Methamphetamine Use and Schizophrenia: A Population-Based Cohort Study in California
Abstract
Objective:
Method:
Results:
Conclusions:
Method
Data
Outcome Measure
Patient Groups
Primary population proxy: appendicitis group.
Drug Category and ICD-9 Code | Description |
---|---|
Alcohol | |
303 | Alcohol dependence |
305.0 | Alcohol abuse |
980.0 | Alcohol (ethyl) poisoning |
Methamphetamine | |
304.4 | Methamphetamine dependence |
305.7 | Methamphetamine abuse |
969.7 | Methamphetamine poisoning |
E854.2 | Accidental methamphetamine poisoning |
Cocaine | |
304.2 | Cocaine dependence |
305.6 | Cocaine abuse |
968.5 | Poisoning by cocaine |
Opioids | |
304.0 | Opioid type dependence |
305.5 | Opioid abuse |
965.0 | Poisoning by opiates and related narcotics |
Cannabis | |
304.3 | Cannabis dependence |
305.2 | Cannabis abuse |
969.6 | Poisoning by cannabis (derivatives) |
Secondary population proxy: exclusion criteria group.
Drug cohorts.
Analysis
Propensity score matching and Cox regression.
Race | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Black | White | Hispanic | Other | Age (Years) | Female | Visitsa | Follow-Up Time (Years)c | ||||||||||
Group | N | % | N | % | N | % | N | % | Mean | SD | N | % | Mean | SD | Schizophrenia Eventsb | Mean | SD |
Appendicitis (N=188,732) | 7,384 | 3.9 | 107,375 | 56.9 | 54,050 | 28.6 | 19,923 | 10.6 | 35.5 | 16.2 | 77,969 | 41.3 | 0.51 | 1.5 | 128 | 5.0 | 2.9 |
Exclusion criteriad (N=10,056,583) | 749,206 | 7.4 | 6,098,589 | 60.6 | 2,193,678 | 21.8 | 1,015,110 | 10.1 | 48.2 | 21.9 | 6,650,615 | 66.1 | 0.63 | 1.5 | 4,545 | 5.1 | 2.9 |
Methamphetamine (N=42,412) | 1,724 | 4.1 | 31,830 | 75.0 | 6,889 | 16.2 | 1,969 | 4.6 | 30.7 | 9.8 | 24,297 | 57.3 | 1.03 | 2.3 | 425 | 4.8 | 2.5 |
Cocaine (N=39,390) | 19,777 | 50.2 | 12,664 | 32.2 | 5,524 | 14.0 | 1,425 | 3.6 | 34.3 | 9.6 | 19,321 | 49.1 | 1.92 | 3.5 | 425 | 5.6 | 2.8 |
Alcohol (N=408,604) | 37,832 | 9.3 | 284,200 | 69.6 | 69,545 | 17.0 | 17,027 | 4.2 | 50.6 | 16.8 | 117,950 | 28.9 | 1.26 | 3.0 | 2,549 | 5.3 | 2.9 |
Opioids (N=56,844) | 6,670 | 11.7 | 36,168 | 63.6 | 11,873 | 20.9 | 2,133 | 3.8 | 41.8 | 14.4 | 28,624 | 50.4 | 2.05 | 5.2 | 263 | 4.8 | 2.9 |
Cannabis (N=23,335) | 4,692 | 20.1 | 14,480 | 62.1 | 3,145 | 13.5 | 1,018 | 4.4 | 27.0 | 10.6 | 13,828 | 59.3 | 0.82 | 2.0 | 182 | 3.9 | 2.6 |
Cox regression.
Results
Propensity Score Matching
Appendicitis Cohort as Matcheda Reference Group | Exclusion Criteria Cohort as Matcheda Reference Group | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Group | Total Nb | Eventsc | Hazard Ratiod | 95% CI | p | Total Nb | Eventsc | Hazard Ratiod | 95% CI | p |
Appendicitis | 352,024e | 102:83 | 1.23 | 0.93–1.63 | 0.15 | |||||
Methamphetamine | 72,324 | 324:34 | 9.37 | 6.59–13.32 | <0.001 | 78,474 | 343:20 | 17.49 | 11.15–27.45 | <0.001 |
Cocaine | 43,752 | 177:31 | 5.84 | 3.99–8.55 | <0.001 | 66,386 | 350:41 | 8.57 | 6.20–11.84 | <0.001 |
Alcohol | 243,064 | 535:97 | 5.56 | 4.48–6.90 | <0.001 | 722,974 | 2028:313 | 6.47 | 5.75–7.29 | <0.001 |
Opioids | 90,436 | 180:49 | 3.60 | 2.63–4.94 | <0.001 | 101,480 | 224:51 | 4.32 | 3.19–5.86 | <0.001 |
Cannabis | 41,670 | 155:19 | 8.16 | 5.08–13.12 | <0.001 | 44,348 | 164:12 | 13.56 | 7.56–24.31 | <0.001 |
Group (Reference Group)a | Hazard Ratiob | 95% CI | Total Nc | Eventsd | p |
---|---|---|---|---|---|
Methamphetamine (cocaine) | 1.46 | 1.15–1.85 | 30,040 | 170:140 | 0.002 |
Methamphetamine (opioids) | 2.81 | 2.21–3.58 | 49,048 | 252:89 | <0.001 |
Methamphetamine (alcohol) | 1.68 | 1.41–1.99 | 72,754 | 353:205 | <0.001 |
Methamphetamine (cannabis) | 1.24 | 0.98–1.56 | 35,756 | 161:129 | 0.073 |
Cox Regression
Matched drug and population proxy cohorts.
Matched methamphetamine and other drug cohort analyses.
Summary of Main Findings
Sensitivity Analyses
Discussion
Comparison With Existing Literature
Strengths and Limitations
Conclusions
Footnotes
Supplementary Material
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