Women with Co-Occurring Serious Mental Illness and a Substance Use Disorder. The NSDUH Report

摘要

Recent research has found that women admitted to substance abuse treatment with co-occurring psychiatric and substance use disorders were less likely to be in the labor force and less likely to have been referred for treatment by the criminal justice system than women admitted to substance abuse treatment with no psychiatric disorder. Additional research also has identified differences between women with co-occurring mental and substance use disorders and their male counterparts. Compared with men, women with cooccurring mental and substance use disorders were more likely to seek help in mental health and outpatient settings, have poorer job skills, and suffer from serious physical health problems. The National Survey on Drug Use and Health (NSDUH) includes questions for adults aged 18 or older to assess serious mental illness (SMI) during the year prior to the survey interview. Individuals are classified as having SMI if at some time during the past year they had a mental, behavioral, or emotional disorder that met criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4thedition (DSM-IV)3, and that resulted in functional impairment that substantially interfered with or limited one or more major life activities. NSDUH measures SMI using the K-6 distress questions.4,5 NSDUH also includes a series of questions to assess dependence on or abuse of alcohol or illicit drugs. Illicit drugs include marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, and prescription- type drugs used nonmedically. These questions are designed to measure dependence and abuse based on criteria specified in the DSM-IV. For the purpose of this report, individuals with either alcohol or drug dependence or abuse are said to have a substance use disorder. Individuals with both SMI and a substance use disorder are said to have co-occurring SMI and a substance use disorder. NSDUH respondents are also asked about their experiences with treatment for a mental problem and with specialty substance use treatment during the past year. Treatment for a mental problem is defined as the receipt of services in any inpatient or outpatient setting for problems with emotions, nerves, or mental health in the 12 months prior to the interview.