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Psychiatric disorders and substance use disorders (SUDs) independently increased the risk of COVID-19 hospitalization, yet their effect together is unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi220100-5\"><jats:title>Objective<\/jats:title><jats:p>To assess how comorbid PD and SUD are associated with the probability of hospitalization among ED patients with COVID-19.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi220100-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cross-sectional study analyzed discharge data for adults (age \u226518 years) with a COVID-19 diagnosis treated in 970 EDs and inpatient hospitals in the United States from April 2020 to August 2021.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi220100-7\"><jats:title>Exposures<\/jats:title><jats:p>Any past diagnosis of (1) SUD from opioids, stimulants, alcohol, cannabis, cocaine, sedatives, or other substances and\/or (2) PD, including attention-deficit\/hyperactivity disorder (ADHD), anxiety, bipolar disorder, major depression, other mood disorder, posttraumatic stress disorder (PTSD), or schizophrenia.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi220100-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main outcome was any hospitalization. Differences in probability of hospitalization were calculated to assess its association with both PD and SUD compared with PD alone, SUD alone, or neither condition.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi220100-9\"><jats:title>Results<\/jats:title><jats:p>Of 1\u202f274\u202f219 ED patients with COVID-19 (mean [SD] age, 54.6 [19.1] years; 667\u202f638 women [52.4%]), 18.6% had a PD (mean age, 59.0 years; 37.7% men), 4.6% had a SUD (mean age, 50.1 years; 61.7% men), and 2.3% had both (mean age, 50.4 years; 53.1% men). The most common PDs were anxiety (12.9%), major depression (9.8%), poly (\u22652) PDs (6.4%), and schizophrenia (1.4%). The most common SUDs involved alcohol (2.1%), cannabis (1.3%), opioids (1.0%), and poly (\u22652) SUDs (0.9%). Prevalence of SUD among patients with PTSD, schizophrenia, other mood disorder, or ADHD each exceeded 21%. Based on significant specific PD-SUD pairs (<jats:italic>Q<\/jats:italic>\u2009&amp;amp;lt;\u2009.05), probability of hospitalization of those with both PD and SUD was higher than those with (1) neither condition by a weighted mean of 20 percentage points (range, 6 to 36; IQR, 16 to 25); (2) PD alone by 12 percentage points (range, \u22124 to 31; IQR, 8 to 16); and (3) SUD alone by 4 percentage points (range, \u22127 to 15; IQR, \u22122 to 7). Associations varied by types of PD and SUD. Substance use disorder was a stronger predictor of hospitalization than PD.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi220100-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This study found that patients with both PD and SUD had a greater probability of hospitalization, compared with those with either disorder alone or neither disorder. Substance use disorders appear to have a greater association than PDs with the probability of hospitalization. Overlooking possible coexisting PD and SUD in ED patients with COVID-19 can underestimate the likelihood of hospitalization. Screening and assessment of both conditions are needed.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2022.5047","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T16:02:25Z","timestamp":1676476945000},"page":"331","source":"Crossref","is-referenced-by-count":22,"title":["Hospitalization Associated With Comorbid Psychiatric and Substance Use Disorders Among Adults With COVID-19 Treated in US Emergency Departments From April 2020 to August 2021"],"prefix":"10.1001","volume":"80","author":[{"given":"Lyna Z.","family":"Schieber","sequence":"first","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Dunphy","sequence":"additional","affiliation":[{"name":"Division of Injury Prevention, National Center for Injury Prevention and Control, Centers 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