M. Driessen et al., AXIS-I AND AXIS-II COMORBIDITY IN ALCOHOL DEPENDENCE AND THE 2 TYPES OF ALCOHOLISM, Alcoholism, clinical and experimental research, 22(1), 1998, pp. 77-86
Background: Although high prevalence rates of psychiatric comorbidity
were reported in alcoholism, there is a lack of studies covering the w
hole spectrum of DSM Axes I and II disorders. The relation of comorbid
psychopathology and Cloninger's and Babor's types of alcoholism still
remained unclear. Methods: Psychiatric comorbidity in 250 hospitalize
d alcohol-dependent patients without additional substance-related diso
rders was assessed by the Composite International Diagnostic Interview
and the International Personality Disorder Examination. Information a
bout the course and severity of alcoholism was obtained from several s
ources. Results: Additional Axis I disorders only were found in 24.0%,
Axis II disorders only in 16.4%, and concurrent Axis I and Axis II di
sorders in 17.2% (total comorbidity rate: 57.6%). Two clusters of alco
hol dependence were found that substantially overlap with Cloninger's
and Babor's types of alcoholism. The majority of type A subjects were
found to be either not comorbid at all, or to be Axis I comorbid only.
Type B, on the other hand, was preferably associated with personality
disorders (mainly Clusters A and B) and dimensional scores of persona
lity pathology (schizoid, schizotypal, all Cluster B, and passive-aggr
essive). Conclusions The entire spectrum of personality pathology shou
ld be assessed in the comorbidity research of alcoholism The two types
of alcoholism differ on a variety of alcohol-related and comorbid per
sonality characteristics, but further research is needed to clarify th
e underlying psychological and biological associations.