Disentangling psychopathology, substance use and dependence: a factor analysis

Jaime Delgadillo, Jan R Böhnke, Elizabeth Hughes, Simon Gilbody

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    3 Citations (Scopus)
    153 Downloads (Pure)

    Abstract

    Background
    The notion that substance use can induce symptoms of depression and anxiety is influential in clinical practice, however questions remain about the empirical support for this hypothesis.

    Methods
    We analysed mental health and substance dependence screening records for 280 outpatients in addictions treatment. Item-level data for depression (PHQ-9), anxiety (GAD-7), severity of dependence (SDS) and self-reported weekly substance use were studied using factor analysis and correlations. Symptom-level associations between substance use and psychological distress symptoms were examined after controlling for underlying levels of psychopathology.

    Results
    We obtained a two-factor solution accounting for approximately 48 % of total variance. Depression and anxiety symptoms loaded onto a single psychopathology factor. Severity of dependence (SDS) and substance use measures loaded onto a distinct but correlated factor. After controlling for latent levels of psychopathology, the only remaining symptom-level associations were impaired concentration linked to cannabis use and irritability linked to alcohol use. Dependence (SDS) was prominently associated with depressive rumination, and negatively correlated with residual anxiety symptoms related to substance use (e.g., craving).

    Conclusions
    Overall, this analysis supports a psychological understanding of comorbidity; with dependence, craving, negative reinforcement and rumination as key variables.
    Original languageEnglish
    Number of pages10
    JournalBMC Psychiatry
    Volume16
    Issue number281
    DOIs
    Publication statusPublished - 1 Aug 2016

    Keywords

    • Depression
    • Anxiety
    • Alcohol
    • Drugs
    • Addiction

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