were significant in the univariate analysis, in the adjusted model these differences were better accounted for by prison time. A diagnosis of PTSD was not associated with increased dependence diagnoses for females (Tables 5). In sum, increasing substance dependence diagnoses were associated with poorer mental health, greater harms (overdose and suicide attempt) and child maltreatment for both sexes; however sex differences emerged with respect to type of psychiatric disorder and child maltreatment.
