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This study aims to disentangle the relationship between childhood adverse experiences (CAE), personality disorders (PDs) and substance use disorders (SUDs), in patients attending an Italian addiction service. Materials and Methods: A cross-sectional naturalistic study of 320 consecutive outpatients. Participants were evaluated by a semi-structured interview including the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse questionnaire). Multivariate Logistic Regression analyses were used to estimate Odds Ratio (OR) and 95% Confidence Intervals (95%CI). Results: 65.5% of the sample experienced some kind of CAE (living in an institution before age 17; suffering of physical punishment; being separated from parents) and the prevalence rate of PDs was 62.2%. PDs were associated with a history of physical punishment in childhood: OR (95% CI)=1.82 (1.05-3.16), p=0.034, and with childhood institutionalization: OR (95% CI)=2.15 (1.02-4.54), p=0.041. Three adverse events together increase the probability of Cluster B PD: OR (95% CI)=5.92 (2.21-15.92), p=0.001. Conclusion: In outpatients with SUDs, PDs are related to CAE. Regardless of drugs use, CAE have substantial effects on personality development and occupational functioning.

Childhood Adverse Experiences and Personality Disorders in Outpatients with Addiction