Professional Documents
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Original Research
Psychiatrist and Researcher, Philippe-Pinel Institute of Montreal, Fernand-Seguin Research Centre, Department of Psychiatry, University of Montreal,
Montreal, Quebec.
Correspondence: Philippe-Pinel Institute of Montreal, Fernand-Seguin Research Centre, Department of Psychiatry, University of Montreal, 10905 HenriBourassa Boulevard East, Montreal, QC H1C 1H1; alexandre.dumais@umontreal.ca.
Psychiatrist, Louis-H Lafontaine Hospital, Fernand-Seguin Research Centre, Department of Psychiatry, University of Montreal, Montreal, Quebec.
Professor of Psychology, University of Quebec, Trois-Rivires, Quebec; Researcher, Philippe-Pinel Institute of Montreal, Montreal, Quebec.
Psychiatrist and Researcher, Louis-H Lafontaine Hospital, Fernand-Seguin Research Centre, Department of Psychiatry, University of Montreal, Montreal,
Quebec.
Director, Philippe-Pinel Research Centre, Philippe-Pinel Institute of Montreal, Montreal, Quebec; Professor of Psychology, University of Quebec,
Trois-Rivires, Quebec.
Objective: Alcohol and (or) illicit drug use (AIDU) problems are associated with mental
health difficulties, but low-to-moderate alcohol consumption may have mental health
benefits, compared with abstinence. Our study aimed to explore the hypothesis of a
nonlinear, or J-curve, relation between AIDU profiles and psychological distress, psychiatric
disorders, and mental health service use in the general Canadian population.
Methods: Data were collected from a representative sample of the Canadian population
(n = 36 984). Multiple correspondence analyses and cluster analyses were used to extract
AIDU profiles. Sociodemographics, psychological distress, psychiatric disorders, and
mental health service use were assessed and compared between profiles.
Results: Seven AIDU profiles emerged, including 3 involving risky or problematic AIDU that
correlate with major affective disorders, anxiety disorders, suicidal behaviours, and higher
levels of psychological distress. No J-curve relation was found for psychiatric disorders and
mental health service use. The lifetime-abstainer profile correlates with the lowest rates
of psychiatric disorders and mental health service use. Lifetime abstainers are also more
often female, immigrant, and unemployed. Compared with other profiles, spirituality is more
important in their life.
Conclusions: The hypothesis of a nonlinear relation between psychiatric disorders and
AIDU was not supported. Lifetime AIDU abstainers have specific sociodemographic and
cultural background characteristics in Canada.
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Profiles and Mental Health Correlates of Alcohol and Illicit Drug Use in the Canadian Population: An Exploration of the J-Curve Hypothesis
BA
bivariate analysis
MAD
MCA
MHP
VT
value test
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Clinical Implications
Limitations
Method
Original Research
Mental Health
Statistical Analyses
Results
Profiles and Mental Health Correlates of Alcohol and Illicit Drug Use in the Canadian Population: An Exploration of the J-Curve Hypothesis
they had not worked during the preceding year, those with
profiles 4 and 6 are mainly retired; those with profiles 1
to 3 have more often been laid off; and those with profile
5 report having family responsibilities. In addition, people
with profiles 4, 6, and 7 attribute greater importance to
spirituality, and those with profile 7 are more commonly
immigrants.
Discussion
4.7
0
0.5
43.1a
51.7a
13.8
18.3
20.9
27.8
9.3
<1/month
13/month
13/week
4/week
0
2.3
91.9a
18.3
10.4
6.5
<1/month
13/month
1/week
43.5a
63.0
20.6a
5.9
14.2
2.1
1/month
Flag for 12-month interference with daily activities and responsibilities by AIDU; BA
0.2
0.3
Has tried one of the following drugs at least once: cocaine, amphetamines, 3,4-methylendioxymethamphetamine, hallucinogens, solvents, heroin, steroids
0.6
13.2
9.6
90.4a
100a
2.4
3.2
36.0a
60.8a
9.5
25.5a
65.0a
25.6
100a
100a
0
0
0
48.2a
100a
51.8a
7
Lifetime AIDU
abstainers
9.2%
9.3a
2.2
28.7
64.0
2.8
40.3a
1.9
16.0
79.8a
52.6a
21.8
5
Low alcohol
users and
illicit-drugs
abstainers
25.5%
6
Occasional
or former
alcohol
users and
lifetime
illicit-drugs
abstainers
23.1%
22.7
16.5
a
73.7a
0.9
5.2
3.2
27.5
a
5.0
86.7a
31.9a
51.2a
0.9
5.6
10.4
67.1a
5.4
4.3
45.7a
41.9a
8.2
3
Excessive
alcohol
users
14.3%
42.3a
1.0
19.3a
43.2
a
18.2
19.4
18.0a
60.7a
16.3
5.0
2
Regular
excessive
AIDU
7.9%
4
Regular
low alcohol
users and
lifetime
cannabis
abstainers
15.5%
Other drugs
12.0
6.2
<1/month
29.8
29.1
14.7
58.8
Never
Cannabis use
5.8
64.8
Never
Never
1
Problematic
AIDU
4.6%
Profile
Percentage
of total
sample
Original Research
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81.1a
18.9
49.0
51.0
Profile
Male
Female
23.6
3.4
30.5
15.0
4564
65
11.4
42.6a
57.1a
12.8
25.4
50.6
43.0
30.6
2.3
19.7
91.3
39.6
14.7
10.1
15.6
77.5
63.2
Family responsibility
Other
Born in Canada
25.4
29.5
13.7
16.4
16.5
14.6
47.0
49.2
91.9a
90.1
22.6a
11.2
20.2a
8.3
18.5
Disability
15.7
13.2
11.8
Studying
17.7
8.6
64.8a
33.3a
8.3
58.4
1.0
21.2
33.2
9.9
62.0a
42.5a
7.2
50.3
1.0
22.1
36.4
a
34.8a
42.6
57.4a
40.4a
32.5
67.5a
3
Excessive
alcohol
users
14.3%
Retired
46.1
61.8
Marital status
35.0
30.6
3044
a
38.0a
24.0
1529
Age, years
1
Problematic
AIDU
4.6%
Percentage
of total
sample
2
Regular
excessive
AIDU
7.9%
68.0a
75.4
14.3
5.7
9.3
63.9
80.5a
16.8
13.2a
15.6
12.4
10.9
3.1
13.0
31.2
57.6a
23.9
10.7
65.4a
26.5
72.8a
72.1
12.8
10.1
8.9
18.1a
10.6
39.4a
38.9a
20.7
18.3a
61.1
9.6
23.3
17.3
32.9a
34.4
37.5
62.5a
32.1a
23.9
53.3a
46.7
5
Low alcohol
users and
illicit-drugs
abstainers
25.5%
54.7a
54.3a
11.8
14.3
73.9a
26.3
a
42.4a
22.4
9.0
47.2
52.9a
4
Regular low
alcohol users
and lifetime
cannabis
abstainers
15.5%
6
Occasional
or former
alcohol
users and
lifetime
illicit-drugs
abstainers
23.1%
76.6a
45.6
13.2
12.9
15.8
12.0
21.1a
25.1
33.1
28.8a
15.3a
55.4
21.2a
25.0
25.9
28.0a
67.5a
32.5
7
Lifetime AIDU
abstainers
9.2%
Profiles and Mental Health Correlates of Alcohol and Illicit Drug Use in the Canadian Population: An Exploration of the J-Curve Hypothesis
8.9
8.3a
1.8a
5.9a
2.3
5.5a
2.9a
11.4a
4.6
5
3.6
3.0
0.5
2.4
1.0
3.7
1.5
8.1
3.0
4
Lifetime mania
1.3
4.6
4.6
a
10.9a
1.8
11.7a
3.7a
5.3a
4.7a
2.2
a
2.9
0.6
4.5a
0.9
3.7
4.7
5.5a
6.8
5.8
17.7a
7.4
22.1a
13.8
3
Excessive
alcohol users
14.3%
16.7a
2
Regular
excessive
AIDU
7.9%
7.9
26.1a
4.8
13.2
17.6a
12.1
Profile
1
Problematic
AIDU
4.6%
Percentage
of total
sample
2.8
8.5
1.0
3.8
0.9
2.7
0.5
3.4
2.7
11.9
4.1
11.7
4
Regular low
alcohol users
and lifetime
cannabis
abstainers
15.5%
2.3
7.2
1.2
3.2
0.6
1.6
0.3
1.9
2.6
10.6
4.3
12.0
5
Low alcohol
users and
illicit-drugs
abstainers
25.5%
2.4
6.8
1.6
3.3
0.6
1.7
0.4
2.6
3.3
11.8
4.1
10.3
6
Occasional
or former
alcohol
users and
lifetime
illicit-drugs
abstainers
23.1%
2.4
4.4
0.8
1.9
0.5
1.1
0.2
1.0
1.9
6.0
3.4
8.5
7
Lifetime AIDU
abstainers
9.2%
Original Research
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Profiles and Mental Health Correlates of Alcohol and Illicit Drug Use in the Canadian Population: An Exploration of the J-Curve Hypothesis
3.3
5.0
3.1
6.0
4.7
9.8
4.1
6.4
b
Psychiatric hospitalization
During lifetime, has ever seen or talked on the telephone to a [professional] about emotions, mental health, or AIDU
b
Significant correlate positively associated with profile (VT 4 or P < 0.001)
c
If person has seen any of these professionals, age at first counselling or therapy (<20 years old)
d
At least one hospitalization for mental or substance use disorder
32.5
37.2
42.7
24.8
71.3
67.1
69.1
76.7
Never consulted
Social workera
Nurse
Psychologista
General practitioner
Profile
Psychiatrista
17.5
19.2
15.3
30.9
87.2b
79.5b
77.9
76.2
2.9
0.5
1.7
5.8
1.3
6.3
1.6
7.0
1.6
10.3b
13.5b
2.8
1.6
3.2
12.7b
10.5b
17.0
20.0
12.2b
17.2
12.6b
8.1
14.7
7.4
2.3
8.1
8.2
9.2
5.8
14.0
15.4
13.9
4.4
7.4
6.6
9.1
11.2b
7.9
9.0
11.9b
1
Problematic
AIDU
4.6%
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Percentage
of total
sample
2
Regular
excessive
AIDU
7.9%
3
Excessive
alcohol users
14.3%
5
Low alcohol
users and
illicit-drugs
abstainers
25.5%
4
Regular low
alcohol users
and lifetime
cannabis
abstainers
15.5%
6
Occasional
or former
alcohol users
and lifetime
illicit-drugs
abstainers
23.1%
7
Lifetime AIDU
abstainers
9.2%
Limitations
Conclusion
Original Research
Acknowledgements
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