Substance Use Disorder, Alexithymia, and Personality Disorders, What is the Link? Pilot African Study

Alexithymia and personality disorders are common in substance use (SUD) patients. This association remains understudied and is considered to hurt the course and management of substance use disorder patients. To determine the prevalence of personality disorders (PD) and alexithymia in addiction care patients. Besides, we targeted investigating a possible link between alexithymia, different personality disorders and clinical aspects of substance use disorder including severity. This cross-sectional study was conducted in the Addictology Center of the university hospital of Fez. We recruited 54 patients with a confirmed substance use disorder according to the DSM 5 criteria. We used the psychometric scales of alexithymia (TAS-20) and the personality assessment scale (PDQ-4+). The average age of our sample was 27.07 ± 8.22. The percentage of poly-consumers of psychoactive substances was around 93%. The alexithymia patients constituted 48% of the sample. We found a significant association between alexithymia and the severity of SUD p-value of 0.033. Alexithymia appeared to be significantly associated with ‘Cluster A’ of personality disorders p-value of 0.013 and more specifically with paranoid personality disorder p-value of 0.022. The mean PDQ-4+ score was significantly higher in the alexithymia group of patients (TAS-20 score ≥62) p-value of 0.047. 89% reported at least one specific personality disorder. Our results showed a significant association between the presence of a specific personality disorder and the existence of a severe substance use disorder p-value of 0.01. We also found that ‘Cluster A’ of personality disorder diagnoses are significantly frequent within the severe subgroup of SUD p-value of 0.042. Our study suggested an overrepresentation of alexithymia and personality disorders in patients followed for SUD. It showed a direct link between alexithymia and personality disorder on the one hand, and the severity of the substance use disorder on the other. Extensive studies are required to fully elucidate the weight of alexithymia in SUD and PD. Such investigations would improve the therapeutical approach and the outcome.