Epidemiology
·
1986 CHCH Psychiatric
Epidemiology Study: Lifetime prevalence rates:
·
Adolescents:
o 5% of 15 year olds meet criteria for alcohol abuse (Fergusson 1994)
o Cannabis dependence 7% at 18 years, 10% at 21 years. Higher in males
·
Co-morbidity or Dual Diagnosis:
o Epidemiologic Catchment Area (ECA) Study 1990 found the lifetime
co-morbidity of substance use disorders by specific diagnoses:
·
Those with a mental disorder have
twice the risk of an alcohol disorder and 4 times the risk of any other drug
disorder
·
Those with a lifetime alcohol
disorder have twice the risk of another mental disorder (37%) and 6 times the
risk of another drug disorder (22%)
·
Those with a lifetime other drug
disorder have a 4 times risk of another mental disorder (53%) and 7 times the
risk of an alcohol disorder (47%)
·
Co-morbidity is higher in
institutional settings (70- 80%) than in the community
·
Þ Dual diagnosis is an expectation not an exception
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