Co-Occurrence of Obsessive-Compulsive Disorder and Substance Use Disorders Among U.S. Veterans: Prevalence and Mental Health Utilization
Co-Occurrence of Obsessive-Compulsive Disorder and Substance Use Disorders Among U.S. Veterans: Prevalence and Mental Health Utilization
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DOI：
10.1891/0889-8391.33.1.23
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发表时间：
2019-01-01
影响因子：
0.7
通讯作者：
Lindsay, Jan A.
中科院分区：
文献类型：
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作者：
Ecker, Anthony H.;Stanley, Melinda A.;Lindsay, Jan A.
强迫症(OCD)和物质使用障碍(SUDS)同时出现的几率很高，这与较差的心理社会结果有关。先前的工作表明，在退伍军人健康管理局(VHA)的退伍军人中，强迫症被低估了诊断和治疗，这可能会加剧强迫症和SUD并存的负面影响。这项研究确定了强迫症和特定的SUD共同出现的模式，以及它们对精神健康和物质使用筛查措施和精神卫生保健利用的影响。使用VHA管理数据，我们确定了2010至2016年间被诊断为强迫症的退伍军人(N=38,157)；36.70%的退伍军人也被诊断为强迫症。酒精使用障碍占17.17%，大麻使用障碍占5.53%，阿片类药物使用障碍占3.60%，苯丙胺使用障碍占1.49%，可卡因使用障碍占3.37%，烟草使用障碍占26.50%。在整个数据采集期间，患有强迫症和sud的退伍军人使用了更多的精神健康服务。研究结果表明，在VHA内，强迫症和SUD的发生率很高，这与医疗保健系统的更多负担有关。有针对性的筛查和治疗努力可能有助于满足这一人群的需求。
Obsessive-compulsive disorder (OCD) and substance-use disorders (SUDs) co-occur at high rates, which is related to poorer psychosocial outcomes. Prior work suggests that, among veterans in the Veterans Health Administration (VHA), OCD is underdiagnosed and undertreated, which can compound negative effects of OCD and SUD co-occurrence. This study identified patterns of OCD and specific SUD co-occurrence and their effect on mental health and substance-use screening measures and mental healthcare utilization. Using VHA administrative data, we identified veterans with an OCD diagnosis from 2010 to 2016 (N = 38,157); 36.70% also had a SUD diagnosis. Specific SUD rates are alcohol-use disorder, 17.17%; cannabis-use disorder, 5.53%; opioid-use disorder, 3.60%; amphetamine-use disorder, 1.49%; cocaine-use disorder, 3.37%; and tobacco-use disorder, 26.50%. Veterans with co-occurring OCD and SUD used more mental health services throughout the data capture period. Findings suggest that OCD and SUD co-occur at high rates within the VHA, and that this is associated with more burden to the healthcare system. Targeted screening and treatment efforts may help address the needs of this population.