Table 1.
Association of incident psychiatric comorbidity outcomes, depression severity indicators, and covariates with opioid and depression exposure groups (2002–2012) (n=4,758)
| Outcomes /covariates, n(%) | Total (N=4,758) |
Non-OAU + NDE (n=4,314) |
OAU + NDE (n=444) |
p-value |
|---|---|---|---|---|
| Incident Psychiatric Outcomes a | ||||
| PTSD | 590 (12.4) | 513 (11.9) | 77 (17.3) | .001 |
| Other anxiety b | 732 (15.4) | 654 (15.2) | 78 (17.6) | .181 |
| Alcohol abuse/dependence | 504 (10.6) | 449 (10.4) | 55 (12.4) | .197 |
| Opioid abuse/dependence | 42 (0.9) | 23 (0.5) | 19 (4.3) | <.0001 |
| Other drug abuse/dependence | 255 (5.4) | 205 (4.8) | 50 (11.3) | <.0001 |
| Number of outcomes | ||||
| None | 3212 (67.5) | 2948 (68.3) | 264 (59.5) | |
| One | 1108 (23.3) | 998 (23.1) | 110 (24.8) | <.0001 |
| Multiple | 438 (9.2) | 368 (8.5) | 70 (15.8) | |
| Depression characteristics | ||||
| Acute ADM treatment length (days) c |
||||
| None | 1405 (29.5) | 1314 (30.5) | 91 (20.5) | |
| 1–83 | 910 (19.1) | 831 (19.3) | 79 (17.8) | <.0001 |
| 84 + | 2443 (51.4) | 2169 (50.3) | 274 (61.7) | |
| Dual ADM treatment a, d | 594 (12.5) | 505 (11.7) | 89 (20.1) | <.0001 |
| Atypical antipsychotic a | 1013 (21.3) | 912 (21.1) | 101 (22.8) | .431 |
| Mood stabilizer a | 1487 (31.3) | 1242 (28.8) | 245 (55.2) | <.0001 |
| Maximum PHQ-9 score, mean (sd) a, e |
11.0 (7.5) | 10.6 (7.4) | 13.4 (7.5) | .001 |
| PHQ-9 score available a, e | 743 (15.6) | 644 (14.9) | 99 (22.3) | <.0001 |
| OAU characteristics | ||||
| Maximum MED (mg) f | n/a | |||
| 1–50 | - | - | 312 (70.3) | |
| 51–100 | - | - | 76 (17.1) | |
| > 100 | - | - | 56 (12.6) | |
| Other Covariates g | ||||
| Obesity | 1829 (38.4) | 1615 (37.4) | 214 (48.2) | <.0001 |
| Nicotine abuse/dependence | 1550 (23.6) | 1317 (30.5) | 233 (52.5) | <.0001 |
| Arthritis | 3460 (72.7) | 3053 (70.8) | 407 (91.7) | <.0001 |
| Back pain | 2566 (53.9) | 2182 (50.6) | 384 (86.5) | <.0001 |
| Headaches | 888 (18.7) | 762 (17.7) | 126 (28.4) | <.0001 |
| Musculoskeletal pain | 2303 (48.4) | 1964 (45.5) | 339 (76.4) | <.0001 |
| Neuropathic pain | 1273 (26.8) | 1052 (24.4) | 221 (49.8) | <.0001 |
| Maximum pain score, mean (sd) | 6.9 (2.9) | 6.7 (2.9) | 9.2 (1.3) | <.0001 |
| High healthcare utilization | 736 (15.5) | 567 (13.1) | 169 (38.1) | <.0001 |
| Demographic Information | ||||
| Age, mean (sd) | 55.4 (14.6) | 55.9 (14.6) | 50.4 (12.4) | <.0001 |
| Gender: male | 4264 (89.6) | 3862 (89.5) | 402 (90.5) | .503 |
| Race: White | 3929 (82.6) | 3556 (82.4) | 373 (84.0) | .403 |
| Insurance: VA only | 2817 (59.2) | 2511 (58.2) | 306 (68.9) | <.0001 |
| Marital status: Married | 2968 (62.4) | 2717 (63.0) | 251 (56.5) | .008 |
Note: OAU = Opioid analgesic use; NDE = New onset depression
a
Must occur on or after date of new onset depression diagnosis
b
Other anxiety disorders = panic disorder, OCD, social phobia, GAD, Anxiety NOS
c
Acute ADM Treatment positive if within 30 days before and 14 days after depression diagnosis
d
Dual ADM is positive if have two or more antidepressants overlapping by at least 31 days
e
PHQ-9 scores available only on a subsample of patients. Availability distribution compared between groups.
f
For opioid use patients only
g
Covariates could have occurred at any point from 2000–2012