Treatment for illegal drug use disorders

The role of comorbid mood and anxiety disorders

Maria Melchior, Elena Prokofyeva, Nadia Younès, Pamela Surkan, Silvia S. Martins

Research output: Contribution to journalArticle

Abstract

Background: Our aim was to examine whether comorbid mood and anxiety disorders influence patterns of treatment or the perceived unmet need for treatment among those not receiving treatment for illegal drug use disorders.Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2002 and 2004-2005, n = 34,653). Lifetime DSM-IV illegal drug use disorder (abuse and dependence), as well as comorbid mood (major depression, dysthymia, manic disorder, hypomanic disorder) and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety) were ascertained by a standardized psychiatric interview. Treatment for illegal drug use disorders and perceived unmet need for treatment were assessed among individuals with illegal drug use disorder. Odds of treatment and odds of perceived unmet need for treatment were assessed using logistic regression, adjusting for socio-demographic characteristics, treatment for mood and anxiety disorders, and comorbid alcohol use disorder.Results: Out of 34,653 participants, 1114 (3.2%) had a diagnosis of lifetime illegal drug use disorder: 21.2% had a comorbid mood disorder only, 11.8% a comorbid anxiety disorder only, and 45.9% comorbid mood and anxiety disorders. Comorbid mood and anxiety disorders were not related to treatment for illegal drug use disorders but were associated with an elevated likelihood of unmet need for treatment: compared to participants with no comorbidities, multivariate ORs were 2.21 (95% CI: 1.23- 4.10) for mood disorder only, 2.38 (95% CI: 1.27-4.45) for anxiety disorder only, and 2.90 (95% CI: 1.71-4.94) for both mood and anxiety disorders.Conclusions: Individuals with an illegal drug use disorder and comorbid mood or anxiety disorders are disproportionately likely to report unmet need for treatment. Integrated mental health and substance use programs could prove effective in addressing their treatment needs.

Original languageEnglish (US)
Article number89
JournalBMC Psychiatry
Volume14
Issue number1
DOIs
StatePublished - Mar 26 2014

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Anxiety Disorders
Mood Disorders
Substance-Related Disorders
Alcohols
Agoraphobia
Panic Disorder
Bipolar Disorder
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
Comorbidity
Mental Health
Anxiety
Logistic Models
Demography
Interviews
Depression

Keywords

  • Anxiety disorders
  • Epidemiology
  • General population sample
  • Illegal drug use disorder
  • Mood disorders
  • Treatment
  • Unmet need for treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)

Cite this

Treatment for illegal drug use disorders : The role of comorbid mood and anxiety disorders. / Melchior, Maria; Prokofyeva, Elena; Younès, Nadia; Surkan, Pamela; Martins, Silvia S.

In: BMC Psychiatry, Vol. 14, No. 1, 89, 26.03.2014.

Research output: Contribution to journalArticle

Melchior, Maria ; Prokofyeva, Elena ; Younès, Nadia ; Surkan, Pamela ; Martins, Silvia S. / Treatment for illegal drug use disorders : The role of comorbid mood and anxiety disorders. In: BMC Psychiatry. 2014 ; Vol. 14, No. 1.
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abstract = "Background: Our aim was to examine whether comorbid mood and anxiety disorders influence patterns of treatment or the perceived unmet need for treatment among those not receiving treatment for illegal drug use disorders.Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2002 and 2004-2005, n = 34,653). Lifetime DSM-IV illegal drug use disorder (abuse and dependence), as well as comorbid mood (major depression, dysthymia, manic disorder, hypomanic disorder) and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety) were ascertained by a standardized psychiatric interview. Treatment for illegal drug use disorders and perceived unmet need for treatment were assessed among individuals with illegal drug use disorder. Odds of treatment and odds of perceived unmet need for treatment were assessed using logistic regression, adjusting for socio-demographic characteristics, treatment for mood and anxiety disorders, and comorbid alcohol use disorder.Results: Out of 34,653 participants, 1114 (3.2{\%}) had a diagnosis of lifetime illegal drug use disorder: 21.2{\%} had a comorbid mood disorder only, 11.8{\%} a comorbid anxiety disorder only, and 45.9{\%} comorbid mood and anxiety disorders. Comorbid mood and anxiety disorders were not related to treatment for illegal drug use disorders but were associated with an elevated likelihood of unmet need for treatment: compared to participants with no comorbidities, multivariate ORs were 2.21 (95{\%} CI: 1.23- 4.10) for mood disorder only, 2.38 (95{\%} CI: 1.27-4.45) for anxiety disorder only, and 2.90 (95{\%} CI: 1.71-4.94) for both mood and anxiety disorders.Conclusions: Individuals with an illegal drug use disorder and comorbid mood or anxiety disorders are disproportionately likely to report unmet need for treatment. Integrated mental health and substance use programs could prove effective in addressing their treatment needs.",
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AU - Surkan, Pamela

AU - Martins, Silvia S.

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AB - Background: Our aim was to examine whether comorbid mood and anxiety disorders influence patterns of treatment or the perceived unmet need for treatment among those not receiving treatment for illegal drug use disorders.Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2002 and 2004-2005, n = 34,653). Lifetime DSM-IV illegal drug use disorder (abuse and dependence), as well as comorbid mood (major depression, dysthymia, manic disorder, hypomanic disorder) and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety) were ascertained by a standardized psychiatric interview. Treatment for illegal drug use disorders and perceived unmet need for treatment were assessed among individuals with illegal drug use disorder. Odds of treatment and odds of perceived unmet need for treatment were assessed using logistic regression, adjusting for socio-demographic characteristics, treatment for mood and anxiety disorders, and comorbid alcohol use disorder.Results: Out of 34,653 participants, 1114 (3.2%) had a diagnosis of lifetime illegal drug use disorder: 21.2% had a comorbid mood disorder only, 11.8% a comorbid anxiety disorder only, and 45.9% comorbid mood and anxiety disorders. Comorbid mood and anxiety disorders were not related to treatment for illegal drug use disorders but were associated with an elevated likelihood of unmet need for treatment: compared to participants with no comorbidities, multivariate ORs were 2.21 (95% CI: 1.23- 4.10) for mood disorder only, 2.38 (95% CI: 1.27-4.45) for anxiety disorder only, and 2.90 (95% CI: 1.71-4.94) for both mood and anxiety disorders.Conclusions: Individuals with an illegal drug use disorder and comorbid mood or anxiety disorders are disproportionately likely to report unmet need for treatment. Integrated mental health and substance use programs could prove effective in addressing their treatment needs.

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KW - Epidemiology

KW - General population sample

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KW - Mood disorders

KW - Treatment

KW - Unmet need for treatment

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