Elsevier

Addictive Behaviors

Volume 23, Issue 6, November–December 1998, Pages 909-918
Addictive Behaviors

Substance misuse and psychiatric comorbidity: An overview of the opcs national psychiatric morbidity survey

https://doi.org/10.1016/S0306-4603(98)00075-6Get rights and content

Abstract

There have been a number of national surveys of psychiatric morbidity which have included questions on drugs, alcohol and tobacco. These surveys have helped delineate the overlap between substance use and dependence and other psychological morbidity. There is a strong association reported between high substance consumption and other measures of psychological problems. This article provides an overview of a national household survey, a survey of institutional residents with psychiatric disorders and a national survey of a homeless population. All three surveys used comprehensive and complex sampling strategies and lay interviewers to conduct structured diagnostic interviews. The household survey included over 10,000 households, the institutional survey interviewed 755 individuals and the homeless survey of hostels, night-shelters, day centres and private-sector leased accommodation interviewed 1,061 individuals. This overview looks at patterns of nicotine, alcohol and other drug use in the different samples and examines interactions with other psychiatric morbidity. The survey reports that substance-related disorders are some of the commonest disorders in the community, with 5% of the household sample alcohol dependent, 7% alcohol dependent in the institutional sample and over 21% in the homeless sample recorded as alcohol dependent. Tobacco, alcohol and other drug use and dependence were dramatically higher in the homeless sample than in either of the other two samples. Substance use was significantly associated with higher rates of psychological morbidity as measured by the Clinical Interview Schedule Revised. Future service planning needs to take account of the striking disparity of prevelance of psychiatric disorders in different subsections of the population.

Section snippets

The surveys

The three different surveys consisted of (a) a private household survey of 10,108 individuals Meltzer, Gill, Petticrew, & Hinds 1995, Jenkins et al. 1997a, Jenkins et al. 1997b; (b) an institutional survey selected on a national basis from a comprehensive list of hospitals, hostels and residential homes to yield a total sample of 755 “permanent” residents Meltzer et al. 1996a, Meltzer et al. 1996b; and (c) a national homeless survey of people in private-sector leased accommodation, in hostels,

Cigarette smoking

Some 31% of the household sample were current smokers, whereas 70% of the homeless and 74% of the institutional sample were smokers. Of the smokers, 11% of the general household, 34% of the homeless and 50% of the institutional sample were heavy smokers Table 1, Table 2

Alcohol consumption and dependence

Rates of abstention were higher in the institutional and homeless sample than in the general household sample. Self-reported rates of very heavy drinking were 5% in the general sample, were lower in the institutional sample at 3%

Discussion and conclusions

Overall reported rates of alcohol and tobacco consumption and dependence are consistent with other national household surveys Jenkins et al. 1997a, Jenkins et al. 1997b. The reported rates of ever drug use in the different age categories are similar to previous British Crime Surveys but conservative by comparison to more recent household surveys, particularly of young people. However, figures in the younger age groups are closer to those from the British Crime Survey but still lower.

Rates are

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