Psychiatric Comorbidities in Substance Use Disorders: Sex-Based Differences in a National Real-World Clinical Sample.

Area of Science:

• Psychiatry
• Addiction Medicine
• Clinical Psychology

Background:

• Substance use disorders (SUDs) frequently co-occur with psychiatric conditions.
• Existing research shows inconsistent sex differences in these comorbidities.
• Understanding these differences is crucial for tailored treatment.

Purpose of the Study:

• To investigate sex-based differences in psychiatric comorbidities among individuals with opioid, alcohol, or cannabis dependence.
• To analyze odds of specific psychiatric disorders (anxiety, bipolar, depressive, psychotic, trauma-related) in relation to sex within different SUD groups.

Main Methods:

• Cross-sectional analysis of a national clinical dataset (2022).
• Included adults (≥18 years) with primary diagnoses of opioid (N=28,808), alcohol (N=23,281), or cannabis dependence (N=5,961).
• Multinomial logistic regressions examined sex, race, ethnicity, and age as predictors of psychiatric comorbidities.

Main Results:

• Males with opioid, alcohol, or cannabis dependence showed lower odds of anxiety, bipolar, depressive, and trauma-related disorders compared to females.
• Males with opioid or cannabis dependence had higher odds of schizophrenia or other psychotic disorders than females.
• Race and ethnicity were also associated with specific comorbidities.

Conclusions:

• Significant sex-based differences exist in psychiatric comorbidities across opioid, alcohol, and cannabis use disorders.
• These findings highlight the need to consider sex in the context of SUDs and psychiatric conditions.
• Further research into the underlying biopsychosocial mechanisms is recommended for personalized care.