The English language literature on the epidemiology of dual diagnosis is reviewed.
The literature shows mental disorders to be significantly related to alcohol and drug
use disorders. The strongest associations involve externalizing mental disorders and
alcohol-drug dependence. Mental disorders are associated with alcohol-drug use, problems
among users, dependence among problem users, and persistence among people with lifetime
dependence. These dual diagnoses are associated with severity and persistence of both
mental and alcohol-drug disorders. A wider range of mental disorders is associated
with nicotine dependence. Most people with dual diagnosis report their first mental
disorder occurred at an earlier age than their first substance disorder. Prospective
studies confirm this temporal order, although significant predictive associations
are reciprocal. Analyses comparing active and remitted mental disorders suggest that
some primary mental disorders are markers and others are causal risk factors for secondary
substance disorders. The article closes with a discussion of ways epidemiologic research
can be used to help target and evaluate interventions aimed at preventing secondary
substance use disorders by treating early-onset primary mental disorders.
Key words
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Article info
Publication history
Published online: September 13, 2004
Accepted:
June 25,
2004
Received in revised form:
June 22,
2004
Received:
March 30,
2004
Identification
Copyright
© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
