Comorbidity between patterns of substance use dependence and psychiatric syndromes.
BACKGROUND
Comorbidity of dependence on single and multiple drugs with psychiatric syndromes was examined in national samples from the National Household Survey on Drug Abuse (NHSDA).


METHODS
Subjects are adults from the l994, l995 and l996 NHSDA surveys. Proxy measures of drug dependence in the last year were constructed from five dependence symptoms that approximated DSM-IV criteria. Measures of patterns of concurrent dependence on cigarettes, alcohol and illicit drugs were constructed. Fallible indicators of a major depressive episode and any anxiety disorder (generalized anxiety disorder, agoraphobia and panic attack) were based on scales measuring symptoms during the last year. Comorbidity was estimated by adjusted odds ratios.


RESULTS
Probable drug dependent individuals have higher rates of psychiatric syndromes. Rates of psychiatric syndromes were similar for those uniquely dependent on alcohol, cigarettes or illicit drugs (adjusted odds ratios approximately 2.0). Rates almost doubled for those dependent on both an illicit and a licit drug.


CONCLUSIONS
Individuals uniquely dependent on a single drug class experience similar rates of psychiatric morbidity. All those dependent on illicit drugs experience higher rates of psychiatric syndromes. This reflects the additive association of dependence on legal and illegal drugs with psychiatric disorders and the increased rates of dependence on a legal drug among those dependent on an illicit drug. Individuals with multiple dependencies on legal and illegal drugs have the highest need for mental health services.
Kandel
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DB
Columbia University School of Medicine, College of Physicians and Surgeons, Department of Psychiatry 1051 Riverside Dr., Unit 20, New York 10032, USA. dbk2@columbia.edu
Huang
F Y
FY
Davies
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States
D013287:Illicit Drugs