Psychiatric comorbidity and the persistence of drug use disorders in the United States.

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Addiction. 2011 Sep 1. doi: 10.1111/j.1360-0443.2011.03638.x. [Epub ahead of print]
Psychiatric comorbidity and the persistence of drug use disorders in the United States.
Fenton MC, Keyes K, Geier T, Greenstein E, Skodol A, Krueger B, Grant BF, Hasin DS.
Source
Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032 New York State Psychiatric Institute, New York, NY 10032 University of Wisconsin, Department of Psychology, Madison, WI 53706 College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032 University of Arizona College of Medicine, Tucson, Arizona 85724 Departments of Psychology, University of Minnesota, Minneapolis, MN 55455 Intramural Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Rockville MD 20849.
Abstract
A.1. Context: DSM-IV drug use disorders, a major public health problem, are highly comorbid with other psychiatric disorders, but little is known about the role of this comorbidity when studied prospectively in the general population. Aims: Determine the role of comorbid psychopathology in the three-year persistence of drug use disorders. Design: Secondary data analysis using Waves 1 (2001-2) and 2 (2004-5) of the National Epidemiologic Survey on Alcohol and Related Conditions. Participants: Respondents with current DSM-IV drug use disorder at Wave 1 who participated in Wave 2 (N = 613). Measurements: AUDADIS-IV obtained DSM-IV Axis I and II diagnoses. Persistent drug use disorder was defined as meeting full criteria for any drug use disorder between Waves 1 and 2. Findings: Drug use disorders persisted in 30.9% of respondents. No Axis I disorders predicted persistence. Antisocial (OR = 2.75; 95% CI = 1.27-5.99), borderline (OR = 1.91; 95% CI = 1.06-3.45) and schizotypal (OR = 2.77; 95% CI = 1.42-5.39) personality disorders were significant predictors of persistent drug use disorders, controlling for demographics, psychiatric comorbidity, family history, treatment and number of drug use disorders. Deceitfulness and lack of remorse were the strongest antisocial criteria predictors of drug use disorder persistence, identity disturbance and self-damaging impulsivity were the strongest borderline criteria predictors, and ideas of reference and social anxiety were the strongest schizotypal criteria predictors. Conclusions: Antisocial, borderline and schizotypal personality disorders are specific predictors of drug use disorder persistence over a three-year period.

© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

PMID: 21883607 [PubMed – as supplied by publisher]