Familial factors associated with development of alcohol and mental health comorbidity.

Background and Aims Co-occurring mental health and alcohol problems appear to be associated with greater health burdens than either single disorder. This study compares familial and individual contributions to development of comorbid alcohol/mental problems and tests whether these differ from single disorders. Design Women ( n = 6703) were recruited during pregnancy to the longitudinal Mater- University of Queensland Study of Pregnancy ( MUSP). Mother/offspring dyads were followed over 21 years. Setting Mater- Misericordiae Public Hospital, Brisbane, Australia. Participants Primary offspring from the MUSP with full psychiatric information at 21 years and maternal information at age 14 ( n = 1755). Measurements Structured interviews at age 21 yielded a four-category outcome using mental health and alcohol modules of the Composite International Diagnostic Interview (no disorder, alcohol only, mental health only and comorbid alcohol/mental health). Multinomial logistic regression models were adjusted for gender, maternal mental health and substance use, family environment and adolescent behaviour. Findings Maternal smoking [odds ratio ( OR) = 1.56; 95% confidence interval ( CI) = 1.09-2.22 versus no-disorder] and low mother-offspring warmth ( OR = 3.19; 95% CI = 1.99-5.13) were associated with mental health/alcohol comorbidity in young adults, as were adolescent drinking ( OR = 2.22; 95% CI = 1.25-3.96), smoking ( OR = 2.24; 95% CI = 1.33-3.77) and attention/thought problems ( OR = 2.04; 95% CI = 1.18-3.52). Some differences were seen from single disorders. In a subsample with paternal data, fathers' drinking problems ( OR = 2.41; 95% CI = 1.10-5.29) were more associated strongly with offspring mental health/alcohol comorbidity than both single disorders ( P < 0.05). Conclusions Maternal smoking and low mother-child warmth appear to be related to alcohol, mental health and comorbid disorders at age 21, possibly via constituent alcohol and mental health disorders. Adolescent drinking and attention/thought problems appear to be associated with comorbid disorders but not with individual alcohol and mental health disorders. [ABSTRACT FROM AUTHOR]