Symptoms of anxiety, depression, and borderline personality in alcohol use disorder with and without comorbid substance use disorder.

Abstract

Alcohol use disorder (AUD) is highly comorbid with other substance use disorders (SUDs) as well as other psychiatric disorders, such as anxiety, depression, and Borderline Personality Disorder (BPD). However, studies of persons with AUD rarely account for its comorbidity with other SUDs. Some research suggests that BPD symptoms reflect an important connection between internalizing disorders and SUDs. The current study investigated: 1) the levels of trait anxiety and symptoms of depression and BPD in persons with an AUD as a function of comorbid SUDs (cannabis use disorder - CUD) and other substance use disorder (oSUD), and 2) the influence of BPD on the association between severity of overall lifetime SUD symptoms (AUD+CUD+oSUD) and both trait anxiety and symptoms of depression. Trait anxiety and symptoms of depression and BPD were assessed in 671 young adults (351 men; 320 women; mean age 21 years) separated into four groups: Controls (n=185), AUD-only (134), AUD+CUD (n=210), and AUD+oSUD (n=142). Trait anxiety and symptoms of depression and BPD were elevated in all AUD groups compared with controls, and in the AUD+oSUD group compared with all other groups as well. Structural models also indicated that BPD symptoms accounted for all of the variance in lifetime SUD symptoms associated with Trait Anxiety, and a significant portion of the variance in lifetime SUD symptoms associated with depression symptoms. Results indicate that when AUD is comorbid with oSUD, it is associated with more severe AUD symptoms and higher levels of trait anxiety and symptoms of both depression and BPD. The results also indicate that BPD symptoms account for the majority of the variance in SUD symptoms associated with both trait anxiety and depression, suggesting that a considerable amount of the internalizing symptomatology in AUD/SUDs is associated with BPD psychopathology.