Psychiatric Outpatients Fell Into Four Distinct Patterns of Substance Use and Mental Health Symptoms

Among 405 psychiatric outpatients, latent class analysis identified four distinct profiles combining substance use and mental health symptoms, with cannabis use prominent across multiple groups.

Ramo, Danielle E et al.·Journal of psychoactive drugs·2018·Moderate EvidenceCross-Sectional
RTHC-01804Cross SectionalModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=405

What This Study Found

Four classes emerged: moderate symptoms with wide-range drug use (22%), moderate depression/panic only (38%), depression/anxiety with tobacco and cannabis (28%), and severe wide-range symptoms and substance use (12%). Cannabis use was notably prevalent across three of the four classes.

Key Numbers

Mean age 38, 69% White, 60% female. Class sizes: 22%, 37.8%, 28%, 12%. Cannabis use was elevated in classes 1, 3, and 4.

How They Did This

405 patients presenting for intake at a psychiatry outpatient clinic completed computerized assessments of psychiatric problems, drinking, and drug use. Latent class analysis identified distinct symptom-substance use profiles.

Why This Research Matters

Understanding that psychiatric outpatients cluster into distinct profiles of co-occurring substance use and mental health symptoms can help clinicians provide more targeted, effective treatment rather than one-size-fits-all approaches.

The Bigger Picture

The high prevalence of cannabis use across multiple symptom profiles in psychiatric outpatients highlights the need for integrated treatment approaches that address both substance use and mental health simultaneously.

What This Study Doesn't Tell Us

Cross-sectional design at a single clinic. Self-reported substance use. The sample was predominantly White and female. Cannot determine whether substance use preceded or followed psychiatric symptoms.

Questions This Raises

  • ?Do these four profiles respond differently to treatment?
  • ?Would the same classes emerge in more diverse populations?
  • ?Does cannabis use in these contexts represent self-medication or a separate risk factor?

Trust & Context

Key Stat:
Cannabis use appeared in 3 of 4 identified patient profiles, underscoring its prevalence among people seeking psychiatric treatment.
Evidence Grade:
Moderate - reasonable sample size and established methodology, but cross-sectional and single-site.
Study Age:
Published in 2018.
Original Title:
Alcohol and Drug Use, Pain and Psychiatric Symptoms among Adults Seeking Outpatient Psychiatric Treatment: Latent Class Patterns and Relationship to Health Status.
Published In:
Journal of psychoactive drugs, 50(1), 43-53 (2018)
Database ID:
RTHC-01804

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

How common is cannabis use among people seeking mental health treatment?

This study found cannabis use was elevated in three of four identified patient profiles (representing about 62% of the sample), making it one of the most commonly used substances among psychiatric outpatients.

Do mental health and substance use problems tend to cluster together?

Yes. This study identified four distinct patterns, ranging from depression with minimal substance use to severe psychiatric symptoms with heavy multi-substance use. The profiles differed in health status and demographics.

Read More on RethinkTHC

Cite This Study

RTHC-01804·https://rethinkthc.com/research/RTHC-01804

APA

Ramo, Danielle E; Bahorik, Amber L; Delucchi, Kevin L; Campbell, Cynthia I; Satre, Derek D. (2018). Alcohol and Drug Use, Pain and Psychiatric Symptoms among Adults Seeking Outpatient Psychiatric Treatment: Latent Class Patterns and Relationship to Health Status.. Journal of psychoactive drugs, 50(1), 43-53. https://doi.org/10.1080/02791072.2017.1401185

MLA

Ramo, Danielle E, et al. "Alcohol and Drug Use, Pain and Psychiatric Symptoms among Adults Seeking Outpatient Psychiatric Treatment: Latent Class Patterns and Relationship to Health Status.." Journal of psychoactive drugs, 2018. https://doi.org/10.1080/02791072.2017.1401185

RethinkTHC

RethinkTHC Research Database. "Alcohol and Drug Use, Pain and Psychiatric Symptoms among Ad..." RTHC-01804. Retrieved from https://rethinkthc.com/research/ramo-2018-alcohol-and-drug-use

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.