A latent class analysis of drug abuse in a national Swedish sample

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A latent class analysis of drug abuse in a national Swedish sample. / Kendler, K. S.; Ohlsson, Henrik; Sundquist, Kristina; Sundquist, Jan.

I: Psychological Medicine, Vol. 43, Nr. 10, 2013, s. 2169-2178.

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T1 - A latent class analysis of drug abuse in a national Swedish sample

AU - Kendler, K. S.

AU - Ohlsson, Henrik

AU - Sundquist, Kristina

AU - Sundquist, Jan

PY - 2013

Y1 - 2013

N2 - Background. Drug abuse (DA) is a clinically heterogeneous syndrome. Using medical, legal, death and pharmacy records covering the entire population of Sweden, could we uncover meaningful subtypes of DA? Method. We performed a latent class analysis (LCA) on all individuals in Sweden born 1950-1993 who were registered with DA or its consequences (n=192 501) and then validated these classes using demographics, patterns of co-morbidity with alcohol use disorder (AUD), non-DA crime and psychiatric illness, and the pattern of aggregation and co-aggregation in sibling pairs. Results. The best-fit LCA had six classes : (1) low-frequency pure criminal, (2) high-frequency medical criminal, (3) low-frequency pure medical, (4) high-frequency medical, (5) prescription and (6) death. Each class had a distinct pattern of demographic features and co-morbidity and aggregated within sibling pairs with at least moderate specificity. For example, class 2 was characterized by early age at registration, low educational attainment, high male preponderance, high rates of AUDs, strong resemblance within sibling pairs [odds ratio (OR) 12.6] and crime and the highest risk for DA in siblings (20.0 %). By contrast, class 5 had a female preponderance, late age at registration, low rates of crime and AUDs, high rates of psychiatric illness, high familiality within sibling pairs (OR 14.7) but the lowest observed risk for DA in siblings (8.9 %). Conclusions. DA as assessed by public records is a heterogeneous syndrome. Familial factors contribute substantially to this heterogeneity. Advances in our understanding of etiological processes leading to DA will be aided by a consideration of this heterogeneity.

AB - Background. Drug abuse (DA) is a clinically heterogeneous syndrome. Using medical, legal, death and pharmacy records covering the entire population of Sweden, could we uncover meaningful subtypes of DA? Method. We performed a latent class analysis (LCA) on all individuals in Sweden born 1950-1993 who were registered with DA or its consequences (n=192 501) and then validated these classes using demographics, patterns of co-morbidity with alcohol use disorder (AUD), non-DA crime and psychiatric illness, and the pattern of aggregation and co-aggregation in sibling pairs. Results. The best-fit LCA had six classes : (1) low-frequency pure criminal, (2) high-frequency medical criminal, (3) low-frequency pure medical, (4) high-frequency medical, (5) prescription and (6) death. Each class had a distinct pattern of demographic features and co-morbidity and aggregated within sibling pairs with at least moderate specificity. For example, class 2 was characterized by early age at registration, low educational attainment, high male preponderance, high rates of AUDs, strong resemblance within sibling pairs [odds ratio (OR) 12.6] and crime and the highest risk for DA in siblings (20.0 %). By contrast, class 5 had a female preponderance, late age at registration, low rates of crime and AUDs, high rates of psychiatric illness, high familiality within sibling pairs (OR 14.7) but the lowest observed risk for DA in siblings (8.9 %). Conclusions. DA as assessed by public records is a heterogeneous syndrome. Familial factors contribute substantially to this heterogeneity. Advances in our understanding of etiological processes leading to DA will be aided by a consideration of this heterogeneity.

KW - Drug abuse

KW - latent class analysis

KW - siblings

KW - Sweden

U2 - 10.1017/S0033291713000081

DO - 10.1017/S0033291713000081

M3 - Article

VL - 43

SP - 2169

EP - 2178

JO - Psychological Medicine

JF - Psychological Medicine

SN - 1469-8978

IS - 10

ER -