Comorbidities: Co-Occurring Mental and Alcohol Use Disorders

Abstract

Co-occurrence of mental and alcohol use disorders presents special challenges in the treatment of people with alcohol problems.

Comorbid mental disorders are common among people with alcohol problems. In Australia, of the 8841 people surveyed in 2007 for the National Survey of Mental Health and Wellbeing, 2.9 per cent met the criteria for harmful alcohol use, and 1.4 per cent met the criteria for alcohol use disorder (AUD). Of this latter group half (53.6%) met the criteria for an anxiety disorder and one-third (34.0%) met the criteria for an affective or mood disorder (ABS 2008). Other disorders associated with alcohol use disorder include other substance use disorders. Conversely, among people with mental disorders, such as depression, 34% of men and 15% of women have concurrent alcohol use problems. Exposure to trauma (such as witnessing serious injury or death, being involved in a life-threatening incident, or being threatened with a weapon etc) is very common among people with an alcohol use disorder. While people with post traumatic stress disorder (PTSD) are more than five times more likely to have an alcohol use disorder than people without PTSD only 5% of people with an AUD meet criteria for PTSD. Approximately one in five people with schizophrenia will have an alcohol use disorder at some time in their life. Thus, comorbid mental disorders are sufficiently common for their presence to be expected and their treatment planned for.