Severe mental illness increases the likelihood of substance abuse in women who have experienced childhood abuse or neglect

Childhood abuse and neglect are associated with substance abuse in women, although the link between childhood maltreatment, mental illness and substance abuse has not been systematically investigated. The present study examined the effect of severe mental illness on alcohol and drug dependence in women who were abused as children.

A community sample of 210 women completed the Millon Clinical Multiaxial Inventory and the Childhood Trauma Questionnaire. Validated cutoff scores on the MCMI were used to determine the presence of severe mental illness as well as alcohol and drug dependence. The CTQ measured the severity of childhood abuse and neglect for each participant. Analyses of variance (ANOVA) and chi-square tests were conducted, and odds ratios were calculated.

Major depression had a significant effect on alcohol and drug dependence in women who were victims of all five types of abuse and neglect measured by the CTQ. Odds ratios ranged from 2.76 to 4.96 for comparisons with significant chi-squares, indicating that abused women with major depression were significantly more likely to be dependent on alcohol or drugs than nondepressed, abused women. Delusional disorder and thought disorder had a significant effect on alcohol or drug dependence in women who were physically abused, sexually abused, or emotionally neglected, with odds ratios ranging from 1.6 to 7.99.

Severe mental illness appears to play a mediating role in the development of alcohol or drug dependence in women who experienced childhood maltreatment. Major depression, in particular, increases the likelihood of substance abuse in abused women.