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Demographic and Clinical Characteristics of Current Comorbid Psychiatric Disorders in a Randomized Clinical Trial for Adults with Stimulant Use Disorders.

Psychiatry Research 2016;246:136-141. [doi: 10.1016/j.psychres.2016.09.007]

Diane Warden, PhD, MBA, Katherine Sanchez, PhD, MSSW (University of Texas Arlington, TX Node), Tracy L. Greer, PhD, Thomas Carmody, PhD, N. Robrina Walker, PhD, Adriane M. dela Cruz, MD, PhD, Marisa Toups, MD, Chad Rethorst, PhD, Madhukar H. Trivedi, MD (all from University of Texas Southwestern Medical Center at Dallas, TX Node, except where noted).

This study aimed to determine if current comorbid psychiatric disorders differ in adults with cocaine use disorder, other stimulant (primarily methamphetamine) use disorder, or both, and identify demographic and clinical characteristics in those with increasing numbers of comorbid disorders. Baseline data from participants enrolled in the NIDA Clinical Trials Network's "Stimulant Reduction Intervention using Dosed Exercise" (STRIDE) study, a multisite randomized controlled trial that compared the efficacy of high intensity exercise and health education, both augmented to substance abuse treatment as usual in adults with stimulant use disorders entering residential treatment settings (N=302). Mood disorders were present in 33.6%, and anxiety disorders in 29.6%, with no differences among stimulant use disorder groups. Panic disorder was more frequently present with other stimulant use disorder. Those with two or more comorbid psychiatric disorders were more often female, white, had more symptoms of depression, greater propensity and risk for suicidal behavior, lower functioning in pyschiatric and family domains, lower quality of life, more symptoms with stimulant abstinence and greater likelihood of marijuana dependence. Those with one or more comorbid disorders had more medical disorder burden, lower cognitive and physical functioning, greater pain, and higher rates of other drug dependence.

Conclusions: With current comorbid psychiatric disorders, the morbidity of stimulant use disorders increases (e.g., increased symptoms with stimulant abstinence, more drug dependencies) and, not surprisingly, functioning across multiple areas decreases. Use of validated assessments near treatment entry, and a treatment plan targeting not only substance use and comorbid psychiatric disorders, but functional impairments, medical disorder burden and pain, may be useful. (Article (Peer-Reviewed), PDF, English, 2016)

Keywords: Anxiety disorders | Cocaine | Co-occurring disorders | CTN platform/ancillary study | Depression | Exercise | Marijuana | Pain management | Stimulant abuse | Suicide | Psychiatry Research (journal)

Document No: 1229, PMID: 27693866, PMCID: PMC5437704.

Submitted by CTN Dissemination Librarians, 9/27/2016.


Carmody, Thomas mail
dela Cruz, Adriane M.
Greer, Tracy L. mail
Rethorst, Chad mail
Sanchez, Katherine mail
Toups, Marisa search
Trivedi, Madhukar H. mail
Walker, N. Robrina mail
Warden, Diane search mail
NIDA-CTN-0037 www

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