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Personality disorder and alcohol treatment outcome: systematic review and meta-analysis

  • Giles M. Newton-Howes (a1), James A. Foulds (a2), Nicola H. Guy (a1), Joseph M. Boden (a3) and Roger T. Mulder (a4)...

Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes.


To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD.


We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies.


Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall.


Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area.

Corresponding author
Giles Newton-Howes, Department of Psychological Medicine, University of Otago, 23 Mein Street, Wellington, New Zealand. Email:
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Declaration of interest


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Personality disorder and alcohol treatment outcome: systematic review and meta-analysis

  • Giles M. Newton-Howes (a1), James A. Foulds (a2), Nicola H. Guy (a1), Joseph M. Boden (a3) and Roger T. Mulder (a4)...
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