The increasing attention given to dual diagnosis does not correlate with well defined and consensual therapeutic interventions. This issue is particularly evident in the case of comorbid severe personality disorders with clear indication for psychotherapy.

To report a case of comorbid borderline personality disorder and alcohol abuse disorder, underlining the impact of dysfunctional personality traits in a specific dangerous pattern of alcohol abuse. To present and discuss a combined psychotherapeutic and pharmocotherapeutic approaches in a dual diagnosis case.

Case study and review of the literature.

A 37 year old woman with a history of alcohol abuse and self-destructive behaviour was referred to an alcohol treatment unit. She had a personal history of childhood parental sexual abuse, alcohol abuse since adolescence and a high risk self-destructive behaviour. A brief psychotherapeutic intervention (weekly 4 months sessions) was started, along with treatment as usual (psychiatric consultation and psychopharmacological treatment). The psychotherapeutic intervention (Person-Centered therapy) focused on her relational difficulties, corresponding to her request - “dealing with unresolved issues in my life”. After the psychotherapeutic intervention, she was able to stop the episodes of alcohol abuse and to reorganize her life at several levels.

Choosing a psychotherapeutic and pharmacological approach for comorbid addiction disorder and personality disorder cases, presents difficulties due to lack of empirical evidence on dual diagnosis treatment. This case of combined psychotherapeutic and pharmacotherapeutic interventions had acknowledged success, in contrast to several prior treatment attempts focused mainly on the alcohol use disorder.