Publications by authors named "Mark Olfson"

While available for decades, the use of bupropion has increased in recent years. To provide an updated review on the use of bupropion, this article aimed to describe bupropion prescription details, potential indication, and treatment duration in children, young adults, and adults starting bupropion treatment. Individuals aged 6-64 newly initiating bupropion hydrochloride treatment were identified from commercial claims data (MarketScan, 1/1/2016-12/31/2022).

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Importance: Given the personal and social burdens of opioid use disorder (OUD), understanding time trends in OUD prevalence in large patient populations is key to planning prevention and treatment services.

Objective: To examine trends in the prevalence of OUD from 2005 to 2022 overall and by age, sex, and race and ethnicity.

Design, Setting, And Participants: This serial cross-sectional study included national Veterans Health Administration (VHA) electronic medical record data from the VHA Corporate Data Warehouse.

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Article Synopsis
  • Access to psychotherapy in the US has increased, but there are concerns over unequal distribution, even with the rise of teletherapy.
  • A study analyzed trends in outpatient psychotherapy use between 2018 and 2021, focusing on various sociodemographic factors and levels of psychological distress among adults.
  • Results showed significant increases in therapy use, especially among females, younger adults, and those with higher education, indicating disparities based on gender, age, and education level.
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The prevalence of depressive and anxiety disorders is higher in women than in men. In contrast, there is still no clear consensus on the existence of sex-related differences in the effectiveness of antidepressant treatments for these disorders. This real-world study used filled prescription sequences to compare antidepressant medications between women and men at a medication level according to their acceptability (ie, combination of efficacy and tolerability).

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Introduction: Physicians and nurses have lower annual mortality rates than the general population. One explanation for the low mortality rates of these healthcare workers emphasizes their specialized medical knowledge and greater access to healthcare while a second emphasizes their generally higher level of education. We evaluated the extent to which general educational level accounts for the lower all-cause mortality rates of US healthcare than non-healthcare workers.

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Despite the high correlation between anxiety and depression, little remains known about the course of each condition when presenting concurrently. This study aimed to identify longitudinal patterns during antidepressant treatment in patients with depression and anxiety, and evaluate related factors associated with these patterns. By analyzing longitudinal self-report Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores that tracked courses of depression and anxiety over a three-month window among the 577 adult participants, six depression and six anxiety trajectory subgroups were computationally derived using group-based trajectory modeling.

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Background: Rates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S.

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Introduction: Medications for opioid use disorder (MOUD) are considered the first line treatment for opioid use disorder. As states expanded Medicaid beginning in 2014 under the Affordable Care Act, policymakers and public health officials were interested in the potential for expansion to increase access to MOUD. This study examined whether there were changes in MOUD use within outpatient admissions to specialty treatment facilities in Medicaid expansion states beyond the initial expansion period.

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Distinctive stressors facing pregnant and postpartum individuals during the COVID-19 pandemic may have affected their emergency department (ED) care-seeking for behavioral health concerns and violence victimization. We tested whether the incidence of postpartum behavioral health and assault injury ED visits differed for individuals according to their months of postpartum pandemic exposure. We used statewide, longitudinally linked hospital and ED administrative claims data from California to classify all individuals with hospital deliveries between January 1, 2016, and December 31, 2020, according to their months of postpartum pandemic exposure.

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Objectives: Social support (SS) and social isolation (SI) are social determinants of health (SDOH) associated with psychiatric outcomes. In electronic health records (EHRs), individual-level SS/SI is typically documented in narrative clinical notes rather than as structured coded data. Natural language processing (NLP) algorithms can automate the otherwise labor-intensive process of extraction of such information.

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Article Synopsis
  • Treatment resistance in major depressive disorder (MDD) is common, but its clinical risk factors are not well understood, prompting this study using data from electronic health records.
  • The researchers conducted phenome-wide association studies (PheWAS) to identify factors linked to treatment resistance, revealing 180 significant phecodes in a large sample, with 71 replicated in a second group.
  • They found that the number of unique antidepressants prescribed correlates with various clinical conditions, suggesting both clinical and genetic factors affect treatment resistance, which could enhance future research and clinical practices.
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Objective: Current information on treatment and clinical characteristics of U.S. adults with schizophrenia spectrum disorders (i.

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Article Synopsis
  • A study examined the incidence of neuroleptic malignant syndrome (NMS), a serious side effect of antipsychotics, in young people aged 5-24 and found that there were 131 NMS cases among over a million patients during the study period (2004-2013).
  • The incidence of NMS was significantly higher in patients exhibiting certain characteristics, including being 18-24 years old, having schizophrenia or other psychotic disorders, neurodevelopmental disorders, using first-generation antipsychotics, or taking doses over 200 mg chlorpromazine-equivalents.
  • The results suggest that patients with 4-5 of these risk factors faced over 100 times the risk of developing NMS compared to
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We examined the prospective associations between nicotine dependence and the likelihood of psychiatric and substance use disorders in the general adult population. Participants came from a nationally representative sample of US adults aged 18 years or older, who were interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001-2002; Wave 2, 2004-2005). The primary analyses were limited to 32,671 respondents (13,751 male (47.

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Objective: This report describes characteristics of patients who had high out-of-pocket (OOP) spending on mental health care relative to income.

Methods: A sample of 8,923 U.S.

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Objective: To examine recent trends in clinical diagnoses of children and adolescents receiving treatment in publicly funded mental health treatment services in the United States.

Method: Data on children and adolescents (≤17 years) receiving treatment from publicly funded mental health treatment services recorded in Mental Health Client-Level Data 2013-2021 (total number of records = 13,684,154) were used to examine temporal trends in the proportion of different child and adolescent psychiatric disorders. Trends were examined overall and in age, sex, racial/ethnic, and service strata focusing on community-based programs.

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Background: Knowledge of clinical, treatment and life circumstances of individuals with bipolar I disorder (BP-I) in US households is informed by decades old epidemiological surveys.

Methods: The Mental and Substance Use Disorders Prevalence Study was conducted October 2020-October 2022. Clinicians administered the Structured Clinical Interview for the DSM-5 diagnosing 12-month prevalence of BP-I and other mental health disorders (MHD) among 4764 adults aged 18-65 years and collected sociodemographic information.

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Background: Challenges to engagement and retention on buprenorphine undermine treatment of individuals with opioid use disorder (OUD). Under the OUD Cascade of Care framework, we sought to identify patient characteristics and treatment response associated with superior clinical outcomes.

Methods: A retrospective cohort study of specialty buprenorphine treatment patients entering treatment (n=19,487) based on EHR records from a large multi-state buprenorphine treatment network (2011-2019).

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Objective: This report uses data from Mental Disorders Prevalence Study (MDPS), a large epidemiologic study that provided national prevalence estimates of seven mental disorders based on the Structured Clinical Interview for DSM-5 (SCID), to assess the odds of treatment disruption during COVID for SMI and non-SMI groups.

Methods: This cross-sectional study conducted from 2020 to 2022 included 2,810 household participants with any lifetime mental health treatment. Weighted logistic regressions estimated the odds of reporting disruptions in access to mental health care or psychotropic prescriptions due to COVID.

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Background And Aims: Extended-release naltrexone (XR-NTX) and sublingual buprenorphine (SL-BUP) are both approved for opioid use disorder (OUD) treatment in any medical setting. We aimed to compare the real-world effectiveness of XR-NTX and SL-BUP.

Design And Setting: This was an observational active comparator, new user cohort study of Medicaid claims records for patients in New Jersey and California, USA, 2016-19.

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