Influence of Comorbid Alcohol and Psychiatric Disorders on Utilization of Mental Health Services in the National Comorbidity Survey

• Published in: The American journal of psychiatry Vol. 156; no. 8; pp. 1230 - 1236
• Main Authors: Wu, Li-Tzy, Kouzis, Anthony C., Leaf, Philip J.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01-08-1999; American Psychiatric Association
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Age Factors; Alcoholism; Alcoholism - diagnosis; Alcoholism - epidemiology; Biological and medical sciences; Comorbidity; Continental Population Groups; Diagnosis, Dual (Psychiatry); Factor Analysis, Statistical; Female; Humans; Influences; Male; Marital Status; Medical sciences; Mental disorders; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental health; Mental health services; Mental Health Services - utilization; Middle Aged; National surveys; Odds Ratio; Probability; Psychiatric disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sex Factors; Substance abuse; Substance Abuse Treatment Centers - utilization; United States - epidemiology; USA; Use; United States; Human; Abuse; Alcoholism; Use; Prediction; Mental health; Health service; Stress; Alcoholic beverage; Family story; Concomitant disease; Life events; Sociodemographic factor; Dependence; Mental disorder; Diagnosis; Public health; Social support
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.156.8.1230

OBJECTIVE: This study sought to determine how comorbidity of psychiatric and substance abuse disorders affects the likelihood of using mental health services. METHOD: The analysis was based on data on adults aged 18-54 years in the National Comorbidity Survey (N=5,393). Users and nonusers of mental health and substance abuse services were compared in terms of their demographic characteristics, recent stressful life events, social support, parental history of psychopathology, self-medication, and symptoms of alcohol abuse dependence. RESULTS: The prevalence of service utilization varied by diagnostic configurations. Comorbid psychiatric or alcohol disorders were stronger predictors of service utilization than a pure psychiatric or alcohol disorder. Factors predicting utilization of services differed for each disorder. CONCLUSIONS: Since comorbidity increases the use of mental health and substance abuse services, research on the relationship of psychiatric and alcohol-related disorders to service utilization needs to consider the coexistence of mental disorders. Attempts to reduce barriers to help seeking for those in need of treatment should be increased.