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Substance Disorders (substance + disorders)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey

ADDICTION, Issue 6 2010
Joel Swendsen
ABSTRACT Aims The comorbidity of mental disorders and substance dependence is well documented, but prospective investigations in community samples are rare. This investigation examines the role of primary mental disorders as risk factors for the later onset of nicotine, alcohol and illicit drug use, abuse and dependence with abuse. Design The National Comorbidity Survey (NCS) was a nationally representative survey of mental and substance disorders in the United States carried out in 1990,92. The NCS-2 re-interviewed a probability subsample of NCS respondents in 2001,03, a decade after the baseline survey. Participants A total of 5001 NCS respondents were re-interviewed in the NCS-2 (87.6% of baseline sample). Results Aggregate analyses demonstrated significant prospective risks posed by baseline mental disorders for the onset of nicotine, alcohol and illicit drug dependence with abuse over the follow-up period. Particularly strong and consistent associations were observed for behavioral disorders and previous substance use conditions, as well as for certain mood and anxiety disorders. Conditional analyses demonstrated that many observed associations were limited to specific categories of use, abuse or dependence, including several mental disorders that were non-significant predictors in the aggregate analyses. Conclusions Many mental disorders are associated with an increased risk of later substance use conditions, but important differences in these associations are observed across the categories of use, abuse and dependence with abuse. These prospective findings have implications for the precision of prevention and treatment strategies targeting substance use disorders. [source]

Socio-demographic risk factors for alcohol and drug dependence: the 10-year follow-up of the national comorbidity survey

ADDICTION, Issue 8 2009
Joel Swendsen
ABSTRACT Aims Continued progress in etiological research and prevention science requires more precise information concerning the specific stages at which socio-demographic variables are implicated most strongly in transition from initial substance use to dependence. The present study examines prospective associations between socio-demographic variables and the subsequent onset of alcohol and drug dependence using data from the National Comorbidity Survey (NCS) and the NCS Follow-up survey (NCS-2). Design The NCS was a nationally representative survey of the prevalence and correlates of DSM-III-R mental and substance disorders in the United States carried out in 1990,2002. The NCS-2 re-interviewed a probability subsample of NCS respondents a decade after the baseline survey. Baseline NCS socio-demographic characteristics and substance use history were examined as predictors of the first onset of DSM-IV alcohol and drug dependence in the NCS-2. Participants A total of 5001 NCS respondents were re-interviewed in the NCS-2 (87.6% of baseline sample). Findings Aggregate analyses demonstrated significant associations between some baseline socio-demographic variables (young age, low education, non-white ethnicity, occupational status) but not others (sex, number of children, residential area) and the subsequent onset of DSM-IV alcohol or drug dependence. However, conditional models showed that these risk factors were limited to specific stages of baseline use. Moreover, many socio-demographic variables that were not significant in the aggregate analyses were significant predictors of dependence when examined by stage of use. Conclusions The findings underscore the potential for socio-demographic risk factors to have highly specific associations with different stages of the substance use trajectory. [source]

Mothers' maximum drinks ever consumed in 24 hours predicts mental health problems in adolescent offspring

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 9 2010
Stephen M. Malone
Background:, The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcohol, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with externalizing disorders in general. In a previous study we found that the maximum number of drinks fathers had ever consumed in 24 hrs was associated with externalizing behaviors and disorders in preadolescent and adolescent children. The purpose of the present study was to determine whether maternal maximum consumption has similar correlates. Method:, We examined associations between maternal maximum consumption and alcohol dependence, respectively, and disruptive disorders and substance-related problems in two large independent population-based cohorts of 17-year-old adolescents. Results:, Maximum consumption was associated with conduct disorder, disruptive disorders in general, early substance use and misuse, and substance disorders in adolescent children regardless of sex. Associations were consistent across cohorts, providing internal replication. They also paralleled our previous findings regarding paternal status. They could not be explained by maternal alcohol dependence, effects of drinking during pregnancy, or paternal maximum consumption. They were not simple artifacts of the fact that maximum consumption is a continuous measure while alcohol dependence is dichotomous. Conclusions:, Despite deriving from a single question about lifetime behavior, parental maximum consumption appears to reflect vulnerability for mental health problems, especially substance-related ones, more directly than a diagnosis of alcohol dependence. [source]

Diagnosing comorbidity: concepts, criteria, and methods

ACTA NEUROPSYCHIATRICA, Issue 1 2004
S. Samet
Background:, The clinical and etiologic implications of comorbid psychiatric and substance-use disorders are relevant across countries and cultures. The DSM-IV now places greater emphasis on the clinical and research utility of the substance-induced disorders classification, and clarifies several important diagnostic issues specific to primary and substance-induced disorders. However, no research consensus exists over the core problem of identifying and differentiating the drug and alcohol intoxication and withdrawal symptoms that can mimic psychiatric symptoms in heavy drinkers and drug users. Objective:, To investigate how various diagnostic instruments have measured comorbid psychiatric and substance-use disorders and how each instrument operationalizes the DSM-IV classification. Method:, We review the evolution of the concept of comorbidity beginning with its formalization as the ,primary,secondary' distinction in the Feighner Criteria. We address the ,organic,non-organic' distinction found in the RDC, DSM-III, and DSM-III-R; and finally, review the ,primary' and ,substance-induced' categories of DSM-IV, DSM-IV-TR and ICD-10. We describe how these distinctions have been operationalized in widely used diagnostic instruments. Conclusion:, Further understanding of these classifications and the rela-tionship of co-occurring psychiatric and substance disorders can be accom-plished with the range of available measures, particularly the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), which reliably utilizes and refines DSM-IV classification distinctions. [source]