PDF(Pubmed)
Abstract：
Knowledge of co-occurring mental disorders (termed \'dual diagnosis\') among patients receiving opioid agonist treatment (OAT) is scarce. This study aimed (1) to estimate the prevalence and structure of dual diagnoses in two national cohorts of OAT patients and (2) to compare mental disorders between OAT patients and the general populations stratified on sex and standardized by age.
A registry-linkage study of OAT patients from Czechia (N = 4,280) and Norway (N = 11,389) during 2010-2019 was conducted. Data on mental disorders (F00-F99; ICD-10) recorded in nationwide health registers were linked to the individuals registered in OAT. Dual diagnoses were defined as any mental disorder excluding substance use disorders (SUDs, F10-F19; ICD-10). Sex-specific age-standardized morbidity ratios (SMR) were calculated for 2019 to compare OAT patients and the general populations.
The prevalence of dual diagnosis was 57.3% for Czechia and 78.3% for Norway. In Czechia, anxiety (31.1%) and personality disorders (25.7%) were the most prevalent, whereas anxiety (33.8%) and depression (20.8%) were the most prevalent in Norway. Large country-specific variations were observed, e.g., in ADHD (0.5% in Czechia, 15.8% in Norway), implying differences in screening and diagnostic practices. The SMR estimates for any mental disorders were 3.1 (females) and 5.1 (males) in Czechia and 5.6 (females) and 8.2 (males) in Norway. OAT females had a significantly higher prevalence of co-occurring mental disorders, whereas SMRs were higher in OAT males. In addition to opioid use disorder (OUD), other substance use disorders (SUDs) were frequently recorded in both countries.
Results indicate an excess of mental health problems in OAT patients compared to the general population of the same sex and age in both countries, requiring appropriate clinical attention. Country-specific differences may stem from variations in diagnostics and care, reporting to registers, OAT provision, or substance use patterns.
A registry-linkage study of OAT patients from Czechia (N = 4,280) and Norway (N = 11,389) during 2010-2019 was conducted. Data on mental disorders (F00-F99; ICD-10) recorded in nationwide health registers were linked to the individuals registered in OAT. Dual diagnoses were defined as any mental disorder excluding substance use disorders (SUDs, F10-F19; ICD-10). Sex-specific age-standardized morbidity ratios (SMR) were calculated for 2019 to compare OAT patients and the general populations.
The prevalence of dual diagnosis was 57.3% for Czechia and 78.3% for Norway. In Czechia, anxiety (31.1%) and personality disorders (25.7%) were the most prevalent, whereas anxiety (33.8%) and depression (20.8%) were the most prevalent in Norway. Large country-specific variations were observed, e.g., in ADHD (0.5% in Czechia, 15.8% in Norway), implying differences in screening and diagnostic practices. The SMR estimates for any mental disorders were 3.1 (females) and 5.1 (males) in Czechia and 5.6 (females) and 8.2 (males) in Norway. OAT females had a significantly higher prevalence of co-occurring mental disorders, whereas SMRs were higher in OAT males. In addition to opioid use disorder (OUD), other substance use disorders (SUDs) were frequently recorded in both countries.
Results indicate an excess of mental health problems in OAT patients compared to the general population of the same sex and age in both countries, requiring appropriate clinical attention. Country-specific differences may stem from variations in diagnostics and care, reporting to registers, OAT provision, or substance use patterns.
摘要：
背景：在接受阿片类药物激动剂治疗（OAT）的患者中，关于并发精神障碍（称为“双重诊断”）的知识很少。这项研究旨在（1）估计两个国家OAT患者队列中双重诊断的患病率和结构，以及（2）比较OAT患者与按性别分层并按年龄标准化的普通人群之间的精神障碍。
方法：在2010-2019年期间，对来自捷克（N=4,280）和挪威（N=11,389）的OAT患者进行了注册链接研究。全国健康登记册中记录的精神障碍数据（F00-F99；ICD-10）与在OAT中注册的个人相关联。双重诊断被定义为任何精神障碍，不包括物质使用障碍(SUD，F10-F19;ICD-10)。计算了2019年的性别特定年龄标准化发病率（SMR），以比较OAT患者和普通人群。
结果：双重诊断的患病率在捷克为57.3%，在挪威为78.3%。在捷克,焦虑（31.1％）和人格障碍（25.7％）最普遍，而焦虑(33.8%)和抑郁(20.8%)在挪威最普遍。观察到特定国家的巨大差异，例如，多动症(0.5%在捷克，挪威15.8%)，暗示筛查和诊断实践的差异。任何精神障碍的SMR估计值在捷克为3.1（女性）和5.1（男性），在挪威为5.6（女性）和8.2（男性）。OAT女性并发精神障碍的患病率明显更高，而SMR在OAT男性中更高。除了阿片类药物使用障碍（OUD），在这两个国家,其他物质使用障碍(SUDs)也经常被记录.
结论：结果表明，与两国相同性别和年龄的普通人群相比，OAT患者的心理健康问题过多，需要适当的临床关注。特定国家的差异可能源于诊断和护理的差异，向登记册报告，OAT规定，或物质使用模式。
方法：在2010-2019年期间，对来自捷克（N=4,280）和挪威（N=11,389）的OAT患者进行了注册链接研究。全国健康登记册中记录的精神障碍数据（F00-F99；ICD-10）与在OAT中注册的个人相关联。双重诊断被定义为任何精神障碍，不包括物质使用障碍(SUD，F10-F19;ICD-10)。计算了2019年的性别特定年龄标准化发病率（SMR），以比较OAT患者和普通人群。
结果：双重诊断的患病率在捷克为57.3%，在挪威为78.3%。在捷克,焦虑（31.1％）和人格障碍（25.7％）最普遍，而焦虑(33.8%)和抑郁(20.8%)在挪威最普遍。观察到特定国家的巨大差异，例如，多动症(0.5%在捷克，挪威15.8%)，暗示筛查和诊断实践的差异。任何精神障碍的SMR估计值在捷克为3.1（女性）和5.1（男性），在挪威为5.6（女性）和8.2（男性）。OAT女性并发精神障碍的患病率明显更高，而SMR在OAT男性中更高。除了阿片类药物使用障碍（OUD），在这两个国家,其他物质使用障碍(SUDs)也经常被记录.
结论：结果表明，与两国相同性别和年龄的普通人群相比，OAT患者的心理健康问题过多，需要适当的临床关注。特定国家的差异可能源于诊断和护理的差异，向登记册报告，OAT规定，或物质使用模式。
