CORONADO, CALIF. – One-year remission from substance abuse disorder among Native American veterans does not reduce the prevalence of mood and anxiety disorders, gambling disorders, or posttraumatic stress symptoms, results from a community survey demonstrated.
However, 1-year remission is associated with better rates of social function and fewer psychological symptoms, researchers led by Dr. Joseph J. Westermeyer reported during a poster session at the annual meeting of the American Academy of Addiction Psychiatry.
“Remitted patients should be informed about, and screened for, internalizing and externalizing disorders,” they wrote. “Remission improves the lives of [Native American] veterans.”
In an effort to assess whether 1-year remission from substance abuse disorders was associated with mental health improvement, Dr. Westermeyer and his associates collected data from a community-based sample of 558 Native American veterans from the Minneapolis VA catchment area, including remission assessed by DSM III-R criteria for 1-year remission; any lifetime and current anxiety disorder or mood disorder; and current social function as assessed by employment status, marital status, type of residence, and level of education.
Of the 558 patients, 359 (64%) had no lifetime history of substance abuse disorder, while 199 (36%) had a lifetime prevalence of substance abuse disorder. Of these 199, 82 (41%), with a mean age of 43 years, were in remission from substance abuse disorder, and 117 (59%), with a mean age of 48, were not.
The researchers pointed out that the estimated lifetime prevalence of substance abuse disorder in the general population of the United States is 14%, while the remission rate is at 74% (Arch. Gen. Psychiatry 2005;62:593–602). These figures stand in stark contrast to the rates reported in this sample of Native Americans.
Compared with the current clinical characteristics of Native American veterans with no lifetime history of substance abuse disorder, those with substance abuse disorder in remission manifest 10% more distress on the Brief Symptom Inventory and 20% more distress on the Posttraumatic Symptom Checklist; two- to threefold higher rates of internalizing disorders; a threefold higher rate of pathological gambling, and two- to threefold higher rates of mental health treatment.
There were no differences between the two groups in the rates of current antisocial personality disorder and social competence, reported Dr. Westermeyer, chief of psychiatry at the Minneapolis VA Hospital and a professor of psychiatry at the University of Minnesota, Minneapolis.
Comparison of Native American veterans who had substance abuse disorder in remission with those in active substance abuse revealed no differences in the rates of internalizing or externalizing disorders, no differences in symptoms based on the Brief Symptom Inventory, and no differences in the rates of mental health treatment.
Veterans in active substance abuse demonstrated more PTSD symptoms, more negative attitudes toward seeking treatment, and less social competence in terms of managing a job, residence, and marriage, compared with those in remission.
The researchers emphasized that the findings may be generalizable to nonveterans, non-Native Americans, or Native Americans from other geographic regions.