title: Does early socio-economic disadvantage predict comorbid alcohol and mental health disorders?
abstract: BACKGROUND
  Alcohol and mental health disorders are highly prevalent in the general population, with co-occurrence recognised as a major public health issue. Socio-economic factors are frequently associated with both disorders but their temporal association is unclear. This paper examines the association between prenatal socio-economic disadvantage and comorbid alcohol and mental health disorders at young adulthood.
  
  
  METHODS
  An unselected cohort of women was enrolled during early pregnancy in the large longitudinal Mater-University of Queensland Study of Pregnancy (MUSP), at the Mater Misericordiae Public Hospital in Brisbane, Australia. The mothers and their offspring were followed over a 21 year period. Offspring from the MUSP birth cohort who provided full psychiatric information at age 21 and whose mothers provided socioeconomic information at baseline were included (n=2399). Participants were grouped into no-disorder, mental health disorder only, alcohol disorder only or comorbid alcohol and mental health disorders according to DSM-IV diagnoses at age 21 as assessed by the Composite International Diagnostic Interview. We used multivariate logistic regression analysis to compare associations of disorder group with single measures of prenatal socio-economic disadvantage including family income, parental education and employment, and then created a cumulative scale of socioeconomic disadvantage.
  
  
  RESULTS
  Greater socio-economic disadvantage was more strongly associated with comorbidity (OR 3.36; CI95 1.37, 8.24) than with single disorders. This relationship was not fully accounted for by maternal mental health, smoking and drinking during pregnancy.
  
  
  CONCLUSIONS
  Multiple domains of socio-economic disadvantage in early life are associated with comorbid alcohol and mental health disorders.
authors.affiliation: School of Population Health, The University of Queensland, Public Health Building, Herston Rd, Herston 4006, QLD, Australia. Electronic address: c.salom@uq.edu.au.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Salom
authors.affiliation: School of Population Health, The University of Queensland, Public Health Building, Herston Rd, Herston 4006, QLD, Australia.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.affiliation: School of Population Health, The University of Queensland, Public Health Building, Herston Rd, Herston 4006, QLD, Australia; School of Social Science, The University of Queensland, Michie Building, St Lucia 4072, QLD, Australia.
authors.forename: Jake M
authors.initials: JM
authors.lastname: Najman
authors.affiliation: School of Population Health, The University of Queensland, Public Health Building, Herston Rd, Herston 4006, QLD, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, K Floor, Mental Health Centre, Royal Brisbane & Womens Hospital, Herston 4029, QLD, Australia.
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
mesh_terms: D000437:Alcoholism / Q000453:epidemiology* / Q000209:etiology; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008603:Mental Health; D011203:Poverty; D015995:Prevalence; D011446:Prospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Alcohol; Comorbid; Longitudinal; Mental health; Socioeconomic