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Study breakdown

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

Cross SectionalModerate evidence
The takeaway

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.

Psychiatrists, clinical psychologists, addiction counselors.

Cannabis use appeared in 3 of 4 identified patient profiles, underscoring its prevalence among people seeking psychiatric treatment.

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Moderate - reasonable sample size and established methodology, but cross-sectional and single-site.

When this study was published

Published in 2018.

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.

Questions still open

  • 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?

Common 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 the original research

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

Citation

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

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