Obsessive-compulsive disorder (OCD) and substance-use disorders (SUDs) co-occur at high rates, which is related to poorer psychosocial outcomes. Prior work suggests that, among veterans in the Veterans Health Administration (VHA), OCD is underdiagnosed and undertreated, which can compound negative effects of OCD and SUD co-occurrence. This study identified patterns of OCD and specific SUD co-occurrence and their effect on mental health and substance-use screening measures and mental healthcare utilization. Using VHA administrative data, we identified veterans with an OCD diagnosis from 2010 to 2016 (N = 38,157); 36.70% also had a SUD diagnosis. Specific SUD rates are alcohol-use disorder, 17.17%; cannabis-use disorder, 5.53%; opioid-use disorder, 3.60%; amphetamine-use disorder, 1.49%; cocaine-use disorder, 3.37%; and tobacco-use disorder, 26.50%. Veterans with co-occurring OCD and SUD used more mental health services throughout the data capture period. Findings suggest that OCD and SUD co-occur at high rates within the VHA, and that this is associated with more burden to the healthcare system. Targeted screening and treatment efforts may help address the needs of this population.

中文翻译：

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美国退伍军人中强迫症和物质使用障碍的共同发生：患病率和心理健康利用

强迫症（OCD）和物质使用障碍（SUD）并发的发生率很高，这与较差的社会心理结果有关。先前的工作表明，在退伍军人卫生管理局（VHA）的退伍军人中，OCD的诊断和治疗不足，这可能会增加OCD和SUD并发的负面影响。这项研究确定了强迫症和特定的SUD并发的模式及其对心理健康和药物使用筛查措施以及心理医疗利用的影响。利用VHA行政数据，我们确定了2010年至2016年患有OCD诊断的退伍军人（N = 38,157）；36.70％的人也有SUD诊断。SUD的特定比例是酒精滥用障碍，占17.17％；大麻使用障碍，占5.53％；阿片类药物使用障碍，3.60％；苯丙胺使用障碍，1.49％；可卡因使用障碍，3.37％；和烟草使用障碍，占26.50％。在数据收集期间，同时出现强迫症和强迫症的退伍军人使用了更多的精神卫生服务。研究结果表明，OCD和SUD在VHA中共同高发，这给医疗保健系统带来了更多负担。有针对性的筛查和治疗工作可能有助于解决这一人群的需求。