Antisocial addicts: the importance of additional axis I disorders for the 28-month outcome

The association between additional co-morbid axis I disorders and the follo wing 28-month course of drinking and mental distress was explored in a nati on-wide representative sample (N = 100) of treatment-seeking alcoholic's wi th antisocial personality disorder (ASPD). Diagnoses at admission were asse ssed with the Diagnostic Interview Schedule and follow-up status was assess ed with a questionnaire and from informants. Only 24% had no additional dia gnoses, 39% had an affective disorder, 43% panic/agoraphobia, 61% other anx iety disorders, and 47% were polysubstance abusers. Polysubstance abusers h ad more prior admissions, and were more often involved in fights, while add itional anxiety disorder was associated with lower prevalence of drunken dr iving arrests. Relapse (87%) was best predicted by the number of prior admi ssions (odds ratio [OR] = 1.3), while affective disorders reduced the risk of relapse (OR = 0.2). Readmissions (55%) were least common among those wit h affective disorders (44%). Identifying axis I diagnoses, and in particula r affective disorders among treatment-seeking ASPD alcoholics, is of substa ntial importance both in research and clinicalpractice. (C) 2000 Editions s cientifiques et medicales Elsevier SAS.