Lifetime Affective and Alcohol Use Disorder: Impact of Comorbidity on Current Functioning and Service Use in a Rural PopulationFrances J Kay Lambkin1,2, Kerry J Inder1,2*, Tonelle E Handley2,3, Yun Ming Yong4, Terry J Lewin1 and Brian J Kelly1
2National Health and Medical Research Council Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Corresponding Author:
- Dr. Kerry Inder
Hunter Institute of Mental Health
PO Box 833, Newcastle, NSW 2300 Australia
Tel: +61 2 4924 6959
Fax: +61 2 4924 6901
Received date: January 27, 2014; Accepted date: May 20, 2014; Published date: May 31, 2014
Citation: Kay Lambkin FJ, Inder KJ, Handley TE, Yong YM, Lewin TJ, et al. (2014) Lifetime Affective and Alcohol Use Disorder: Impact of Comorbidity on Current Functioning and Service Use in a Rural Population. J Addict Res Ther S10:009. doi:10.4172/2155-6105.S10-009
Copyright: © 2014 Kay Lambkin FJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Depression and alcohol use problems frequently co-occur and significant barriers to service use for co-morbid mental health problems exist.
Purpose of the study: This study examines relationships between current functioning and lifetime treatment among people with an affective disorder (AD) and/or an alcohol use disorder (AUD) in a rural sample.
Methodology: A sub-sample of participants in the Australian Rural Mental Health Study with lifetime AD and/or AUD were assessed for current functioning using measures of psychological distress, alcohol use, and physical and psychological impairment, using multivariate logistic regression. Help seeking and perceived treatment effectiveness were examined across disorders.
Major findings: 234 participants (55% female) met criteria for a lifetime AD and/or AUD. A lifetime history of both disorders (24%) was associated with higher levels of current psychological distress, psychological and physical impairment than a lifetime history of AUD alone, and higher levels of risky current alcohol use than AD alone. Substantial delays in treatment seeking were detected (from 9-14 years). Those with AUD alone reported unacceptably low rates of treatment seeking (11%) compared with the other groups (76-78%). Those with comorbid AD+AUD reported the lowest endorsement of past perceived “effective treatment” for either condition. Effective treatment for depression was less likely to be reported by those with both AD and AUD.
Conclusion: Lifetime comorbid AD+AUD has a specific impact on current psychological and physical functioning that is not accounted for by age, gender, recent life events or chronic illness, highlighting the pressing need for better and more effective ways to offer assessment and treatment for these conditions. Rural participants more frequently accessed treatment for AD than AUD, representing an important opportunity to intervene early to better manage or prevent AUD and their associated burden. Technological solutions offer promise in this context as a way to address this need.