Disentangling psychopathology, substance use and dependence: a factor analysis

Delgadillo, Jaime; Böhnke, Jan R.; Hughes, Elizabeth; Gilbody, Simon

doi:10.1186/s12888-016-0988-1

Cited by 8 publications

(7 citation statements)

References 77 publications

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“…Finally, other studies show that mental health problems can be validly assessed among people undergoing treatment for DUD with use of self-report instruments [55][56][57]. As such, identification of co-existing psychopathology should be highlighted even more as a potential first step towards suicide prevention.…”

Section: Implications For Practicementioning

confidence: 99%

Suicide among people treated for drug use disorders: a Danish national record-linkage study

et al. 2020

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Background: Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. Methods: This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000-2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls without drug use disorder and with (n = 138,136) or without psychiatric history (n = 1574). Competing risk regression was used to identify risk factors of completed suicide. Results: There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% confidence interval (CI): 0.95, 0.98), history of psychiatric care (HR = 1.96, CI 95%: 1.39, 2.77), opioid use (HR = 1.81, 95% CI: 1.23, 2.68), and alcohol use (HR = 1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR = 0.69, 95% CI: 0.50, 0.96). Compared with age-and gender-matched controls without a history of treatment for substance use disorders or recent psychiatric care, the standardized mortality ratio due to suicide was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50). Conclusions: Risk of suicide is increased among people with drug use disorders. Access to treatment for comorbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.

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Section: Implications For Practicementioning

confidence: 99%

Suicide among people treated for drug use disorders: a Danish national record-linkage study

et al. 2020

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“…Studies investigating the relationship between alcohol use and anxiety are scarce and indicate mixed findings. Some studies investigating cross‐sectional associations report no significant associations (e.g., Delgadillo, Böhnke, Hughes, & Gilbody, 2016; Delgadillo, Godfrey, Gilbody, & Payne, 2013). Other studies indicate that remitted or severe alcohol dependence are associated with a poorer longitudinal course of anxiety severity (e.g., Boschloo et al., 2012), which fits a nonlinear pattern as described above.…”

Section: Discussionmentioning

confidence: 99%

“…As argued by Delgadillo, Böhnke, et al. (2016), the lack of a linear dose‐response relationship between alcohol use and anxiety severity makes it less plausible that alcohol use has a direct influence on anxiety symptoms, and any apparent relationship may therefore be explained by intermediate (i.e., mediating) variables.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of consistency between the pre-treatment and post-treatment analyses makes it improbable that alcohol use per se is associated with 'alcohol induced' anxiety symptoms. As argued by Delgadillo, B€ ohnke, et al (2016), the lack of a linear dose-response relationship between alcohol use and anxiety severity makes it less plausible that alcohol use has a direct influence on anxiety symptoms, and any apparent relationship may therefore be explained by intermediate (i.e., mediating) variables.…”

Section: Interpretation and Wider Empirical Contextmentioning

confidence: 99%

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Is alcohol use associated with psychological treatment attendance and clinical outcomes?

Hunt

Delgadillo

2021

British J Clinic Psychol

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Objectives To investigate associations between alcohol use, psychological treatment attendance, and clinical outcomes. Methods We analysed electronic health records for N = 7,986 patients accessing psychological treatment for common mental disorders. Data were collected for pre‐treatment alcohol use (average units per week) and severity of dependence (SDS), number of therapy contacts attended, pre‐ and post‐treatment anxiety (GAD‐7), and depression (PHQ‐9) symptom severity. Hierarchical regression was used to examine associations between alcohol use/dependence and post‐treatment symptom severity controlling for intake severity and relevant confounders. Results After controlling for confounders, alcohol use had significant nonlinear associations with pre‐treatment depression severity (R2 = .54, p < .01, cubic trend), and post‐treatment anxiety (R2 = .23, p < .01, quadratic trend). Alcohol use was not significantly associated with intake anxiety, post‐treatment depression or treatment duration. SDS was not significantly associated with depression severity, alcohol severity, or total contacts after controlling for confounders. Conclusion Alcohol users are just as likely to engage in and benefit from evidence‐based psychological treatments for depression in primary care. A nonlinear association between alcohol use and anxiety treatment outcomes indicates that light‐to‐moderate drinkers have some shared characteristic that favours treatment response. Practitioner points Depression and anxiety problems often co‐occur with alcohol use and dependence. Conventional wisdom in the field suggests that heavy alcohol users may not engage well or benefit from psychological therapies for depression and anxiety. We found no empirical support for the above assumptions in a large clinical sample. Alcohol consumption was not significantly associated with treatment attendance or depression treatment outcomes. A nonlinear association between alcohol use and anxiety outcomes suggests that moderate drinkers may have some shared characteristic that favours treatment response.

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“…Furthermore, there is robust evidence that antidepressants can be helpful for people with co-morbid depression and substance use disorders, even if the effects are larger when patients are abstinent before being treated (45, 46) and the quality of the evidence is mixed (47). Finally, other studies show that mental health problems can be validly assessed among people undergoing treatment for DUD with use of self-report instruments (48,49). As such, identification of co-existing psychopathology should be highlighted even more as a potential first step towards suicide prevention.…”

Section: Implications For Practicementioning

confidence: 99%

Suicide among people treated for drug use disorders: a Danish national record-linkage study

Hesse

Thylstrup

Seid

et al. 2019

Preprint

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Background Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. Methods This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000-2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls. Competing risk regression was used to identify risk factors of completed suicide. Results There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% CI: 0.95, 0.98), history of psychiatric care (HR=1.96, CI 95%: 1.39, 2.77), opioid use (HR=1.81, 95% CI: 1.23, 2.68) and alcohol use (HR=1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR=0.69, 95% CI: 0.50, 0.96). The standard mortality ratio was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50) Conclusions Risk of suicide is increased among people with drug use disorders. Access to treatment for co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.

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Disentangling psychopathology, substance use and dependence: a factor analysis

Cited by 8 publications

References 77 publications

Suicide among people treated for drug use disorders: a Danish national record-linkage study

Suicide among people treated for drug use disorders: a Danish national record-linkage study

Is alcohol use associated with psychological treatment attendance and clinical outcomes?

Suicide among people treated for drug use disorders: a Danish national record-linkage study

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