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Using electronic health records data to assess comorbidities of substance use and psychiatric diagnoses and treatment settings among adults.

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Date
2013-04
Authors
Wu, Li-Tzy
Gersing, Kenneth R
Swartz, Marvin S
Burchett, Bruce
Li, Ting-Kai
Blazer, Dan G
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Abstract
To examine prevalences of substance use disorders (SUD) and comprehensive patterns of comorbidities among psychiatric patients ages 18-64 years (N = 40,099) in an electronic health records (EHR) database.DSM-IV diagnoses among psychiatric patients in a large university system were systematically captured: SUD, anxiety (AD), mood (MD), personality (PD), adjustment, childhood-onset, cognitive/dementia, dissociative, eating, factitious, impulse-control, psychotic (schizophrenic), sexual/gender identity, sleep, and somatoform diagnoses. Comorbidities and treatment types among patients with a SUD were examined.Among all patients, 24.9% (n = 9984) had a SUD, with blacks (35.2%) and Hispanics (32.9%) showing the highest prevalence. Among patients with a SUD, MD was prevalent across all age groups (50.2-56.6%). Patients aged 18-24 years had elevated odds of comorbid PD, adjustment, childhood-onset, impulse-control, psychotic, and eating diagnoses. Females had more PD, AD, MD, eating, and somatoform diagnoses, while males had more childhood-onset, impulse-control, and psychotic diagnoses. Blacks had greater odds than whites of psychotic and cognitive/dementia diagnoses, while whites exhibited elevated odds of PA, AD, MD, childhood-onset, eating, somatoform, and sleep diagnoses. Women, blacks, and Native American/multiple-race adults had elevated odds of using inpatient treatment; men, blacks, and Hispanics had increased odds of using psychiatric emergency care. Comorbid MD, PD, adjustment, somatoform, psychotic, or cognitive/dementia diagnoses increased inpatient treatment.Patients with a SUD, especially minority members, use more inpatient or psychiatric emergency care than those without. Findings provide evidence for research on understudied diagnoses and underserved populations in the real-world clinical settings.
Type
Journal article
Subject
Humans
Substance-Related Disorders
Diagnosis, Dual (Psychiatry)
Hospitalization
Prevalence
Mental Disorders
Comorbidity
Age Distribution
Sex Distribution
Adolescent
Adult
Middle Aged
Inpatients
Academic Medical Centers
United States
Female
Male
Young Adult
Electronic Health Records
Permalink
https://hdl.handle.net/10161/19956
Published Version (Please cite this version)
10.1016/j.jpsychires.2012.12.009
Publication Info
Wu, Li-Tzy; Gersing, Kenneth R; Swartz, Marvin S; Burchett, Bruce; Li, Ting-Kai; & Blazer, Dan G (2013). Using electronic health records data to assess comorbidities of substance use and psychiatric diagnoses and treatment settings among adults. Journal of psychiatric research, 47(4). pp. 555-563. 10.1016/j.jpsychires.2012.12.009. Retrieved from https://hdl.handle.net/10161/19956.
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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Scholars@Duke

Blazer

Daniel German Blazer

J. P. Gibbons Distinguished Professor Emeritus of Psychiatry
I am currently semi-retired. Most of my recent work has been focused on roles with the National Academy of Medicine (former Institute of Medicine). I have chaired three committees during the past four years, one on the mental health and substance use workforce, one on cognitive aging, and one on hearing loss in adults. I currently also chair the Board on the Health of Select Populations for the National Academies. In the past I have been PI on a number of research

Bruce Myatt Burchett

Assistant Professor in Psychiatry and Behavioral Sciences
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.

Ting-Kai Li

Professor Emeritus in Psychiatry and Behavioral Sciences
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Swartz

Marvin Stanley Swartz

Professor of Psychiatry and Behavioral Sciences
My major research interest is in examining the effectiveness of services for severely mentally ill individuals, including factors that improve or impede good outcomes. Current research includes: the effectiveness of involuntary outpatient commitment, psychiatric advance directives, criminal justice outcomes for persons with mental illnesses, violence and mental illness and antipsychotic medications. I also served as member of the MacArthur Foundation Research Network on Mandate
Wu

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
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