Substance use and mental diagnoses among adults with and without type 2 diabetes: Results from electronic health records data.
Abstract
BACKGROUND:Comorbid diabetes and substance use diagnoses (SUD) represent a hazardous
combination, both in terms of healthcare cost and morbidity. To date, there is limited
information about the association of SUD and related mental disorders with type 2
diabetes mellitus (T2DM). METHODS:We examined the associations between T2DM and multiple
psychiatric diagnosis categories, with a focus on SUD and related psychiatric comorbidities
among adults with T2DM. We analyzed electronic health record (EHR) data on 170,853
unique adults aged ≥18 years from the EHR warehouse of a large academic healthcare
system. Logistic regression analyses were conducted to estimate the strength of an
association for comorbidities. RESULTS:Overall, 9% of adults (n=16,243) had T2DM.
Blacks, Hispanics, Asians, and Native Americans had greater odds of having T2DM than
whites. All 10 psychiatric diagnosis categories were more prevalent among adults with
T2DM than among those without T2DM. Prevalent diagnoses among adults with T2MD were
mood (21.22%), SUD (17.02%: tobacco 13.25%, alcohol 4.00%, drugs 4.22%), and anxiety
diagnoses (13.98%). Among adults with T2DM, SUD was positively associated with mood,
anxiety, personality, somatic, and schizophrenia diagnoses. CONCLUSIONS:We examined
a large diverse sample of individuals and found clinical evidence of SUD and psychiatric
comorbidities among adults with T2DM. These results highlight the need to identify
feasible collaborative care models for adults with T2DM and SUD related psychiatric
comorbidities, particularly in primary care settings, that will improve behavioral
health and reduce health risk.
Type
Journal articleSubject
HumansDiabetes Mellitus, Type 2
Substance-Related Disorders
Diagnosis, Dual (Psychiatry)
Prevalence
Mental Disorders
Anxiety Disorders
Mood Disorders
Personality Disorders
Schizophrenia
Age Factors
International Classification of Diseases
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Ethnic Groups
Female
Male
Young Adult
Electronic Health Records
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https://hdl.handle.net/10161/19948Published Version (Please cite this version)
10.1016/j.drugalcdep.2015.09.003Publication Info
Wu, Li-Tzy; Ghitza, Udi E; Batch, Bryan C; Pencina, Michael J; Rojas, Leoncio Flavio;
Goldstein, Benjamin A; ... Brady, Kathleen T (2015). Substance use and mental diagnoses among adults with and without type 2 diabetes:
Results from electronic health records data. Drug and alcohol dependence, 156. pp. 162-169. 10.1016/j.drugalcdep.2015.09.003. Retrieved from https://hdl.handle.net/10161/19948.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Bryan Courtney Batch
Associate Professor of Medicine
Type 2 Diabetes, Obesity/Overweight, Behavior change, Non-pharmacologic intervention,
Health disparities
Benjamin Alan Goldstein
Associate Professor of Biostatistics & Bioinformatics
I study the meaningful use of Electronic Health Records data. My research interests
sit at the intersection of biostatistics, biomedical informatics, machine learning
and epidemiology. I collaborate with researchers both locally at Duke as well as nationally.
I am interested in speaking with any students, methodologistis or collaborators interested
in EHR data.Please find more information at: https://sites.duke.edu/bgoldstein/
Michael J Pencina
Professor of Biostatistics & Bioinformatics
As Vice Dean for Data Science, Dr. Pencina is responsible for developing and implementing
quantitative science strategies as they pertain to the education and training, and
laboratory, clinical science, and data science missions of the School of Medicine.
Dr. Pencina is a Professor of Biostatistics and Bioinformatics at Duke University
and Director of Duke AI Health. Previously, he served as Director of Biostatistics
at the Duke Clinical Research Institute.
Dr. Pencina is an internati
Shelley Rusincovitch
Senior Dir, IT
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder, Opio
Alphabetical list of authors with Scholars@Duke profiles.

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