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Cited by 60Mental Health Treatment and AccessSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment

Comorbid substance and mental disorders among rural Americans: Results from the national comorbidity survey

Simmons, Leigh Ann, Havens, Jennifer R.·2007·Journal of Affective Disorders
DOI 10.1016/j.jad.2006.08.016
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Abstract

Background The purpose of this study was to examine whether rural inhabitants were more likely than urban inhabitants to meet the criteria for comorbid mental health and substance abuse or dependence disorders.Methods Data were from the National Comorbidity Survey, and included 5185 (532=rural; 4653=urban) persons age 14-54 years of age who were interviewed using the Composite International Diagnostic Interview (CIDI). Logistic regression that accounted for the complex survey data and weighting scheme was utilized.Results Participants residing in rural areas were more likely to meet the DSM-III-R criteria for past month alcohol abuse or dependence if they also met the diagnostic criteria for past month major depressive disorder (MDD) or lifetime antisocial personality disorder (ASPD), adjusting for age, race, gender, education and income. Similarly, rural participants were more likely to meet the criteria for comorbid drug abuse or dependence in the past month if they met the diagnosis for either past month MDD, generalized anxiety disorder or lifetime ASPD, controlling for demographic characteristics. Rural residents with any current mental disorder also were less likely to seek treatment than their urban counterparts.Limitations Data were collected in 1991 and do not capture changes in prevalence of comorbidities. Also, the small number of rural residents sampled resulted in small cell sizes for some comorbidities.Conclusions Rural residents were significantly more likely to meet the criteria for substance disorders given they also met the criteria for a mental disorder, and those with any current mental disorder were less likely to seek treatment. Since the overall prevalence of these disorders does not differ between rural and urban inhabitants, findings suggest that rural persons may lack access to adequate treatment for their mental health disorders and subsequently may be self-medicating with alcohol and/or drugs.

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Authors
Simmons, L. A., & Havens, J. R.
Affiliations
University of Kentucky (US)
Corresponding author
Havens, Jennifer R.
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2007-04
Volume
99
Issue
1-3
Pages
265-271
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2006.08.016
OpenAlex
W2059494361
Cited by
60
References
43
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 4 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 3
FWCI
8.06
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
comorbidities, substance use disorders, mental illness, urban-rural differences, alcohol abuse, alcoholism, major depressive disorder, antisocial personality disorder, generalized anxiety disorder, treatment seeking, access to mental health care, self-medication, rural mental health
MeSH terms
Adolescent, Adult, Alcoholism, Antisocial Personality Disorder, Anxiety Disorders, Mental Disorders, Cross-Sectional Studies, Major Depressive Disorder, Female, Health Surveys, Humans, Male, Middle Aged, Rural Population, Statistics as Topic, United States, Comorbidity, Substance-Related Disorders

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