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Sandra C. Lapham, MD, MPH; Elizabeth Smith, PhD; Janet C'de Baca, PhD; Iyiin Chang, MS; Betty J. Skipper, PhD; George Baum, BA; William C. Hunt, MA

Arch Gen Psychiatry. 2001;58:943-949.

Background  Large numbers of convicted drunk drivers are entering alcohol treatment programs, yet little information is available about their need for psychiatric treatment. This study of convicted drunk drivers estimates lifetime and 12-month prevalence of DSM-III-R psychiatric disorders (alcohol and drug abuse and dependence, major depressive disorder, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder, and antisocial personality disorder) and compares rates with estimates from a US population-based survey.

Methods  Six hundred twelve women and 493 men, aged 23 to 54 years, convicted of driving while impaired, who had been referred to a screening program in Bernalillo County, New Mexico, were located and interviewed using the Diagnostic Interview Schedule between January 25, 1994, and June 30, 1997. Psychiatric diagnoses were compared with findings from the National Comorbidity Survey for the western region of the United States, conducted between September 14, 1990, and February 6, 1992.

Results  Eighty-five percent of female and 91% of male offenders reported a lifetime alcohol-use disorder, compared with 22% and 44%, respectively, in the National Comorbidity Survey sample. Thirty-two percent of female and 38% of male offenders had a drug-use disorder, compared with 16% and 21%, respectively, in the National Comorbidity Survey sample. For offenders with alcohol-use disorders, 50% of women and 33% of men had at least 1 additional psychiatric disorder other than drug abuse or dependence, mainly posttraumatic stress disorder or major depression.

Conclusion  Drunk-driving offenders need assessment and treatment services not only for alcohol problems but also for drug use and the other psychiatric disorders that commonly accompany alcohol-related problems.

From the Behavioral Health Research Center of the Southwest, Albuquerque, NM. Dr Smith is deceased. Dr Smith was affiliated with the Department of Psychiatry, Washington University, St Louis, Mo.

Corresponding author and reprints: Sandra C. Lapham, MD, MPH, Behavioral Health Research Center of the Southwest, 6624 Gulton Ct NE, Albuquerque, NM 87109 (e-mail: slapham{at}bhrcs.org).

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