title: Stimulant use disorders: characteristics and comorbidity in an Australian population sample.
abstract: OBJECTIVE
  To describe the correlates of stimulant use disorders (abuse, dependence) in an Australian population sample, to compare the characteristics of stimulant users with and without stimulant use disorders and to describe the patterns of service use and help-seeking in people with stimulant use disorders.
  
  
  METHODS
  Data were drawn from the 2007 National Survey of Mental Health and Wellbeing, which sampled 8841 residents of private dwellings in Australia in 2007. Lifetime DSM-IV substance use and mental disorder diagnoses were obtained from interviews conducted by lay interviewers, using the Composite International Diagnostic Interview (CIDI). Socio-demographic, socio-economic and clinical correlates of stimulant use disorders were identified using binary logistic regression models. Stimulant users with and without stimulant use disorders were compared to non-stimulant users via multinomial logistic regression models.
  
  
  RESULTS
  Compared to Australians without stimulant use disorder, people with stimulant use disorders were younger, more likely to be male, of non-heterosexual orientation and born in Australia, but were not more socially disadvantaged. Lifetime comorbidity rates were high: 79% of persons with stimulant use disorders had a lifetime alcohol use disorder, 73% a lifetime cannabis use disorder, and more than one third a lifetime mood or anxiety disorder. Stimulant use disorders were associated with a family history of substance use, affective disorders and psychosis. One in five people with lifetime stimulant use disorders had been imprisoned, homeless or hospitalised for substance or mental health problems, and 13% reported at least one symptom of psychosis. Nearly half had sought help for substance or mental health problems, primarily from General Practitioners (GPs), psychologists or psychiatrists.
  
  
  CONCLUSIONS
  Stimulant use disorders in a representative population sample are associated with significant comorbidity and harm. Many persons with stimulant use disorders had sought care and found this helpful. There is scope for screening and intervention in this group.
authors.affiliation: InforMH, Mental Health and Drug and Alcohol Office, NSW Health, NSW, Australia. GRSara@nsccahs.health.nsw.gov.au
authors.forename: Grant
authors.initials: G
authors.lastname: Sara
authors.forename: Philip
authors.initials: P
authors.lastname: Burgess
authors.forename: Meredith
authors.initials: M
authors.lastname: Harris
authors.forename: Gin S
authors.initials: GS
authors.lastname: Malhi
authors.forename: Harvey
authors.initials: H
authors.lastname: Whiteford
authors.forename: Wayne
authors.initials: W
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000493:pharmacokinetics*; D015897:Comorbidity; D003710:Demography; D017831:Diagnosis, Dual (Psychiatry) / Q000706:statistics & numerical data; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012919:Social Behavior; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology
chemical_list: D000697:Central Nervous System Stimulants