اختلالات مصرف مواد و اختلالات روانپزشکی محور اول و دوم در بیماران جوان روانپزشکی: یافته های یک پایگاه داده بزرگ ثبت الکترونیکی سلامت

This study examined the prevalence of substance use disorders (SUDs) among psychiatric patients aged 2–17 years in an electronic health records database (N = 11,457) and determined patterns of comorbid diagnoses among patients with a SUD to inform emerging comparative effectiveness research (CER) efforts. DSM-IV diagnoses of all inpatients and outpatients at a large university-based hospital and its associated psychiatric clinics were systematically captured between 2000 and 2010: SUD, anxiety (AD), mood (MD), conduct (CD), attention deficit/hyperactivity (ADHD), personality (PD), adjustment, eating, impulse-control, psychotic, learning, mental retardation, and relational disorders. The prevalence of SUD in the 2–12-year age group (n = 6210) was 1.6% and increased to 25% in the 13–17-year age group (n = 5247). Cannabis diagnosis was the most prevalent SUD, accounting for more than 80% of all SUD cases. Among patients with a SUD (n = 1423), children aged 2–12 years (95%) and females (75–100%) showed high rates of comorbidities; blacks were more likely than whites to be diagnosed with CD, impulse-control, and psychotic diagnoses, while whites had elevated odds of having AD, ADHD, MD, PD, relational, and eating diagnoses. Patients with a SUD used more inpatient treatment than patients without a SUD (43% vs. 21%); children, females, and blacks had elevated odds of inpatient psychiatric treatment. Collectively, results add clinical evidence on treatment needs and diagnostic patterns for understudied diagnoses.