Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder

Wan-Chen Lee; Hu-Ming Chang; Ming-Chyi Huang; Chun-Hung Pan; Sheng-Siang Su; Shang-Ying Tsai; Chiao-Chicy Chen; Chian-Jue Kuo

doi:10.1080/00952990.2021.1979990

Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder

Am J Drug Alcohol Abuse. 2022 Mar 4;48(2):245-254. doi: 10.1080/00952990.2021.1979990. Epub 2021 Oct 20.

Authors

Wan-Chen Lee¹, Hu-Ming Chang¹, Ming-Chyi Huang^{1

2

3}, Chun-Hung Pan^{1

4}, Sheng-Siang Su¹, Shang-Ying Tsai^{2

3}, Chiao-Chicy Chen^{2

3

5

6}, Chian-Jue Kuo^{1

2

3}

Affiliations

¹ Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
² Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
³ Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
⁴ Department of Psychology, National Chengchi University, Taipei, Taiwan.
⁵ Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
⁶ Department of Psychiatry, Mackay Medical College, Taipei, Taiwan.

PMID: 34670448
DOI: 10.1080/00952990.2021.1979990

Abstract

Background: Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limitedObjective: This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder.Methods: A total of 3321 cases (79% were male) of methamphetamine use disorder between January 1, 1996, and December 31, 2012, were identified from Psychiatric Inpatient Medical Claims database in Taiwan. Information was collected on demographics, diagnoses, and medical utilizations. The date of newly diagnosed with methamphetamine use disorder was defined as the baseline. Mirror-image study design was used to compare changes in medical utilization and comorbidities between the pre-baseline period (within 1 year before diagnosis) and the post-baseline period (within 1 year after diagnosis). Conditional logistic regression was used to estimate changes in medical utilization and comorbidities.Results: Most cases (77%) were first identified in a psychiatric department. There is a significant increase (P < .001) in psychiatric admission (odds ratio[OR] = 2.19), psychiatric emergency visits (OR = 1.31), and psychiatric outpatient visits (OR = 1.15) after diagnosis. Multivariable analysis revealed significantly increased risks (P < .001) of non-methamphetamine drug induced mental disorders (adjusted OR[aOR] = 29.47), schizophrenia (aOR = 2.62), bipolar disorder (aOR = 2.14), organic mental disorder (aOR = 1.82), and upper respiratory tract infection (aOR = 2.03) after diagnosis.Conclusions: We found significant increases of medical utilization and psychiatric comorbidities after diagnosed with methamphetamine use disorder. These findings may reflect the problem of delayed diagnosis and treatment. Enhancement of early identification of methamphetamine use disorder in general practice is required for early intervention and decreased subsequent morbidities.

Keywords: Methamphetamine; medical utilization; mirror-image study; psychiatric comorbidity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bipolar Disorder*
Comorbidity
Female
Hospitalization
Humans
Male
Mental Disorders* / complications
Mental Disorders* / epidemiology
Methamphetamine*
Odds Ratio

Substances

Methamphetamine