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Abstract
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AIM: Co-occurrence of mental health and substance-use disorders adds complexity to already-significant health burdens. This study tests whether mental health disorders group differently across substance use disorder types and compares associations of early factors with the development of differing comorbidities.
DESIGN: Consecutive antenatal clinic attendees were recruited to the longitudinal Mater-University of Queensland Study of Pregnancy (MUSP). Mother/offspring dyads were followed over 21 years. SETTING: Mater-Misericordiae Public Hospital, Brisbane, Australia. PARTICIPANTS: MUSP offspring with maternal baseline information (n = 7223), offspring behaviour data at 14 (n = 4815) and psychiatric diagnoses at 21 (n = 2233). MEASUREMENTS: The Composite International Diagnostic Interview yielded lifetime diagnoses of mental health (MH) and substance use (SU) disorders for offspring, then latent class modelling predicted membership of poly-disorder groups. We fitted the resulting estimates in multinomial logistic regression models, adjusting for maternal smoking, drinking and mental health, adolescent drinking, smoking and behaviour and mother-child closeness.
FINDINGS: Fit indices (BIC = 12415; AIC = 12234) from LCA supported a four-class solution: low-disorder (73.6%), MH/low-SU-disorder (10.6%), alcohol/cannabis/low-MH-disorder (12.2%), and poly-SU/moderate-MH-disorder (3.5%). Adolescent drinking predicted poly-SU/MH-disorders (OR 3.34; CI95 1.42-7.84), while externalising predicted membership of both SU-disorder groups (ORalcohol/cannabis 2.04, CI95 1.11-3.75; ORpoly-substance 2.65, CI95 1.1-6.08). Maternal smoking during pregnancy predicted MH (OR 1.53, CI95 1.06-2.23) and alcohol/cannabis-use disorders (OR 1.73; CI95 1.22-2.45). Low maternal warmth predicted mental health disorders only (OR 2.21, CI95 1.32-3.71).
CONCLUSIONS: Mental health disorders are more likely in young adults with poly-substance-use disorders than those with alcohol/cannabis use disorders. Predictors of comorbid mental health/poly-substance use disorders differ from those for alcohol/cannabis use disorders, and are detectable during adolescence.
Language: en |