The Association Between Substance Use and the Needs of Patients With Psychiatric Disorder, Levels of Anxiety, and Caregiving Burden

BackgroundAlthough childhood adversity is a strong determinant of psychopathology, it remains unclear whether there are ‘sensitive periods’ when a first episode of adversity is most harmful.AimsTo examine whether variation in the developmental timing of a first episode of interpersonal violence (up to age 18) associates with risk for psychopathology.MethodUsing cross-sectional data, we examined the association between age at first exposure to four types of interpersonal violence (physical abuse by parents, physical abuse by others, rape, and sexual assault/molestation) and onset of four classes of DSM-IV disorders (distress, fear, behaviour, substance use) (n=9984). Age at exposure was defined as: early childhood (ages 0–5), middle childhood (ages 6–10) and adolescence (ages 11–18).ResultsExposure to interpersonal violence at any age period about doubled the risk of a psychiatric disorder (odds ratios (ORs) = 1.51–2.52). However, few differences in risk were observed based on the timing of first exposure. After conducting 20 tests of association, only three significant differences in risk were observed based on the timing of exposure; these results suggested an elevated risk of behaviour disorder among youth first exposed to any type of interpersonal violence during adolescence (OR = 2.37, 95% CI 1.69–3.34), especially being beaten by another person (OR = 2.44; 95% CI 1.57–3.79), and an elevated risk of substance use disorder among youth beaten by someone during adolescence (OR=2.77, 95% CI 1.94–3.96).ConclusionsChildren exposed to interpersonal violence had an elevated risk of psychiatric disorder. However, age at first episode of exposure was largely unassociated with psychopathology risk.

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Hypersomnolence Disorders

Management of Sleep Disorders in Psychiatry ◽

10.1093/med/9780190929671.003.0011 ◽

2020 ◽

pp. 134-157

Author(s):

Sulaiman Alhifzi ◽

Nevin Zaki ◽

Aljohara S. Almeneesier ◽

Ahmed S. BaHammam

Keyword(s):

Substance Use ◽

Psychiatric Disorder ◽

Treatment Strategies ◽

Classification Systems ◽

Common Symptom ◽

Clinical Investigations ◽

Idiopathic Hypersomnia ◽

Multiple Sleep Latency

Despite varied classification systems, hypersomnolence disorders (or central disorders of hypersomnolence) are a group of disorders with a common symptom of excessive daytime sleepiness. In addition to a thorough clinical interview and examination, the assessment of hypersomnolence may require clinical investigations such as polysomnography and the multiple sleep latency test. This chapter examines the disorders of hypersomnolence with an emphasis on their clinical features and treatment strategies. The authors discuss the four main types of hypersomnolence disorders, narcolepsy type 1, narcolepsy type 2, idiopathic hypersomnia and Kleine–Levin syndrome, as well as hypersomnia due to a medical disorder, medication, or substance use; a psychiatric disorder; and insufficient sleep syndrome. It also discusses the relationships between hypersomnolence and psychiatric disorders.

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Evidence-Based Pharmacotherapy for Mood and Anxiety Disorders with Concurrent Alcoholism

CNS Spectrums ◽

10.1017/s109285290000290x ◽

2008 ◽

Vol 13 (S6) ◽

pp. 7-9 ◽

Cited By ~ 6

Author(s):

Kathleen T. Brady

Keyword(s):

Substance Use ◽

Psychiatric Disorder ◽

American Psychiatric Association ◽

Alcohol Use Disorders ◽

Professional Experience ◽

Evidence Based ◽

The Face ◽

A Prospective Study ◽

Alcohol Dependent

Co-occurring psychiatric and alcohol use disorders can have devastating personal and societal effects, yet little evidence exists to guide clinical treatment. In the face of scant data, individual practitioners must rely instead on professional experience and those limited practice guidelines that currently exist. The American Psychiatric Association (APA) advises that failure to treat a concurrent psychiatric disorder reduces the likelihood that the treatment for a substance use disorder (SUD) will be effective. Indeed, the effects of nontreatment were demonstrated in a prospective study assessing alcohol-dependent patients for 1 year following hospitalization for alcohol dependence, in which untreated depression was directly associated with a shorter time to first drink. The results also showed that among those patients with depression (Slide 1), taking antidepressants at the time of discharge increased the likelihood of an individual remaining abstinent during the follow-up period.

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The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 (AUDADIS-5): Reliability of substance use and psychiatric disorder modules in a general population sample

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2014.11.026 ◽

2015 ◽

Vol 148 ◽

pp. 27-33 ◽

Cited By ~ 145

Author(s):

Bridget F. Grant ◽

Rise B. Goldstein ◽

Sharon M. Smith ◽

Jeesun Jung ◽

Haitao Zhang ◽

...

Keyword(s):

Substance Use ◽

Alcohol Use ◽

General Population ◽

Psychiatric Disorder ◽

Alcohol Use Disorder ◽

Population Sample ◽

General Population Sample ◽

Interview Schedule

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Homeless youth in London: II. Accommodation, employment and health outcomes at 1 year

Psychological Medicine ◽

10.1017/s0033291799001488 ◽

2000 ◽

Vol 30 (1) ◽

pp. 187-194 ◽

Cited By ~ 34

Author(s):

T. K. J. CRAIG ◽

S. HODSON

Keyword(s):

Substance Use ◽

Young People ◽

Psychiatric Disorder ◽

Health Outcomes ◽

Homeless Youth ◽

Homeless People ◽

Antisocial Behaviour ◽

Medical Needs ◽

The Impact

Background. While there is considerable evidence of a high prevalence of psychiatric disorder among homeless youth, much less is known about its long-term course or the impact it may have on accommodation outcomes.Method. A random sample of 161 homeless people 16–21 years of age were recruited from consecutive attendees at two of London's largest facilities for homeless young people. These young people were traced and re-interviewed a year later to examine accommodation, occupation and health outcomes.Results. A total of 107 (67%) people were successfully re-interviewed. Psychiatric disorder was identified in 55% at follow up. Two thirds of those with a psychiatric disorder at index interview remained symptomatic at follow-up. Persistence of psychiatric disorder was associated with adverse childhood experiences and rough sleeping. Satisfactory accommodation outcomes were achieved by 45 subjects (42%). Better accommodation outcomes were associated with three variables measured at the index assessment: ethnic minority status; educational achievement; and, the presence of accommodation plans negotiated through a resettlement agency. While psychiatric disorder at index interview was not associated with accommodation outcome, persistent substance use in the follow-up year was associated with poor accommodation outcome. Over half of the young people had been involved in petty crime and just under a third had been convicted for more serious criminal activity. Offending and antisocial behaviour in the follow-up year were related to a history of conduct disorder, persistent substance abuse and poor accommodation outcomes.Conclusions. Young homeless people are characterized by multiple social and medical needs. Successful resettlement of this population may depend upon integrated services that address problems of persisting substance use and mental illness as well as the immediate housing need.

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Bulimia comorbidity in the general population and in the clinic

Psychological Medicine ◽

10.1017/s0033291700027756 ◽

1994 ◽

Vol 24 (3) ◽

pp. 605-611 ◽

Cited By ~ 78

Author(s):

J. A. Bushnell ◽

J. E. Wells ◽

J. M. McKenzie ◽

A. R. Hornblow ◽

M. A. Oakley-Browne ◽

...

Keyword(s):

Substance Use ◽

General Population ◽

Psychiatric Disorder ◽

Substance Use Disorder ◽

Clinical Sample ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Base Rates ◽

Specific Increase ◽

Bulimic Women

SynopsisThis study compares rates of comorbidity of lifetime psychiatric disorder in a clinical sample of women with bulimia, with general population base rates, and with rates of comorbidity among bulimic women in the general population. Eighty-four per cent of the clinical sample of bulimic women had a lifetime affective disorder, and 44% a lifetime alcohol or drug disorder. These rates of disorder were significantly higher than the base rates in the general population. Bulimic women in the general population also had more affective and substance-use disorders than the general population base rates, but the rates of these disorders were lower than found in the clinical sample. In the general population, quite similar rates of other disorders including generalized anxiety, panic, phobia and obsessive–compulsive disorder, are found among those with bulimia, substance-use disorder and depression. Furthermore, among those with depression and substance-use disorder in the general population, rates of eating disorder are comparable. Rather than suggesting a specific relationship between bulimia and either depression or substance-use disorder, the data from this study suggest that the presence of any disorder is associated with a non-specific increase in the likelihood of other psychiatric disorder.

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Prevalence of Psychiatric Disorder in a Methadone Maintenance Population

Australian & New Zealand Journal of Psychiatry ◽

10.1080/0004867010060507 ◽

2001 ◽

Vol 35 (5) ◽

pp. 601-605 ◽

Cited By ~ 62

Author(s):

Tom Callaly ◽

Tom Trauer ◽

Leigh Munro ◽

Greg Whelan

Keyword(s):

Substance Use ◽

Anxiety Disorder ◽

Psychiatric Disorder ◽

Affective Disorder ◽

Diagnostic Criteria ◽

Substance Use Disorder ◽

Psychiatric Illness ◽

Methadone Maintenance ◽

Service Planning ◽

Icd 10

Objective: The objective of this study was to examine the prevalence of psychiatric disorders in a group of patients who had recently entered a methadone maintenance programme. Method: A total of 62 patients were interviewed using the Composite International Diagnostic Interview (CIDI) within 6 months of commencing methadone maintenance. The CIDI was used to establish symptoms of psychiatric illness at interview and in the 12 months prior. Results: In the 12 months prior to interview, 76% of the sample fulfilled ICD-10 criteria for a psychiatric disorder other than substance-use disorder. Over half of the group interviewed fulfilled ICD-10 criteria for an affective disorder, two-thirds fulfilled criteria for an anxiety disorder and just under half fulfilled diagnostic criteria for both an affective disorder and an anxiety disorder in the 12 months prior to interview. At the time of interview, 19% fulfilled ICD-10 diagnostic criteria for a moderate or severe affective disorder. Seventy per cent of males and 89% of females interviewed had a comorbid psychiatric illness. In 71% of the group who had a comorbid psychiatric illness, the onset of psychiatric symptomatology was reported to predate the use of heroin. Conclusion: The prevalence of psychiatric disorder is up to 10 times higher in the population on methadone maintenance than in the general population and is two to three times higher than that found in community surveys of those with a substance-use disorder. These results are consistent with earlier findings and have implications for service planning.

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Psychiatric Disorder, Sexual Abuse, and Substance Use Among Adolescent Inpatients

PsycEXTRA Dataset ◽

10.1037/e521192007-001 ◽

2006 ◽

Author(s):

Joanna C. M. Cole ◽

Madeleine Dupre ◽

Peter L. Sheras ◽

Donald Ball

Keyword(s):

Sexual Abuse ◽

Substance Use ◽

Psychiatric Disorder ◽

Adolescent Inpatients

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The effects of unemployment on psychiatric illness during young adulthood

Psychological Medicine ◽

10.1017/s0033291796004412 ◽

1997 ◽

Vol 27 (2) ◽

pp. 371-381 ◽

Cited By ~ 64

Author(s):

D. M. FERGUSSON ◽

L. J. HORWOOD ◽

M. T. LYNSKEY

Keyword(s):

Substance Use ◽

Anxiety Disorder ◽

Young People ◽

Psychiatric Disorder ◽

Family Background ◽

Personal Factors ◽

The Social ◽

Dsm Iv ◽

Before School ◽

Using Data

Background. The aims of this study were to examine the associations between exposure to unemployment following school leaving and rates of psychiatric disorder using data gathered on a birth cohort of New Zealand young people studied up to the age of 18.Methods. At age 18 cohort members were assessed on: (a) duration of exposure to unemployment from age 16; (b) DSM-IV diagnostic criteria for major depression, anxiety disorders, conduct disorder, nicotine dependence, other substance abuse/dependence and attempted suicide. This information was integrated into longitudinal data gathered on the social circumstances, family background and adjustment of the cohort up to the age of 18.Results. Increasing exposure to unemployment was associated with increasing risks of psychiatric disorder in adolescence. Those exposed to 6 months or more unemployment had rates of disorder that were 1·5 to 5·4 times higher than those not exposed to unemployment. However, most of the elevated risk of disorder among those unemployed was explained by family and personal factors that were present prior to school leaving age. Nonetheless, even after control for these factors those exposed to unemployment had significantly higher rates of anxiety disorder and substance use disorders.Conclusions. To a large extent the relationships between unemployment and psychiatric disorder seen in this cohort were explained by social, family and personal factors that were present before school leaving age. Nonetheless, young people exposed to unemployment had higher rates of substance use and anxiety disorder.

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Managing a Co-occurring Psychiatric Disorder

Managing Your Substance Use Disorder ◽

10.1093/med-psych/9780190926670.003.0020 ◽

2019 ◽

pp. 159-168

Author(s):

Dennis C. Daley ◽

Antoine Douaihy

Keyword(s):

Substance Use ◽

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Substance Use Disorder ◽

Psychiatric Symptoms ◽

The Other ◽

Medication Assisted Treatment ◽

Different Types

The term “co-occurring disorders” refers to the presence of a psychiatric disorder and a substance use disorder. A psychiatric disorder increases the risk of a substance use disorder and vice versa. Treating one disorder improves the outcomes in treating the other. Psychiatric medications can be both effective and appropriate in treating the psychiatric disorder in people with co-occurring disorders. Medication-assisted treatment (MAT) can treat effectively the substance use disorder in people with co-occurring disorders. The goals of this chapter are to learn about the different types of psychiatric disorders, to learn about the causes of psychiatric disorders, and to assess the client’s psychiatric symptoms, if applicable.

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