavioral treatments for substance use disorders. Curr Psychiatry Rep 2013; 15: 420
    CrossrefPubMedGoogle Scholar
  • 61 Walter M, Wiesbeck GA. Pharmakotherapie von Abhängigkeits- und Entzugssyndromen. Therapeutische Umschau 2009; 66: 449-457
    CrossrefPubMedGoogle Scholar
  • 62 Kratzer S, Hegerl U. Ist „Internetsucht“ eine eigenständige Erkrankung?. Psychiat Prax 2008; 35: 80-83
    Article in Thieme ConnectPubMedGoogle Scholar
  • 63 Mann K, Kiefer F. Den „Mythos des Selbstverschuldens“ entkräften. Nervenarzt 2009; 80: 1013-1014
    CrossrefPubMedGoogle Scholar
  • 64 Grant JE, Schreiber LR, Odlaug BL. Phenomenology and treatment of behavioural addictions. Can J Psychiatry 2013; 58: 252-259
    PubMedGoogle Scholar
  • 65 Byun S, Ruffini C, Mills J et al. Internet Addiction: Metasynthesis of 1996-2006 Quantitative Research. CyberPsychology & Behavior 2009; 12: 203-2077
    CrossrefPubMedGoogle Scholar
  • 66 Baumgärtner G, Soyka M. DSM-5 – Was ändert sich für die Suchttherapie und -forschung?. Fortschr Neurol Psychiatr 2013; 81: 648-654
    Article in Thieme ConnectPubMedGoogle Scholar
  • 67 Spada MM. An overview of problematic internet use. Addict Behav 2014; 39: 3-6
    CrossrefPubMedGoogle Scholar
  • 68 Petersen KU, Weymann N, Schelb Y et al. Pathologischer Internetgebrauch – Epidemiologie, Diagnostik, komorbide Störungen und Behandlungsansätze. Fortschr Neurol Psychiatr 2009; 77: 263-271
    Article in Thieme ConnectPubMedGoogle Scholar
  • 69 Müller KW, Beutel ME, Wölfling K. A contribution to the clinical characterization of Internet addiction in a sample of treatment seekers: validity of assessment, severity of psychopathology and type of co-morbidity. Compr Psychiat 2014; 55: 770-777
    CrossrefPubMedGoogle Scholar
  • 70 te Wildt BT, Putzig I, Drews M et al. Pathological Internet use and psychiatric diorders: A cross-sectional study on psychiatric phenomenology and clinical relevance of Internet dependency. Eur J Psychiatry 2010; 24: 136-145
    PubMedGoogle Scholar
  • 71 Li W, O’Brien JE, Snyder SM et al. Characteristics of Internet Addiction/Pathological Internet Use in U.S. University Students: A Qualitative-Method Investigation. PLoS One 2015; 10: e0117372
    CrossrefPubMedGoogle Scholar
  • 72 Lorrains FK, Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction 2012; 106: 490-498
    PubMedGoogle Scholar
  • 73 Wölfling K, Bühler M, Leménager T et al. Glücksspiel- und Internetsucht. Nervenarzt 2009; 80: 1030-1039
    CrossrefPubMedGoogle Scholar
  • 74 teWildt BT, Wölfling K, Müller A. Nicht substanzgebundene Abhängigkeit – Verhaltenssüchte. Psychother Psych Med 2014; 64: 151-160
    Article in Thieme ConnectPubMedGoogle Scholar
  • 75 Cowlishaw S, Merkouris S, Dowling N et al. Psychological therapies for pathological and problem gambling. Cochrane Database Syst Rev DOI: 10.1002/14651858.CD008937.
    PubMedGoogle Scholar
  • 76 Rash CJ, Petry NM. Psychological treatments for gambling disorder. Psychol Res Behav Manag 2014; 7: 285-295
    PubMedGoogle Scholar
  • 77 Winkler A, Dörsing B, Rief W et al. Treatment of internet addiction: a meta-analysis. Clin Psychol Rev 2013; 33: 317-329
    CrossrefPubMedGoogle Scholar
  • 78 Przepiorka AM, Blachnio A, Miziak B et al. Clinical approaches to treatment of Internet addiction. Pharmacol Rep 2014; 66: 187-191
    CrossrefPubMedGoogle Scholar
  • 79 Marazziti D, Presta S, Baroni S et al. Behavioral addictions: a novel challenge for psychopharmacology. CNS Spectr 2014; 19: 486-495
    CrossrefPubMedGoogle Scholar
  • 80 Achab S, Khazaal Y. Psychopharmacological treatment in pathological gambling: a critical review. Curr Pharm Des 2011; 17: 1389-1395
    CrossrefPubMedGoogle Scholar
  • 81 van den Brink W. Evidence-based pharmacological treatment of substance use disorders and pathological gambling. Curr Drug Abuse Rev 2012; 5: 3-31
    CrossrefPubMedGoogle Scholar
  • 82 Trull TJ, Jahng S, Tomko RL et al. Revised NESARC personality disorder diagnoses: gender, prevalence, and comorbidity with substance dependence disorders. J Pers Disord 2010; 24: 412-426
    CrossrefPubMedGoogle Scholar
  • 83 McGlashan TH, Grilo CM, Skodol AE et al. The Collaborative Longitudinal Personality Disorders Study: baseline Axis I/II and II/II diagnostic co-occurrence. Acta Psychiatr Scand 2000; 102: 256-264
    CrossrefPubMedGoogle Scholar
  • 84 Ritter K, Roepke S, Merkl A et al. Comorbidity in patients with narcissistic personality disorder in comparison to patients with borderline personality disorder. Psychotherapie, Psychosomatik, Medizinische Psychologie 2010; 60: 14-24
    Article in Thieme ConnectPubMedGoogle Scholar
  • 85 Mueser KT, Gottlieb JD, Cather C et al. Antisocial Personality Disorder in People with Co-Occurring Severe Mental Illness and Substance Use Disorders: Clinical, Functional, and Family Relationship Correlates. Psychosis 2012; 4: 52-62
    CrossrefPubMedGoogle Scholar
  • 86 Sylvers P, Landfield KE, Lilienfeld SO. Heavy episodic drinking in college students: associations with features of psychopathy and antisocial personality disorder. J Am Coll Health J ACH 2011; 59: 367-372
    PubMedGoogle Scholar
  • 87 Compton WM, Conway KP, Stinson FS et al. Prevalence, correlates, and comorbidity of DSM-IV antisocial personality syndromes and alcohol and specific drug use disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 2005; 66: 677-685
    CrossrefPubMedGoogle Scholar
  • 88 Baigent M. Managing patients with dual diagnosis in psychiatric practice. Curr Opin Psychiatry 2012; 25: 201-205
    CrossrefPubMedGoogle Scholar
  • 89 Crawford M, Sahib H, Bratton P et al. Service provision for men with antisocial personality disorder who make contact with mental health services. Pers Ment Health 2009; 3: 165-171
    CrossrefPubMedGoogle Scholar
  • 90 Chavez JX. Assessing the incidence rates of substance use disorders among those with antisocial and borderline personality disorders in rural settings. Int J Psychol 2010; 57-66
    PubMedGoogle Scholar
  • 91 Mellos E, Liappas I, Paparrigopoulos T. Comorbidity of personality disorders with alcohol abuse. In Vivo 2010; 24: 761-769
    PubMedGoogle Scholar
  • 92 Rentrop M, Zilker T, Lederle A et al. Psychiatric comorbidity and personality structure in patients with polyvalent addiction. Psychopathology 2014; 47: 133-140
    CrossrefPubMedGoogle Scholar
  • 93 Casadio P, Olivoni D, Ferrari B et al. Personality disorders in addiction outpatients: prevalence and effects on psychosocial functioning. Subst Abuse 2014; 31: 17-24
    PubMedGoogle Scholar
  • 94 Preuss UW, Johann M, Fehr C et al. Personality disorders in alcohol-dependent individuals: relationship with alcohol dependence severity. Eur Addict Res 2009; 15: 188-195
    CrossrefPubMedGoogle Scholar
  • 95 Paim Kessler FH, Barbosa Terra M, Faller S et al. Brazilian ASI Group. Crack users show high rates of antisocial personality disorder, engagement in illegal activities and other psychosocial problems. Am J Addict 2012; 21: 370-380
    CrossrefPubMedGoogle Scholar
  • 96 Ronningstam E, Weinberg I. Narcissistic personality disorder: Progress in recognition and treatment. Focus 2013; 1: 167-177
    PubMedGoogle Scholar
  • 97 Di Pierro R, Preti E, Vurro N et al. Dimensions of personality structure among patients with substance use disorders and co-occuring personality disorders: A comparison with psychiatric outpatients and healthy controls. Compr Psychiatry 2014; 55: 1398-1404
    CrossrefPubMedGoogle Scholar
  • 98 Dowling NA, Cowlishaw S, Jackson AC et al. The Prevalence of Comorbid Personality Disorders in Treatment-Seeking Problem Gamblers: A Systematic Review and Meta-Analysis. J Pers Disord 2014; 23: 1-20
    PubMedGoogle Scholar
  • 99 Bischof A, Meyer C, Bischof G et al. Suicidal events among pathological gamblers: the role of comorbidity of axis I and axis II disorders. Psychiat Res 2015; 28: 413-419
    PubMedGoogle Scholar
  • 100 Petry NM, Stinson FS, Grant BF. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiat 2005; 66: 564-574
    CrossrefPubMedGoogle Scholar
  • 101 Sacco P, Cunningham-Williams RM, Ostmann E et al. The association between gambling pathology and personality disorders. J Psychiatr Res 2008; 42: 1122-1130
    CrossrefPubMedGoogle Scholar
  • 102 Saez-Abad C, Bertolin-Guillen JM. Personality traits and disorders in pathological gamblers versus normal controls. J Addict Dis 2008; 27: 33-40
    CrossrefPubMedGoogle Scholar
  • 103 Fernández-Montalvo J, Echeburúa E. Pathological gambling and personality disorders: an exploratory study with the IPDE. J Pers Disord 2004; 18: 500-505
    CrossrefPubMedGoogle Scholar
  • 104 Floros G, Siomos K, Stogiannidou A et al. Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: the effect of personality, defense style and psychopathology. Addict Behav 2014; 39: 1839-1845
    CrossrefPubMedGoogle Scholar
  • 105 te Wildt BT, Putzig I, Zedler M et al. Internetabhängigkeit als ein Symptom depressiver Störungen. Psychiatrische Praxis 2007; 34: 318-322
    Article in Thieme ConnectPubMedGoogle Scholar
  • 106 Lev-Ran S, Imtiaz S, Rehm J et al. Exploring the association between lifetime prevalence of mental illness and transition from substance use to substance use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Am J Addict 2013; 22: 93-98
    CrossrefPubMedGoogle Scholar
  • 107 Langås AM, Malt UF, Opjordsmoen S. In-depth study of personality disorders in first-admission patients with substance use disorders. BMC Psychiatry 2012; 12: 180
    CrossrefPubMedGoogle Scholar
  • 108 Bottlender M, Preuss UW, Soyka M. Association of personality disorders with Type A and Type B alcoholics. Eur Arch Psychiatry Clin Neuroscience 2006; 256: 55-61
    PubMedGoogle Scholar
  • 109 Zanarini MC, Frankenburg FR, Hennen J et al. The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. J Pers Disord 2005; 19: 505-523
    CrossrefPubMedGoogle Scholar
  • 110 Martinez-Raga J, Marshall EJ, Keaney F et al. Unplanned versus planned discharges from in-patient alcohol detoxification: retrospective analysis of 470 first-episode admissions. Alcohol 2002; 37: 277-281
    PubMedGoogle Scholar
  • 111 Ross S, Dermatis H, Levounis P et al. A comparison between dually diagnosed inpatients with and without Axis II comorbidity and the relationship to treatment outcome. Am J Drug Alcohol Abuse 2003; 29: 263-279
    CrossrefPubMedGoogle Scholar
  • 112 Yen S, Shea MT, Pagano M et al. Axis I and Axis II disorders as predictors of prospectivesuicide attempts: Findings from the Collaborative Longitudinal Personality Disorders Study. Journal of Abnormal Psychology 2003; 112: 375-381
    CrossrefPubMedGoogle Scholar
  • 113 Yuodelis-Flores C, Ries RK. Addiction and suicide: A review. Am J Addict 2015; 24: 98-104
    CrossrefPubMedGoogle Scholar
  • 114 Walter M, Berth H, Selinger J et al. The lack of negative affects as an indicator for identity disturbance in borderline personality disorder: a preliminary report. Psychopathology 2009; 42: 399-404
    CrossrefPubMedGoogle Scholar
  • 115 Coffey SF, Schumacher JA, Baschnagel JS et al. Impulsivity and risk-taking in borderline personality disorder with and without substance use disorders. Personal Disord 2011; 2: 128-141
    CrossrefPubMedGoogle Scholar
  • 116 Linehan MM, Schmidt H, Dimeff LA et al. Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. Am J Addict 1999; 8: 279-292
    CrossrefPubMedGoogle Scholar
  • 117 Linehan MM, Dimeff LA, Reynolds SK et al. Dialectical behaviour therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence 2002; 67: 13-26
    CrossrefPubMedGoogle Scholar
  • 118 Harned MS, Chapman AL, Dexter-Mazza ET et al. Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: a 2-year randomized trial of dialectical behavior therapy versus community treatment by experts. J Consult Clin Psychol 2008; 76: 1068-1075
    CrossrefPubMedGoogle Scholar
  • 119 Gregory RJ, Remen A. A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder. Psychotherapy 2008; 45: 15-27
    CrossrefPubMedGoogle Scholar
  • 120 Gregory RJ, Remen AL, Soderberg M et al. A Controlled Trial of Psychodynamic Psychotherapy for Co-Occurring Borderline Personality Disorder and Alcohol use Disorder: Six-Month Outcome. J Amer Psychoanal Assn 2009; 57: 199-205
    CrossrefPubMedGoogle Scholar
  • 121 Gregory RJ, DeLucia-Deranja E, Mogle JA. Dynamic deconstructive psychotherapy versus optimized community care for borderline personality disorder co-occuring with alcohol use disorder. J Nerv Ment Disease 2010; 198: 292-298
    CrossrefPubMedGoogle Scholar
  • 122 Ball S. Manualized treatment for substance abusers with personality disorders: Dual focus schema therapy. Addictive Behaviours 1998; 23: 883-891
    CrossrefPubMedGoogle Scholar
  • 123 Ball S, Cobb-Richardson P, Connolly AJ et al. Substance abuse and personality disorders in homeless drop-in centre clients: Symptoms severity and psychotherapy retention in a randomized clinical trial. Compr Psychiatry 2005; 46: 371-379
    CrossrefPubMedGoogle Scholar
  • 124 Ball SA, Maccarelli LM, LaPaglia DM et al. Randomized trial of dual-focused vs. single-focused individual therapy for personality disorders and substance dependence. J Nerv Ment Dis 2011; 199: 319-328
    CrossrefPubMedGoogle Scholar
  • 125 Ball S. Comparing individual therapies for personality disordered opioid dependent patients. J Pers Disord 2007; 21: 305-321
    CrossrefPubMedGoogle Scholar
  • 126 Gibbon S, Duggan C, Stoffers J et al. Psychological interventions for antisocial personality disorder. Cochrane Database Syst Rev DOI: 10.1002/14651858.CD007668.
    PubMedGoogle Scholar
  • 127 Ralevski E, Ball S, Nich C et al. The impact of personality disorders on alcohol-use outcomes in a pharmacotherapy trial for alcohol dependence and comorbid Axis I disorders. Am J Addict 2007; 16: 443-449
    CrossrefPubMedGoogle Scholar
  • 128 Verheul R, Kranzler HR, Poling J et al. Axis I and Axis II disorders in alcoholics and drug addicts: fact or artifact?. J Stud Alcohol 2000; 61: 101-110
    CrossrefPubMedGoogle Scholar
  • 129 Bohus M, Stieglitz RD, Fiedler P et al. Persönlichkeitsstörungen. In: Berger M, Hrsg. Psychiatrie und Psychotherapie. München: Urban & Schwarzenberg; 1999: 771-846
    Google Scholar
  • 130 Dimaggio G, D'Urzo M, Pasinetti M. Metacognitive interpersonal therapy for co-occurrent avoidant personality disorder and substance abuse. J Clin Psychol 2015; 71: 157-166
    CrossrefPubMedGoogle Scholar
  • 131 Morken K, Karterud S, Arefjord N. Transforming Disorganized Attachment Through Mentalization-Based Treatment. J Contemp Psychother 2014; 44: 117-126
    CrossrefPubMedGoogle Scholar
  • 132 Euler S, Schultz-Venrath U. Mentalisierungsbasierte Therapie (MBT) – Mentalisieren als Grundlage wirksamer Psychotherapien. Psychotherapie im Dialog 2014; 3: 40-43
    PubMedGoogle Scholar
  • 133 Bender DS, Morey LC, Skodol AE. Toward a model for assessing level of personality functioning in DSM–5, part I: a review of theory and methods. J Pers Assess 2011; 93: 332-346
    CrossrefPubMedGoogle Scholar
  • 134 Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract 2008; 4 (02) 39-47
    CrossrefPubMedGoogle Scholar
  • 135 Grant JE, Potenza MN, Hollander E et al. Multicenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling. Am J Psychiatry 2006; 163: 303-312
    CrossrefPubMedGoogle Scholar
  • 136 Mann K, Bladström A, Torup L et al. Extending the treatment options in alcohol dependence: a randomized controlled study of as-needed nalmefene. Biol Psychiatry 2012; 73: 706-713
    PubMedGoogle Scholar
  • 137 Ingenhoven T, Lafay P, Rinne T et al. Effectiveness of pharmacotherapy for severe personality disorders: meta-analyses of randomized controlled trials. J Clin Psychiatry 2010; 71: 14-25
    PubMedGoogle Scholar
  • 138 Mutschler J, Kiefer F. Wirkmechanismen von Disulfiram und Behandlungsoptimierung in der Alkohol-Rückfallprophylaxe. Praxis 2013; 102: 139-146
    CrossrefPubMedGoogle Scholar
  • 139 Verheul R, Van Den Bosch LM, Koeter MW et al. Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. Br J Psychiatry 2003; 182: 135-140
    CrossrefPubMedGoogle Scholar