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美国精神卫生治疗中,2015 年至 2019 年,与焦虑或抑郁障碍诊断共病的原发性阿片类药物使用障碍诊断增加。

Increases in primary opioid use disorder diagnoses co-occurring with anxiety or depressive disorder diagnoses in mental health treatment in the United States, 2015-2019.

机构信息

School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC 27599, USA.

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.

出版信息

Drug Alcohol Depend. 2023 Dec 1;253:111022. doi: 10.1016/j.drugalcdep.2023.111022. Epub 2023 Nov 10.

Abstract

BACKGROUND

Opioid use disorders (OUDs) often co-occur with anxiety and depressive disorders. While the proportion of mental health (MH) treatment facilities providing substance use treatment has increased, the proportion of these facilities able to simultaneously treat MH and substance use decreased. This warrants investigation into the integrated treatment needs of persons with a primary OUD diagnosis treated in MH treatment facilities.

METHODS

Using the Mental Health Client Level Data, we examined a sample of N = 83,975 adults with OUD as their primary diagnosis who received treatment from a MH treatment facility in the United States from 2015 to 2019. Joinpoint regression was used to examine annual trends of the number of individuals with co-occurring anxiety or depression diagnoses.

RESULTS

Most of the sample were men (53.7%) and received treatment in a community-based program (93.3%). Approximately 17% of the sample had either an anxiety or depressive disorder diagnosis. Approximately 9% of our sample had an anxiety disorder diagnosis, and 10% had a depressive disorder diagnosis. An increase in the number of individuals with a co-occurring anxiety disorder diagnosis from 2015 to 2019 was identified (annual percent change (APC) = 61.4; 95% confidence interval (CI) = [10.0, 136.9]; p =.029). An increase in the number of individuals with a co-occurring depressive disorder diagnosis from 2015 to 2019 was identified (APC = 39.0; 95% CI = [7.4; 79.9]; p =.027).

CONCLUSIONS

This study highlights increases in adults receiving MH treatment for OUD having co-occurring anxiety or depression diagnoses, furthering the importance of integrated dual disorder treatment.

摘要

背景

阿片类药物使用障碍(OUD)常与焦虑和抑郁障碍共病。尽管提供物质使用治疗的心理健康(MH)治疗设施的比例有所增加,但能够同时治疗 MH 和物质使用障碍的设施比例却有所下降。这就需要调查在 MH 治疗设施中接受主要 OUD 诊断治疗的患者的综合治疗需求。

方法

我们使用心理健康患者水平数据,对 2015 年至 2019 年期间在美国接受 MH 治疗设施治疗的 83975 名患有 OUD 的成年人样本进行了研究。使用 Joinpoint 回归分析了共病焦虑或抑郁诊断的个体数量的年度趋势。

结果

大多数样本为男性(53.7%),并在社区为基础的项目中接受治疗(93.3%)。约 17%的样本有焦虑或抑郁障碍诊断。约 9%的样本有焦虑障碍诊断,10%有抑郁障碍诊断。2015 年至 2019 年期间,共病焦虑障碍患者数量增加(年变化百分比(APC)=61.4;95%置信区间(CI)=[10.0, 136.9];p=.029)。2015 年至 2019 年期间,共病抑郁障碍患者数量增加(APC=39.0;95%CI=[7.4;79.9];p=.027)。

结论

本研究强调了接受 MH 治疗 OUD 的成年人中同时患有焦虑或抑郁诊断的人数增加,进一步强调了综合双相障碍治疗的重要性。

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