Comorbid Mental Disorders in Adolescents with Substance Use Disorders

2001 ◽  
pp. 145-180
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Comorbid Mental Disorders

scholarly journals O7.1. ASSOCIATION BETWEEN PATTERNS OF COMORBID MENTAL DISORDERS AND MORTALITY-RELATED ESTIMATES. A NATIONWIDE, REGISTER-BASED COHORT STUDY BASED ON 7.5 MILLION INDIVIDUALS LIVING IN DENMARK

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Oleguer Plana-Ripoll ◽  
Natalie Momen ◽  
Nanna Weye ◽  
John McGrath
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Substance Use Disorders ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Neurotic Disorders ◽  
Comorbid Mental Disorders

Abstract Background Comorbidity within mental disorders is common – individuals with one type of mental disorder are at increased risk of subsequently developing other types of disorders. Previous studies are usually restricted to temporally-ordered pairs of disorders. While more complex patterns of comorbidity have been described (e.g. internalizing and externalizing disorders), there is a lack of detailed information on the nature of the different sets of comorbid mental disorders. Additionally, mental disorders are associated with premature mortality, and people with two or more types of mental disorders have a shorter life expectancy compared to those with exactly one type of mental disorder. The aims of this study were to: (a) describe the prevalence and demographic correlates of combinations of mental disorders; and (b) estimate the excess mortality for each of these combinations. Methods We conducted a population-based cohort study including all 7,505,576 persons living in Denmark in 1995–2016. Information on mental disorders and mortality was obtained from national registers. First, we described the most common combinations of mental disorders defined by the ICD-10 F-subchapters (substance use disorders, schizophrenia spectrum disorder, mood disorders, neurotic disorders, etc.). Then, we investigated excess mortality using mortality rate ratios (MRRs) and differences in life expectancy after disease diagnosis compared to the general population of same sex and age. Results At the end of the 22-year observation, 6.2% individuals were diagnosed with exactly one type of disorder, 2.7% with exactly two, 1.1% with exactly three, and 0.5% with four or more types. The most prevalent mental disorders were neurotic disorders (4.6%) and mood disorders (3.8%), even when looking particularly at persons with a specific number of disorders (exactly one type, exactly two types, etc.). We observed 616 out of 1,024 possible sets of disorders, but the 52 most common sets (with at least 1,000 individuals each) represented 92.8% of all persons with diagnosed mental disorders. Mood and/or neurotic disorders, alone or in combination with other disorders, were present in 64.8% of individuals diagnosed with mental disorders. People with all combinations of mental disorders had higher mortality rates than those without any mental disorder diagnosis, with MRRs ranging from 1.10 (95% CI 0.67 – 1.84) for the two-disorder set of developmental-behavioral disorders to 5.97 (95% CI 5.52 – 6.45) for the three-disorder set of schizophrenia-neurotic-substance use disorders. Additionally, any combination of mental disorders was associated with shorter life expectancies compared to the general population, with estimates ranging from 5.06 years [95% CI 5.01 – 5.11] for the one-disorder set of organic disorders to 17.46 years [95% CI 16.86 – 18.03] for the three-disorder set of schizophrenia-personality-substance use disorders. Discussion Within those with mental disorders, approximately 2 out of 5 had two more types of mental disorders. Our study provides prevalence estimates of the most common sets of mental disorders – mood disorders (e.g. depression) and neurotic disorders (e.g. anxiety) commonly co-occur, and contribute to many different sets of comorbid mental disorders. The association between mental disorders comorbidity and mortality-related estimates revealed the prominent role of substance use disorders with respect to both elevated mortality rates and reduced life expectancies. Substance use disorders are relatively common, and these disorders often feature in sets of mental disorders. In light of the substantial contribution to premature mortality, efforts related to the ‘primary prevention of secondary comorbidity’ warrant added scrutiny.

scholarly journals Discussion questions about the therapy of nonchemical addictions

2021 ◽  
Vol LIII (1) ◽  
pp. 52-56
Author(s):  
Alexey Y. Egorov
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Pharmacological Therapy ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Addictive Disorders ◽  
Dsm V ◽  
Comorbid Mental Disorders ◽  
High Comorbidity

Today there are no international standards for the treatment of non-chemical (behavioral) addiction (NA). This is largely due to the vagueness of their existence as nosological units and, as a consequence, their place in international classifications. This article discusses the forms of NA that are or will be included in DSM-V and ICD-11. It has been shown that NA research has sparked discussions about the spectrum of addictive disorders, expands the multidisciplinary understanding of the etiology and pathogenesis of addictive disorders, and promotes the study of new forms and expansion of therapeutic approaches. The criticism of the addictive spectrum concept is analyzed. The modern approaches of non-drug and pharmacological therapy of different forms of NA are presented. The following conclusions are drawn. The existence of NA is confirmed by the inclusion of a part of them in the International Classifications of Diseases. NA have high comorbidity with other mental disorders, in respect of which pharmacotherapy and psychotherapy are not in doubt. Taking into account the general neurobiological mechanisms of the formation of addictive disorders, the possible pharmacotherapy of non-chemical addictions, officially recognized in the ICD and DSM, should proceed from the currently available approaches to the therapy of substance use disorders. Treatment of non-chemical addictions that are not included in the International Classifications can only be carried out within the framework of therapy for confirmed comorbid mental disorders. In its absence, psychological correction seems to be possible. There is an obvious need to continue researching the problem of non-chemical addictions to expand new approaches to their therapy and psychological correction.

scholarly journals 307Association between patterns of comorbid mental disorders and mortality-related estimates. A Danish register-based cohort study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Oleguer Plana-Ripoll ◽  
John J McGrath
Keyword(s):  
Substance Use ◽  
Cohort Study ◽  
Mental Disorders ◽  
Life Expectancy ◽  
Substance Use Disorders ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Population Based ◽  
Substantial Contribution ◽  
Comorbid Mental Disorders

Abstract Background Comorbidity within mental disorders is common, and people with two or more types of mental disorders have shorter life expectancy compared to those with exactly one type. The aims of this study were to: (a) describe the prevalence of combinations of mental disorders; and (b) estimate the excess mortality for each of these combinations. Methods We conducted a population-based cohort study including all 7,505,576 persons living in Denmark in 1995-2016. Using national registers, we described the most common combinations of mental disorders and investigated excess mortality by means of mortality rate ratios (MRRs) and differences in life expectancy. Results At the end of the 22-year observation, 6.2% individuals were diagnosed with exactly one disorder, and 5.3% with two or more types. People with any combination of disorders had higher mortality rates than those without any diagnosis (MRRs ranging from 1.10 [95% CI 0.67 – 1.84] to 5.97 [95% CI 5.52 – 6.45]) and shorter life expectancies compared to the general population (estimates ranging from 5.06 years [95% CI 5.01 – 5.11] to 17.46 years [95% CI 16.86 – 18.03]). Conclusions Mood disorders and neurotic disorders commonly co-occur, and contribute to many different sets of comorbid mental disorders. The association between mental disorders comorbidity and mortality revealed the prominent role of substance use disorders. Key messages Our study provides prevalence estimates of the most common sets of mental disorders. In light of the substantial contribution of substance use disorders to premature mortality, efforts related to the ‘primary prevention of secondary comorbidity’ warrant added scrutiny.

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

Frequent use of emergency departments for mental and substance use disorders

2018 ◽  
Vol 35 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Karen Urbanoski ◽  
Joyce Cheng ◽  
Jürgen Rehm ◽  
Paul Kurdyak
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Service Use ◽  
Secondary Analysis ◽  
Mental Healthcare ◽  
Specialist Care ◽  
Ed Visits ◽  
Administrative Health Databases

ObjectivesWe described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD.MethodsThis retrospective observational study included all Ontario residents 15 years and older who had five or more ED visits during any 12-month period from 2010 to 2012 (n=263 346). The study involved a secondary analysis of administrative health databases capturing emergency, hospital and ambulatory care. Frequent ED users for mental disorders (n=5416) were grouped into nested categories based on the number of ED visits for SUD. Logistic regression was used to examine group differences in the receipt of follow-up services and mortality, controlling for sociodemographics, comorbidities and past service use.ResultsThe majority of frequent ED users for mental disorders had at least one ED visit for SUD, most commonly involving alcohol. Relative to people with no visits for SUD, those with ED visits for SUD were older and more likely to be men (Ps <0.001). As the number of ED visits for SUD increased, the likelihood of receiving follow-up care, particularly specialist mental healthcare, declined while 2-year mortality steadily increased (Ps <0.001). These associations remained after controlling for comorbidities and past service use.ConclusionsFindings highlight disparities in the receipt of specialist care based on use of ED services for SUD, coupled with a greater mortality risk. There is a need for policies and procedures to help address unmet needs for care and to connect members of this vulnerable subgroup with services that are better able to support recovery and improve survival.

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