Psychiatric comorbidities in SUDs vary by sex

Psychiatric comorbidities for various substance use disorders (SUDs) tend to differ by sex, according to a cross-sectional study.

Males diagnosed with opioid, alcohol, or cannabis dependence were less likely to experience anxiety, bipolar, depressive, and trauma- and stressor-related disorders than females. However, males with opioid or cannabis dependence appeared to be at greater risk of schizophrenia or other psychotic disorders than females.

In adjusted analyses, the investigators also observed association of race and ethnicity with specific psychiatric comorbidities.

This study used data from state-funded and state-run mental health programs in 2022 (Mental Health Client-Level Data from the US Substance Abuse and Mental Health Services Administration). Adults with a primary diagnosis of either opioid (n=28,808), alcohol (n=23,281), or cannabis dependence (n=5,961) provided the necessary data for analysis.

The investigators examined data from individuals with each SUD for psychiatric comorbidity outcomes, based on secondary diagnoses of an anxiety disorder, bipolar disorder, a depressive disorder, schizophrenia or other psychotic disorders, or a trauma- and stressor-related disorder vs no comorbidity.

Multinomial logistic regressions were performed for data analysis, with sex, race, ethnicity, and age as predictors.

“Future studies should examine biopsychosocial mechanisms that underlie these differences, with the goal of improving personalized care,” the investigators said.

“SUDs are associated with risk of psychiatric comorbidities, with inconsistent sex differences across studies,” they noted.