Levels of personality organization and psychopathology among drug abusers in Sweden

✍ Scribed by Rolf Sandell; Ulla Bertling

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 882 KB
• Volume: 52
• Category: Article
• ISSN: 0021-9762
• DOI: 10.1002/(sici)1097-4679(199611)52:6<711::aid-jclp14>3.0.co;2-p

✦ Synopsis

In a case-finding sample of 1,824 drug abusers in the greater Stockholm area, personality organization (PO), according to Kernberg's theory, was assessed by using a standardized questionnaire, with the clients' contact persons as informants. Twenty percent of the sample were diagnosed as psychotic PO (PPO), 40% had a clear borderline PO (BPO), and 40% a high BPO or a neurotic PO (NPO). This distribution agreed closely with that found in a comparison sample of social service clients. However, in the NPO and BPO groups, the mean scores were higher for the social service clients than for the abusers. A clustering into nine sub-clusters revealed interesting differences within each PO. 0 1996 John Wiley & Sons, Inc.

Allowing for some oversimplification, it can be said that the treatment of drug abusers in Sweden, although heterogeneous in the methods used and the theories underlying them, is generally focused on their abuse, somewhat to the neglect of its psychological and other kinds of antecedents. This is generally so even in cases where it is obvious that there is a more or less severe psychiatric condition complicating the clinical picture of the abuse. Even when the abuser is referred to a general psychiatry clinic, the typical decision is to re-refer him to a special clinic for drug abusers as soon as the abuse becomes known.

This practice has rather serious consequences in view of the fact that so many drug abusers seem to be afflicted with various kinds of substance-independent psychiatric disturbances. As many as 80-90% of an abuser sample may have had at least one psychiatric diagnosis during their lifetime and 50% or more may have had more than one