ArticleBMJ open2020
Trends in the diagnosis of diseases of despair in the United States, 2009-2018: a retrospective cohort study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 55 citations in OpenAlex.
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- Parental Diseases of Despair and Suicidal Events in Their Children.JAMA network open · 2025Article
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- Transformational narrative changes as a community-level approach to the prevention of adverse childhood experiences and substance use.American journal of community psychology · 2024Article
- Pro-Environmental Behavior and Climate Change Anxiety, Perception, Hope, and Despair According to Political Orientation.Behavioral sciences (Basel, Switzerland) · 2023Article
- Gender differences in transdiagnostic domains and function of adults measured by DSM-5 assessment scales at the first clinical visit: a cohort study.BMC psychiatry · 2023Article
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- The bystander effect: Impact of rural hospital closures on the operations and financial well-being of surrounding healthcare institutions.Journal of hospital medicine · 2022Article
- Deaths of Despair: A Scoping Review on the Social Determinants of Drug Overdose, Alcohol-Related Liver Disease and Suicide.International journal of environmental research and public health · 2022Article
- "Lives of despair" at risk for "deaths of despair": tracking an under-recognized, vulnerable population.Social psychiatry and psychiatric epidemiology · 2022Article
- What Makes an Intervention a Life Course Intervention?Pediatrics · 2022Article
- Diagnoses and Treatment After Depression Screening in Primary Care Among Youth.American journal of preventive medicine · 2022Article
- On the Use of Aggregate Survey Data for Estimating Regional Major Depressive Disorder Prevalence.Psychometrika · 2022Article
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- Self-reported Access to Firearms Among Patients Receiving Care for Mental Health and Substance Use.JAMA health forum · 2021Article
- Perceptions of Diseases of Despair by Members of Rural and Urban High-Prevalence Communities: A Qualitative Study.JAMA network open · 2021Article
- From data to decisions: Supporting mental health solutions in primary care.Canadian family physician Medecin de famille canadienArticle
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8 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectiveIncreasing mortality and decreasing life expectancy in the USA are largely attributable to accidental overdose, alcohol-related disease and suicide. These 'deaths of despair' often follow years of morbidity, yet little is known about trends in the clinical recognition of 'diseases of despair'. The objective of this study is to characterise rates of clinically documented diseases of despair over the last decade and identify sociodemographic risk factors.
designRetrospective study using a healthcare claims database with 10 years of follow-up.
settingParticipants resided nationwide but were concentrated in US states disproportionately affected by deaths of despair, including Pennsylvania, West Virginia and Delaware.
participantsCohort included 12 144 252 participants, with no restriction by age or gender. OUTCOME MEASURES: Diseases of despair were defined as diagnoses related to alcohol misuse, substance misuse and suicide ideation/behaviours. A lookback period was used to identify incident diagnoses. Annual and all-time incidence/prevalence estimates were computed, along with risk for current diagnosis and patterns of comorbidity.
results515 830 participants received a disease of despair diagnosis (58.5% male, median 36 years). From 2009 to 2018, the prevalence of alcohol-related, substance-related and suicide-related diagnoses respectively increased by 37%, 94%, and 170%. Ages 55-74 had the largest increase in alcohol/substance-related diagnoses (59% and 172%). Ages <18 had the largest increase in suicide-related diagnoses (287%). Overall, odds for current-year diagnosis were higher among men (adjusted OR (AOR) 1.49, 95% CI 1.47 to 1.51), and among those with Affordable Care Act or Medicare coverage relative to commercial coverage (AOR 1.30, 1.24 to 1.37; AOR 1.51, 1.46 to 1.55).
conclusionsIncreasing clinical rates of disease of despair diagnoses largely mirror broader societal trends in mortality. While the opioid crisis remains a top public health priority, parallel rises in alcohol-related diagnoses and suicidality must be concurrently addressed. Findings suggest opportunities for healthcare systems and providers to deploy targeted prevention to mitigate the progression of morbidities towards mortality.
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