The object of the study was to test the hypothesis that mental illness is associated with drug abuse by pregnant smokers. We abstracted data from the State of Missouri Risk Appraisal of Pregnant Women database on 239 (115 black and 124 white) women who attended an inner-city hospital from 1999 through 2000. Thirty-four percent abused drugs, 16% used alcohol, and 8% reported having a history of mental illness or psychiatric treatment. On multivariable logistic regression analyses, pregnant smokers were more likely to use drugs if they had mental illness (odds ration [OR], 7), consumed alcohol (OR, 2), or were black (OR, 3). In conclusion, drug abuse is associated with mental illness, suggesting that this behavior may be a marker of underlying mental illness among pregnant smokers. Therefore, in addition to initiating social service intervention, the identification of drug abuse by pregnant smokers should prompt a mental health evaluation.
KEYWORDS
Pregnancy - mental health - health behaviors
REFERENCES
-
1
Stewart D E, Streiner D L.
Cigarette smoking during pregnancy.
Can J Psychiatry.
1995;
40
603-607
-
2
Ismail K, Sloggett A, De Stavola B.
Do common mental disorders increase cigarette smoking? Results from five waves of a population-based panel cohort study.
Am J Epidemiol.
2000;
152
651-657
-
3
Lasser K, Boyd J W, Woolhandler S, Himmelstein D U, McCormick D, Bor D H.
Smoking and mental illness: a population-based prevalence study.
JAMA.
2000;
284
2606-2610
-
4
Ahijevych K, Wewers M E.
Factors associated with nicotine dependence among African American women cigarette smokers.
Res Nurs Health.
1993;
16
283-292
-
5
Romans S E, McNoe B M, Herbison G P, Walton V A, Mullen P E.
Cigarette smoking and psychiatric morbidity in women.
Aust N Z Psychiatry.
1993;
27
399-404
-
6
Patten C A, Gillin J C, Golshan S, Wolter T D, Rapaport M, Kelsoe J.
Relationship of mood disturbance to cigarette smoking status among 252 patients with a current mood disorder.
J Clin Psychiatry.
2001;
62
319-324
-
7
Degenhardt L, Hall W, Lynskey M.
Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis.
Addiction.
2001;
96
1603-1614
-
8
Kandel D B, Huang F Y, Davies M.
Comorbidity between patterns of substance use dependence and psychiatric syndromes.
Drug Alcohol Depend.
2001;
64
233-241
-
9
Raskin V D.
Maternal bereavement in the parinatal substance user.
J Subst Abuse Treat.
1992;
9
142-149
-
10
Kovalesky A, Flagler S.
Child placement issues of women with addictions.
J Obstet Gynecol Neonatal Nurs.
1997;
26
585-592
-
11
Poland M L, Dombrowski M P, Ager J W, Sokol R J.
Punishing pregnant drug users: enhancing the flight from care.
Drug Alcohol Depend.
1993;
31
199-203
-
12
Warner L A, Kessler R C, Hughes M, Anthony J C, Nelson C B.
Prevalence and correlates of drug use and dependence in the United States. Results from the National Comorbidity Survey.
Arch Gen Psychiatry.
1995;
52
219-229
-
13
de Leon J, Becona E, Gurpegui M, Gonzalez-Pinto A, Diaz F J.
The association between high nicotine dependence and severe mental illness may be consistent across countries.
J Clin Psychiatry.
2002;
63
812-816
-
14
Shavers V L, Shankar S, Alberg A J.
Perceived access to health care and its influence on the prevalence of behavioral risks among urban African Americans.
J Natl Med Assoc.
2002;
94
952-962
-
15
Dupree C Y.
Racial bias in health care, still economy-based. [Review of: Byrd WB, Clayton LA. An American health dilemma: a medical history of African-Americans and the problem of race, beginnings to 1900. Routledge, 2000].
Med Humanity Rev.
2002;
16
46-48
-
16
Alexander G R, Kogan M D, Nabukera S.
Racial differences in prenatal care use in the United States: are disparities decreasing?.
Am J Public Health.
2002;
92
1970-1975
-
17
Degenhardt L, Hall W.
The relationship between tobacco use, substance-use disorders and mental health: results from the National Survey of Mental Health and Well-being.
Nicotine Tob Res.
2001;
3
225-234
-
18
Miles D R, Svikis D S, Kulstad J L, Haug N A.
Psychopathology in pregnant drug-dependent women with and without co-morbid alcohol dependence.
Alcohol Clin Exp Res.
2001;
25
1012-1017
-
19
Reinarz S E, Ecord J S.
Drug-of-abuse testing in the neonate.
Neonatal Netw.
1999;
18
55-61
-
20
Jacobson S W, Chiodo L M, Sokol R J, Jacobson J L.
Validity of maternal report of prenatal alcohol, cocaine, and smoking in relation to neurobehavioral outcome.
Pediatrics.
2002;
109
815-825
-
21
Caron C, Rutter M.
Co-morbidity in child psychopathology: concepts, issues and research strategies.
J Child Psychol Psych.
1991;
32
1063-1080
-
22
Finch B K, Vega W A, Kolody B.
Substance use during pregnancy in the state of California, USA.
Soc Sci Med.
2001;
52
571-583
-
23
Hans S L.
Demographic and psychosocial characteristics of substance-abusing pregnant women.
Clin Perinatol.
1999;
26
55-74
-
24
Gillies P A, Madeley R J, Power F L.
Why do pregnant women smoke?.
Public Health.
1989;
103
337-343
-
25
Graham H.
Women's smoking and family health.
Soc Sci Med.
1987;
25
47-56
-
26
Okah F A, Choi W S, Okuyemi K S, Ahluwalia J S.
Effect of children on home smoking restriction by inner-city smokers.
2002;
109
244-249
Felix A OkahM.D. M.S.
Children's Mercy Hospital and Clinics, Section of Neonatal-Perinatal Medicine
2401 Gillham Road, Kansas City, MO 64108
