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Use of Psychoactive Substances and Health Care in Response to Anxiety and Depressive Disorders

Dr. Encrenaz and Dr. Messiah are affiliated with the Institut National de la Santé et de la Recherche Médicale, Unit 897, 146 rue Léo Saignat, Bordeaux 33076, France (email: gaelle.encrenaz{at}isped.u-bordeaux2.fr). Dr. Kovess-Masféty, Ms. Carmona, and Mr. Sapinho are with Mutuelle Générale de l'Education Nationale Public Health Foundation, Paris V University, Ms. Jutand is with the Institut de Santé Publique d'Epidémiologie et de Développement, Université Bordeaux 2, Bordeaux, France.

OBJECTIVES: The use of psychoactive substances in response to psychological distress is not well documented in the general population and has never been studied in combination with health care use. This study estimated the frequency of health care and substance use in response to anxiety or depressive disorders and determined factors associated with these behaviors. METHODS: From a large survey of adults from four French regions, the authors selected those with a 12-month probable anxiety or depressive disorder without a substance use disorder (N=4,071). These disorders were determined with the Composite International Diagnostic Interview Short Form, and participants were asked whether they used substances or health care in response to each disorder. RESULTS: The use of substances in response to anxiety or depressive disorders was 12.9% among men and 5.2% among women. Compared with those who used health care only, those who used substances (with or without health care) were more likely to be men, single, and young. Those who used both substances and health care were also less likely to have a depressive disorder. CONCLUSIONS: This study shows that a sizeable portion of the general population uses substances in response to anxiety or depressive disorders. It also shows that these substance users have distinctive sociodemographic characteristics and can thus be targeted by prevention programs. Strategies to reach substance users with depressive or anxiety disorders who do not use health care remain to be elaborated.

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