Risk of psychiatric disorders among concerned significant others of people with substance use
- 1Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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 problems. However, population studies on mental health in this group are rare. This study aimed to examine the association between exposure to harm from a known person’s substance use problems and psychiatric conditions up to two years later among adults in Sweden. More specifically, the study aimed to assess whether the risk varies by different types of psychiatric conditions.
Methods: Self-reported data on harm from a known person’s alcohol and illicit drug use from a general population survey (n = 11,112) were linked with registry records on psychiatric conditions. The risk of psychiatric conditions among CSOs compared to those not exposed, adjusted for confounders (socio-demographic factors and one’s own drinking and illicit drug use habits), including prior psychiatric conditions, was analysed using Poisson regression with robust standard errors.
Results: Around 12% of participants reported experiencing harm from others’ substance use within a one-year period, and another 5% reported severe harm, defined as being harmed “a lot.” After adjusting for confounders, the incidence rate ratio (IRR) of having a psychiatric condition up to two years after exposure was 1.96 (95% CI 1.42, 2.69) for externalizing disorders and 1.10 (1.00, 1.22) for internalizing disorders. All results are preliminary.
Conclusions: CSOs of individuals with substance use problems have an increased risk of subsequent psychiatric conditions up to two years after exposure. In addition, the elevated risk appeared to be stronger for externalizing conditions compared to internalizing. These findings highlight the need for societal efforts to support CSOs.
Key messages: • Adults harmed by others’ substance use face a higher risk of psychiatric disorders, especially for externalizing disorders.
• Findings highlight the need for healthcare professionals to screen and support concerned significant others affected by others’ substance use.
Related
- Supporting Concerned Significant Others of People Who Use Substances in Rural Australia: A Qualitative Study of Barriers, Enablers and Service Preferences
- Real-world effectiveness of psychiatric pharmacotherapies in reducing the risk of substance use- and psychiatric hospitalisations in cannabis use disorder – An exploratory nationwide register-based study
- Editorial: Emerging treatment approaches for substance use disorders, vol II
- Community-based interventions to improve hepatitis C linkage to care among people with substance use disorders in Southwest Virginia: a pragmatic sequential cohort study
- Electrophysiological reactivity to emotional images and targets predicts the development of substance use disorders in adolescent girls
BibTeX
@article{sundin2026risk,
title = {{Risk of psychiatric disorders among concerned significant others of people with substance use}},
author = {EM Sundin},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1967},
url = {https://doi.org/10.1093/eurpub/ckag169.1967},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Risk of psychiatric disorders among concerned significant others of people with substance use
AU - EM Sundin
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1967
UR - https://doi.org/10.1093/eurpub/ckag169.1967
AB - 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 problems. However, population studies on mental health in this group are rare. This study aimed to examine the association between exposure to harm from a known person’s substance use problems and psychiatric conditions up to two years later among adults in Sweden. More specifically, the study aimed to assess whether the risk varies by different types of psychiatric conditions. Methods: Self-reported data on harm from a known person’s alcohol and illicit drug use from a general population survey (n = 11,112) were linked with registry records on psychiatric conditions. The risk of psychiatric conditions among CSOs compared to those not exposed, adjusted for confounders (socio-demographic factors and one’s own drinking and illicit drug use habits), including prior psychiatric conditions, was analysed using Poisson regression with robust standard errors. Results: Around 12% of participants reported experiencing harm from others’ substance use within a one-year period, and another 5% reported severe harm, defined as being harmed “a lot.” After adjusting for confounders, the incidence rate ratio (IRR) of having a psychiatric condition up to two years after exposure was 1.96 (95% CI 1.42, 2.69) for externalizing disorders and 1.10 (1.00, 1.22) for internalizing disorders. All results are preliminary. Conclusions: CSOs of individuals with substance use problems have an increased risk of subsequent psychiatric conditions up to two years after exposure. In addition, the elevated risk appeared to be stronger for externalizing conditions compared to internalizing. These findings highlight the need for societal efforts to support CSOs. Key messages: • Adults harmed by others’ substance use face a higher risk of psychiatric disorders, especially for externalizing disorders. • Findings highlight the need for healthcare professionals to screen and support concerned significant others affected by others’ substance use.
SN - 1101-1262
SN - 1464-360X
ER -