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Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates.
Am J Psychiatry. 2020 11 01; 177(11):1073-1081.AJ

Abstract

OBJECTIVE

The authors examined psychiatric comorbidities associated with alcohol use disorders and tobacco use disorders among heterosexual, bisexual, and gay and lesbian men and women in the United States and whether stress-related factors were predictive of comorbidities.

METHODS

The authors used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013, N=36,309) to examine the co-occurrence of past-year alcohol or tobacco use disorder with past-year anxiety disorders, mood disorders, and posttraumatic stress disorder by sexual identity (heterosexual, bisexual, gay or lesbian) and sex. The authors also examined the association of stress-related factors and social support with the presence of comorbidities.

RESULTS

Comorbidities were more prevalent among women and sexual minorities, particularly bisexual women. More than half of bisexual (55%) and gay or lesbian (51%) individuals who met criteria for a past-year alcohol use disorder had a psychiatric comorbidity, while only one-third of heterosexual individuals who met criteria for a past-year alcohol use disorder did. Similar differences were found among those who met criteria for a past-year tobacco use disorder. Among sexual minorities, the frequency of sexual orientation discrimination (adjusted odds ratio range=1.08-1.10), number of stressful life events (adjusted odds ratio range=1.25-1.43), and number of adverse childhood experiences (adjusted odds ratio range=1.04-1.18) were significantly associated with greater odds of comorbidities. Greater social support was significantly inversely associated with tobacco use disorder comorbidities (adjusted odds ratio range=0.96-0.97).

CONCLUSIONS

This research suggests that integrated substance use and mental health prevention and treatment programs are needed, particularly for individuals who identify as sexual minorities. The increased stressors experienced by sexual minority individuals may be important drivers of these high levels of comorbidities.

Authors+Show Affiliations

Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing (all authors), Addiction Center, Department of Psychiatry (Boyd), and Rogel Cancer Center, Institute for Social Research, and Institute for Healthcare Policy and Innovation (McCabe), University of Michigan, Ann Arbor.Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing (all authors), Addiction Center, Department of Psychiatry (Boyd), and Rogel Cancer Center, Institute for Social Research, and Institute for Healthcare Policy and Innovation (McCabe), University of Michigan, Ann Arbor.Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing (all authors), Addiction Center, Department of Psychiatry (Boyd), and Rogel Cancer Center, Institute for Social Research, and Institute for Healthcare Policy and Innovation (McCabe), University of Michigan, Ann Arbor.Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing (all authors), Addiction Center, Department of Psychiatry (Boyd), and Rogel Cancer Center, Institute for Social Research, and Institute for Healthcare Policy and Innovation (McCabe), University of Michigan, Ann Arbor.Center for the Study of Drugs, Alcohol, Smoking, and Health, School of Nursing (all authors), Addiction Center, Department of Psychiatry (Boyd), and Rogel Cancer Center, Institute for Social Research, and Institute for Healthcare Policy and Innovation (McCabe), University of Michigan, Ann Arbor.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

32911997

Citation

Evans-Polce, Rebecca J., et al. "Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates." The American Journal of Psychiatry, vol. 177, no. 11, 2020, pp. 1073-1081.
Evans-Polce RJ, Kcomt L, Veliz PT, et al. Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates. Am J Psychiatry. 2020;177(11):1073-1081.
Evans-Polce, R. J., Kcomt, L., Veliz, P. T., Boyd, C. J., & McCabe, S. E. (2020). Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates. The American Journal of Psychiatry, 177(11), 1073-1081. https://doi.org/10.1176/appi.ajp.2020.20010005
Evans-Polce RJ, et al. Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates. Am J Psychiatry. 2020 11 1;177(11):1073-1081. PubMed PMID: 32911997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates. AU - Evans-Polce,Rebecca J, AU - Kcomt,Luisa, AU - Veliz,Philip T, AU - Boyd,Carol J, AU - McCabe,Sean Esteban, Y1 - 2020/09/11/ PY - 2021/11/01/pmc-release PY - 2020/9/12/pubmed PY - 2020/12/15/medline PY - 2020/9/11/entrez KW - Bisexual KW - Gay KW - Lesbian KW - Substance-Related and Addictive Disorders KW - Transgender (LGBT) Disparities SP - 1073 EP - 1081 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 177 IS - 11 N2 - OBJECTIVE: The authors examined psychiatric comorbidities associated with alcohol use disorders and tobacco use disorders among heterosexual, bisexual, and gay and lesbian men and women in the United States and whether stress-related factors were predictive of comorbidities. METHODS: The authors used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013, N=36,309) to examine the co-occurrence of past-year alcohol or tobacco use disorder with past-year anxiety disorders, mood disorders, and posttraumatic stress disorder by sexual identity (heterosexual, bisexual, gay or lesbian) and sex. The authors also examined the association of stress-related factors and social support with the presence of comorbidities. RESULTS: Comorbidities were more prevalent among women and sexual minorities, particularly bisexual women. More than half of bisexual (55%) and gay or lesbian (51%) individuals who met criteria for a past-year alcohol use disorder had a psychiatric comorbidity, while only one-third of heterosexual individuals who met criteria for a past-year alcohol use disorder did. Similar differences were found among those who met criteria for a past-year tobacco use disorder. Among sexual minorities, the frequency of sexual orientation discrimination (adjusted odds ratio range=1.08-1.10), number of stressful life events (adjusted odds ratio range=1.25-1.43), and number of adverse childhood experiences (adjusted odds ratio range=1.04-1.18) were significantly associated with greater odds of comorbidities. Greater social support was significantly inversely associated with tobacco use disorder comorbidities (adjusted odds ratio range=0.96-0.97). CONCLUSIONS: This research suggests that integrated substance use and mental health prevention and treatment programs are needed, particularly for individuals who identify as sexual minorities. The increased stressors experienced by sexual minority individuals may be important drivers of these high levels of comorbidities. SN - 1535-7228 UR - https://www.unboundmedicine.com/medline/citation/32911997/Alcohol_Tobacco_and_Comorbid_Psychiatric_Disorders_and_Associations_With_Sexual_Identity_and_Stress_Related_Correlates_ L2 - https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.20010005?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -