title: The association between psychopathology and substance use: adolescent and young adult substance users in inpatient treatment in Cape Town, South Africa.
abstract: BACKGROUND
  Evidence suggests that comorbid psychopathology can negatively affect treatment outcomes in substance users. In South Africa, limited information exists regarding the prevalence, nature and role of psychiatric comorbidity in substance users. This study examined psychiatric comorbidity and its association with specific substance use, and young adult substance users in treatment for substance use.
  
  
  METHODS
  Male and female inpatient substance users (n=95; ages 17-30 years) were sampled consecutively in order of admission from three clinics in Cape Town. An interview schedule was administered to elicit patients' sociodemographic and substance use history details. The computer-assisted Diagnostic Interview Schedule DSM IV (C-DIS IV) was administered to screen patients for current psychiatric disorders.
  
  
  RESULTS
  The sample was largely male, Coloured, Muslim and single. Cannabis (51.6%) and crystal methamphetamine (17.9%) were the most common first substances of use. Heroin (53.7%) and crystal methamphetamine (33.7%) were the most common substances for which treatment was sought (primary substances). The most common comorbid psychopathologies were anti-social personality disorder (ASPD 87.4%) and conduct disorder (CD 67.4%). Regression analyses showed a marginally significant association between specific phobia and first use of cannabis, but indicated no statistically significant associations between psychopathology and substance use.
  
  
  CONCLUSIONS
  The results demonstrated a high proportion of previously unidentified comorbid psychopathology in inpatient substance users. Further research is needed to investigate psychiatric comorbidity in inpatient substance users.
authors.affiliation: Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa ; School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Amina
authors.initials: A
authors.lastname: Saban
authors.affiliation: Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa ; Deceased.
authors.forename: Alan
authors.initials: A
authors.lastname: Flisher
authors.affiliation: Biostatistics Unit, Medical Research Council, Cape Town, South Africa.
authors.forename: Ria
authors.initials: R
authors.lastname: Laubscher
authors.affiliation: School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Leslie
authors.initials: L
authors.lastname: London
authors.affiliation: Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa.
authors.forename: Neo
authors.initials: N
authors.lastname: Morojele
mesh_terms: D000293:Adolescent; D000328:Adult; D003936:Diagnosis, Computer-Assisted; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012044:Regression Analysis; D013019:South Africa / Q000453:epidemiology; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D055815:Young Adult
keywords: Comorbidity; psychopathology; substance use treatment