Substance misuse and psychiatric comorbidity: an overview of the OPCS National Psychiatric Morbidity Survey

Abstract

There have been a number of national surveys of psychiatric morbidity, which have included questions on drugs, alcohol, and tobacco. These surveys have helped delineate the overlap between substance use and dependence and other psychological morbidity. There is a strong association reported between high substance consumption and other measures of psychological problems. This article provides an overview of a national household survey, a survey of institutional residents with psychiatric disorders, and a national survey of a homeless population. All three surveys used comprehensive and complex sampling strategies and lay interviewers to conduct structured diagnostic interviews. The household survey included over 10,000 households, the institutional survey interviewed 755 individuals, and the homeless survey of hostels, night shelters, day centres, and private sector leased accommodation interviewed 1,061 individuals. This overview looks at patterns of nicotine, alcohol, and other drug use in the different samples and examines interactions with other psychiatric morbidity. The survey reports that substance-related disorders are some of the commonest disorders in the community, with 5% of the household sample alcohol dependent, 7% alcohol dependent in the institutional sample and over 21% in the homeless sample recorded as alcohol dependent. Tobacco, alcohol and other drug use and dependence were dramatically higher in the homeless sample than in either of the other two samples. Substance use was significantly associated with higher rates of psychological morbidity as measured by the Clinical Interview Schedule Revised. Future service planning needs to take account of the striking disparity of prevalence of psychiatric disorders in different subsections of the population.

Psychoactive substance use and perception of mental health status in inmates of two Portuguese prisons

“…However, other studies have concluded the opposite: substance abuse is associated with worse mental health, following epidemiological or clinical diagnostic criteria (Cuijpers, Smit, Have, & de Graaf, 2007;Farrell et al, 2003;Martínez-Ortega, Jurado, Martínez-González, & Gurpegui, 2006;Regier et al, 1990). However, an important difference between those studies and the present one is that the mental health was self-rated by the prisoners in the current study.…”

Metabotropic glutamate receptor mGluR2/3 and mGluR5 binding in the anterior cingulate cortex in psychotic and nonpsychotic depression, bipolar disorder and schizophrenia: implications for novel mGluR-based therapeutics

“…3,7,[40][41][42] Although our study provides valuable information on these binding sites in psychiatric pathology, additional studies examining binding specifically to membranous mGluR2/3 and mGluR5 and the affinity of novel mGluR2/3-and mGluR5-targeting drugs for these receptors in psychiatric disorders will provide valuable insight into the effectiveness of these drugs in the patient. 33 One confound of postmortem studies in neuropsychiatric disorders, is the presence of comorbid substance abuse, especially alcohol and drug abuse, or at least substantially higher alcohol 43 and illicit drug 44 intake in patients with psychiatric disorders. While reliable quantitative patient histories were not available in the present study, mGluR1/5 densities in the prefrontal cortex may be affected by alcohol, 45 and mGluR2 gene expression was reported to be reduced in the ACC of patients with alcohol addiction.…”

Prevalence of Co-Occurring Substance Use and other Mental Disorders in the Canadian Population

“…Since then, numerous surveys have assessed the epidemiology of comorbidity internationally. [5][6][7][8][9][10][11][12][13][14][15][16][17] Several common themes have emerged from this work. First, relative to those without SUDs, people with SUDs have elevated rates of co-occurring Axis I and II disorders, and vice versa.…”