Gender differences in the associations of multiple psychiatric and chronic conditions with major depressive disorder among patients with opioid use disorder

Abstract

Purpose

The study examined the associations of multiple psychiatric and chronic conditions with the self-reported history of major depressive disorder (MDD) among patients with opioid use disorder (OUD) and tested whether the associations differed by gender.

Methods

We conducted a secondary data analysis of baseline data from a clinical trial including 1,646 participants with OUD, of which 465 had MDD. A variable cluster analysis was used to classify chronic medical and psychiatric conditions. Multivariable logistic regression analyses were used to estimate their associations with MDD in subjects with OUD.

Results

Nine variables were divided into three clusters: cluster 1 included heart condition, hypertension, and liver problems; cluster 2 included gastrointestinal (GI) problems and head injury, and cluster 3 included anxiety disorder, bipolar disorder, and schizophrenia. The overall prevalence of MDD in participants with OUD was 28.3% (22.8% for males and 39.5% for females). Gender, anxiety disorder, schizophrenia, liver problems, heart condition, GI problems, and head injury were significantly associated with MDD. Gender-stratified analyses showed that bipolar disorder, liver problems and individuals with one chronic condition were associated with MDD only in males, whereas heart condition, hypertension, and GI problems were associated with MDD only in females. In addition, anxiety disorder, head injury, individuals with one or more than two psychiatric conditions, and individuals with more than two chronic conditions were associated with MDD regardless of gender.

Conclusions

Treatment plans in patients with OUD should not only address MDD but also co-morbid psychiatric and chronic medical conditions that occur with MDD.

Keywords:

• Opioid use disorder
• major depressive disorder
• psychiatric conditions
• chronic conditions
• gender differences

Acknowledgements

The information reported here results from secondary analyses of data from clinical trials conducted by the National Institute on Drug Abuse (NIDA). Specifically, data from NIDA-CTN-0027 (Starting Treatment with Agonist Replacement Therapies (START)) were included.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

The data that support the findings of this study are openly available in [https://datashare.nida.nih.gov/index.php/data/nida-ctn-0027] at ClinicalTrials.gov, reference number [NCT00315341].

Ethical approval

The original START study was approved by the institutional review boards at participating sites, and participants provided written informed consent. There was an Institutional Review Board exemption for the present study due to secondary data analysis using publicly accessed database.