Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
J Dual Diagn. 2021 Oct-Dec;17(4):296-303. doi: 10.1080/15504263.2021.1979349. Epub 2021 Sep 28.
Among persons with opioid use disorder (OUD), co-occurring depression is linked to a greater risk of opioid misuse, overdose and suicide. Less is known about characteristics and other comorbid health conditions of persons with co-occurring opioid use and depressive disorders.
This study used electronic health record (EHR) encounters from the Geisinger Health System prior to the fall of 2019. Adult patients were recruited from a medication-based treatment clinic and had an OUD diagnosis ( = 692). Co-occurring depression was defined by a depression diagnosis in the EHR. Multivariable logistic regression was performed to assess differences in characteristics, behavioral health and medical diagnoses, as well as opioid overdose and suicide attempt or ideation between individuals with and without comorbid depression.
Forty-seven percent of patients with OUD had a lifetime depression diagnosis. Individuals with co-occurring depression were more likely to be female and have comorbid chronic pain or other medical conditions. Co-occurring depression was associated with an increased likelihood of other mental health and substance use disorders, as well as opioid overdose and/or suicide attempt or ideation.
While it is established that co-occurring depression is associated with increased risk of overdose and suicide, this study adds that other health conditions, including chronic pain and common medical conditions, are more prevalent among persons with co-occurring depressive disorders. Results highlight the need to consider these complex health needs when developing treatment plans and services.
在患有阿片类药物使用障碍(OUD)的人群中,同时存在抑郁与阿片类药物滥用、过量用药和自杀的风险增加有关。然而,同时患有阿片类药物使用障碍和抑郁障碍的人群的特征和其他合并健康状况则知之甚少。
本研究使用了 2019 年秋季之前的 Geisinger 健康系统的电子健康记录(EHR)就诊记录。从药物治疗诊所招募成年患者,这些患者患有 OUD 诊断( = 692)。EHR 中的抑郁诊断定义为同时存在抑郁。多变量逻辑回归用于评估合并抑郁与无合并抑郁的个体在特征、行为健康和医疗诊断以及阿片类药物过量和自杀未遂或意念方面的差异。
47%的 OUD 患者有终生抑郁诊断。同时患有抑郁的个体更可能是女性,并且患有共病慢性疼痛或其他医疗状况。同时患有抑郁与其他心理健康和物质使用障碍以及阿片类药物过量和/或自杀未遂或意念的可能性增加有关。
虽然已经确定同时存在抑郁与过量用药和自杀的风险增加有关,但本研究补充说,其他健康状况,包括慢性疼痛和常见的医疗状况,在同时患有抑郁障碍的人群中更为普遍。研究结果强调了在制定治疗计划和服务时需要考虑这些复杂的健康需求。