Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder.
BACKGROUND
Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limited.


OBJECTIVE
This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder.


METHODS
A total of 3321 cases (79% were male) of methamphetamine use disorder between January 1, 1996, and December 31, 2012, were identified from Psychiatric Inpatient Medical Claims database in Taiwan. Information was collected on demographics, diagnoses, and medical utilizations. The date of newly diagnosed with methamphetamine use disorder was defined as the baseline. Mirror-image study design was used to compare changes in medical utilization and comorbidities between the pre-baseline period (within 1 year before diagnosis) and the post-baseline period (within 1 year after diagnosis). Conditional logistic regression was used to estimate changes in medical utilization and comorbidities.


RESULTS
Most cases (77%) were first identified in a psychiatric department. There is a significant increase (P < .001) in psychiatric admission (odds ratio[OR] = 2.19), psychiatric emergency visits (OR = 1.31), and psychiatric outpatient visits (OR = 1.15) after diagnosis. Multivariable analysis revealed significantly increased risks (P < .001) of non-methamphetamine drug induced mental disorders (adjusted OR[aOR] = 29.47), schizophrenia (aOR = 2.62), bipolar disorder (aOR = 2.14), organic mental disorder (aOR = 1.82), and upper respiratory tract infection (aOR = 2.03) after diagnosis.


CONCLUSIONS
We found significant increases of medical utilization and psychiatric comorbidities after diagnosed with methamphetamine use disorder. These findings may reflect the problem of delayed diagnosis and treatment. Enhancement of early identification of methamphetamine use disorder in general practice is required for early intervention and decreased subsequent morbidities.
['Lee|Wan-Chen|WC|', 'Chang|Hu-Ming|HM|', 'Huang|Ming-Chyi|MC|', 'Pan|Chun-Hung|CH|', 'Su|Sheng-Siang|SS|', 'Tsai|Shang-Ying|SY|', 'Chen|Chiao-Chicy|CC|', 'Kuo|Chian-Jue|CJ|']
medical utilization psychiatric comorbidity Methamphetamine mirror-image study