OBJECTIVES: To quantify the relation between substance misuse and psychiatric illness in the UK general practice population in terms of (a) the relative risk of developing one condition given prior exposure to the other and (b) the proportion of cases of one condition attributable to exposure to the other. DESIGN: Population based prospective observational study using the general practice research database (GPRD) between 1993 and 1998. The 230 GP practices represent 3.1% of the population. SETTING: England and Wales. PARTICIPANTS: 1.4 million registered patients of whom 3969 had both substance misuse and psychiatric diagnoses between 1993 and 1998. MAIN OUTCOME MEASURES: Relative risk (RR) for subsequent psychiatric illness among participants exposed to substance misuse and RR for subsequent substance misuse among participants exposed to psychiatric illness. Population attributable risk (PAR) of psychiatric illness attributable to substance misuse and of substance misuse attributable to psychiatric illness. RESULTS: The baseline prevalence of psychiatric illness over the study period was 15% and 0.3% for substance abuse. RR for psychiatric illness for substance misusers compared with non-substance misusers was 1.54 (95% CI 1.47 to 1.62). RR for substance misuse among psychiatric compared with non-psychiatric cases was 2.09 (95% CI 1.99 to 2.22). PAR for psychiatric illness attributable to substance misuse was 0.2%. PAR for substance misuse attributable to psychiatric illness was 14.2%. DISCUSSION: Only a comparatively small proportion of psychiatric illness seems possibly attributable to substance use whereas a more substantial proportion of substance use seems possibly attributable to psychiatric illness. This study does not support the hypotheses that comorbidity between substance misuse and psychiatric illness is primarily the result of substance misuse or that increasing comorbidity is largely attributable to increasing substance misuse.
OBJECTIVES: To quantify the relation between substance misuse and psychiatric illness in the UK general practice population in terms of (a) the relative risk of developing one condition given prior exposure to the other and (b) the proportion of cases of one condition attributable to exposure to the other. DESIGN: Population based prospective observational study using the general practice research database (GPRD) between 1993 and 1998. The 230 GP practices represent 3.1% of the population. SETTING: England and Wales. PARTICIPANTS: 1.4 million registered patients of whom 3969 had both substance misuse and psychiatric diagnoses between 1993 and 1998. MAIN OUTCOME MEASURES: Relative risk (RR) for subsequent psychiatric illness among participants exposed to substance misuse and RR for subsequent substance misuse among participants exposed to psychiatric illness. Population attributable risk (PAR) of psychiatric illness attributable to substance misuse and of substance misuse attributable to psychiatric illness. RESULTS: The baseline prevalence of psychiatric illness over the study period was 15% and 0.3% for substance abuse. RR for psychiatric illness for substance misusers compared with non-substance misusers was 1.54 (95% CI 1.47 to 1.62). RR for substance misuse among psychiatric compared with non-psychiatric cases was 2.09 (95% CI 1.99 to 2.22). PAR for psychiatric illness attributable to substance misuse was 0.2%. PAR for substance misuse attributable to psychiatric illness was 14.2%. DISCUSSION: Only a comparatively small proportion of psychiatric illness seems possibly attributable to substance use whereas a more substantial proportion of substance use seems possibly attributable to psychiatric illness. This study does not support the hypotheses that comorbidity between substance misuse and psychiatric illness is primarily the result of substance misuse or that increasing comorbidity is largely attributable to increasing substance misuse.
Authors: John Macleod; Rachel Oakes; Alex Copello; Ilana Crome; Matthias Egger; Mathew Hickman; Thomas Oppenkowski; Helen Stokes-Lampard; George Davey Smith Journal: Lancet Date: 2004-05-15 Impact factor: 79.321
Authors: Lisa J Phillips; Christina Curry; Alison R Yung; Hok Pan Yuen; Steven Adlard; Patrick D McGorry Journal: Aust N Z J Psychiatry Date: 2002-12 Impact factor: 5.744
Authors: Martin Frisher; Juliet Collins; David Millson; Ilana Crome; Peter Croft Journal: J Epidemiol Community Health Date: 2004-12 Impact factor: 3.710
Authors: Joel Swendsen; Kevin P Conway; Louisa Degenhardt; Meyer Glantz; Robert Jin; Kathleen R Merikangas; Nancy Sampson; Ronald C Kessler Journal: Addiction Date: 2010-03-10 Impact factor: 6.526
Authors: William W Stoops; Joshua A Lile; C Glenn Robbins; Catherine A Martin; Craig R Rush; Thomas H Kelly Journal: Addict Behav Date: 2006-10-02 Impact factor: 3.913
Authors: Leonora E Long; Rose Chesworth; Xu-Feng Huang; Alexander Wong; Adena Spiro; Iain S McGregor; Jonathon C Arnold; Tim Karl Journal: PLoS One Date: 2012-04-03 Impact factor: 3.240
Authors: Keith T Palmer; Stefania D'Angelo; E Clare Harris; Cathy Linaker; David Coggon Journal: Occup Environ Med Date: 2014-03-13 Impact factor: 4.402