Comorbidity of mental disorders with alcohol and other drug abuse: results from the epidemiologic catchment area (ECA) study

Article Abstract:

Public health awareness during the past decade has focused on problems related to alcohol and drug abuse, as well as on mental disorders (ADM). The comorbidity (occurrence of more than one disorder in the same person) of ADM was investigated by analyzing data from the Epidemiologic Catchment Area (ECA) study, carried out by the National Institute of Mental Health (NIMH). The ECA study gathered data regarding the prevalence of ADM in structured interviews, using a standardized questionnaire; the format was such that all three disorders could be evaluated in the same interview. Information was elicited from 20,291 subjects over the age of 18. One-month, six-month, and lifetime prevalence rates of ADM per 100 persons were calculated. The rates for the lifetime occurrences of mental disorder, alcohol abuse/dependence or drug abuse/dependence were 22.5, 13.5, and 6.1 percent, respectively. Slightly more than 22 percent of people who had received a diagnosis of a mental disorder in their lifetimes had a history of alcohol abuse; 15 percent had a history of other drug abuse; and 29 percent had a history of either addictive disorder. Of those with alcohol disorders, 37 percent had one or more other mental disorder and 22 percent had another drug abuse disorder. Over half of those with a lifetime history of drug abuse also had a mental disorder; half also had a history of alcohol abuse. Comorbidity figures for specific diagnostic categories of mental disorder and drug and alcohol abuse are presented, as are figures for specific substance abuse disorders. The results show that care of mental disorders should be a primary goal of any efforts to prevent substance abuse. The reasons these comorbidity rates are so high remain a mystery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Alcoholism, Mental illness, Mental disorders, Drug abuse

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From the Alcohol, Drug Abuse, and Mental Health Administration (Diagnosis and treatment of clinical depression by primary care physicians) (column)

Article Abstract:

Clinical depression in many cases is a chronic condition that recurs over the years. At least 1 in 20 persons develops clinical depression at some time during their life. When patients seek medical help, they frequently do not complain of depression, but of various physical symptoms, and the physician typically consulted is not a psychiatrist, but a general primary care physician. The most common physical manifestation of depression is sleep disturbance, but other frequent complaints are digestive problems, fatigue, and muscle aches. Because the true illness may be hidden behind physical complaints, depression is often misdiagnosed. One study found that general physicians missed the diagnosis of depression in approximately 50 percent of patients. More doctors working for prepaid health plans failed to diagnose depression than physicians in fee-for-service practice. It has also been shown that when general practitioners do recognize the psychological root of the patient's complaints, they often fail to make a specific diagnosis, and also often inappropriately prescribe psychotropic drugs. It is not surprising that general physicians have difficulty with the diagnosis and treatment of depression. Knowledge and treatments are evolving so quickly, even psychiatrists can easily become out of date. The American Medical Association and the US Public Health Service are taking measures to educate general physicians about clinical depression; it is hoped that this will improve patient care and reduce medical costs in the long run. Also, by paying attention to the proper treatment of depression, the stigma that is attached to this disorder will be reduced. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Management, Depression, Mental, Depression (Mood disorder), Physicians (General practice), General practitioners, column

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From the Alcohol, Drug Abuse, and Mental Health Administration

Article Abstract:

Within the past decade, there has been increased opposition to the use of animals in biomedical research. Antivivisectionists, people opposed to the use of animals in biomedical research, have taken over the animal welfare movement. The scientific illiteracy of the young and complicity within the medical and academic research communities have contributed to the increase in antivivisectionist sentiment. Although animal research makes up less than 25 percent of all biomedical research, animal models provide the intermediate stage between in vitro or test tube-like research and patient studies. The antivivisectionist philosophy is based on the moral equivalence between humans and other sentient beings, or creatures capable of perceiving sensation. The use of animals by humans is considered 'speciesism', similar to racism or sexism. As a result, the research and medical committees have tried to reduce the number of animals used, refine procedures, and replace animals with alternatives. However, physicians must work to expose the philosophy of animal rights, with emphasis on its incompatibility with the humanistic values of the health profession, and become aware of the activists' arguments opposing animal research. The contributions of animal research to the treatment of several diseases, particularly in the cardiovascular-pulmonary fields should be emphasized. The animal rights movement has now targeted research of mental and addictive disorders, which may be particularly damaging in a time when the country is facing a crisis of drug abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Models, Evaluation, Diseases, Beliefs, opinions and attitudes, Ethical aspects, Medical research, Public relations, Animal experimentation, Animal rights movement, Vivisection, Medicine, Experimental, United States. Alcohol, Drug Abuse and Mental Health Administration

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