Examining the link between psychological distress, mental health disorders and sharing behaviors among cocaine users.
Psychiatric problems and cocaine use are associated with heightened vulnerability for HIV and Hepatitis C infections. Little is known regarding the relationship between psychiatric symptoms, psychiatric diagnoses and injection risk behaviors among cocaine users. We examined the association between psychological distress and injection material sharing among cocaine users, while accounting for comorbid anxious and mood disorders.



Participants included cocaine users who inject drugs recruited in a prospective cohort study in Montreal, Canada. Diagnosis of mood and anxiety disorders in the year preceding baseline were established using the Composite International Diagnostic Interview (CIDI) questionnaire. Psychological distress based on the Kessler scale and injection material sharing in the past 3months were assessed at baseline and at each of the five follow-up visits at 3-month intervals. Statistical analyses were conducted using generalized estimation equation.



Of the 387 participants (84.5% male; 80.1%, ≥30y.o.), 35% reported severe psychological distress, 43% qualified for an anxiety disorder diagnosis and 29% for a mood disorder diagnosis at baseline. Psychological distress was not associated with any injection risk behavior when adjusting for socio-demographic and psychiatric disorders. Participants with anxiety disorders were more likely to share needle (adjusted odds ratio: 1.89, 95% CI: 1.17-3.03). Sharing of injection material other than needle was not associated with psychiatric disorders or with psychological distress in multivariate analyses.



Anxiety disorders are associated with needle sharing among cocaine users. Our results suggest the importance of screening for anxiety disorders as part of preventive interventions to decrease blood-borne viruses' transmission.
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Family Medicine, McGill University, Montréal, Québec, Canada.
Annie
A
Lévesque
Department of Community Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada; Montreal Public Health Department, Agence de la santé et des services sociaux de Montréal, Montréal, Québec, Canada.
Élise
É
Roy
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada.
Didier
D
Jutras-Aswad
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
Geng
G
Zang
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Family Medicine, McGill University, Montréal, Québec, Canada.
Andreea Adelina
AA
Artenie
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Family and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada. Electronic address: Julie.bruneau@umontreal.ca.
Julie
J
Bruneau
D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology*; D016485:Needle Sharing / Q000523:psychology*; D015995:Prevalence; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D057566:Self Report; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D015819:Substance Abuse, Intravenous / Q000523:psychology
Anxiety disorder; Cocaine; Injection; Mental health; Needle sharing; Psychological distress