Comorbidity of psychiatric and substance use disorders in the United States

Hasin, Deborah S.; Kilcoyne, Bari

doi:10.1097/yco.0b013e3283523dcc

Cited by 112 publications

(72 citation statements)

References 43 publications

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“…Those with comorbidity are also likely to be an important subgroup for prognosis or treatment response. Comorbidity is, unfortunately, the “norm” in psychiatric diagnosis [43, 44]. It clouds clinical taxonomic systems and complicates research.…”

Section: The Prevalence Of Aud In Pd and Pd In Audmentioning

confidence: 99%

Personality Disorder and Alcohol Use Disorder: An Overview

Newton‐Howes

Foulds

2018

Psychopathology

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Background: Clinically, personality disorder (PD) commonly coexists with alcohol use disorder (AUD), although within mainstream mental health services both of these mental disorders are routinely overlooked. Despite a rich literature examining the interactions between AUD and personality functioning, personality traits, and PD, there remains conflicting evidence as to the degree of association and impact of one on the other. Methods: A narrative review and a synthesis of the literature were done. Results: The lifetime prevalence of AUD approaches 50% in some PD populations. The rates of PD in AUD populations are less clear but likely similar. Personality influences outcomes in AUD regardless of whether a categorical personality diagnosis or dimensional trait domain approach is taken. There are, however, no good data to inform clinicians on the impact of AUD on the outcomes of PD. Understanding the extent of this impact is complicated by the multiple tools used for diagnosis (of both PD and AUD) and the statistical methods used. Overall, caution is required in interpreting the data due to the quality of the current literature; however, comorbidity between the two disorders is likely significant and the impact of PD on AUD outcomes is sufficient to require consideration. Conclusions: From a research perspective, better agreement on both diagnoses and outcomes is urgently needed to improve the overall quality of the evidence. Clinically, despite the limitations in the literature, it is unacceptable for PD services to ignore AUD and for AUD services not to screen for PD. Both are likely to have an impact on health and functioning and should be considered in routine reviews. A better conceptualization of the putative mechanisms of this interaction, as well as an understanding of the neurobiology and reasons for the impact on treatment outcomes, will help to move the field forward.

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Section: The Prevalence Of Aud In Pd and Pd In Audmentioning

confidence: 99%

Personality Disorder and Alcohol Use Disorder: An Overview

Newton‐Howes

Foulds

2018

Psychopathology

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“…La coexistencia de trastornos por consumo de sustancias (TCS) con otros trastornos psiquiátricos (OTP), también conocida como Patología Dual (PD) (Szerman et al, 2013), ha sido ampliamente documentada desde los años 80, con los estudios de epidemiología psiquiátrica de tercera generación (Borges, Medina-Mora, & López-Moreno, 2004;Hasin & Kilcoyne, 2012;Hasin, Nunes, & Meylan, 2004;Kessler et al, 2004), que marcan un nuevo paradigma en la categorización de los trastornos mentales y sus comorbilidades. Aunque esto ha permitido avances en la comprensión de este fenó-meno, los grandes estudios epidemiológicos en psiquiatría se basan en encuestas realizadas en hogares y población universitaria (Grant & Dawson, 2006;Kessler et al, 2004;Demyttenaere et al, 2004), lo que limita el conocimiento sobre la salud mental en poblaciones marginadas (por ejemplo indigentes, reclusos, migrantes y refugiados) (Baxter, Patton, Scott, Degenhardt, & Whiteford, 2013).…”

Section: Introductionunclassified

Patología dual en poblaciones especiales: una revisión narrativa

Szerman¹,

Marín-Navarrete²,

Fernández-Mondragón³

et al. 2015

RIIAD

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RESUMENIntroducción: la patología dual se refiere a la concurrencia de un trastorno por consumo de sustancias con otro trastorno psiquiátrico. Estudios epidemiológicos en población general reportan una alta prevalencia de patología dual. Sin embargo, la información disponible sobre el tema en poblaciones especiales es limitada. Objetivo: revisar la evidencia disponible sobre la epidemiología, la atención y los aspectos relevantes para la salud pública acerca de la patología dual en las siguientes poblaciones especiales: personas en situación de indigencia, en prisión, con VIH, VHB y VHC, mujeres y adultos mayores. Método: búsqueda en bases de datos bibliográficos (PubMed, Science Direct, EBSCO y OVID) de reportes de investigación enfocados en la prevalencia y el tratamiento de patología dual en las poblaciones mencionadas. Resultados: la prevalencia de la patología dual se presenta de manera diferenciada en estas poblaciones, en comparación con la población general; además está altamente asociada con mayores tasas de morbilidad y mortalidad. La mayoría de los estudios específicos sobre patología dual y las poblaciones especiales, tanto de epidemiología como de tratamientos, se ha realizado en países de alto ingreso. Discusión y conclusiones: se requiere de políticas públicas que contemplen la medición epidemiológica de la patología dual en estas poblaciones, sobre todo en países de mediano y bajo ingreso, e incluyan intervenciones integradas adecuadas a las necesidades específicas de cada población.Palabras clave: patología dual; grupos minoritarios; epidemiología; revisión. ABSTRACTBackground: dual disorders is a term that refers to the co-occurrence of a substance use disorder with other mental disorders. Epidemiological studies have reported a high prevalence of dual disorders in the general population. However, information on dual disorders in special population is limited. Objective: to give an overview of the available evidence on the epidemiology, care and other relevant aspects for public health of dual disorders in the following special populations: homeless, prison inmates, people with sexually-transmitted infections, and the elderly. Method: search in peer-review publication databases (PubMed, Science Direct, EBSCO and OVID) for research reports on the epidemiology and treatment of dual pathology in the aforementioned populations. Results: prevalence of dual disorders in these populations appears to be different than in the general population; and it is highly associated with higher mortality and morbidity rates. The majority of studies aimed specifically on the epidemiology and treatment of dual disorders and special populations has been conducted in high-income countries. Discussion and conclusions: there is a need for public policies that consider the epidemiological assessment of dual disorders in special populations, specially in low-and middle-income countries, and include integrated care interventions adequate to the specific needs of each population.

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“…Both epidemiological [1,2] and clinical [3,4] studies have reported that individuals diagnosed with severe mental illness (SMI) are more prone to substance use than are people without SMI. Individuals diagnosed with SMI are also at greater risk of hospitalization, homelessness and suicide [5], and experience more adversity in different arenas throughout life [6,7].…”

Section: Introductionmentioning

confidence: 99%

Searching for Sobriety: How Persons with Severe Mental Illness Experience Abstaining from Substance Use

Pettersen

Ruud²,

Ravndal³

et al. 2014

J Addict Res Ther

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Individuals diagnosed with severe mental illness (SMI) are more vulnerable to substances than are other people. Many people with SMI tend to attain full remission of their substance use, but others relapse frequently. There is more research on the reasons for substance use than on the reasons for abstaining among these individuals. Information from the latter may contribute to a better understanding of how individuals with SMI experience abstaining from substance use. Objective: The aim of this explorative study was to examine experiences of abstaining from substances of persons diagnosed with SMI. We examined both the reasons given and the requirements and strategies used when abstaining. Methods:A qualitative study with semi-structured interviews was conducted, and a descriptive and explorative design was applied. This study included a purposeful sample of 11 patients with SMI and substance use being treated by assertive community treatment teams. Results:The main reasons for quitting substance use were social relationships and meaningful activities. The stated requirements and strategies used in the search for sobriety were detachment towards people and places, positive thinking, controlling feelings and emotions, and fear of dependency. Conclusion:Our results are consistent with those from other qualitative studies on the importance of social relationships and meaningful activities as expressed reasons for abstaining. The strategy of actively avoiding a former adverse milieu to reach sobriety is consistent with findings from one similar study. The strategies of fear of adverse consequences, positive thinking, and controlling feelings and emotions found in the present study have not been reported by other qualitative studies.

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Comorbidity of psychiatric and substance use disorders in the United States

Cited by 112 publications

References 43 publications

Personality Disorder and Alcohol Use Disorder: An Overview

Personality Disorder and Alcohol Use Disorder: An Overview

Patología dual en poblaciones especiales: una revisión narrativa

Searching for Sobriety: How Persons with Severe Mental Illness Experience Abstaining from Substance Use

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