Does early socio-economic disadvantage predict comorbid alcohol and mental health disorders?

• Published in: Drug and alcohol dependence 2014-09, Vol.142, p.146-153
• Main Authors: Salom, Caroline L, Williams, Gail M, Najman, Jake M, Alati, Rosa
• Format: Article
• Language: English
• Subjects: Alcohol; Alcoholism - epidemiology; Alcoholism - etiology; Australia - epidemiology; Brisbane, Australia; Comorbid; Comorbidity; Female; Hospitals; Humans; Longitudinal; Longitudinal Studies; Male; Marriage and Family Education; Mental Disorders - epidemiology; Mental Disorders - etiology; Mental Health; Mothers; Parents; Poverty; Pregnancy; Prevalence; Prospective Studies; Psychiatry; Public Health; Socioeconomic; Socioeconomic Factors; Young Adult
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2014.06.011

Abstract Background Alcohol and mental health disorders are highly prevalent in the general population, with co-occurrence recognised as a major public health issue. Socio-economic factors are frequently associated with both disorders but their temporal association is unclear. This paper examines the association between prenatal socio-economic disadvantage and comorbid alcohol and mental health disorders at young adulthood. Methods An unselected cohort of women was enrolled during early pregnancy in the large longitudinal Mater-University of Queensland Study of Pregnancy (MUSP), at the Mater Misericordiae Public Hospital in Brisbane, Australia. The mothers and their offspring were followed over a 21 year period. Offspring from the MUSP birth cohort who provided full psychiatric information at age 21 and whose mothers provided socioeconomic information at baseline were included ( n = 2399). Participants were grouped into no-disorder, mental health disorder only, alcohol disorder only or comorbid alcohol and mental health disorders according to DSM-IV diagnoses at age 21 as assessed by the Composite International Diagnostic Interview. We used multivariate logistic regression analysis to compare associations of disorder group with single measures of prenatal socio-economic disadvantage including family income, parental education and employment, and then created a cumulative scale of socioeconomic disadvantage. Results Greater socio-economic disadvantage was more strongly associated with comorbidity (OR 3.36; CI95 1.37, 8.24) than with single disorders. This relationship was not fully accounted for by maternal mental health, smoking and drinking during pregnancy. Conclusion Multiple domains of socio-economic disadvantage in early life are associated with comorbid alcohol and mental health disorders.