Relationship between non-psychotic morbidity and substance dependence in male prisoners suffering from dissocial personality disorder

Background and objectives: To study (1) comparative prevalence of non-psychotic morbidity (NPM) in male dissocial personality disorder (DPD) patients with or without psychoactive substance dependence (SD). (2) Relationship of NPM with pattern and duration of SD. Methods: This was a 20-month single blind cross sectional hospital-based study with a sample size of total 1036 male prisoners >= 18 years of age suffering from DPD (study = 518, control = 518). Participants in study group fulfilled further criteria of being suffering from SD. Results: Majority of participants in both groups were unemployed, married individuals with occupational skills of less than skilled labour level and educational attainment of higher secondary level or lesser. Intensity of substance use was higher in study participants with NPM than those without NPM, and they started consuming substance at younger age, had a longer duration of substance use and dependence, and majority of them had onset of NPM after onset of SD. NPM was present in 350 (67.6%) of study participants against 159 (30.7%) in controls. Study participants had especially high prevalence of Major Depressive Disorder (MDD)/Recurrent Depressive Disorder (RDD) (24.9%) and Adjustment Disorder (13.3%). Among study participants, 203 (58%) participants with NPM used >= 3 psychoactive substances against 33 (19.7%) in those without NPM. Conclusions: The results suggested that a higher burden of NPM exists in substance using DPD population than those without NPM and occurrence of NPM in turn leads to earlier onset and increased severity of SD in this population. (C) 2016 Asociacion Universitaria de Zaragoza para el Progreso de la Psiquiatria y la Salud Mental. Published by Elsevier Espana, S.L.U. All rights reserved.