Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Themenschwerpunkt

Komorbide Substanzstörungen in der erwachsenen Allgemeinbevölkerung

Published Online:December 23, 2013https://doi.org/10.1024/0939-5911.a000277

Abstract

Ziel: Ziel ist die Untersuchung der homotypischen Komorbidität von Störungen im Zusammenhang mit dem Konsum von legalen und illegalen Substanzen sowie Medikamenten in der erwachsenen Bevölkerung. Methodik: Die Auswertungen basieren auf Daten des Epidemiologischen Suchtsurveys 2012. In einem zweistufigen Zufallsverfahren wurde eine Stichprobe von n = 9084 Personen realisiert (Ausschöpfung 53.6 %). Substanzbezogene Störungen nach DSM-IV wurden mithilfe des Münchener Composite International Diagnostic Interview für Alkohol, Tabak, Cannabis, Kokain, Amphetamine sowie Schmerz-, Schlaf- und Beruhigungsmittel erfasst. Ergebnisse: Multiple Diagnosen (Missbrauch und/oder Abhängigkeit) lagen bei insgesamt 6.6 % der Stichprobe vor. Der Anteil komorbider Substanzstörungen war bei Störungen durch Cannabis-, Schlafmittel- und Kokainkonsum am höchsten. Als Risikofaktoren für das Auftreten mindestens einer bzw. mehr als einer Diagnose erwiesen sich männliches Geschlecht, jüngeres Alter, niedrigere Schulbildung, lediger/geschiedener Familienstand und nicht-deutsche Staatsbürgerschaft. Schlussfolgerungen: Ein nicht unerheblicher Anteil der deutschen Bevölkerung ist von multiplen Substanzstörungen betroffen. Weitere epidemiologische Studien zur Beschreibung dieser Hochrisikogruppe sind nötig.


Comorbid Substance Use Disorders in the Adult General Population

Aims: It is aimed to assess homotypic comorbidity of substance use disorders in a representative sample of the adult general population in Germany. Methods: Data from the 2012 Epidemiological Survey of Substance Abuse are used. Based on a two-stage probability sampling, a total of n = 9 084 individuals participated (net response rate 53.6 %). Substance use disorders according to DSM-IV for alcohol, tobacco, cannabis, cocaine, amphetamines, analgesics, hypnotics and tranquilizers were assessed using the Munich Composite International Diagnostic Interview (M-CIDI). Results: Multiple diagnoses (abuse and/or dependence) were prevalent in 6.6 % of the sample. The percentage of comorbid substance use disorders was highest among those with a diagnosis related to cannabis, hypnotics and cocaine. Risk factors for at least one and more than one substance use disorders were male gender, younger age, lower educational level, being single or divorced and non-German citizenship. Conclusions: A relevant proportion of the general population in Germany is affected by more than one clinical diagnosis related to substance use. Further epidemiological research is necessary to describe this population of high risk.

Literatur

  • Angold, A. , Costello, E. J. , Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57 – 87. First citation in articleCrossref, Google Scholar

  • Betz, C. , Mihalic, D. , Pinto, M. E. , Raffa, R. B. (2000). Could a common biochemical mechanism underlie addictions? Journal of Clinical Pharmacy and Therapeutics, 25, 11 – 20. First citation in articleCrossref, Google Scholar

  • Burns, L. , Teesson, M. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders: Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence, 68, 299 – 307. First citation in articleCrossref, Google Scholar

  • Byqvist, S. (1999). Polydrug misuse patterns in Sweden. Gender differences. Substance Use & Misuse, 34, 195 – 216. First citation in articleCrossref, Google Scholar

  • Choquet, M. , Morin, D. , Hassler, C. , Ledoux, S. (2004). Is alcohol, tobacco, and cannabis use as well as polydrug use increasing in France? Addictive Behaviors, 29, 607 – 614. First citation in articleCrossref, Google Scholar

  • Compton, W. M. , Cottler, L. B. , Ben Abdallah, A. , Phelps, D. L. , Spitznagel, E. L. , Horton, J. C. (2000). Substance dependence and other psychiatric disorders among drug dependent subjects: Race and gender correlates. The American Journal on Addictions, 9, 113 – 125. First citation in articleCrossref, Google Scholar

  • Cone, E. J. , Fant, R. V. , Rohay, J. M. , Caplan, Y. H. , Ballina, M. , Reder et al., (2004). Oxycodone involvement in drug abuse deaths. II. Evidence for toxic multiple drug-drug interactions. Journal of Analytical Toxicology, 28, 217 – 225. First citation in articleCrossref, Google Scholar

  • Conway, K. P. , Compton, W. , Stinson, F. S. , Grant, B. F. (2006). Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 67, 247 – 257. First citation in articleCrossref, Google Scholar

  • Earleywine, M. , Newcomb, M. D. (1997). Concurrent versus simultaneous polydrug use: Prevalence, correlates, discriminant validity, and prospective effects on health outcomes. Experimental and Clinical Psychopharmacology, 5, 353 – 364. First citation in articleCrossref, Google Scholar

  • Falk, D. E. , Yi, H. , Hiller-Sturmhofel, S. (2006). An epidemiologic analysis of co-occurring alcohol and tobacco use and disorders. Alcohol Research and Health, 29, 162 – 171. First citation in articleGoogle Scholar

  • Goldstein, R. B. , Dawson, D. A. , Chou, S. P. , Grant, B. F. (2012). Sex differences in prevalence and comorbidity of alcohol and drug use disorders: Results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Studies on Alcohol and Drugs, 73, 938 – 950. First citation in articleCrossref, Google Scholar

  • Grant, B. F. , Pickering, R. P. (1996). Comorbidity between DSM-IV alcohol and drug use disorders: Results from the National Longitudinal Alcohol Epidemiologic Survey. Alcohol Health and Research World, 20, 67 – 72. First citation in articleGoogle Scholar

  • Hasin, D. S. , Stinson, F. S. , Ogburn, E. , Grant, B. F. (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 64, 830 – 842. First citation in articleCrossref, Google Scholar

  • Hawkins, J. D. , Catalano, R. F. , Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64 – 105. First citation in articleCrossref, Google Scholar

  • Hemby, S. E. , Dworkin, S. I. , Smith, J. E. (1999). Synergistic elevations in nucleus accumbens extracellular dopamine concentrations during self-administration of cocaine/heroin combinations (Speedball) in rats. Journal of Pharmacology and Experimental Therapeutics, 288, 274 – 280. First citation in articleGoogle Scholar

  • Huang, B. , Dawson, D. A. , Stinson, F. S. , Hasin, D. S. , Ruan, W. , Saha, T. D. et al. (2006). Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 67, 1062 – 1073. First citation in articleCrossref, Google Scholar

  • Jessor, R. , Jessor, S. L. (1977). Problem behavior and psychosocial development: A longitudinal study of youth. New York: Academic Press. First citation in articleGoogle Scholar

  • Kedia, S. , Sell, M. A. , Relyea, G. (2007). Mono-versus polydrug abuse patterns among publicly funded clients. Substance Abuse Treatment, Prevention, and Policy, 2, 33. First citation in articleCrossref, Google Scholar

  • Kendler, K. S. , Neale, M. C. , Sullivan, P. , Corey, L. A. , Gardner, C. O. , Prescott, C. A. (1999). A population-based twin study in women of smoking initiation and nicotine dependence. Psychological Medicine, 29, 299 – 308. First citation in articleCrossref, Google Scholar

  • Koob, G. F. , Le Moal, M. (2001). Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmacology, 24, 97 – 129. First citation in articleCrossref, Google Scholar

  • Kraus, L. , Piontek, D. , Pabst, A. , Gomes de Matos, E. (2013). Studiendesign und Methodik des Epidemiologischen Suchtsurveys 2012. SUCHT, 59, 309 – 320. First citation in articleLink, Google Scholar

  • Kreuter, F. , Presser, S. , Tourangeau, R. (2008). Social desirability bias in CATI, IVR, and web surveys: The effects of mode and question sensitivity. Public Opinion Quarterly, 70, 847 – 865. First citation in articleCrossref, Google Scholar

  • Lachner G., Wittchen H. U. , Perkonigg A., Holly A. , Schuster P., Wunderlich U. et al. (1998). Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI) substance use sections. European Addiction Research, 4, 28 – 41. First citation in articleCrossref, Google Scholar

  • Martins, S. S. , Mazzotti, G. , Chilcoat, H. D. (2005). Trends in ecstasy use in the United States from 1995 to 2001: Comparison with marijuana users and association with other drug use. Experimental and Clinical Psychopharmacology, 13, 244 – 252. First citation in articleCrossref, Google Scholar

  • McCabe, S. E. , Cranford, J. A. , Morales, M. , Young, A. (2006). Simultaneous and concurrent polydrug use of alcohol and prescription drugs: Prevalence, correlates, and consequences. Journal of Studies on Alcohol, 67, 529 – 537. First citation in articleCrossref, Google Scholar

  • McCance-Katz, E. F. , Kosten, T. R. , Jatlow, P. (1998). Concurrent use of cocaine and alcohol is more potent and potentially more toxic than use of either alone – a multiple-dose study. Biological Psychiatry, 44, 250 – 259. First citation in articleCrossref, Google Scholar

  • Midanik, L. T. , Tam, T. W. , Weisner, C. (2007). Concurrent and simultaneous drug and alcohol use: Results of the 2000 National Alcohol Survey. Drug and Alcohol Dependence, 90, 72 – 80. First citation in articleCrossref, Google Scholar

  • Nutt, D. J. (1997). The neurochemistry of addiction. Human Psychopharmacology: Clinical and Experimental, 12, S53–S58. First citation in articleCrossref, Google Scholar

  • Onyeka, I. N. , Uosukainen, H. , Korhonen, M. J. , Beynon, C. , Bell, J. S. , Ronkainen, K. et al. (2012). Sociodemographic characteristics and drug abuse patterns of treatment-seeking illicit drug abusers in Finland, 1997 – 2008: The Huuti Study. Journal of Addictive Diseases, 31, 350 – 362. First citation in articleCrossref, Google Scholar

  • Perkonigg, A. , Lieb, R. , Wittchen, H. U. (1998). Prevalence of use, abuse and dependence of illicit drugs among adolescents and young adults in a community sample. European Addiction Research, 4, 58 – 66. First citation in articleCrossref, Google Scholar

  • Petraitis, J. , Flay, B. R. , Miller, T. Q. (1995). Reviewing theories of adolescent substance use: Organizing pieces in the puzzle. Psychological Bulletin, 117, 67 – 67. First citation in articleCrossref, Google Scholar

  • Reed V., Gander F. , Pfister H., Steiger A. , Sonntag H., Trenkwalder C. et al. (1998). To what degree does the Composite International Diagnostic Interview (CIDI) correctly identify DSM-IV disorders? Testing validity issues in a clinical sample. International Journal of Methods in Psychiatric Research, 7, 142 – 155. First citation in articleCrossref, Google Scholar

  • Robert Koch Institut (2008). Schwerpunktbericht der Gesundheitsberichterstattung des Bundes. Migration und Gesundheit. Berlin: Robert Koch Institut. First citation in articleGoogle Scholar

  • Schifano, F. , Di Furia, L. , Forza, G. , Minicuci, N. , Bricolo, R. (1998). MDMA (ecstasy) consumption in the context of polydrug abuse: A report on 150 patients. Drug and Alcohol Dependence, 52, 85 – 90. First citation in articleCrossref, Google Scholar

  • Shaffer, H. J. , LaPlante, D. A. , LaBrie, R. A. , Kidman, R. C. , Donato, A. N. , Stanton, M. V. (2004). Toward a syndrome model of addiction: Multiple expressions, common etiology. Harvard Review of Psychiatry, 12, 367 – 374. First citation in articleCrossref, Google Scholar

  • Statistisches Bundesamt (2011). Bildungsfinanzbericht 2011. Wiesbaden: Statistisches Bundesamt. First citation in articleGoogle Scholar

  • Stinson, F. S. , Grant, B. F. , Dawson, D. A. , Ruan, W. J. , Huang, B. , Saha, T. (2006). Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States. Alcohol Research and Health, 29, 94 – 106. First citation in articleGoogle Scholar

  • Teesson, M. , Hall, W. , Slade, T. , Mills, K. , Grove, R. , Mewton et al., (2010). Prevalence and correlates of DSM‐IV alcohol abuse and dependence in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing. Addiction, 105, 2085 – 2094. First citation in articleCrossref, Google Scholar

  • True, W. R. , Heath, A. C. , Scherrer, J. F. , Xian, H. , Lin, N. , Eisen, S. A. et al. (1999). Interrelationship of genetic and environmental influences on conduct disorder and alcohol and marijuana dependence symptoms. American Journal of Medical Genetics, 88, 391 – 397. First citation in articleCrossref, Google Scholar

  • Tsuang, M. T. , Lyons, M. J. , Meyer, J. M. , Doyle, T. , Eisen, S. A. , Goldberg, J.et al. (1998). Co-occurrence of abuse of different drugs in men: The role of drug-specific and shared vulnerabilities. Archives of General Psychiatry, 55, 967 – 972. First citation in articleCrossref, Google Scholar

  • von Sydow, K. , Lieb, R. , Pfister, H. , Höfler, M. , Wittchen, H. U. (2002). What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults. Drug and Alcohol Dependence, 68, 49 – 64. First citation in articleCrossref, Google Scholar

  • Williams, R. (2006). Generalized Ordered Logit/Partial Proportional Odds Models for Ordinal Dependent Variables. The Stata Journal, 6, 58 – 82. First citation in articleCrossref, Google Scholar

  • Wittchen, H.-U. , Beloch, E. , Garczynski, E. , Holly, A. , Lachner, G. , Perkonigg, A. et al. (1995). Münchener Composite International Diagnostic Interview (M-CIDI, Paper-pencil 2.2, 2/95). München: Max-Planck-Institut für Psychiatrie, Klinisches Institut. First citation in articleGoogle Scholar

  • Young, S. E. , Rhee, S. H. , Stallings, M. C. , Corley, R. P. , Hewitt, J. K. (2006). Genetic and environmental vulnerabilities underlying adolescent substance use and problem use: General or specific? Behavior Genetics, 36, 603 – 615. First citation in articleCrossref, Google Scholar