Psychiatric risk among concerned significant others of people with alcohol or drug use problems

Abstract Background Being a concerned significant other (CSO) to someone with alcohol or illicit drug use problems can cause stress and strain, increasing the risk of mental health issues. However, population studies on mental health in this group are rare. This study aimed to examine the association between exposure to harm from others’ substance use and psychiatric conditions up to two years later among adults in Sweden. Hence, this study covers the connection between two major public health issues, namely substance use-related harm and mental health problems. Methods Self-reported data on harm from others’ substance use from a general population survey (n = 11,043) was linked with health registry records on psychiatric conditions. The risk of psychiatric conditions among CSOs compared to non-CSOs, adjusted for confounders (sex, age, education level, own drinking and illicit drug use habits) including prior psychiatric conditions, was analysed using Poisson regression with robust standard errors. Results Around 17% of participants reported experiencing harm from others’ substance use within a one-year period, and 5% reported severe harm, defined as being harmed ‘a lot’. After adjusting for confounders, the incidence rate ratio (IRR) of having a psychiatric condition was higher among those reporting harm from others’ substance use (IRR = 1.06, CI 0.89-1.26) compared to those not reporting such harm. The corresponding IRR among those reporting severe harm was 1.30 (CI 1.04-1.63). All results are preliminary. Conclusions Being a CSO to someone with alcohol or illicit drug use problems is associated with an increased risk of psychiatric conditions, in particularly among those experiencing severe harm. These findings highlight the need for targeted societal efforts to improve the situation for CSOs. For example, they could encourage professionals to routinely assess the mental health of CSOs and, if necessary, refer them to relevant healthcare services. Key messages • Adults harmed by others’ substance use face a higher risk of psychiatric conditions, especially those reporting severe harm. • Findings highlight the need for healthcare professionals to screen and support concerned significant others affected by others’ substance use.