Substance use and mental diagnoses among adults with and without type 2 diabetes: Results from electronic health records data.

Wu, Li-Tzy

Ghitza, Udi E

Batch, Bryan C

Pencina, Michael J

Rojas, Leoncio Flavio

Goldstein, Benjamin A

Schibler, Tony

Dunham, Ashley A

Rusincovitch, Shelley

Brady, Kathleen T

2020-02-03T04:25:10Z

2020-02-03T04:25:10Z

2015-11

2020-02-03T04:25:09Z

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.

S0376-8716(15)01629-4

0376-8716

1879-0046

https://hdl.handle.net/10161/19948

eng

Elsevier BV

Drug and alcohol dependence

10.1016/j.drugalcdep.2015.09.003

Humans

Diabetes 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

Substance use and mental diagnoses among adults with and without type 2 diabetes: Results from electronic health records data.

Journal article

Wu, Li-Tzy|0000-0002-5909-2259

Batch, Bryan C|0000-0002-7138-2064

Pencina, Michael J|0000-0001-5798-8855|0000-0002-1968-2641

Goldstein, Benjamin A|0000-0001-5261-3632

162

169

School of Medicine

Duke

Center for Child and Family Policy

Sanford School of Public Policy

Duke Clinical Research Institute

Institutes and Centers

Duke Institute for Brain Sciences

University Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Psychiatry & Behavioral Sciences

Clinical Science Departments

Medicine, General Internal Medicine

Medicine

Biostatistics & Bioinformatics

Basic Science Departments

Population Health Sciences

Staff

Medicine, Endocrinology, Metabolism, and Nutrition

Published

156