Nitrous oxide use and psychiatric disorders: a retrospective clinical cohort study on prevalence and patterns

TL;DR

This study found that a notable percentage of psychiatric patients have used nitrous oxide, with younger individuals being more likely to use it.

Contribution

The study provides new insights into the prevalence and patterns of nitrous oxide use among psychiatric patients.

Findings

7.67% of psychiatric patients reported a history of nitrous oxide use.

Younger age was statistically associated with nitrous oxide use.

Most users obtained nitrous oxide from friends or social events.

Abstract

Nitrous oxide (N2O) is used for anesthetic purposes but has gained popularity as a recreational substance. Despite its potentially severe adverse effects, knowledge about N2O use within psychiatric populations is limited. This study aimed to evaluate the life-time prevalence and patterns of N2O consumption among patients with psychiatric disorders.

A retrospective observational cohort study was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, involving assessments of N2O use lifetime prevalence among patients in various psychiatric settings over a six-month period in 2024. Further data on demographic characteristics and psychiatric diagnoses were collected from electronic patient records.

Out of 287 screened records, 22 patients (7.67%) reported a N2O use history, with a positive statistical relationship between younger age and positive lifetime prevalence (mean age: 28.14 ± 7.29 years, range 19–48 years, 6/22 female). Most users acquired N2O through low-threshold means such as friends or social events. The predominant psychiatric diagnoses among users included major depressive disorder, cannabis-related disorder and attention deficit and hyperactivity disorder.

This study highlights the concerning life-time prevalence of N2O use in a clinical psychiatric sample, emphasizing the need for increased awareness and education regarding its potential risks and side effects. Given the vulnerability of this population to substance-related issues, routine assessment for N2O use should be integrated into standard psychiatric evaluations.

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