title: Influence of comorbid alcohol and psychiatric disorders on utilization of mental health services in the National Comorbidity Survey.
abstract: OBJECTIVE
  This study sought to determine how comorbidity of psychiatric and substance abuse disorders affects the likelihood of using mental health services.
  
  
  METHODS
  The analysis was based on data on adults aged 18-54 years in the National Comorbidity Survey (N = 5,393). Users and nonusers of mental health and substance abuse services were compared in terms of their demographic characteristics, recent stressful life events, social support, parental history of psychopathology, self-medication, and symptoms of alcohol abuse/dependence.
  
  
  RESULTS
  The prevalence of service utilization varied by diagnostic configurations. Comorbid psychiatric or alcohol disorders were stronger predictors of service utilization than a pure psychiatric or alcohol disorder. Factors predicting utilization of services differed for each disorder.
  
  
  CONCLUSIONS
  Since comorbidity increases the use of mental health and substance abuse services, research on the relationship of psychiatric and alcohol-related disorders to service utilization needs to consider the coexistence of mental disorders. Attempts to reduce barriers to help seeking for those in need of treatment should be increased.
authors.affiliation: Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, USA.
authors.forename: L T
authors.initials: LT
authors.lastname: Wu
authors.forename: A C
authors.initials: AC
authors.lastname: Kouzis
authors.forename: P J
authors.initials: PJ
authors.lastname: Leaf
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D011336:Probability; D044469:Racial Groups; D012737:Sex Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology