Substance abuse and psychiatric co-morbidity as predictors of premature mortality in Swedish drug abusers a prospective longitudinal study 1970 - 2006

Nyhlén, Anna; Fridell, Mats; Bäckström, Martin; Hesse, Morten; Krantz, Peter

doi:10.1186/1471-244x-11-122

Cited by 56 publications

(42 citation statements)

References 37 publications

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“…Given that the 1991 NHIS did not include assessments of mental disorders, negative mood served as a proxy for mental health status. Among treated cohorts of people who use drugs, there is evidence that comorbid mental disorders are associated with premature mortality (Bogdanowicz et al, 2015; Nyhlén et al, 2011). Given the high prevalence of comorbidity for illegal drug use and mental disorders (Compton et al, 2007; Grant et al, 2004; Kessler et al, 2005), as well as the association of mental disorders with elevated mortality risk (Walker et al, 2015), mental disorders are a concern in this population.…”

Section: Discussionmentioning

confidence: 99%

Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

Walker

Pratt

Schoenborn

et al. 2017

Drug and Alcohol Dependence

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Objective The purpose of this study was to determine the mortality risks, over 20 years of follow-up in a nationally representative sample, associated with illegal drug use and to describe risk factors for mortality. Methods We analyzed data from the 1991 National Health Interview Survey, which is a nationally representative household survey in the United States, linked to the National Death Index through 2011. This study included 20,498 adults, aged 18–44 years in 1991, with 1,047 subsequent deaths. A composite variable of self-reported lifetime illegal drug use was created (hierarchical categories of heroin, cocaine, hallucinogens/inhalants, and marijuana use). Results Mortality risk was significantly elevated among individuals who reported lifetime use of heroin (HR=2.40, 95% CI: 1.65–3.48) and cocaine (HR=1.27, 95% CI: 1.04–1.55), but not for those who used hallucinogens/inhalants or marijuana, when adjusting for demographic characteristics. Baseline health risk factors (smoking, alcohol use, physical activity, and BMI) explained the greatest amount of this mortality risk. After adjusting for all baseline covariates, the association between heroin or cocaine use and mortality approached significance. In models adjusted for demographics, people who reported lifetime use of heroin or cocaine had an elevated mortality risk due to external causes (poisoning, suicide, homicide, and unintentional injury). People who had used heroin, cocaine, or hallucinogens/inhalants had an elevated mortality risk due to infectious diseases. Conclusions Heroin and cocaine are associated with considerable excess mortality, particularly due to external causes and infectious diseases. This association can be explained mainly by health risk behaviors.

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Section: Discussionmentioning

confidence: 99%

Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

Walker

Pratt

Schoenborn

et al. 2017

Drug and Alcohol Dependence

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“…Chronic alcohol users had increased risk of non-drug related death. This study had patients with schizophrenia, substance induced psychosis, affective disorders, neurosis, anxiety, hysteria, phobias, and obsessive-compulsive neurosis (Nyhlen et al, 2011). Our sample included only people with schizophrenia, schizoaffective disorder or psychosis NOS.…”

Section: Discussionmentioning

confidence: 99%

Alcohol and cannabis use and mortality in people with schizophrenia and related psychotic disorders

Koola

McMahon

Wehring

et al. 2012

Journal of Psychiatric Research

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The impact of co-morbid substance use on mortality is not well studied in psychotic disorders. The objective of this study was to examine the impact of substance use on mortality in people with psychotic disorders and alcohol and/or drug use. We examined the rate of substance use and the risk of substance use on mortality risk over a 4–10 year period in 762 people with psychotic disorders. Deceased patients were identified from the Social Security Death Index and the Maryland Division of Vital Records. Substance use was defined as regular and heavy use or abuse or dependence. Seventy seven percent had co-morbid lifetime substance use, with co-morbid cannabis and alcohol use occurring most commonly. Out of 762 subjects, 62 died during follow up. In a Cox model, predicted mortality risk was higher in age group 35–55 compared to <35 years and in males, but reduced in cannabis users. Overall five- (3.1% vs 7.5%) and ten-year mortality risk (5.5% vs. 13.6%) was lower in cannabis users than in non-users with psychotic disorders (p=0.005) in a survival model. Alcohol use was not predictive of mortality. We observed a lower mortality risk in cannabis-using psychotic disorder patients compared to cannabis non-users despite subjects having similar symptoms and treatments. Future research is warranted to replicate these findings and to shed light on the anti-inflammatory properties of the endocannabinoid system and its role in decreased mortality in people with psychotic disorders.

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“…In addition to the economic burden, pain and/or fear of pain negatively affect quality of life 4 . The impact may even go beyond morbidity, quality of life and cost, as pain management with narcotics carries a higher mortality risk 5–7 .…”

Section: Introductionmentioning

confidence: 99%

Abdominal Pain in Ulcerative Colitis

Coates¹,

Lahoti²,

Binion³

et al. 2013

Inflammatory Bowel Diseases

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BACKGROUND Chronic pain is common in inflammatory bowel disease (IBD) patients and often attributed to inflammation. However, many IBD patients without evidence of active disease continue to experience pain. This study was undertaken to determine the prevalence of pain in ulcerative colitis (UC) patients and examine the role of inflammation and psychiatric comorbidities in UC patients with pain. METHODS We performed a retrospective cross-sectional analysis of adult UC patients seen at a tertiary referral IBD center. Age, gender, disease duration and extent, abdominal pain rating, quality of life, physician global assessment (PGA), endoscopic and histologic rating of disease severity, C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were abstracted. RESULTS 1268 patients were identified using billing codes for colitis. 502 (48.2% women) met all inclusion criteria. 262 (52.2%) individuals complained of abdominal pain, with 108 (21.5%) individuals describing more frequent pain (‘some of the time or more’). Of those with quiescent disease (n=326), 33 (10%) patients complained of more frequent pain. PGA, endoscopic and histologic severity rating, ESR and CRP significantly correlated with pain ratings. The best predictors of pain were PGA, CRP and ESR, female gender and coexisting mood disorders. CONCLUSIONS Abdominal pain affects more than 50% of UC patients. While inflammation is important, the skewed gender distribution and correlation with mood disorders highlights parallels with functional bowel disorders and suggest a significant role for central mechanisms. Management strategies should thus go beyond a focus on inflammation and also include interventions that target psychological mechanisms of pain.

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Substance abuse and psychiatric co-morbidity as predictors of premature mortality in Swedish drug abusers a prospective longitudinal study 1970 - 2006

Cited by 56 publications

References 37 publications

Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey

Alcohol and cannabis use and mortality in people with schizophrenia and related psychotic disorders

Abdominal Pain in Ulcerative Colitis

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