title: Anxiety, mood disorders and injection risk behaviors among cocaine users: Results from the COSMO study.
abstract: OBJECTIVE
  Despite being common among cocaine users, mental health problems and their relationship with HIV and hepatitis C high risk injection behaviors are poorly documented. This study was undertaken to examine the relationships between mood and anxiety disorders and the sharing of drug injection equipment among cocaine users who inject drugs.
  
  
  METHODS
  The sample was drawn from a prospective cohort study and comprised of 387 participants. The outcome of interest was "sharing injection material" in the past 3 months. The presence of mood and anxiety disorders during the past year was assessed using the CIDI questionnaire. Statistical analyses were conducted on baseline data using logistic regression.
  
  
  RESULTS
  Most participants were male (84.5%) and were aged 25 or over (92.2%); 43.0% qualified for an anxiety disorder diagnosis and 29.3% for a mood disorder diagnosis. Participants with anxiety disorders were more likely to share needles (Adjusted Odds Ratio [AOR]: 2.13, 95%CI: 1.15-3.96) and other injection material (AOR: 1.81, 95%CI: 1.12-2.92). No significant association was found between mood disorders and sharing behaviors.
  
  
  CONCLUSIONS
  Primary anxiety disorders but not mood disorders increases injection risk behaviors among cocaine users. These results bring to light another negative outcome of mental health comorbidity in this vulnerable population.
  
  
  CONCLUSIONS
  This study underlines the need to fine-tune therapeutic approaches targeting specific mental health problems in individuals with cocaine use disorders. Longitudinal studies that assess impulsivity and other correlates of psychiatric disorders are needed to examine underlying mechanisms of high risk injection behaviors in comorbid populations.
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.|Institut national de santé publique du Québec, Montréal, Québec, Canada.
authors.forename: Élise
authors.initials: É
authors.lastname: Roy
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.|Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Didier
authors.initials: D
authors.lastname: Jutras-Aswad
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Bertrand
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Magali
authors.initials: M
authors.lastname: Dufour
authors.affiliation: Douglas Mental Health Institute, Montréal, Québec, Canada.|Department of Psychiatry, McGill University, Montréal, Québec, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Perreault
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Émélie
authors.initials: É
authors.lastname: Laverdière
authors.affiliation: Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Bene-Tchaleu
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.|Department of Family Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Bruneau
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D016485:Needle Sharing / Q000009:adverse effects*; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D055815:Young Adult