Substance use disorders and comorbid Axis I and II psychiatric disorders among young psychiatric patients: findings from a large electronic health records database.
Abstract
This study examined the prevalence of substance use disorders (SUDs) among psychiatric
patients aged 2-17 years in an electronic health records database (N=11,457) and determined
patterns of comorbid diagnoses among patients with a SUD to inform emerging comparative
effectiveness research (CER) efforts. DSM-IV diagnoses of all inpatients and outpatients
at a large university-based hospital and its associated psychiatric clinics were systematically
captured between 2000 and 2010: SUD, anxiety (AD), mood (MD), conduct (CD), attention
deficit/hyperactivity (ADHD), personality (PD), adjustment, eating, impulse-control,
psychotic, learning, mental retardation, and relational disorders. The prevalence
of SUD in the 2-12-year age group (n=6210) was 1.6% and increased to 25% in the 13-17-year
age group (n=5247). Cannabis diagnosis was the most prevalent SUD, accounting for
more than 80% of all SUD cases. Among patients with a SUD (n=1423), children aged
2-12 years (95%) and females (75-100%) showed high rates of comorbidities; blacks
were more likely than whites to be diagnosed with CD, impulse-control, and psychotic
diagnoses, while whites had elevated odds of having AD, ADHD, MD, PD, relational,
and eating diagnoses. Patients with a SUD used more inpatient treatment than patients
without a SUD (43% vs. 21%); children, females, and blacks had elevated odds of inpatient
psychiatric treatment. Collectively, results add clinical evidence on treatment needs
and diagnostic patterns for understudied diagnoses.
Type
Journal articleSubject
HumansSubstance-Related Disorders
Prevalence
Risk Factors
Anxiety
Attention Deficit Disorder with Hyperactivity
Mood Disorders
Personality Disorders
Age Factors
Comorbidity
Sex Factors
Diagnostic and Statistical Manual of Mental Disorders
Adolescent
Child
Child, Preschool
Female
Male
Comparative Effectiveness Research
Electronic Health Records
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https://hdl.handle.net/10161/19990Published Version (Please cite this version)
10.1016/j.jpsychires.2011.06.012Publication Info
Wu, Li-Tzy; Gersing, Ken; Burchett, Bruce; Woody, George E; & Blazer, Dan G (2011). Substance use disorders and comorbid Axis I and II psychiatric disorders among young
psychiatric patients: findings from a large electronic health records database. Journal of psychiatric research, 45(11). pp. 1453-1462. 10.1016/j.jpsychires.2011.06.012. Retrieved from https://hdl.handle.net/10161/19990.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
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.
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
Alphabetical list of authors with Scholars@Duke profiles.

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