Silvia Franco1, Mark Olfson2, Melanie M Wall2, Shuai Wang2, Nicolas Hoertel3, Carlos Blanco4. 1. Department of Psychiatry, New York State Psychiatric Institute / Columbia University, New York, NY, 10032, USA; Icahn School of Medicine at Mount Sinai St Luke's-West Hospital, Psychiatry Program, USA. Electronic address: sfrancocorso@gmail.com. 2. Department of Psychiatry, New York State Psychiatric Institute / Columbia University, New York, NY, 10032, USA. 3. Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France; AP-HP, Corentin Celton Hospital, Department of Psychiatry, 92130, Issy-les-Moulineaux, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France. 4. Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA.
Abstract
BACKGROUND AND AIMS: Substance use disorders (SUD) frequently co-occur and are associated with numerous adverse outcomes and lower quality of life. The goal of this study was to examine whether the associations of SUD with adverse outcomes occur through a shared liability or are disorder-specific even after taking into account their frequent co-occurrence. BASIC PROCEDURES: Data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions. The association between nine SUDs assessed at Wave 1 (2001-2002) and a broad range of outcomes (divorce/separation, violence, unemployment, financial crisis, legal problems, problems with a neighbor, friend, or relative, and quality of life) at Wave 2 (2005-2005) were estimated separately and simultaneously using a latent variable model to account for their co-occurrence and identify potential disorder-specific effects. MAIN FINDINGS: SUD at Wave 1 were associated with increased prevalence of all adverse outcomes at Wave 2 (p < .05). With the exception of nicotine dependence and tranquilizer use disorder, we found no specific associations of any SUD with any adverse outcome. Rather, associations occurred primarily through the latent variable representing the shared effects of the different SUDs. CONCLUSIONS AND RELEVANCE: Our findings underscore the importance of adopting dimensional approaches to model the co-occurrence of SUD. Because SUD increases the risk of adverse outcomes mainly through a general predisposition representing mechanisms shared across SUD rather than through drug-specific mechanisms, this dimension should be considered as a therapeutic target to substantially advance prevention of adverse outcomes caused by SUD.
BACKGROUND AND AIMS: Substance use disorders (SUD) frequently co-occur and are associated with numerous adverse outcomes and lower quality of life. The goal of this study was to examine whether the associations of SUD with adverse outcomes occur through a shared liability or are disorder-specific even after taking into account their frequent co-occurrence. BASIC PROCEDURES: Data were drawn from the National Epidemiological Survey on Alcohol and Related Conditions. The association between nine SUDs assessed at Wave 1 (2001-2002) and a broad range of outcomes (divorce/separation, violence, unemployment, financial crisis, legal problems, problems with a neighbor, friend, or relative, and quality of life) at Wave 2 (2005-2005) were estimated separately and simultaneously using a latent variable model to account for their co-occurrence and identify potential disorder-specific effects. MAIN FINDINGS: SUD at Wave 1 were associated with increased prevalence of all adverse outcomes at Wave 2 (p < .05). With the exception of nicotine dependence and tranquilizer use disorder, we found no specific associations of any SUD with any adverse outcome. Rather, associations occurred primarily through the latent variable representing the shared effects of the different SUDs. CONCLUSIONS AND RELEVANCE: Our findings underscore the importance of adopting dimensional approaches to model the co-occurrence of SUD. Because SUD increases the risk of adverse outcomes mainly through a general predisposition representing mechanisms shared across SUD rather than through drug-specific mechanisms, this dimension should be considered as a therapeutic target to substantially advance prevention of adverse outcomes caused by SUD.
Authors: Zu Wei Zhai; Rani A Hoff; Jordan C Howell; Jeremy Wampler; Suchitra Krishnan-Sarin; Marc N Potenza Journal: J Psychiatr Res Date: 2019-11-14 Impact factor: 4.791