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The structural core of dual diagnosis: Personality structure profiles in substance use disorders with and without Comorbid personality pathology.

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Τίτλος: The structural core of dual diagnosis: Personality structure profiles in substance use disorders with and without Comorbid personality pathology.
Συγγραφείς: Fanti E; University of Milano-Bicocca, Department of Psychology, Milan, Italy. Electronic address: erika.fanti@unimib.it., Felici C; University of Milano-Bicocca, Department of Psychology, Milan, Italy., Di Pierro R; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy., Di Sarno M; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy., Madeddu F; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy., Preti E; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy; Bicocca Center for Applied Psychology, University of Milano-Bicocca, Department of Psychology, Milan, Italy.
Πηγή: Journal of psychiatric research [J Psychiatr Res] 2026 Aug; Vol. 199, pp. 138-144. Date of Electronic Publication: 2026 Apr 24.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Pergamon Press Country of Publication: England NLM ID: 0376331 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1379 (Electronic) Linking ISSN: 00223956 NLM ISO Abbreviation: J Psychiatr Res Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford : Pergamon Press
Ιατρικοί όροι (MeSH): Personality Disorders*/epidemiology , Personality Disorders*/diagnosis , Personality Disorders*/complications , Personality Disorders*/psychology , Substance-Related Disorders*/epidemiology , Substance-Related Disorders*/psychology , Substance-Related Disorders*/complications , Substance-Related Disorders*/diagnosis , Personality*, Humans ; Female ; Male ; Adult ; Diagnosis, Dual (Psychiatry) ; Middle Aged ; Comorbidity ; Psychiatric Status Rating Scales ; Young Adult
Περίληψη: The coexistence of substance use disorders (SUDs) and personality disorders (PDs) is a complex and frequent phenomenon that presents significant clinical challenges. This study adopted Kernberg's Object Relations Theory (ORT) to explore differences in profiles of personality structure among SUD patients with and without comorbid PD. A total of 60 nonclinical participants, 45 outpatients with SUDs, and 42 inpatients with both SUD and PD (dual diagnosis, DD) were assessed using the STIPO-R, a semi-structured interview grounded in ORT. Group differences were analyzed across all domains and subdomains of the interview. The STIPO-R effectively distinguished both DD and SUD patients from nonclinical participants across all domains and subdomains of personality functioning. However, after adjusting for age and gender, no significant differences emerged between DD and SUD groups. Both clinical groups showed comparable levels of impairment across identity, object relations, defenses, aggression, moral functioning, and narcissism. Our findings support the utility of the STIPO-R and highlight the relevance of dimensional models in capturing personality dysfunction in SUD populations, even in the absence of comorbid PD.
(Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Dual diagnosis; Object relations theory; Personality disorders; Severity of personality functioning; Substance use disorders
Entry Date(s): Date Created: 20260430 Date Completed: 20260715 Latest Revision: 20260811
Update Code: 20260812
DOI: 10.1016/j.jpsychires.2026.04.013
PMID: 42061207
Βάση Δεδομένων: MEDLINE
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  Data: The structural core of dual diagnosis: Personality structure profiles in substance use disorders with and without Comorbid personality pathology.
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  Data: <searchLink fieldCode="AU" term="%22Fanti+E%22">Fanti E</searchLink>; University of Milano-Bicocca, Department of Psychology, Milan, Italy. Electronic address: erika.fanti@unimib.it.<br /><searchLink fieldCode="AU" term="%22Felici+C%22">Felici C</searchLink>; University of Milano-Bicocca, Department of Psychology, Milan, Italy.<br /><searchLink fieldCode="AU" term="%22Di+Pierro+R%22">Di Pierro R</searchLink>; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy.<br /><searchLink fieldCode="AU" term="%22Di+Sarno+M%22">Di Sarno M</searchLink>; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy.<br /><searchLink fieldCode="AU" term="%22Madeddu+F%22">Madeddu F</searchLink>; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy.<br /><searchLink fieldCode="AU" term="%22Preti+E%22">Preti E</searchLink>; University of Milano-Bicocca, Department of Psychology, Milan, Italy; Personality Disorder Lab (PDLab), Milan, Parma, Italy; Bicocca Center for Applied Psychology, University of Milano-Bicocca, Department of Psychology, Milan, Italy.
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  Data: <searchLink fieldCode="MM" term="%22Personality+Disorders%22">Personality Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Personality+Disorders+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Personality+Disorders%22">Personality Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Personality+Disorders+diagnosis%22">diagnosis</searchLink> <br /><searchLink fieldCode="MM" term="%22Personality+Disorders%22">Personality Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Personality+Disorders+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Personality+Disorders%22">Personality Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Personality+Disorders+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Substance-Related+Disorders%22">Substance-Related Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Substance-Related+Disorders+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Substance-Related+Disorders%22">Substance-Related Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Substance-Related+Disorders+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Substance-Related+Disorders%22">Substance-Related Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Substance-Related+Disorders+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Substance-Related+Disorders%22">Substance-Related Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Substance-Related+Disorders+diagnosis%22">diagnosis</searchLink> <br /><searchLink fieldCode="MM" term="%22Personality%22">Personality*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Diagnosis%2C+Dual+%28Psychiatry%29%22">Diagnosis, Dual (Psychiatry)</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Comorbidity%22">Comorbidity</searchLink> ; <searchLink fieldCode="MH" term="%22Psychiatric+Status+Rating+Scales%22">Psychiatric Status Rating Scales</searchLink> ; <searchLink fieldCode="MH" term="%22Young+Adult%22">Young Adult</searchLink>
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  Data: The coexistence of substance use disorders (SUDs) and personality disorders (PDs) is a complex and frequent phenomenon that presents significant clinical challenges. This study adopted Kernberg's Object Relations Theory (ORT) to explore differences in profiles of personality structure among SUD patients with and without comorbid PD. A total of 60 nonclinical participants, 45 outpatients with SUDs, and 42 inpatients with both SUD and PD (dual diagnosis, DD) were assessed using the STIPO-R, a semi-structured interview grounded in ORT. Group differences were analyzed across all domains and subdomains of the interview. The STIPO-R effectively distinguished both DD and SUD patients from nonclinical participants across all domains and subdomains of personality functioning. However, after adjusting for age and gender, no significant differences emerged between DD and SUD groups. Both clinical groups showed comparable levels of impairment across identity, object relations, defenses, aggression, moral functioning, and narcissism. Our findings support the utility of the STIPO-R and highlight the relevance of dimensional models in capturing personality dysfunction in SUD populations, even in the absence of comorbid PD.<br /> (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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  Data: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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