Women seeking substance abuse treatment often have diverse and complex medical and social problems. Co-occurring disorders in women tend to be associated with severe psychological distress, high rates of trauma and interpersonal violence, medical problems, few vocational skills, low income and severe addictions.
Co-occurring psychiatric disorders are associated with lower social functioning, decreased quality of life, poorer general health, worse treatment adherence, and less positive substance abuse treatment outcomes. The question is whether women have higher comorbidities and if there are specific types of co-occurring disorders that impact women more often than men.
Alcohol Use and Co-Occurring Disorders
It is estimated that more than 51% of people with psychiatric disorders abuse or depend on psychoactive substances, especially alcohol. When this progresses to an AUD, 37% of people have a co-occurring psychiatric disorder. Epidemiologic data indicate nearly half (48.5%) of women with lifetime AUDs report lifetime episodes of major depression (MD).
Clinically, the rates of AUD-MD co-morbidity are even higher, with estimates ranging from 50% to 70%. Overall, alcohol dependence is associated with a three-fold increased risk of mood disorders, while anxiety disorders, panic disorders and PTSD prevalence rates are approximately double.
Prevalence Differences by Gender
An estimated 5% of adult females versus 3% of adult males experienced past-year severe mental illness in 2015. AUD was more prevalent in males than females (ages 12 and older); 7.8% versus 4.1%. In 2015, an estimated 8.1 million adults ages 18 or older had past-year mental illness and SUDs, although this study did not break down statistics by gender. Two earlier, large-scale comorbidity studies analyzed co-occurring alcoholism and major psychiatric disorders, although none of the published statistics was gender-specific.
Several studies have attempted to analyze potential gender differences in comorbid anxiety disorders and AUD. Population surveys consistently have shown anxiety disorders are more prevalent in women, whereas AUDs are more common in men. While women have an increased likelihood of developing anxiety disorders independently, a prior anxiety disorder diagnosis is more predictive of subsequent alcohol dependence in women than men.
Another study found women exposed to trauma had two times the risk of developing alcohol dependency than men exposed to trauma. Further, women diagnosed with PTSD were even more likely to develop alcohol dependency than women exposed to trauma without a PTSD diagnosis.
The Benefits of Female-Specific Treatment
Addiction is a chronic disease and comorbidities make treatment more complex. Although all-encompassing statistics are not available that break down co-occurring disorders by gender, key differences have been identified. Women’s addiction treatment incorporates evidence-based findings including unique patterns of disorder onset, life stressors, hormonal influences, behaviors and coping methods. A nurturing, calm and comfortable treatment environment enables women with co-occurring diagnoses to properly heal.