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Predictors of comorbid polysubstance use and mental health disorders in young adults—a latent class analysis
Author(s) -
Salom Caroline L.,
Betts Kim S.,
Williams Gail M.,
Najman Jackob M.,
Alati Rosa
Publication year - 2016
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13058
Subject(s) - psychiatry , polysubstance dependence , conduct disorder , mental health , alcohol use disorder , latent class model , cannabis , medicine , odds ratio , offspring , pregnancy , substance abuse , psychology , biochemistry , chemistry , statistics , alcohol , mathematics , biology , genetics
Aim The 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 = 2575). Measurements The Composite International Diagnostic Interview yielded life‐time diagnoses of mental health (MH) and substance use (SU) disorders for offspring, then latent class modelling predicted membership of polydisorder 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 [Bayesian information criterion (BIC) = 12 415; Akaike information criterion (AIC) = 12 234] 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 [odds ratio (OR) = 3.34, 95% confidence interval (CI) = 1.42–7.84], while externalizing predicted membership of both SU disorder groups (OR alcohol/cannabis = 2.04, 95% CI = 1.11–3.75; OR polysubstance = 2.65, 95% CI = 1.1–6.08). Maternal smoking during pregnancy predicted MH (OR = 1.53, 95% CI = 1.06–2.23) and alcohol/cannabis‐use disorders (OR = 1.73; 95% CI = 1.22–2.45). Low maternal warmth predicted mental health disorders only (OR = 2.21, 95% CI = 1.32–3.71). Conclusions Mental health disorders are more likely in young adults with polysubstance use disorders than those with alcohol/cannabis use disorders. Predictors of comorbid mental health/polysubstance use disorders differ from those for alcohol/cannabis use disorders, and are detectable during adolescence.