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Lifetime psychiatric comorbidity with substance use disorders: Does healthcare use modify the strength of associations ?

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Abstract

Background

The frequent psychiatric comorbidity among subjects with a substance use disorder (SUD) can be explained by an increased vulnerability to problematic drug use among subjects with a non-substance-related psychiatric disorder (NSRPD). The care of this disorder should then reduce the likelihood of a secondary SUD.

Objective

To examine how healthcare use for psychological symptoms modifies the lifetime association between SUD and NSRPD.

Methods

Two hundred and twenty four students were evaluated for mental disorders and healthcare use. Mental disorders were assessed with the Mini-International Neuropsychiatric Interview (MINI). Healthcare use included consultations with a general practitioner (GP), a psychiatrist or a psychologist. The lifetime occurrence of a SUD was analysed by lifetime number of NSRPD and healthcare use for psychological symptoms. Analyses were adjusted on gender, university affiliation, living environment and temperament and character dimensions.

Results

Compared to subjects without NSRPD, those with at least two NSRPD who did not use healthcare were more likely to have had a lifetime SUD (ÔR = 3.9). By contrast, those who had only one NSRPD seemed to be as likely as those with no NSRPD to have had a SUD.

Discussion

These results suggest a decreased probability of SUD among subjects with several NSRPD who used healthcare. Due to the cross-sectional design of this study, causal inferences cannot be drawn. This analysis shows the importance, however, of taking healthcare use into account in comorbidity studies.

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Abbreviations

GP:

General practitioner

MINI:

Mini-International Neuropsychiatric Interview

MHP:

Mental health professional

NSRPD:

Non-substance-related psychiatric disorder

OR:

Odds ratio

SD:

Standard deviation

SUD:

Substance use disorder

TCI:

Temperament and character inventory

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Acknowledgments and grants

This study was supported by the French Mission interministérielle de lutte contre les drogues et les toxicomanies (MILDT), grant number AH027G. G. Encrenaz was a research fellow of the French ministry of education, research and technology.

This work has been presented in part at the 48th International ICAA (International Council on Alcohol and Addictions) Conference in Budapest, October 2005.

The authors want to thank Luc Letenneur and Marthe-Aline Jutand for their help with the data analysis and result interpretation. They also thank Malika Faytout, Nadia Vinciguerra and Olivier Grondin for their help with the data management and Viviane Kovess for her help with the manuscript.

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Authors and Affiliations

  1. Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 593 Institut de Santé Publique d’Epidémiologie et de Développement (ISPED) Institut Fédératif de Recherche en Santé Publique (IFR INSERM 99), Université Victor Segalen Bordeaux 2, Bordeaux, France

    Gaelle Encrenaz & Antoine Messiah

  2. INSERM, U593, Institut de Santé Publique d’Epidémiologie et de Développement, Université Bordeaux 2, case 11, 146 rue Léo Saignat, 33076, Bordeaux Cedex, France

    Gaelle Encrenaz

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  1. Gaelle Encrenaz
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  2. Antoine Messiah
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Correspondence to Gaelle Encrenaz.

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Encrenaz, G., Messiah, A. Lifetime psychiatric comorbidity with substance use disorders: Does healthcare use modify the strength of associations ?. Soc Psychiat Epidemiol 41, 378–385 (2006). https://doi.org/10.1007/s00127-006-0039-1

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  • DOI: https://doi.org/10.1007/s00127-006-0039-1

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