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Prior research has found bidirectional associations between psychotic experiences (PEs), and selected substance use disorders. We aimed to extend this research by examining the bidirectional association between PEs, and various types of substance use (SU), and substance use disorders (SUDs), and the influence of antecedent mental disorders on these associations. We used data from the World Health Organisation World Mental Health surveys. A total of 30,902 adult respondents across 18 countries were assessed for (a) six types of lifetime PEs, (b) a range of types of SU and DSM-IV SUDs, and (c) mental disorders using the Composite International Diagnostic Interview. Discrete-time survival analyses based on retrospective age-at-onset reports examined the bidirectional associations between PEs and SU/SUDs controlling for antecedent mental disorders. After adjusting for demographics, comorbid SU/SUDs and antecedent mental disorders, those with prior alcohol use disorders (OR=1.6, 95% CI=1.2-2.0), extra-medical prescription drug use (OR=1.5, 95% CI=1.1-1.9), alcohol use (OR=1.4, 95% CI=1.1-1.7), and tobacco use (OR=1.3, 95% CI=1.0-1.8) had increased odds of subsequent first onset of PEs. In contrast, those with temporally prior PEs had increased odds of subsequent onset of tobacco use (OR=1.5, 95% CI=1.2-1.9), alcohol use (OR=1.3, 95% CI=1.1-1.6) or cannabis use (OR=1.3, 95% CI=1.0-1.5) as well as of all substance use disorders (ORs ranged between 1.4 and 1.5). There was a dose response relationship between both count and frequency of PEs and increased subsequent odds of selected SU/SUDs. Associations between psychotic experiences (PEs) and substance use/substance use disorders (SU/SUDs) are often bidirectional, but not all types of SU/SUDs are associated with PEs. These findings suggest that it is important to be aware of the presence of PEs within those with SUDs or at risk of SUDs, given the plausibility that they may each impact upon the other.

Aims To establish the 3-year persistency rate of alcohol use disorder (AUD) and its predictors, and to examine drinking patterns of recently remitted individuals. Design and Setting The Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) surveyed a nationally representative sample of adults (aged 18–64 years) at baseline (response = 65.1%) and 3-year follow-up (response = 80.4%). Participants People with AUD at baseline, as defined by DSM-5 (n = 198). Measurements AUD, drinking patterns and mental disorders were assessed using the Composite International Diagnostic Interview 3.0. Other predictors were assessed with an additional questionnaire. Predictors of persistency were examined with univariable and multivariable logistic regression analyses. Results The AUD persistency rate was 29.5% [95% confidence intervals (CI) = 20.0–39.0]. In the multivariable model, the older (25–34 and 35–44) age groups had lower AUD persistency [odds ratio (OR) = 0.05; 95% CI = 0.00–0.49 and OR = 0.14; 95% CI = 0.02–0.79, respectively] than the youngest age group (18–24). A higher number of weekly drinks and a comorbid anxiety disorder predicted AUD persistency (OR = 1.03; 95% CI = 1.00–1.07 and OR = 4.56; 95% CI = 1.04–20.06, respectively). Furthermore, remission was associated with a reduction of six drinks per week between T0 and T1. It should be noted, however, that 35.8% (95% CI = 22.4–49.2) of people in diagnostic remission still drank more than the recommended maximum (more than seven/14 drinks weekly for women/men). Conclusions Only a minority of people in the Netherlands with alcohol use disorder as defined by DSM-5 still have the disorder 3 years later. Factors that help to identify people at risk of alcohol use disorder persistence are: younger age, a higher number of weekly drinks and a comorbid anxiety disorder. A substantial number of people recently in diagnostic remission still drink above the maximum recommended level.

Aims To compare the prevalence of mental disorders between frequent cannabis users with and without dependence and the general population. Design Cross-sectional comparison of interview data. Setting Enriched community sample of frequent cannabis users and a representative sample of non-users and non-frequent users from the general population. Participants A total of 521 young adult (aged 18–30 years) frequent cannabis users, 252 of whom were with DSM-IV cannabis dependence (D+) and 269 without DSM-IV cannabis dependence (D−), and 1072 young adults from the general population. Measurements Multinomial logistic regression was used to compare groups regarding the presence of DSM-IV mental disorders. Detailed measures of cannabis use, childhood adversity and other substance use were considered confounders. Findings Compared with the general population, externalizing disorders were more prevalent in D− [odds ratio (OR) = 8.91, P

Aim Very little is known about the relationship between obsessive–compulsive disorder (OCD) and substance use disorder (SUD). The aim of this study is to compare the co-occurrence of OCD with SUD to the co-occurrence of SUD with other psychiatric disorders in a representative community sample. Design In order to examine the association of SUD and OCD, logistic regression analyses were used generating odds ratios and 95% confidence intervals for life-time prevalence and 12-month prevalence. Setting and participants Cross-sectional data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a large representative sample of the Dutch population (n = 7076). Measurements The Composite International Diagnostic Interview (CIDI) 1.1 was used to assess Diagnostic and Statistical Manual of Mental Disorders Axis I criteria for psychiatric disorders. Findings The life-time and 12-month odds of being diagnosed with SUD in subjects with OCD are significantly higher than the odds of SUD for people without a psychiatric disorder. In men, the co-occurrence of substance dependence and OCD is significantly higher than the co-occurrence of substance dependence and other psychiatric disorders, whereas in women this co-occurrence does not differ significantly. Conclusions The co-occurrence of substance dependence in obsessive–compulsive disorder is higher than the co-occurrence of substance dependence in other non-obsessive–compulsive disorder DSM disorders, especially in men.

Aims: It is well established that tobacco use is associated with mental disorders. However, the association between tobacco use and mental disorders has not yet been examined sufficiently in prospective, population-based studies. The current study is aimed at examining whether smoking is associated with first-ever incidence of mental disorders. Design, setting and participants: We conducted a prospective, population-based epidemiological study (the Netherlands Mental Health Survey and Incidence Study: NEMESIS) in which a representative sample of adults aged 18-64 years (n = 7076) were interviewed to establish the presence of a broad range of mental disorders. We re-interviewed them at 1 year (n = 5618; response 79.4%) and 3 years (n = 4796; 67.8%) after baseline. Measurements: The presence of mental disorders was assessed according to DSM-III-R criteria with the Composite International Diagnostic Interview (CIDI), which was administered by trained lay interviewers. Tobacco use was assessed by asking respondents whether they had smoked in the past year, and how many cigarettes they smoked. Findings: Subjects who smoked but never had a mental disorder in their life, had an increased risk of developing a mental disorder (P < 0.01), and this remained significant after correcting for major risk indicators of mental disorders. Conclusions: Smoking is associated not only with the prevalence, but also with first-ever incidence of mental disorders. More research is needed to study the causal pathways. © 2007 The Authors.