Abstract

Objective

Substance abuse comorbidity is highly prevalent and is linked to detrimental outcomes in individuals with psychotic disorder, but the role of personality traits as the underlying mechanism is being increasingly underscored. This study aimed to profile temperamental risks of comorbid substance use disorder in psychotic disorders by performing meta-analyses on personality trait differences between psychotic disorders with comorbidity (dual diagnosis; DD) and without it (psychotic disorders; PSD). Methods: A systematic review of English articles using PubMed, MEDLINE, Scopus, Google Scholar, and ProQuest Dissertation and Theses. Only original empirical studies including participants with diagnosis of psychotic disorders based on structured diagnostic interviews, with and without substance use disorder evaluated with reliable and valid tests were included. Articles were independently extracted by two authors using predefined data fields, including study quality indicators. All pooled analyses were based on random-effect models. Thirteen studies (N = 885) met our inclusion criteria. All effect-size estimates were calculated based on means and standard deviations of included measures. Separate effect size estimates were obtained for four traits in the UPPS model (negative urgency, low premeditation, low perseverance, sensation seeking), four traits in the HS model (unconscientious disinhibition, negative affect, disagreeable disinhibition, positive affect) and trait anhedonia. Results: Negative urgency (four studies with 262 participants; ES = 0.59; 95% confidence interval [CI] [0.34, 0.84]), low premeditation (five studies with 349 participants; ES = 0.60; 95% CI [0.39, 0.80]), sensation seeking (seven studies with 550 participants; ES = 0.63; 95% CI [0.17, 1.09]) and unconscientious disinhibition (five studies with 291 participants; ES = 0.36; 95% CI [0.13, 0.59]) were elevated in DD than PSD. Heterogeneity of sensation seeking was significant (I ² = 86.2%). Conclusions: The findings of the current meta-analysis highlight a unique profile of impulsive and externalizing trait personality domains pertaining to DD. The study emphasizes the importance of emotion regulation interventions targeting impulsivity or negative affect (i.e. negative urgency, low premeditation) in substance abuse comorbidity patients.

中文翻译：

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双重诊断为精神病和物质使用障碍的人格特征：全面审查和荟萃分析

摘要

目的

药物滥用合并症非常普遍，并与精神病患者的不良结局有关，但人格特质作为潜在机制的作用日益受到重视。这项研究旨在通过对合并症（双重诊断； DD）和不合并症（精神病； PSD）的精神病患者的人格特质差异进行荟萃分析，以分析精神病中合并症的气质风险。方法：使用PubMed，MEDLINE，Scopus，Google Scholar和ProQuest Dissertation and Thes对英语文章进行系统的审查。仅包括原始的实证研究，包括根据结构性诊断访谈对患有精神病的患者进行诊断，并通过可靠且有效的测试评估有无药物滥用障碍。两位作者使用预定义的数据字段（包括研究质量指标）独立提取了文章。所有汇总分析均基于随机效应模型。十三项研究（N = 885）符合我们的纳入标准。所有效应大小的估计值均基于所包含度量的均值和标准差来计算。对UPPS模型中的四个特征（负紧迫性，低沉思，低毅力，寻求感官），HS模型中的四个特征（不自觉地抑制，负面影响，令人讨厌的抑制性，正面影响）和特征性快感缺乏症分别获得了效应量估计。结果：负紧急程度（四项研究，有262名参与者； ES = 0.59； 95％置信区间[CI] [0.34，0.84]），低沉思性（五项研究，有349名参与者； ES = 0.60； 95％CI [0.39，0.80]），寻求感觉（七项研究，有550名参与者； ES = 0.63； 95％CI [0.17，1.09]）和不认真的抑制作用（五项研究，有291名参与者； ES = 0.36； 95％CI [0.13，0.59]）在DD上高于PSD。寻求感觉的异质性很明显（I ² = 86.2％）。结论：当前荟萃分析的结果突出了与DD相关的冲动性和外在性格特征域的独特概况。该研究强调了针对药物滥用合并症患者的冲动或负面影响（即负面的紧迫感，低沉迷性）的情绪调节干预措施的重要性。