One hundred consecutive admissions to an intensive outpatient cocaine treatment clinic in Camden, Nf, were assigned DSM-IH-R Axis I and II psychiatric diagnoses by means of the FCID. Prevalence rates for non-substance-use Axis I disorders were equivalent to expected population base rates. By far the most common diagnoses were on Axis II (73% of subjects), with over one-third of subjects receiving more than one personality disorder diagnosis, frequently crossing DSM-III-R “clusters.” In the distribution of psychopathology, certain gender differences were noted. The authors discuss implications for the clinical management and treatment of cocaine-addicted individuals in urban environments.