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Flexibly modeling age trends in the prevalence of co-occurring patterns of substance use and mental health disorders using time-varying effects and latent class analysis.

ABSTRACT: Background: Substance use disorders (SUDs) and mental health disorders may change and co-occur in complex patterns across adult ages, but these processes can be difficult to capture with traditional statistical approaches.Objective: To elucidate disorder prevalence and comorbidities across adult ages by using time-varying effect models (TVEMs), latent class analysis (LCA), and modeling latent class prevalences as complex functions of age.Methods: Data were drawn from participants who are 18-65 years old in the National Epidemiologic Survey on Alcohol and Related Conditions III (n = 30,999; 51% women) and a subsample who reported a past-year post-traumatic stress disorder (PTSD), mood, anxiety, or SUD based on DSM-5 diagnoses (n = 11,279). TVEM and LCA were used to examine age trends and comorbidity patterns across ages.Results: SUD prevalence peaked at age 23 (31%) and decreased thereafter, while mental health disorder prevalence was stable (20%-26% across all ages). The prevalence of five classes of individuals based on specific combinations of mental health and SUDs varied by age: the Alcohol Use Disorder class had the highest prevalence at age 26, whereas the Mood and Anxiety Disorder classes peaked around age 63. Interestingly, the Poly-Disorder class prevalence was greatest at age 18 but decreased sharply across young adulthood; however, the prevalence of the other high comorbidity class, PTSD with Mood or Anxiety Disorder, remained fairly constant across age, peaking at age 44.Conclusions: Multimorbid mental health disorders (excluding SUDs) persist in prevalence across adult ages. LCA, TVEM, and their integration together hold substantial potential to advance addiction research.

SUBMITTER: Stull SW

PROVIDER: S-EPMC9933145 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Flexibly modeling age trends in the prevalence of co-occurring patterns of substance use and mental health disorders using time-varying effects and latent class analysis.

Stull Samuel W SW Linden-Carmichael Ashley N AN Cloutier Renee M RM Bonny Andrea E AE Lanza Stephanie T ST

The American journal of drug and alcohol abuse 20220131 3

Background: Substance use disorders (SUDs) and mental health disorders may change and co-occur in complex patterns across adult ages, but these processes can be difficult to capture with traditional statistical approaches.Objective: To elucidate disorder prevalence and comorbidities across adult ages by using time-varying effect models (TVEMs), latent class analysis (LCA), and modeling latent class prevalences as complex functions of age.Methods: Data were drawn from partici ...[more]

PMID: 35100070

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Project description:AimsTo estimate recent trends in cigarette use and health insurance coverage for United States adults with and without mental health and substance use disorders (MH/SUD).DesignEvent study analysis of smoking and insurance coverage trends among US adults with and without MH/SUD using 2008-19 public use data from the National Survey on Drug Use and Health, an annual, cross-sectional survey.SettingUSA.ParticipantsA nationally representative sample of non-institutionalized respondents aged 18-64 years (n = 448 762).MeasurementsOutcome variables were three measures of recent cigarette use and one measure of past-year health insurance coverage. We compared outcomes between people with and without MH/SUD (MH disorder: past-year mental illness, predicted from Kessler-6 and the World Health Organization-Disability Assessment Schedule impairment scale; SUD: met survey-based DSM-IV criteria for past-year alcohol, cannabis, cocaine or heroin use disorder) and over time.FindingsComparing pooled data from 2008 to 2009 and from 2018 to 2019, current smoking rates of adults with MH/SUD decreased from 37.9 to 27.9% while current smoking rates of adults without MH/SUD decreased from 21.4 to 16.3%, a significant difference in decrease of 4.9 percentage points (pts) [95% confidence interval (CI) = 3.3-6.6 pts]. Daily smoking followed similar patterns (difference in decrease of 3.9 pts (95% CI = 2.3-5.4 pts). Recent smoking abstinence rates for adults with MH/SUD increased from 7.4 to 10.9%, while recent smoking abstinence rates for adults without MH/SUD increased from 9.6 to 12.0%, a difference in increase of 1.0 pts (95% CI = -3.0 to 0.9 pts). In 2018-19, 11% of net reductions in current smoking, 12% of net reductions in daily smoking and 12% of net increases in recent smoking abstinence coincided with greater gains in insurance coverage for adults with MH/SUD compared to those without MH/SUD.ConclusionsImprovements in smoking and abstinence outcomes for US adults with mental health and substance use disorders appear to be associated with increases in health insurance coverage.

Dataset Information

Flexibly modeling age trends in the prevalence of co-occurring patterns of substance use and mental health disorders using time-varying effects and latent class analysis.

Publications

Flexibly modeling age trends in the prevalence of co-occurring patterns of substance use and mental health disorders using time-varying effects and latent class analysis.

Similar Datasets

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