2026 ECNP Congress

EP01-1008

The family factor: examining parental personality disorders in substance use disorders

Haytham Hasan — A. El Rasheed, M. Elhamshary, A. Ashour, D. Nader · Capital University- Faculty of Medicine, Neuropsychiatry, Cairo, Egypt- Arab Rep

2026 ECNP Congress

Background

Substance use disorders (SUDs) represent a major public health concern with substantial psychological, social, and economic consequences affecting both individuals and their families. Accumulating evidence indicates that offspring of individuals with SUDs are at increased risk for a broad spectrum of psychiatric conditions, including mood disorders, anxiety disorders, conduct problems, and substance misuse. Although the direct impact of parental substance use has been widely studied, comparatively less attention has been directed toward the role of co-occurring parental personality disorders (PDs) as a potential contributing factor to this vulnerability. Personality disorders, particularly those within Cluster B, are characterized by emotional dysregulation, interpersonal instability, and maladaptive behavioral patterns, which may negatively influence parenting styles, family cohesion, and the overall developmental environment of children. These dysfunctional dynamics may, in turn, increase susceptibility to substance use and related disorders across generations.

Objectives

This study aimed to determine the prevalence and pattern of personality disorders among biological parents of individuals with substance use disorders, and to examine the association between specific parental personality disorders and the risk of substance dependence in their offspring.

Methods

A matched case-control study design was conducted, including 100 parents of individuals diagnosed with SUDs and 100 parents of healthy controls matched for age, sex, and socioeconomic status. Offspring in the case group were diagnosed according to DSM-IV criteria using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and urine drug screening was performed to confirm recent substance use and identify substances involved. Parents in both groups were assessed using SCID-I to exclude Axis I disorders and the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) to establish personality disorder diagnoses. Sociodemographic and clinical data were systematically collected. Statistical analyses included descriptive statistics, chi-square tests for categorical comparisons, and calculation of relative risks (RR) with corresponding p-values to assess the strength and significance of associations.

Results

Personality disorders were more prevalent among parents of individuals with SUDs compared to controls (34% vs. 24%; RR=1.6, p=0.024). Paternal personality disorders showed a statistically significant association with increased risk of substance dependence in offspring (RR=1.9, p=0.048), whereas the overall association with maternal personality disorders did not reach statistical significance (RR=1.4, p=0.263). However, analysis of specific personality disorders revealed significant group differences. Obsessive-compulsive personality disorder was significantly more common among fathers of individuals with SUDs (p=0.025). Among mothers, both paranoid personality disorder (p=0.045) and borderline personality disorder (p=0.04) were significantly more prevalent in the case group compared to controls.

Conclusions

These findings suggest that parental personality pathology, particularly paternal obsessive-compulsive traits and specific maternal traits such as paranoid and borderline personality features, may contribute to the intergenerational transmission of vulnerability to substance use disorders. Addressing these factors within a family-based framework may enhance prevention and treatment strategies.

References

•El Missiry, A., Sorour, A., Sadek, A., AbdelMawgoud, M., & Asaad, T. Homicide and psychiatric illness: An Egyptian study [MD thesis, Ain-Shams University]. Ain-Shams University, Cairo, 2004. •First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. Structured clinical interview for DSM-IV Axis II disorders – Clinical version (SCID-CV). APA Press, 1997. •First, M. B., Spitzer, R. L., Williams, W., & Gibbon, M. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) – Clinician version. American Psychiatric Press, 1996. •Fonagy, P., & Bateman, A. Parenting and personality disorder: Clinical and child protection implications. British Journal of Psychiatry Advances. 2019; 25, 327–335. •Hatata, H., Khalil, A., Asaad, T., Abo Zeid, M., & Okasha, T. Dual diagnosis in substance use disorders [MD thesis, Faculty of Medicine, Ain-Shams University]. Ain-Shams University, Cairo, 2004. •Kendler, K. S., Ohlsson, H., Sundquist, J., & Sundquist, K. Offspring of parents with alcohol use disorder: Psychiatric risks. American Journal of Psychiatry. 2024; 181, 322–9. •Lingiardi, V., & Gazzillo, F. Cluster B disorders and drug addiction. Frontiers in Psychology. 2014; 5, 1234–42. •Träskman, M., Lundberg, M., Eklund, P., Ståhlberg, O., Andersson, M., Eriksson, A., et al. Psychiatric risk in offspring of parents with SUD. Journal of Psychiatry. 2019; 62, 190–8. •Würn, S., Seitz, K., Becker, T., Müller, B., Krieger, T., Reininghaus, U., et al. Parental Cluster B symptoms and child social skill development. European Child & Adolescent Psychiatry. 2022; 31, 1025–34.