Pathological personality traits and suicidal ideation among older adolescents and young adults with alcohol misuse: A pilot case-control study in a primary care setting

Objective. To compare the clinical and demographic characteristics of older adolescents and young adults with and without alcohol misuse in a primary care setting. Methods. This study is a case-control study. Eighty-one 18-30 year old adolescents and young adults attending a primary care center were assessed with the CAGE questionnaire, the PRIME-MD instrument and the IPDE screening questionnaire. Sub-samples of positive screen for alcohol misuse (n=21) and a negative age- and gender matched group (n=21) were compared. Results. Of those with alcohol misuse, 71.9% had a comorbid psychiatric diagnosis. Depressive and anxiety disorders appeared to be more prevalent among the subjects with alcohol misuse than among controls. Among those patients with depressive or anxiety disorders and alcohol misuse, 212.2% reported suicidal ideation as compared to none among the controls suffering from depressive or anxiety disorders. 69.1% of subjects with alcohol misuse had a comorbid personality disorder. Significantly more adolescents and young adults with alcohol misuse exhibited borderline personality traits (p=0.03) and there was also a trend towards a greater proportion exhibiting histrionic traits (p=0.07) than among those without alcohol misuse. Conclusions. Adolescents and young adults with alcohol misuse in a primary care center have a high prevalence of psychiatric comorbidity. Cluster B personality disorders may be more prevalent in the population with alcohol misuse. Adolescents and young adults with alcohol misuse may be more likely to report suicidal ideation while suffering from depressive or anxiety disorders. Further studies that evaluate the clinical and demographic characteristics of adolescents and young adults with alcohol misuse attended in a primary care center are needed.