Background
Methods
Design
Sample
Measurements
Baseline
Statistical analysis
Results
Baseline characteristics | Total (n = 291) | AUD alone (n = 130) | Poly-SUDs (n = 161) |
p
a
| Living (n = 189) | Deceased total cohort (n = 102) |
p
b
| Deceased AUD only (n = 66) | Deceased poly-SUDs (n = 36) |
p
c
| |
---|---|---|---|---|---|---|---|---|---|---|---|
Demographics
| |||||||||||
Sex, male | n (%) | 208 (72) | 101 (78) | 107 (67) | 0.035d | 126 (67) |
82 (80)
| 0.013d | 57 (86) | 25 (69) | 0.040d |
Age, years at baseline | mean (SD) | 38.3 (11.4) | 45.8 (9.86) | 32.3 (8.67) | < 0.001e | 35.1 (10.2) |
44.3 (11.1)
| < 0.001e | 48.6 (9.4) | 36.5 (9.8) | < 0.001e |
Married or cohabitant (n = 288) | n (%) | 98 (34) | 55 (42) | 43 (27) | 0.007d | 61 (33) |
37 (37)
| 0.493d | 25 (38) | 12 (34) | 0.721d |
Upper secondary school (n = 285) | n (%) | 139 (48) | 75 (59) | 64 (41) | 0.003d | 86 (47) |
53 (52)
| 0.421d | 36 (55) | 17 (47) | 0.479d |
Fulltime ordinary work (n = 287) | n (%) | 61 (21) | 39 (30) | 22 (14) | 0.001d | 42 (23) |
19 (19)
| 0.456d | 16 (24) | 3 (9) | 0.055d |
Mental health Diagnoses CIDI lifetime
| |||||||||||
Affective disorder (n = 287) | n (%) | 182 (63) | 75 (58) | 107 (68) | 0.067d | 129 (70) | 53 (52) | 0.003d | 27 (41) | 26 (72) | 0.002d |
Anxiety disorder (n = 283) | n (%) | 233 (82) | 97 (76) | 136 (88) | 0.009d | 154 (84) | 79 (80) | 0.412d | 48 (73) | 31 (94) | 0.013d |
Number of psychiatric symptom disorders (not SUD) | mean (SD) | 3.6 (2.6) | 3.2 (2.5) | 3.9 (2.6) | 0.029e | 3.7 (2.6) | 3.3 (2.6) | 0.201e | 2.8 (2.5) | 4.2 (2.5) | 0.012e |
Personality disorder MCMI-II
| |||||||||||
No personality disorder (n = 264) | n (%) | 74 (28) | 44 (36) | 30 (21) | 0.006d | 47 (27) | 27 (30) | 0.608d | 21 (36) | 6 (19) | 0.110d |
Number of personality disorders (n = 264) | mean (SD) | 2.7 (2.7) | 2.4 (2.9) | 3.0 (2.6) | 0.107e | 2.7 (2.7) | 2.7 (2.8) | 0.992e | 2.6 (2.9) | 3.0 (2.7) | 0.471 e |
Substance use disorders
| |||||||||||
Number of SUDs | mean (SD) | 2.5 (2.0) | 1.00 (0) | 3.6 (2.0) |
f
| 2.7 (2.0) | 2.1 (1.8) | 0.011e | 1.00 (0) | 4.0 (2.0) |
f
|
Onset SUD before 18 years | n (%) | 133 (46) | 24 (18.5) | 109 (68) | < 0.001d | 97 (51) | 36 (35) | 0.009d | 13 (20) | 23 (64) | < 0.001d |
Age onset SUD | mean (SD) | 22.6 (10.7) | 28.9 (11.4) | 17.6 (6.7) | < 0.001e | 20.8 (9.1) | 26.0 (12.8) | < 0.001e | 29.8 (12.02) | 19.1 (10.14) | < 0.001e |
AUD alone (vs. poly-SUDs) | n (%) | 130 (45) |
f
|
f
|
f
| 64 (34) | 66 (65) | < 0.001d |
f
|
f
|
f
|
Characteristics of deceased patients and principal causes of death
Total cohort 102 deceased | AUD alone 66 deceased | Poly-SUDs 36 deceased |
p
a
| ||
---|---|---|---|---|---|
Somatic disease | n (%) | 48 (47) | 38 (58) | 10 (28) | 0.004 |
Cancer |
n
| 16 | 14 | 2 | |
Alcoholic liver disease (ICD-10 F70.0–F70.4) |
n
| 7 | 4 | 3 | |
Heart/coronary disease |
n
| 7 | 7 | – | |
Lung |
n
| 8 | 6 | 2 | |
Others (only one participant per disease) |
n
| 10 | 7 | 3 | |
Traumatic death | n (%) | 12 (12) | 7 (11) | 5 (14) | 0.623 |
Accidents |
n
| 7 | 4 | 3 | |
Suicide |
n
| 3 | 2 | 1 | |
Homicide |
n
| 2 | 1 | 1 | |
Overdose | n (%) | 18 (18) | 6 (9) | 12 (33) | 0.002 |
Heroin |
n
| 7 | 1 | 6 | |
Methadone |
n
| 5 | 2 | 3 | |
‘Other’ opiods |
n
| 1 | – | 1 | |
Alcohol |
n
| 2 | 2 | – | |
Unspecified |
n
| 3 | 1 | 2 | |
Other | n (%) | 24 (24) | 15 (23) | 9 (25) | 0.796 |
AUD (ICD-10, F10)b |
n
| 15 | 11 | 4 | |
Opioid use disorder (ICD-10, F11)b |
n
| 4 | 1 | 3 | |
No diagnosis |
n
| 3 | 2 | 1 | |
Sudden death (ICD-10, R960) |
n
| 2 | 1 | 1 |
CMRs and SMRs after entering treatment for SUDs
Deaths (%) | Mortality rate per 100 PY (95% CI) | Standardized mortality ratio (95% CI) | |
---|---|---|---|
Total cohort | 102 (35) | 2.2 (1.8–2.7) | 3.8 (3.2–4.6) |
Sex
| |||
Male | 82 (39) | 2.5 (2.1–3.2) | 3.6 (2.9–4.5) |
Female | 20 (24) | 1.4 (0.9–2.2) | 5.2 (3.3–7.9) |
Age at baseline
| |||
Under 30 years | 11 (16) | 0.9 (0.5–1.6) | |
30–39 years | 25 (26) | 1.6 (1.1–2.3) | |
40–49 years | 32 (48) | 3.1 (2.2–4.4) | |
Over 50 years | 34 (61) | 4.6 (3.3–6.4) | |
AUD alone at baseline
| |||
AUD alone | 66 (51) | 3.5 (2.8–4.5) | 3.4 (2.6–4.2) |
Poly-SUDs | 36 (22) | 1.3 (1.0–1.8) | 5.2 (3.7–7.2) |
Baseline characteristics associated with risk of death in patients with AUD alone and poly-SUDs
Model 1a | Model 2b | |
---|---|---|
Bivariate HR (95% CI) | Multiple, AIC reduced HR (95% CI) | |
Demographics
| ||
Sex, male (female – ref.) | 1.50 (0.87–2.57) | 1.12 (1.07–1.17)c *** |
Age | 1.06 (1.04–1.08)*** | 1.06 (1.00–1.73)d |
Mental health
| ||
Affective disorder (no affective disorder – ref) | 0.56 (0.37–0.87)** | 0.58 (0.37–0.91)* |
Anxiety disorder (no anxiety disorder – ref) | 0.83 (0.49–1.41) | |
Number of psychiatric symptom disorders (except SUDs) | 0.95 (0.87–1.03) | |
Personality disorder (no personality disorder – ref) | 1.00 (0.63–1.60) | |
Substance use
| ||
First SUD onset before the age of 18 years (above 18 years – ref.)c | 0.58 (0.37–0.93)* | 1.01 (0.96–1.07)c |
AUD alone (poly-SUDs – ref.)c | 2.67 (1.67–4.24)*** | 1.00 (0.96–1.05)c |