Self-reported psychotic disorders among Individuals with substance use disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions.
OBJECTIVE
Comorbidity of substance use disorders (SUDs) and psychotic disorders (PDs) presents many challenges in diagnosis and treatment. Most reports to-date focus on the prevalence of SUDs among clinical populations of patients with PDs, and there is a lack of data pertaining to rates of PDs among individuals with substance use and SUDs.


METHODS
We analyzed data on 43,093 respondents age 18 and above from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative US survey (Wave 1, 2001-2002). Cross-tabulations were used to derive prevalence estimates of PDs among individuals with 12-month substance use or SUDs across 10 categories of substances. Odds ratios (ORs) were derived from bivariate logistic regression analyses to examine the relationships between lifetime PDs and 12-month substance use or SUDs for the specific categories of substances.


RESULTS
Among individuals with 12-month substance use, prevalence of PDs was found to be elevated in 8 of 10 categories of substances, particularly among amphetamine (OR = 8.8) and cocaine (OR = 10.3) users compared to nonusers. Among individuals with SUDs, prevalence of PDs was elevated in 9 of 10 categories of substances compared to individuals without SUDs.


CONCLUSIONS
Our findings on the increased rates of PDs among substance users and individuals with SUDs across a wide range of substances emphasize the importance of screening for PDs while treating patients with substance use and SUDs. This may allow for early intervention and adequate referral to appropriate settings.
Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. saul_levran@camh.net
Shaul
S
Lev-Ran
Sameer
S
Imtiaz
Bernard
B
Le Foll
D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D057566:Self Report; D019966:Substance-Related Disorders / Q000453:epidemiology*