Psychiatric correlates of injection risk behavior among young people who inject drugs.

Abstract

Background People who inject drugs (PWID) and have mental health conditions, such as major depression, an anxiety disorder, or anti-social or borderline personality disorder, may have elevated risk for HIV/HCV infection. This study examined the associations between psychiatric disorders and risky injection behavior in an out-of-treatment sample of young PWID. Design We recruited participants through outreach and respondent-driven sampling. Participants completed a computer-assisted self-interview, and a psychiatric interview. Methods Interviews took place at a community-based field site of the Community Outreach Intervention Projects. Participants were 570 young adults (18-25 years) who injected drugs in the previous 30 days. Psychiatric diagnoses were based on interviews using the Psychiatric Research Instrument for Substance and Mental Disorders (PRISM). Injection behavior was classified into three categories: receptive syringe sharing, other equipment sharing only, and no sharing. Associations between injection risk behavior and psychiatric diagnoses were tested using RDS-weighted multinomial regressions. Results Substance-induced lifetime and past year major depression, and borderline personality disorder were significantly associated with a greater likelihood of receptive syringe sharing (p < .001). Substance-induced major depression in the past year was also associated with non-syringe equipment sharing (p < .01). Primary major depression, antisocial personality disorder, and anxiety disorders other than post-traumatic stress disorder were slightly more prevalent among injectors who shared syringes, however the associations were not statistically significant. Conclusions Substance-induced major depression and borderline personality disorder are common among young people who inject drugs and are associated with risky injection behavior.

Prescription opioid misuse and mental health among young injection drug users

“…Details of the study procedures have been described previously (44, 45). All study procedures were approved by the Institutional Review Board of the University of Illinois at Chicago.…”

People Who Inject Drugs and Have Mood Disorders—A Brief Assessment of Health Risk Behaviors

“…Despite the significant health concerns for PWID, little evidence is available to inform health service providers on the potentially synergistic effects of comorbid mental health disorders on the incidence of risk behaviors among PWID (Buckingham et al, 2013; Mackesy-Amiti et al, 2014). Social marginalization is likely to result in a constellation of health risk behaviors for PWID including unclean “works” (i.e.…”

A Hazard Analysis of Risk Factors of Mortality in Individuals Who Inject Drugs in Denver CO

“…While this study was not powered to detect HIV-specific mortality the use of shared equipment may mark other risk-taking behaviors that would be predictive of all-cause mortality. Indeed, correlations between unsterile injection practices and major psychiatric conditions such as borderline personality disorder and anti-social personality disorder have been identified within PWID [45, 46]. These conditions may predispose to other risky behaviors through impulsivity and emotional dysregulation that are commonplace in these conditions [47–49].…”