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BEDREHELSE-Bedre helse og livskvalitet

Pathways from Normal and Disordered Personality to Substance Use Disorders

Awarded: NOK 4.7 mill.

The main aim of the project is to study the relationship between normal personality, patholigical personality traits, and personality disorders and symptoms of licit and illicit substance use and use disorders in a population-based twin study. Twin studies are well suited to investigate casual mechanisms. We have previously measured various mental health symptoms in more than 8000 twins. In 2800 of these, DSM-IV mental disorders and personality disorders were assessed using structured interviews. Approximately 10 years later, selected mental disorders including personality disorders were re-investigated in approximately 2300 twins. The participation was very good (about 85%) Normal personality and pathological personality traits (according to DSM-5) have also been assessed. We have enriched the dataset even further, by collecting additional information (questionnaire based) on licit and illicit substance use and symptoms of use disorders for caffeine, alcohol, nicotine and cannabis and other illicit drugs more than ten years later. In addition to this we have identified substance use disorders in the Primary health care and Specialized health services by linking the MoBa dataset to the Control and payment of health mergers (KUHR) and to the Norwegian Patient Registry (NPR). The Norwegian Prescription database will be used to identify use and absuse of prescription drugs. Data from the registries at Statistics Norway has provided objective information on demographics, socioeconomic status and psychosocial dysfunction, as well as diagnoses of mental disorders in connection with sick leave and disability pension. In collaboration with Virginia Institute for Psychiatric and Behavioral Genetics we will apply state-of-the-art genetic epidemiological methods to explore the complex longitudinal relationship between normal personality, pathological personality traits and personality disorders and how this is associated with substance initiation and transition to symptoms of substance use disorders. We have also studied how mental disorders including substance use disorders is associated with the use of primary and specialist health care. The results have been published in a number of papers in well known international journals and lectures in national and international scientific meetings. We will also use population-based registry information to evaluate consequences of substance use and use disorders.

Resultatene kan forventes å ha og betydning for forståelsen av forholdet mellom personlighet og personlighetsforstyrrelser og rusmiddelslidelser. Dette vil gi klinikere en indikasjon på hvilke personlighetstrekk det er viktig å konsentrere seg om å evaluere ved mistanke om rusproblemer eller lidelser og vice versa. Resultatene vil også kunne få betydning for vår måte å klassifisere personlighetsforstyrrelser på. Klassifiseringen er preget av kontroverser noe som reflekteres i alternative forslag til klassifisering i DSM-5. På den ene side et tradisjonelt alternativ med kategorielle diagnoser, identisk med den tidligere klassifiseringen, og en alternativ dimensjonal modell. Studien viser at det eksisterer et betydelig felles genetisk grunnlag for de to nivåene. Personlighetsforstyrrelser kan ikke bare betraktes som ekstreme varianter av normal personlighet, men en betydelig del av det genetiske grunnlaget for personlighetsforstyrrelser ikke er felles med domene for normal personlighet.

The main aim of the project is to study the relationship between personality and personality pathology and symptoms of licit and illicit substance use and use disorders in a genetically informative population-based dataset. Twin studies are well suited to address the etiological mechanisms underlying this relationship. We have previously measured various mental health symptoms in more than 8000 twins. In 2800 of these, DSM-IV common mental disorders and personality disorders were assessed using structure d interview. Approximately 10 years later, selected mental disorders including personality disorders were re-assessed in 2300 twins. We now propose to enrich this dataset even further, by collecting additional information on licit and illicit substance us e and symptoms of use disorder for caffeine, alcohol, nicotine, cannabis. We will also include questions about use of other illicit drugs. In addition to this we propose to identify substance use disorders by linking the dataset to the Norwegian Patient R egistry. The Norwegian Prescription database will be used to identify misuse of prescriptions and thus serves as a proxy for substance use disorder. Finally we will link the data to registries at Statistics Norway, providing objective information on demog raphics, socioeconomic status and psychosocial dysfunction measured as sick leave and disability. In collaboration with Virginia Institute of Psychiatric and Behavioral Genetics we will apply state-of-the-art genetic epidemiological methods to explore the complex longitudinal relationship between dysfunctional personality traits and substance initiation and transition to symptoms of substance use disorders. We will also use population- based registry information to evaluate consequences of substance use a nd use disorders.

Publications from Cristin

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Funding scheme:

BEDREHELSE-Bedre helse og livskvalitet