Prevalence of co‐occurring mental illness and substance use disorder and association with overdose: a linked data cohort study among residents of British Columbia, Canada.

Aims: To estimate the treated prevalence of mental illness, substance use disorder (SUD) and dual diagnosis and the association between dual diagnosis and fatal and non‐fatal overdose among residents of British Columbia (BC), Canada. Design A retrospective cohort study using linked health, income as...

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Publicado en:Addiction Vol. 117; no. 1; pp. 129 - 141
Autores principales: Keen, Claire, Kinner, Stuart A., Young, Jesse T., Jang, Kerry, Gan, Wenqi, Samji, Hasina, Zhao, Bin, Krausz, Michael, Slaunwhite, Amanda
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jan2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2022
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Prevalence of co‐occurring mental illness and substance use disorder and association with overdose: a linked data cohort study among residents of British Columbia, Canada.
      aug:
        au:
          Keen, Claire
          Kinner, Stuart A.
          Young, Jesse T.
          Jang, Kerry
          Gan, Wenqi
          Samji, Hasina
          Zhao, Bin
          Krausz, Michael
          Slaunwhite, Amanda
        affil: Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne,, Australia
      sug:
        subj:
          Mental Disorders
          Substance Use Disorders
          Comorbidity Epidemiology
          Overdose Epidemiology
          Diagnosis, Dual (Psychiatry)
          Human
          Male
          Female
          British Columbia
          Retrospective Design
          Record Review
          Prospective Studies
          Regression
          Descriptive Statistics
          Confidence Intervals
          Child
          Adolescence
          Adult
          Middle Age
          Aged
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Aims: To estimate the treated prevalence of mental illness, substance use disorder (SUD) and dual diagnosis and the association between dual diagnosis and fatal and non‐fatal overdose among residents of British Columbia (BC), Canada. Design A retrospective cohort study using linked health, income assistance, corrections and death records. Setting: British Columbia (BC), Canada. Participants: A total of 921 346 BC residents (455 549 males and 465 797 females) aged 10 years and older. Measurements Hospital and primary‐care administrative data were used to identify a history of mental illness only, SUD only, dual diagnosis or no history of SUD or mental illness (2010–14) and overdoses resulting in medical care (2015–17). We calculated crude incidence rates of non‐fatal and fatal overdose by dual diagnosis history. Andersen–Gill and competing risks regression were used to examine the association between dual diagnosis and non‐fatal and fatal overdose, respectively, adjusting for age, sex, comorbidities, incarceration history, social assistance, history of prescription opioid and benzodiazepine dispensing and region of residence. Findings Of the 921 346 people in the cohort, 176 780 (19.2%), 6147 (0.7%) and 15 269 (1.7%) had a history of mental illness only, SUD only and dual diagnosis, respectively; 4696 (0.5%) people experienced 688 fatal and 6938 non‐fatal overdoses. In multivariable analyses, mental illness only, SUD only and dual diagnosis were associated with increased rate of non‐fatal [hazard ratio (HR) = 1.8, 95% confidence interval (CI) = 1.6–2.1; HR = 9.0, 95% CI = 7.0–11.5, HR = 8.7, 95% CI = 6.9–10.9, respectively] and fatal overdose (HR = 1.6, 95% CI = 1.3–2.0, HR = 4.3, 95% CI = 2.8–6.5, HR = 4.1, 95% CI = 2.8–6.0, respectively) compared with no history. Conclusions: In a large sample of residents of British Columbia (Canada), approximately one in five people had sought care for a substance use disorder or mental illness in the past 5 years. The rate of overdose was elevated in people with a mental illness alone, higher again in people with a substance use disorder alone and highest in people with a dual diagnosis. The adjusted hazard rates were similar for people with substance use disorder only and people with a dual diagnosis.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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