Comorbidity of substance use disorders and other psychiatric disorders among adolescents: Evidence from an epidemiologic survey

Abstract

This paper extends our knowledge of comorbidity of substance use disorders (SUDs) and other psychiatric disorders by examining comorbidity of specific types of SUDs and risk of comorbidity separately for abuse and dependence. The research question is whether there is specificity of risk for comorbidity for different SUDs and whether greater comorbidity is associated with dependence. Data are presented from a probability sample of 4,175 youths aged 11-17 assessed with the NIMH DISC-IV and self-administered questionnaires. SUDs outcomes are alcohol, marijuana and other substances in past year. Mean number of other comorbid disorders ranged from 1.9 for marijuana abuse to 2.2 for other substance abuse and 1.9 for marijuana dependence to 2.8 for other substance dependence. None of the abuse SUDs does not increase risk of anxiety disorders, but dependence does. Both abuse and dependence increased risk of comorbid mood disorders. Similar results were observed for disruptive disorders. Patterns of comorbidity varied by substance, by abuse versus dependence, and by category of other psychiatric disorders. In general, there was greater association of comorbidity with other disorders for dependence vs. abuse. Marijuana is somewhat less associated with other disorders than alcohol or other substances. The strongest association is for comorbid disruptive disorders, regardless of SUD category. Having SUDs and comorbid other psychiatric disorders was associated with substantial functional impairment. Females with SUDs tended to have higher rates of comorbid disorders, as did older youths. There were no differences observed among ethnic groups. When comorbidity of SUDs with other disorders was examined, controlling for other non-SUDs disorders for each specific disorder examined, the greater odds for dependence versus abuse essentially disappeared for all disorders except disruptive disorders, suggesting larger number of comorbid non-SUDs in part account for the observed effects for dependence.

Patterns of substance use in adolescents attending a mental health department

“…In line with previous reports [5,11,21], the only primary diagnosis significantly related with a risky or problematic substance use was CD. Accordingly, after controlling for age in the multivariate logistic regression, youth self-reports of symptoms also showed significant differences for aggressive, delinquent, and global externalizing symptoms.…”

“…In adolescents with psychiatric disorders, rates of comorbidity with SUD vary from 11 to 70% depending on the setting (primary care vs. clinical or legal settings; drug vs. psychiatric service, outpatient vs. inpatient), the type of drug (legal vs. illegal) and the type of SUD (abuse vs. dependence) [5,6]. Most of the studies in this field have been conducted with inpatients or severely impaired psychiatric patients [7][8][9], with rates of SUD reported at between 60 and 70%.…”

Youth Services System Review: Moving From Knowledge Gathering to Implementation Through Collaboration, Youth Engagement, and Exploring Local Community Needs

“…Problematic substance use can have long term impacts for youth, and is often complicated by co-occurring mental health concerns, increasing the risk for negative health and life outcomes (Grella, Hser, Joshi, & Rounds-Bryant, 2001;Roberts, Roberts, & Xing, 2007;Storr, Pacek, & Martins, 2012;Vida et al, 2009). Adolescence and emerging adulthood are challenging periods of transition and change; unmet need for mental health and substance use services can interfere with developmentally salient domains including education, work, and relationships (Goodman, Henderson, Peterson-Badali, & Goldstein, 2015;MacLeod & Brownlie, 2014).…”

Association of psychiatric morbidity with quality of life among late adolescent girls: exploring the iceberg

“…However, if we consider the prevalence of psychiatric disorders in adolescent age group which ranges from 10-19 years, with the available studies (both done in India and other countries) it is seen that the prevalence of overall psychiatric morbidity ranges from 6.7% to 31.2%. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] This difference in the prevalence can be attributed to the inherent nature of the psychiatric disorders, the existence of stigma due to which eliciting history becomes difficult, differences in diagnostic tools used, recall bias, differences in the definition that is used to define the cases and the differences in sampling methods. The difference can also be attributed to the varying age groups, and the inclusion of both sexes in most of the studies.…”