Polysubstance addiction patterns among 7,989 individuals with cocaine use disorder
Brendan Stiltner,
Robert H. Pietrzak,
Daniel S. Tylee,
Yaira Z. Nunez,
Keyrun Adhikari,
Henry R. Kranzler,
Joel Gelernter,
Renato Polimanti
Affiliations
Brendan Stiltner
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
Robert H. Pietrzak
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT 06516, USA
Daniel S. Tylee
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
Yaira Z. Nunez
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
Keyrun Adhikari
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
Henry R. Kranzler
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA; Mental Illness Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
Joel Gelernter
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA
Renato Polimanti
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA; VA Connecticut Healthcare System, West Haven, CT 06516, USA; Corresponding author
Summary: To characterize polysubstance addiction (PSA) patterns of cocaine use disorder (CoUD), we performed a latent class analysis (LCA) in 7,989 participants with a lifetime DSM-5 diagnosis of CoUD. This analysis identified three PSA subgroups among CoUD participants (i.e., low, 17%; intermediate, 38%; high, 45%). While these subgroups varied by age, sex, and racial-ethnic distribution (p 0.05). After accounting for sex, age, and race-ethnicity, the CoUD subgroup with high PSA had higher odds of antisocial personality disorder (OR = 21.96 vs. 6.39, difference-p = 8.08✕10−6), agoraphobia (OR = 4.58 vs. 2.05, difference-p = 7.04✕10−4), mixed bipolar episode (OR = 10.36 vs. 2.61, difference-p = 7.04✕10−4), posttraumatic stress disorder (OR = 11.54 vs. 5.86, difference-p = 2.67✕10−4), antidepressant medication use (OR = 13.49 vs. 8.02, difference-p = 1.42✕10−4), and sexually transmitted diseases (OR = 5.92 vs. 3.38, difference-p = 1.81✕10−5) than the low-PSA CoUD subgroup. These findings underscore the importance of modeling PSA severity and comorbidities when examining the clinical, molecular, and neuroimaging correlates of CoUD.
