PMID- 31556662
OWN - NLM
STAT- MEDLINE
DCOM- 20191224
LR  - 20201001
IS  - 1939-2117 (Electronic)
IS  - 0022-006X (Print)
IS  - 0022-006X (Linking)
VI  - 87
IP  - 10
DP  - 2019 Oct
TI  - Diverse diagnostic profiles associated with prescription opioid use disorder in a 
      nationwide sample: One crisis, multiple needs.
PG  - 849-858
LID - 10.1037/ccp0000429 [doi]
AB  - OBJECTIVE: The opioid crisis has had devastating effects on individuals and 
      communities, and it has rapidly increased in severity. However, we still lack 
      nationally representative information on the diversity of comorbidity patterns 
      among prescription opioid use disorder (P-OUD), other substance use disorders 
      (SUDs), and psychopathology using the newest edition of the Diagnostic and 
      Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric 
      Association, 2013). This impedes planning for multiple aspects of intervention, 
      including society-wide allocation of treatment resources, program design at 
      individual treatment centers, and personalized care to individual patients. 
      METHOD: To address this critical gap in information, we evaluated clinical 
      profiles of American adults via latent class analysis in a large, recently 
      collected epidemiological dataset that uses structured diagnostic assessment for 
      DSM-5 psychopathology (National Epidemiologic Survey on Alcohol and Related 
      Conditions-III; N = 36,309). Variables considered for profiles included lifetime 
      diagnosis for multiple SUDs, various externalizing and internalizing conditions, 
      and demographic variables. We then associated clinical profiles with demographic 
      variables and functional impairment. RESULTS: Comorbid psychopathology and other 
      SUDs were common in latent classes with elevated and very high rates of P-OUD. To 
      illustrate, alcohol use disorder rates were greater than 45%, and posttraumatic 
      stress disorder rates were greater than 28% in classes with higher P-OUD rates. 
      Higher P-OUD rates were associated with White/non-Hispanic and American 
      Indian/Alaska Native populations. Relationships between P-OUD rates and 
      functional impairment were inconsistent. CONCLUSION: Many current treatment 
      delivery systems are not designed to accommodate the heterogeneous profiles 
      associated with high P-OUD rates. We provide specific suggestions for 
      improvements to the mental health service system, individual clinical care 
      programs, and future research approaches. (PsycINFO Database Record (c) 2019 APA, 
      all rights reserved).
FAU - De Nadai, Alessandro S
AU  - De Nadai AS
AD  - Department of Psychology, Texas State University.
FAU - Little, Tara B
AU  - Little TB
AD  - Department of Psychology, Texas State University.
FAU - McCabe, Sean E
AU  - McCabe SE
AD  - Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, 
      University of Michigan.
FAU - Schepis, Ty S
AU  - Schepis TS
AD  - Department of Psychology, Texas State University.
LA  - eng
GR  - National Institutes of Health; National Institute on Drug Abuse/
GR  - R01 DA031160/DA/NIDA NIH HHS/United States
GR  - R01 DA036541/DA/NIDA NIH HHS/United States
GR  - R01 DA042146/DA/NIDA NIH HHS/United States
GR  - R01 DA043691/DA/NIDA NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - J Consult Clin Psychol
JT  - Journal of consulting and clinical psychology
JID - 0136553
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Alcoholism/*epidemiology
MH  - Comorbidity
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Female
MH  - Humans
MH  - Male
MH  - Mental Health Services
MH  - Middle Aged
MH  - Opioid-Related Disorders/*diagnosis/epidemiology/psychology
MH  - Prevalence
MH  - Stress Disorders, Post-Traumatic/*epidemiology
MH  - United States
MH  - Young Adult
PMC - PMC6764519
MID - NIHMS1037889
EDAT- 2019/09/27 06:00
MHDA- 2019/12/25 06:00
PMCR- 2020/10/01
CRDT- 2019/09/27 06:00
PHST- 2019/09/27 06:00 [entrez]
PHST- 2019/09/27 06:00 [pubmed]
PHST- 2019/12/25 06:00 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - 2019-57426-002 [pii]
AID - 10.1037/ccp0000429 [doi]
PST - ppublish
SO  - J Consult Clin Psychol. 2019 Oct;87(10):849-858. doi: 10.1037/ccp0000429.