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Articles by Mark Olfson
Mental Health and Substance Use Disorder Expenditures in the US
Key Points Question What were US mental health and substance use disorder expenditures in 2021-2023, and how were they distributed across disorders, populations, and services? Findings In this cross-sectional study of the 2021-2023 Medical Expenditure Panel Survey, annualized mental health care expenditures totaled $174 billion, representing 7% of all medical expenditures.
A Randomized Experiment of Mailed Incentives to Improve Emergency Physician Survey Participation
Emergency physicians are frequently asked to provide feedback on clinical practice, quality improvement, and implementation efforts. Physician surveys remain one of the most efficient methods for obtaining such feedback, yet response rates among physicians continue to decline [1]. Emergency physicians may be particularly challenging to engage because of shift-based schedules, high clinical workloads, and administrative overload [2], all of which limit time available for research participation.
A population-level approach to the treatment of psychiatric disorders
Suboptimal response to the clinical treatment of psychiatric disorders highlights the need for improved treatment approaches. Attempts to improve psychiatric treatment outcomes have mostly focused on identification of patient-level predictors or moderators of treatment response that could guide matching patients with the treatment approaches most likely to benefit them.
Insufficient Sleep Among US Adolescents—Reply
In Reply In his thoughtful comments on our Research Letter1 examining trends in insufficient sleep among US adolescents, Dr White raises an important point regarding the comparability of the 2021 and 2023 screen time measures with those used in prior years (2007-2019). We agree that these measures may not be directly comparable. Accordingly, we repeated our analyses restricting screen time–stratified analyses to 2007 through 2019. This reanalysis did not meaningfully alter our findings.
Antipsychotic Medication Use by Older Adults
Antipsychotic medications have limited proven effectiveness in people 65 years or older and have been associated with increased risks of falls, fractures, cardiovascular and cerebrovascular events, pulmonary embolism, and death in this age group.1 Little is known about national trends in antipsychotic use in the general population of older adults.
Telemental Health, Hybrid, and In-Person Outpatient Mental Health Care in the US
Key Points Question How are mental health outpatients in the US distributed across telehealth, hybrid, and in-person care? Findings In this cross-sectional study including 4720 participants, mental health outpatients most commonly received all in-person care, followed by all telehealth and hybrid care.
Risk of Suicide among US Adults with Work Disability
Prior research has not evaluated whether US adults with federally qualified work disability have an increased risk of suicide. A basic understanding of their suicide risk could help inform preventive interventions. A nationally representative sample, ages 20-61 years, from the 2008 American Community Survey (N=2,403,000) was followed through 2019 to calculate suicide rates with 95% confidence intervals per 100,000 person-years.
Psychotropic Medications and Child Health
With the release of Make Our Children Healthy Again: Assessment,1 the federal Make America Healthy Again (MAHA) Commission chaired by the US Secretary of Health and Human Services has elevated poor diet, environmental chemicals, physical inactivity, chronic stress, and medication overprescription as leading threats to the health of our nation’s children.
Oportunidades prometedoras para intervenir en el consumo de sustancias entre los adolescentes
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Tendencias nacionales en pensamientos e intentos de suicidio entre estudiantes de secundaria en Estados Unidos
Me Gusta 1 1 Comentar 2 2 Autor/autores: Tanner J. Bommersbach, Mark Olfson, and Taeho Greg Rhee...(et.al) Fecha de publicación: 28/07/2025 Artículo | Artículo revisado por nuestra redacción Objetivo Este estudio tuvo como objetivo estimar las tendencias nacionales de pensamientos suicidas e intentos de suicidio entre estudiantes de secundaria en los Estados Unidos, enfocándose en comparar a los adolescentes con y sin conductas de riesgo para la salud.
Risk of Opioid Use Disorder in Surgical Patients with Medicaid and Ass
Back to Journals » Journal of Pain Research » Volume 18 Original Research Opioids and Substance Abuse Authors Doan LV , Hung AM , Williams NT, Olfson M, Rudolph KE Received 12 June 2025 Accepted for publication 27 September 2025 Published 5 December 2025 Volume 2025:18 Pages 6505—6514 DOI https://doi.org/10.2147/JPR.S543280 Checked for plagiarism Yes Review by Single anonymous peer review Peer reviewer comments 2 Editor who approved publication: Dr Timothy Atkinson Lisa V Doan,1 Anton M...
Completeness and Quality of Data for Children in Medicaid Comprehensive Managed Care Compared to Fee‐for‐Service, 2001-2019
What is known on this topic: ○ Medicaid encounter data complement fee-for-service (FFS) billing claims by recording the service use of enrollees covered by managed care organizations. ○ Encounter data are more complex to collect, and both completeness and quality vary by state, year, and file type. ○ Studies to inform researchers seeking to use national Medicaid encounter data for children exist for only a few years.
Demographic Gaps and Digital Innovations in Therapy Trends
To the Editor The study1 by Olfson and colleagues provides valuable insights into how sociodemographic factors intersect with psychotherapy use patterns, particularly in the context of the growing role of teletherapy. However, several limitations restrict the scope and impact of the study, particularly with respect to the demographic factors considered, the granularity of the variables captured, and the scope of digital interventions. Demographic Gaps and Digital Innovations in Therapy Trends
Demographic Gaps and Digital Innovations in Therapy Trends-Reply
Demographic Gaps and Digital Innovations in Therapy Trends—Reply In Reply We thank Xie for his comments regarding our study1 published in a recent issue of JAMA Psychiatry and for drawing attention to several important sociodemographic groups, including those defined by immigrant status, disability status, sexual orientation, and gender identity with limited access to psychotherapy.
Trends in Outpatient Psychotherapy Among Adults in the US
Trends in Outpatient Psychotherapy Among Adults in the US Key Points Question How have US psychotherapy use patterns changed between 2018 and 2021?
Comparative effectiveness of extended‐release naltrexone and sublingual buprenorphine for treatment of opioid use disorder among Medicaid patients
DATA AVAILABILITY STATEMENT Research data are not shared. The data that support the findings of this study are available from the Research Data Assistance Center. Restrictions apply to the availability of these data, which were used under license for this study. All code and data definitions are available at https://github.com/CI-NYC.
Social Vulnerability and Prevalence and Treatment for Mental Health and Substance Use Disorders
Key Points Question What is the association between social vulnerability and mental health and substance use disorders and related treatment in the US noninstitutionalized population of adults aged 18 years and older? Findings In this survey study of 4674 participants from US households, large increases in several mental health and substance use disorders and corresponding decreases in treatment were found in the most socially vulnerable communities.
National Trends in Emergency Department Visits for Suicide Attempts and Intentional Self-Harm
Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Register for access Purchase Save for later Item saved, go to cart Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources.
Impact of Emergency Department Safety Planning on 30-Day Mental Health Service Use
Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Register for access Purchase Save for later Item saved, go to cart Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources.
Mental Health Impairment and Outpatient Mental Health Care of US Children and Adolescents
Key Points Question Was there a change between 2019 and 2021 in the percentage of US children and adolescents with severe mental health impairment and the percentage of youth using outpatient mental health care? Findings This survey study including 8331 participants found that the percentage of youth with severe mental health impairment was 9.7% in 2019 and 9.4% in 2021.
Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals
Key Points Question What percentage of people who attempt suicide meet criteria for a psychiatric disorder? Findings In this cross-sectional study using data from 1948 US adults with lifetime suicide attempts from a nationally representative population-based survey, an estimated 20% reported not having met criteria for any psychiatric disorders prior to their first attempt. Meaning The findings suggest a possible need to broaden suicide risk screening beyond psychiatric populations.
Trends in Psychological Distress and Outpatient Mental Health Care of Adults During the COVID-19 Era
In addition to the physical disease burden of the COVID-19 pandemic, concern exists over its adverse mental health effects (1, 2). A review of 40 European reports concluded that nonspecific mental health problems, depression, and generalized anxiety disorder were more prevalent during than before the pandemic (3).
Evaluating Associations Between Cannabis and Heroin Use Study says in conclusion” Raises doubts about the assertion that cannabis use has a role in the treatment of individuals with opioid use disorder”
Despite being illegal under U.S. federal law, cannabis has gained widespread public acceptance. Over half of U.S. adults (59%) believe that cannabis should be legal for recreational and medical purposes (1), and nearly one in five (19.6%) report using cannabis in the past year (2). Cannabis use is particularly common among individuals with opioid use disorder.
Evaluating Associations Between Cannabis and Heroin Use
Despite being illegal under U.S. federal law, cannabis has gained widespread public acceptance. Over half of U.S. adults (59%) believe that cannabis should be legal for recreational and medical purposes (1), and nearly one in five (19.6%) report using cannabis in the past year (2). Cannabis use is particularly common among individuals with opioid use disorder.
Comparative effectiveness of extended release naltrexone and sublingual buprenorphine for treatment of opioid use disorder among Medicaid patients
Declarations of competing interest: Dr. Nunes has served as an investigator on NIH-funded studies that received donated medication or digital therapeutics from Alkermes, Braeburn, Camurus, Indivior, Chess Health, and Pear Therapeutics, and has served as a consultant without compensation to Alkermes, Camurus, Indivior, and Pear Therapeutics.
Trends in Suicide Among Black Women in the United States, 1999-2020
Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Register for access Purchase Save for later Item saved, go to cart Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources.
Antipsychotic Medications and Mortality in Children and Young Adults
Key Points Question Is antipsychotic treatment of children and young adults without severe somatic illness or psychosis associated with increased risk of death? Findings In a cohort of 2 067 507 Medicaid patients aged 5 to 24 years, antipsychotic treatment was associated with increased risk of death only for patients with doses greater than 100-mg chlorpromazine equivalents. Risk was not significantly associated with lower doses or with either dose in children aged 5 to 17 years.
Prognosis and risk of suicide after cancer diagnosis
CONFLICT OF INTEREST STATEMENT Tony J. C. Wang reports personal fees and nonfinancial support from AbbVie, Elekta, Merck, Novocure, and RTOG Foundation; personal fees from Cancer Panels, Doximity, Rutgers, University of Iowa, Wolters Kluwer, and Iylon Precision Oncology; and grants and nonfinancial support from Genentech and Varian. Lisa A.
Trends in Prevalence of Cannabis Use Disorder Among U.S. Veterans With and Without Psychiatric Disorders Between 2005 and 2019
Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Register for access Purchase Save for later Item saved, go to cart Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources.
Gestión de urgencias de autolesiones deliberadas
Aproximadamente 500000 pacientes en los Estados Unidos acuden a los departamentos de emergencia (ED) anualmente después de la autolesión deliberada y tienen un alto riesgo a corto plazo de autolesiones repetidas y suicidio. La mejora de su atención de emergencia es un enfoque clave de las estrategias nacionales para reducir la tasa de suicidio, sin embargo, poco se sabe sobre el manejo de la DE por autolesiones deliberadas.
Evaluating the Liability of Antidepressants to Induce Mania
Evaluating the Liability of Antidepressants to Induce Mania in Children and Adolescents With Depression Antidepressant Use and Risk of Manic Episodes in Children and Adolescents With Depression Suvi Virtanen, PhD; Tyra Lagerberg, PhD; Christine Takami Lageborn, MD; Ralf Kuja-Halkola, PhD; Isabell Brikell, PhD; Anthony A. Matthews, PhD; Paul Lichtenstein, PhD; Brian M.
Suicide Risks of Health Care Workers in the US
Suicide Risks of Health Care Workers in the US Key Points Question Are US health care workers at greater risk of suicide than non–health care workers?
Fatal Drug Overdose Risks of Health Care Workers in the United States
Original Research8 August 2023 A Population-Based Cohort Study Author, Article, and Disclosure Information Abstract Background: Despite an unprecedented increase in drug overdose deaths in the United States, the risks faced by U.S. health care workers, who often have access to controlled prescription drugs, are not known. Objective: To estimate risks for drug overdose death among health care workers relative to non–health care workers. Design: Prospective cohort study. Setting: United States.
Race, Ethnicity, and ED Disposition for Mental Health Visits
ABSTRACT Objective: To describe associations between patient race and ethnicity with emergency department disposition for mental health visits in the United States. Methods: We identified 674,821 visits for mental health in the 2019 National Emergency Department Sample and classified them by ICD-10 diagnostic group: schizophrenia-spectrum, bipolar, major depressive, anxiety, or other disorders. Racial and ethnic categories were White, Black, Hispanic, or other.
Use of Non-Psychiatric Medications With Potential Depressive Symptom Side Effects and Level of Depressive Symptoms in Major Depressive Disorder
menu This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.
Nicotine Vaping and Co-occurring Substance Use Among Adolescents in the United States from 2017-2019
Methods This study examined 51,872 US adolescents (grades:8/10/12) from Monitoring the Future (MTF) in 2017 (N = 13,073), 2018 (N = 13,038), and 2019 (N = 25,761) (Miech et al., Citation2020, , , , , & (2020). Monitoring the Future national survey results on drug use, 1975–2019: Volume I, secondary school students. [Crossref], [Google Scholar]). Data were collected annually through self-administered student surveys, yielding nationally-representative samples.
Nondisordered Cannabis Use Among US Adolescents
Key Points Question Is nondisordered cannabis use (NDCU) among US adolescents associated with adverse psychosocial events? Findings In this cross-sectional study of 68 263 adolescents, NDCU was approximately 4 times more common than cannabis use disorder (CUD). NDCU and CUD were both significantly associated with adverse psychosocial events in a stepwise gradient manner. Meaning These findings suggest that adolescents with NDCU or CUD had increased odds of adverse psychosocial events.
National Trends in Mental Health-Related Emergency Department Visits Among Youth, 2011-2020
National Trends in Mental Health–Related Emergency Department Visits Among Youth, 2011-2020 Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019 Mary Arakelyan, MPH; Seneca Freyleue, MS; Divya Avula, MPH; Jennifer L. McLaren, MD; A. James O’Malley, PhD; JoAnna K. Leyenaar, MD, PhD, MPH The New Crisis of Increasing All-Cause Mortality in US Children and Adolescents Steven H. Woolf, MD, MPH; Elizabeth R. Wolf, MD, MPH; Frederick P.
Treatment of US Children With Attention-Deficit/Hyperactivity Disorder in the Adolescent Brain Cognitive Development Study
Key Points Question What percentage of children with parent-reported attention-deficit/hyperactivity disorder (ADHD) receive treatment?
Prevalence and Correlates of Mental Disorders in Children Aged 9 and 10 Years: Results From the ABCD Study.
To estimate the prevalence of current DSM-5 disorders in children, ages 9 to 10 years, and their associations with sociodemographic and physical characteristics.
Living Alone and Drug Overdose Deaths in the US
The increase in US drug overdose deaths has spurred interest in identifying high-risk populations. Being alone while using drugs poses added risks because it decreases opportunities for others to intervene. One study1 reported that 69% of overdose deaths occurred among people using drugs while alone. Living alone might be associated with increased fatal drug overdose risk.
Prevalence and Correlates of Mental Disorders in Children Aged 9 and 10 Years: Results From the ABCD Study
Article info Publication history Accepted: April 7, 2023 Received in revised form: November 21, 2022 Received: March 31, 2022 Publication stage In Press Journal Pre-Proof Footnotes This analysis of the ABCD data was performed without external funding. The views expressed in this manuscript are those of the authors and do not necessarily represent those of the National Institutes of Health or the US Government.
Hindcasts and forecasts of suicide mortality in US: A modeling study
Validation period (2012-2019) Fig 2 shows improved forecast quality when trend and seasonality in mortality rates were included in the models — the median quantile score for auto is lower than baseline (0.114 vs. 0.21), with an increase in spread (interquartile range: 0.28 vs. 0.21), and noticeably longer left tail indicating a higher proportion of good forecasts. Informing the models with near real-time proxy data further improved forecast quality.
Living Alone and Suicide Risk in the United States, 2008-2019
Abstract and Introduction Abstract Objectives: To evaluate the association between living alone and suicide and how it varies across sociodemographic characteristics. Methods: A nationally representative sample of adults from the 2008 American Community Survey (n = 3 310 000) was followed through 2019 for mortality. Cox models estimated hazard ratios of suicide across living arrangements (living alone or with others) at the time of the survey.
Sleep Complaints Among Adults With Major Depressive Episode Are Associated With Increased Risk of Incident Psychiatric Disorders: Results From a Population-Based 3-Year Prospective Study
menu This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions. Original Research Bénédicte Barbotin, MDa,b,*; Nicolas Hoertel, MD, MPH, PhDc,d,e; Mark Olfson, MD, MPHf; Carlos Blanco, MD, PhDg; Marina Sanchez-Rico, MPHc,e; Michel Lejoyeux, MD, PhDa,d,h; Frédéric Limosin, MD, PhDc,d,e; and Pierre A.
Living Alone and Suicide Risk in the United States, 2008‒2019
You must log in or purchase access to view the full text. Log in and purchase options are available below. Objectives. To evaluate the association between living alone and suicide and how it varies across sociodemographic characteristics. Methods. A nationally representative sample of adults from the 2008 American Community Survey (n = 3 310 000) was followed through 2019 for mortality.
Adolescents’ Use of Free Time and Associations with Substance Use from 1991 to 2019
Time use We examined seventeen ordinal variables that covered a broad variety of adolescent time use domains (social, academic, recreational, etc.). Full items are available in Supplemental Table 1, including the variables that were combined into more comprehensive measures (e.g., combining items asking about reading newspapers and reading magazines into a comprehensive measure of reading periodicals). Social media use, one of the time use items, was only available from 2009 onward.
Trends in Cannabis Use Disorder Diagnoses in the U.S. Veterans Health Administration, 2005-2019
Abstract Objective: In the United States, adult cannabis use has increased over time, but less information is available on time trends in cannabis use disorder. The authors used Veterans Health Administration (VHA) data to examine change over time in cannabis use disorder diagnoses among veterans, an important population subgroup, and whether such trends differ by age group (<35 years, 35–64 years, ≥65 years), sex, or race/ethnicity.
Tempering Optimism Concerning the Recent Decline in US Suicide Deaths
Identify all potential conflicts of interest that might be relevant to your comment. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Err on the side of full disclosure.
Psychotherapy provision declined significantly in recent decades
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