Association of Lifetime Mental Disorders and Subsequent Alcohol and Illicit Drug Use: Results From the National Comorbidity Survey-Adolescent Supplement
OBJECTIVE:
To
estimate the association of prior lifetime mental disorders with transitions
across stages of substance use in a cross-sectional, nationally representative
sample of US adolescents.
METHOD:
The sample
includes 10,123 adolescents aged 13 to 18 years who participated in the
National Comorbidity Survey-Adolescent Supplement (NCS-A), and who were
directly interviewed with the Composite International Diagnostic Interview
(CIDI) Version 3.0 that generates criteria for DSM-IV disorders.
RESULTS:
Adolescents
with prior lifetime mental disorders had high rates of both alcohol (10.3%) and
illicit drug (14.9%) abuse, with or without dependence. Alcohol and drug abuse
were highest among adolescents with prior anxiety disorders (17.3% and 20%,
respectively) and behavior disorders (15.6% and 24%, respectively). Any prior
disorder significantly increased the risk of transition from nonuse to first
use, and from use to problematic use of either alcohol or illicit drugs.
Multivariate models attenuated the magnitude of the risk of transition
associated with each disorder, although prior weekly smoking and illicit drug
use demonstrated significant risks of transitions across the 3 stages of
alcohol or drug use, as did behavior disorders.
CONCLUSION:
The
findings provide the first evidence from a nationally representative sample
that prior mental disorders represent risk factors for the transition from
nonuse to use, and the progression to drug- and alcohol-related problems.
Treatment of primary mental disorders is likely to be an important target for
the prevention of secondary substance use disorders in youth.
- 1Division of Epidemiology, Services and Prevention Research at the National Institute on Drug Abuse (NIDA), Rockville, MD.
- 2École Pratique des Hautes Études (EPHE), Paris, the National Center for Scientific Research (CNRS), Paris, and University of Bordeaux, France.
- 3University of Paris Descartes, Paris.
- 4Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health (NIMH), Bethesda, MD.
- 5Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health (NIMH), Bethesda, MD. Electronic address: merikank@mail.nih.gov.
- J Am Acad Child Adolesc Psychiatry. 2016 Apr;55(4):280-8. doi: 10.1016/j.jaac.2016.01.006. Epub 2016 Feb 2.
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