Association of psychiatric and substance use disorder comorbidity with cocaine dependence severity and treatment utilization in cocaine-dependent individuals.
paper
Cited
Public
- Authors
- Ford, Julian D; Gelernter, Joel; DeVoe, Judith S; Zhang, Wanli; Weiss, Roger D; Brady, Kathleen; Farrer, Lindsay; Kranzler, Henry R
- Year
- 2009
- Journal
- Drug and alcohol dependence
- PMID
- 18775607
- DOI
- 10.1016/j.drugalcdep.2008.07.004
- PMCID
- PMC2745327
The relations among psychiatric and substance dependence disorders and treatment utilization are of interest both for their clinical management and for health services. We examined these relations using six self-reported indices of cocaine dependence severity and three self-reported measures of treatment utilization and self-help group participation for cocaine dependence. The sample consisted of dyads: namely, a cocaine-dependent adult proband (N=449) and a cocaine-dependent sibling (N=449). Psychiatric and substance use disorders were assessed with the Semi-structured Assessment for Drug Dependence and Alcoholism. We controlled for the nesting within families of proband-sibling dyads and for demographic features using generalized estimating equation linear and logistic regression analyses. We found that psychiatric disorders were associated with an increased likelihood of cocaine dependence treatment or self-help group participation, but with only one of six indices of cocaine dependence severity. Bipolar disorder and antisocial personality disorder were associated with greater past heavy cocaine use, and with utilizing self-help but not treatment. Major depressive disorder and posttraumatic stress disorder were associated with treatment utilization and overall services utilization, respectively. The presence of other substance use disorders (SUDs) was the strongest correlate of cocaine dependence severity. Results suggest that co-occurring substance dependence and psychiatric disorders warrant attention in cocaine dependence assessment, treatment, and self-help.
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| # | Section | Preview |
|---|---|---|
| 40 | 4. Discussion — 4.3 Co-Occurring Substance Use Disorders and Cocaine Dependence Severity and Services | Alcohol dependence also was associated with heavy past cocaine use and lifetime dependence severity,… |
| 41 | 4. Discussion — 4.3 Co-Occurring Substance Use Disorders and Cocaine Dependence Severity and Services | Sedative use disorders have been associated with increased cocaine dependence severity (Chutuape et… |
| 42 | 4. Discussion — 4.4 Study Strengths and Limitations | The study had several methodological strengths including the large, demographically diverse… |
| 43 | 4. Discussion — 4.4 Study Strengths and Limitations | Study limitations include use of a convenience sample comprised of affected sibling pairs, which is… |
| 44 | 4. Discussion — 4.5 Conclusion | After accounting for the effects of demographic factors and other substance dependence disorders,… |
| 45 | 4. Discussion — 4.5 Conclusion | Moreover, in addition to bipolar disorder and ASPD, MDD and PTSD were associated with an increased… |
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41–46 of 46
| Name | Type |
|---|---|
| Adverse legal consequences local | phenotype |
| affective disorders | phenotype |
| African American | cohort |
| age | phenotype |
| age-matched siblings local | cohort |
| Age of first heavy cocaine use local | phenotype |
| agoraphobia | phenotype |
| alcohol | phenotype |
| alcohol dependence | phenotype |
| Alcohol Problems | phenotype |
| Alcohol Use | phenotype |
| Alcohol Use Disorder | phenotype |
| Antidepressant pharmacotherapy local | drug |
| antisocial personality disorder | phenotype |
| anxiety | phenotype |
| arrests | phenotype |
| ASPD | phenotype |
| bipolar disorder | phenotype |
| borderline personality disorder | phenotype |
| cannabis dependence | phenotype |
| cannabis use | phenotype |
| clinical samples | cohort |
| Cluster B personality disorders local | phenotype |
| cocaine | phenotype |
| cocaine arrest local | phenotype |
| Cocaine dependence self-help participation local | phenotype |
| cocaine dependence self-help support programs local | phenotype |
| cocaine dependence treatment local | cohort |
| Cocaine dependence treatment participation local | phenotype |
| Cocaine dependence treatment utilization local | phenotype |
| cocaine dependent adults local | cohort |
| Cocaine dependent adults local | cohort |
| Cocaine-dependent sibling pairs cohort local | cohort |
| cocaine overdose local | phenotype |
| cocaine-related impairment local | phenotype |
| Cocaine-related treatment utilization local | phenotype |
| cocaine use disorder | phenotype |
| cocaine use severity local | phenotype |
| cocaine withdrawal | phenotype |
| combined psychiatric comorbidity local | phenotype |
| community | cohort |
| Community study local | cohort |
| Co-occurring alcohol and cocaine dependence local | phenotype |
| Co-occurring sedative and cocaine use local | phenotype |
| Co-occurring substance use disorder local | phenotype |
| Days of cocaine use (heaviest period) local | phenotype |
| Days of Use in the Heaviest Period of Use local | phenotype |
| Dependence symptoms | phenotype |
| depression | phenotype |
| diagnosis | phenotype |
| Earlier age of onset of heavy cocaine use local | phenotype |
| educational attainment | phenotype |
| employed | phenotype |
| employment | phenotype |
| employment problems local | phenotype |
| Employment problems local | phenotype |
| Episodes of substance abuse treatment local | phenotype |
| European population | cohort |
| Family and social problems local | phenotype |
| Heaviest cocaine use days local | phenotype |
| Heavy cocaine use local | phenotype |
| heavy drinking | phenotype |
| Heavy past cocaine use local | phenotype |
| Heroin use reduction local | phenotype |
| heroin users | phenotype |
| Hispanic | phenotype |
| history of cannabis dependence local | phenotype |
| history of opioid dependence local | phenotype |
| History of overdoses local | phenotype |
| Lamotrigine local | drug |
| legal problems | phenotype |
| Less educated | phenotype |
| Lifetime cocaine dependence criteria local | phenotype |
| Lifetime cocaine withdrawal symptoms local | phenotype |
| Lifetime dependence severity local | phenotype |
| Lifetime withdrawal severity local | phenotype |
| liver disease | phenotype |
| Longer drug use history local | phenotype |
| major depressive disorder | phenotype |
| marijuana | phenotype |
| marital status | phenotype |
| Marital violence local | phenotype |
| medical problems | phenotype |
| Mental distress local | phenotype |
| Mental health services local | phenotype |
| mental health treatment local | drug |
| Methadone | drug |
| Methadone maintenance local | cohort |
| Mills et al. 2007 study local | cohort |
| Mixed and rapid cycling mania local | phenotype |
| Mixed substance use disorder local | phenotype |
| mood disorders | phenotype |
| Multiple psychiatric comorbidity local | phenotype |
| Native Americans | cohort |
| No history of diagnosis local | phenotype |
| Non-treatment samples local | cohort |
| Opiate dependent local | phenotype |
| Opiate dependent treatment recipients local | cohort |
| opioid | drug |
| opioid dependence | phenotype |
| Opioid dependence severity local | phenotype |
| other drug use | phenotype |
| other substances | phenotype |
| overdose | phenotype |
| Pacific Islander local | phenotype |
| Panic/Agoraphobia local | phenotype |
| Panic/agoraphobia disorder local | phenotype |
| panic disorder | phenotype |
| past arrest for cocaine-related crimes local | phenotype |
| past cocaine-related overdose local | phenotype |
| Past history of diagnosis local | phenotype |
| Past opioid dependence local | phenotype |
| Past risky behaviors local | phenotype |
| Physical impairment local | phenotype |
| polysubstance dependence | phenotype |
| Poor retention and drug use outcomes local | phenotype |
| posttraumatic stress disorder | phenotype |
| Post-Traumatic Stress Disorder | phenotype |
| Proband cohort local | cohort |
| probands | cohort |
| psychiatric disorders | phenotype |
| Psychiatric symptom severity local | phenotype |
| psychological distress | phenotype |
| Psychosocial impairment local | phenotype |
| psychosocial problems | phenotype |
| Research treatment recipients local | cohort |
| Retention | phenotype |
| risk-taking behavior | phenotype |
| risky sexual behavior | phenotype |
| schizoaffective disorder | phenotype |
| schizophrenia | phenotype |
| sedative dependence | phenotype |
| sedatives | drug |
| Seeking Safety local | drug |
| self-help local | drug |
| self-help participation local | phenotype |
| Self-help participation local | phenotype |
| Self-help program participation local | phenotype |
| Self-help support program participation local | phenotype |
| self-help support programs local | cohort |
| Self-help support programs local | cohort |
| service utilization local | phenotype |
| Severe cocaine dependence local | phenotype |
| severity | phenotype |
| sex | phenotype |
| Sibling local | cohort |
| Sibling cohort local | cohort |
| sibling pairs | cohort |
| siblings | cohort |
| stimulant | drug |
| stimulant dependence | phenotype |
| Stimulant dependence (non-cocaine) local | phenotype |
| stimulants | drug |
| substance abuse | phenotype |
| substance dependence disorders local | phenotype |
| Substance dependence disorders local | phenotype |
| Substance dependence severity local | phenotype |
| substance dependence treatment local | drug |
| substance use | phenotype |
| SUD | phenotype |
| SUD comorbidity local | phenotype |
| SUD self-help group participation local | phenotype |
| SUD symptoms local | phenotype |
| SUD treatment outcomes local | phenotype |
| suicide | phenotype |
| suicide risk | phenotype |
| Sustained recovery from SUDs local | phenotype |
| Trafton et al. 2006 study local | cohort |
| Traumatic stressors local | phenotype |
| Treatment attendance local | phenotype |
| treatment participation local | phenotype |
| Treatment participation local | phenotype |
| treatment response | phenotype |
| treatment retention | phenotype |
| treatment samples | cohort |
| treatment/self-help variable local | phenotype |
| Treatment use local | phenotype |
| treatment utilization | phenotype |
| Twin cohort | cohort |
| unemployment | phenotype |
| United States adult population local | cohort |
| Unmarried | phenotype |
| Use of self-help for cocaine dependence local | phenotype |
| Use of treatment for cocaine dependence local | phenotype |
| utilization of services for cocaine dependence local | phenotype |
| withdrawal | phenotype |
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|---|---|---|
| The aggregate effect of dopamine genes on dependence symptoms among cocaine users: cross-validation of a candidate system scoring approach. | 2012 | 22358648 |
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