Prevalence Of Co-occurring Disorders Research Articles

Co-occurring mental and substance use disorders in Australia 2020-2022: Prevalence, patterns, conditional probabilities and correlates in the general population.

Previous estimates from 2007 found that co-occurring mental and/or substance use disorders were a pervasive feature of Australia's mental health. Since that time there have been shifts and improvements in the conceptualisation and incorporation of co-occurring disorders in research and treatment settings. The current study provides up-to-date estimates on the prevalence of co-occurring mental and/or substance use disorders, highlights common patterns of co-occurrence, identifies significant correlates and examines any changes in the extent of co-occurring disorders since 2007. Data were from the two Australian National Surveys of Mental Health and Wellbeing conducted in 2020-2022 (N = 15,893) and 2007 (N = 8841). Descriptive statistics were estimated for the number of co-occurring conditions, correlations and pairwise conditional probabilities. Multinomial logistic and robust Poisson regressions were used to identify significant correlates and compare changes in co-occurring conditions across surveys. Approximately 46% of people with a mental or substance use disorder in the past 12 months experienced two or more diagnosable conditions. There was little evidence to suggest that the prevalence of co-occurring disorders has changed since 2007 (Prevalence Ratio (PR) = 1.08, 95% CI = 0.98-1.18). Subgroup analysis indicated that those aged 16-24 years were significantly more likely to experience any co-occurrence in 2020-2022 compared with those aged 16-24 years in 2007 (PR = 1.44, 95% CI = 1.17-1.77). Co-occurring mental and substance use disorders remain endemic in Australia. Indeed, they appear to be increasingly problematic in younger, more recent cohorts. The results suggest that continued effort is needed to develop and implement transdiagnostic interventions that target broad contextual and/or societal factors.

Differences in Service Utilization, Co-occurring Disorders and Risk Behaviors between Men and Women Receiving Substance Use Treatment in Residential Facilities

Introduction: gender differences are notorious in population with a substance use disorder (SUD), from consumption patterns to treatment needs. Objective: to determine the differences between men and women in the prevalence of co-occurring disorders, contact with services and other health risks, like suicidal and high-risk sexual behaviors in a sample of patients with SUD currently receiving care in residential facilities. Method: comparative analysis between men and women, secondary to a multicenter cross-sectional study, conducted in 30 residential centers located in Mexico City, Puebla, Hidalgo, Queretaro and State of Mexico. Bivariate statistics studies were performed (Student’s t and Chi-square) to determine the difference between men and women. Results: differences were found in the prevalence of post-traumatic stress disorder and bulimia, as well as inconsistent condom use in the last year, which predominantly affect women. Discussion and conclusions: the female population is at higher risk, which highlights the importance of considering other paradigms in future studies in order to understand mental disorders and their comorbidities, such as the paradigms of social determinants in health and syndemic.

Socio-Demographic Correlates and Patterns of Use Among Patients Visiting Addiction Services of Almadinah Specialized Psychiatric Hospital in Saudi Arabia

Background: Substance use disorders are on the increase worldwide with negative consequences on individuals, their family and the community. Our objective is to study the socio-demographic and patterns of use in those requesting addiction treatment in Addiction treatment services of Almadinah Specialist Psychiatrist Hospital (ASPH). Methods: A descriptive chart review study of 622 patients requesting treatment between the first January 2019 and 31 December 2012. Information was taken from patients’ records and if necessary, completed by a direct interview with the patient. Data collected were analysed using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: The majority were male (96.6%) with a mean age of 32.1 ± 9.2 years. More than half had less than a bachelor’s degree, while 23.5% were highly educated. The majority of patients were single (70.7%), 53.1% reported difficulty keeping a job, 17.8% a high income, 90% a negative family history of substance abuse and 94.7% a negative family history of psychiatric illness. The most frequent substances used, in descendant order, were captagon (69.8%), cannabis (63%) and alcohol (30.7%). The mean age of initiation was around 21 years for the three main substances. The prevalence of co-occurring disorders was at 14%. Two thirds of patients were from the outpatient department (67.7%) and 32.2% from the emergency department (ED). Around a third of our sample visited the emergency room at least once during the month prior to their evaluation and overall, 32.3% needed hospital admission. Conclusions: The fact that 90% of our sample reported a negative history of substance abuse with about 4 out of 5 having an early age of initiation to substance use emphasizes the urgent need for psychoeducational preventive efforts on substance abuse and dependence targeting our youths and their families, in multiple areas particularly in school and neighbourhoods.

Recent/Childhood Adversities and Mental Disorders Among US Immigrants.

Past research documents the heterogeneity in US immigrants, particularly in terms of racial and ethnic categories and specific ethnic subgroups. The present study builds on this research foundation by investigating heterogeneity in immigrants' experiences of adversity, both recent and during childhood, and associations with mental disorders. Data are drawn from 6,131 adult immigrants in the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Prevalence estimates for mental disorders and adversities were calculated overall and by gender. Latent class analysis was utilized to characterize patterns of self-reported experiences of childhood and recent adversities, and multinomial logistic regression established the statistical association between latent class membership and past-year mental disorder outcomes (substance use disorder only, mood/anxiety/trauma disorder only, co-occurring disorder, or no mental disorder). Neglect was the most commonly-reported childhood adversity among immigrant men and women. Prevalence of meeting criteria for a substance use disorder only, or a mood/anxiety/trauma disorder only, varied between men and women, yet no gender differences were observed in prevalence of co-occurring disorders. For latent class analyses, a five-class solution was selected based on fit indices and parsimony. Approximately 10.0% of the sample was categorized in the latent class characterized by severe childhood adversities, while 57.5% was classified in the latent class with low probabilities of reported adversities. The relative risk of meeting criteria for a past-year substance use disorder only (compared to no substance use or mood/anxiety/trauma disorder) was more than three times as high for members of the class with severe childhood adversities (RRR, 3.26; 95% CI, 2.08–5.10), as well as the class with recent employment/financial adversities (RRR, 3.82; 95% CI, 2.36–6.19), compared to the class with low adversities. The relative risk of past-year co-occurring disorders (compared to no disorder) was more than 12 times as high for those in the severe childhood adversities class (RRR, 12.21; 95% CI, 7.06–21.10), compared to the class with low adversities. Findings underscore the importance of considering both recent and childhood adversities when assessing and providing services for US immigrant groups.

Co-occurring substance use and mental disorders among adults with opioid use disorder

BackgroundCo-occurring substance use and mental disorders among people with opioid use disorder (OUD) increase risk for morbidity and mortality. Addressing these co-occurring conditions is critical for improving treatment and health outcomes. There is limited recent research on the prevalence of co-occurring disorders, demographic characteristics associated with co-occurring disorders, and receipt of mental health and substance use treatment services among those with OUD. This limits the development of targeted and resourced policies and clinical interventions. MethodsUsing 2015–2017 National Survey on Drug Use and Health data, prevalence of co-occurring substance use and mental disorders and receipt of mental health and substance use treatment services was estimated for adults aged 18–64 with OUD. Multivariable logistic regression assessed demographic and substance use characteristics associated with past-year mental illness (AMI) and serious mental illness (SMI) among adults with OUD as well as treatment receipt. ResultsAmong adults with OUD, prevalence of specific co-occurring substance use disorders ranged from 26.4% (95% CI:23.6%–29.4%) for alcohol to 10.6% (95% CI:8.6%–13.0%) for methamphetamine. Prevalence of AMI was 64.3% (95% CI:60.4%–67.9%) and SMI was 26.9% (95% CI:24.2%–29.8%). Receiving both mental health and substance use treatment services in the past year was reported by 24.5% (95% CI:21.5%–29.9%) of adults with OUD and AMI and 29.6% (95% CI:23.3%–36.7%) of adults with OUD and SMI. ConclusionsCo-occurring substance use and mental disorders are common among adults with OUD. Expanding access to comprehensive service delivery models that address the substance use and mental health co-morbidities of this population is urgently needed.

Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services.

Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record

Beyond co-occurring disorders to behavioral health integration

Purpose– Despite the high prevalence of co-occurring disorders and the need for systems of care to integrate mental health and addiction services, integration remains a challenge. The purpose of this paper is to address this challenge by focussing on shared processes of recovery.Design/methodology/approach– After reviewing commonalities between mental health and substance use recovery, integration of treatment with recovery supports under the rubric of a “recovery-oriented system of care” is described. Philadelphia's Department of Behavioral Health and Intellectual disAbility Services is then used as an example to illustrate strategies for achieving two forms of integration: mental health and addiction and treatment and recovery supports.Findings– Viewed through the lens of people with mental health and addiction challenges, the services and supports that promote recovery are very similar. One of the common themes that emerged was the need for these services to go beyond helping people manage their symptoms or achieve abstinence, to also helping them to rebuild their lives in their communities. In addition to co-location and increased collaboration, service providers must possess common values, a consistent approach, and a shared vision for the people they serve.Practical implications– Systems need to find innovative and effective ways to integrate recovery support services with treatment and other interventions, hopefully transforming existing services in the process.Originality/value– In the process of developing a truly integrated behavioral health system, a shared vision across all sectors of the system must shift away from the field's historical focus on illness and problems to a new focus on strengths and possibilities.

Prevalence of co-occurring disorders in a sample of adults with mild and moderate intellectual disabilities who reside in a residential treatment setting.

The presence of an intellectual disability (ID) is associated with a myriad of co-occurring conditions, including psychiatric and genetic disorders, behavior problems, physical disabilities, and seizure disorders. Often the most severely affected individuals reside in residential treatment facilities, where they may obtain specialized treatment and management of their challenging behavior. The present study examines the prevalence of psychiatric disorders, seizures, and ID within the context of demographic categories in a sample of 101 individuals with mild to moderate ID living in a long-term residential treatment facility. Autism spectrum disorders (ASDs) were more prevalent among individuals with moderate ID, whereas personality disorders were more likely to be diagnosed in individuals with mild ID. Impulse disorders were more frequently observed in females. Further research is needed in order to determine appropriate treatment for such individuals, which should include therapies that are targeted to the specific problems of this population.

Prevalence and Profile of People with Co-Occurring Mental and Substance Use Disorders within a Comprehensive Mental Health System

To examine the prevalence and profile of people with co-occurring mental and substance use disorders in relation to numerous demographic, diagnostic, and needs-related variables across a comprehensive system of mental health services using a standard methodology. Data were collected on cases (n = 9839) sampled from specialty tertiary inpatient, specialty outpatient, and community-based mental health programs. Status with respect to co-occurring disorders was based on recorded diagnosis of substance use disorder and the substance abuse measure within the Colorado Client Assessment Record. The demographic and needs profile was compared across groups with or without co-occurring disorders within each level of care. Overall, the prevalence of co-occurring disorders was 18.5%, and highest among clients receiving specialty tertiary inpatient care (28%), and within selected subpopulations such as younger adults (55%) and those with personality disorders (34%). There were few differences between groups based on co-occurring disorders in the specialty inpatient programs. For outpatient and community settings, the clients with co-occurring disorders were distinguished by a more impaired and complex needs profile and more likely to be young, single, male, and of low education. Across all levels of care, having a co-occurring disorder was strongly associated with antisocial and challenging behaviour, legal involvement, and risk of suicide or self-harm. The prevalence estimate of co-occurring disorders is likely representative of a multilevel system of care that serves a large, mixed urban and rural population. Results highlight the need to focus on specific subpopulations and sectors in pursuit of more integrated treatment and support for their mental health and addictions problems.

A Review of Treatment Improvement Protocol (TIP) Series 42

ABSTRACT Treatment Improvement Protocol (TIP) 42 was developed in response to the recognized prevalence of co-occurring disorders (COD) and research showing the failure of treatment informed by either a mental health or addiction model of change (Drake, Mueser, Brunette, & McHugo, 2004; Hendrickson, Schmal, & Ekleberry, 2004). Based on the work of a consensus panel that gathered information from evidence-based treatment research and clinical practice, TIP 42 has the goal of presenting a “state-of-the-art” integrated treatment model. In creating TIP 42, two questions were kept in mind: “What does the clinician need to know?” and “How can information be conveyed in a manner that makes it readily accessible?”(CAST, 2005a, p. 17). This critique examines the success of TIP 42 in addressing these questions.

Prevalence of Co-Occurring Disorders Among Juveniles Committed to Detention Centers

The Practical Adolescent Diagnostic Interview (PADDI), a structured diagnostic interview designed to gather basic information about substance use disorders, mental health conditions, and related experiences, was used in routine evaluation of all adolescents committed to two juvenile detention centers. Anonymous data from 252 consecutively admitted adolescents were analyzed to assess the prevalence and severity of problem areas and to provide a preliminary exploration of interrelationships among those problems. Results demonstrated that a majority of adolescents manifested multiple problems. Whereas prevalence rates were high across gender, females displayed significantly greater mental health problems and maltreatment histories.

Co-occurring addictive and mental disorders among adolescents: Prevalence research and future directions.

Recent epidemiological research documenting the pervasive co-occurrence of addictive and mental disorders has been concerned primarily with adults. This paper proposes the need for similar studies of adolescents, considers the special problems inherent in the assessment of co-occurrence in this age group, reviews evidence suggesting that the prevalence of co-occurring disorders in adolescents parallels that documented for adults, and delineates future research strategies.