Exploration of potential mechanisms underlying substance use disorders in individuals with personality disorders

Background Cluster-B personality disorders (DSM-V), particularly borderline and antisocial personality disorders, are associated with high rates of substance use disorder. However, the mechanisms underlying this relationship have yet to be fully understood. Craving has recently been identified as an important component of substance use disorder. The purpose of this article is therefore to review the current literature and explore whether craving could be implicated as an underlying mechanism of comorbid substance use disorder in antisocial and borderline personality disorders. Method Critical review of the literature. Results Emerging evidence indicates that there is in fact an association between craving and personality disorders. Patients afflicted with the latter, incidentally, respond differently to anti-craving medication when compared to normal subjects. While a limited number of studies have directly assessed craving in patients with personality disorders, a growing number have looked at the association between craving and specific personality traits. The correlation between impulsivity, negative affect and craving seems like a plausible explanation for the high prevalence and severity of substance use disorder in subjects with antisocial or borderline personality disorders. Conclusion These findings suggest that specific personality traits are related to craving and could represent promising targets for the prevention, assessment and management of comorbid substance use disorders.