Psychopathology in pregnant drug-dependent women with and without comorbidalcohol dependence

Background: Individuals with comorbid alcohol and drug use disorders are at particularly high risk for a variety of problems, including other psychiat ric disorders. In general, patients with comorbid alcohol and drug dependen ce tend to have more severe dependence problems and often have poorer treat ment outcomes than individuals with single disorders. For treatment-seeking pregnant women, psychiatric comorbidity can lead to relapse and premature treatment dropout, with adverse consequences to mother and infant. Methods: Psychopathology, as measured by the Minnesota Multiphasic Personal ity Inventory-Revised (MMPI-2), was examined in 170 pregnant women admitted to a comprehensive treatment program for cocaine or opiate dependence. Mos t were single (75%) and African American (80%), with a mean age of 29 years . Thirty-six met DSM-III-R criteria for both alcohol and drug dependence (a lcohol positive), whereas 134 were drug dependent only (alcohol negative). Results: Alcohol-positive women had higher levels of psychopathology than a lcohol-negative women, with higher scores on scales 2 (Depression), 4 (Psyc hopathic Deviance), 8 (Schizophrenia), and 0 (Social Introversion; p < 0.05 ). The mean MMPI-2 profile for alcohol-positive women was 2-4-8 (Depression -Psychopathic Deviance-Schizophrenia; all T-scores > 65), whereas alcohol-n egative women had only a scale 4 increase. Conclusions: Results suggest that pregnant, drug-dependent women with comor bid alcohol dependence present for treatment with greater psychopathology a nd thus may require more intense interventions than pregnant, drug-dependen t women without comorbid alcohol dependence. Alcohol use by pregnant women is particularly important to address in treatment, because alcohol is a kno wn teratogen associated with mental retardation and behavioral problems.