AXIS-I AND AXIS-II COMORBIDITY IN ALCOHOL DEPENDENCE AND THE 2 TYPES OF ALCOHOLISM

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.