Prevalence of mental disorders among people with opioid use disorder: A systematic review and meta-analysis
Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of spec...
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| Published in | Drug and alcohol dependence Vol. 238; p. 109551 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Ireland
Elsevier B.V
01.09.2022
Elsevier Science Ltd |
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| Abstract | Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of specific mental disorders among people with OUD.
We searched Embase, MEDLINE, and PsycInfo from 1990 to 2021 for observational studies of depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, personality, and other pre-specified mental disorders among people with OUD. We pooled current and lifetime estimates of each disorder using random-effects meta-analyses with 95% Confidence Intervals (CIs). Meta-regressions and stratified analyses were used to assess heterogeneity of prevalence estimates by methodological factors and sample characteristics.
Of the 36,971 publications identified, we included data from 345 studies and 104,135 people with OUD in at least one pooled estimate. Among people with OUD, the prevalence of current depression was 36.1% (95%CI 32.4–39.7%), anxiety was 29.1% (95%CI 24.0–33.3%), attention-deficit/hyperactivity disorder was 20.9% (95%CI 15.7–26.2%), PTSD was 18.1% (95%CI 15.4–20.9%), and bipolar disorder was 8.7% (95%CI 6.7–10.7%). Lifetime prevalence of anti-social personality disorder was 33.6% (95%CI 29.1–38.0%) and borderline personality disorder was 18.2% (95% CI 13.4–23.1%). Sample characteristics and methodological factors, including sex, were associated with variance of multiple prevalence estimates.
Our findings emphasise the need for access to mental disorder treatment among people with OUD. Specific mental disorder estimates may inform clinical guidelines, treatment services, and future research for people with OUD, including subpopulations with distinct treatment needs.
•We estimated prevalence of mental disorders among people with OUD.•Depression (36%), anxiety (29%), & PTSD (18%) were common.•Prevalence of anti-social (34%) & borderline personality disorder (18%) was high.•ADHD (21%), bipolar disorder (9%), dysthymia (7%), & OCD (7%) were also examined.•Depression, anxiety, and PTSD was more common among women. |
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| AbstractList | Background Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of specific mental disorders among people with OUD. Methods We searched Embase, MEDLINE, and PsycInfo from 1990 to 2021 for observational studies of depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, personality, and other pre-specified mental disorders among people with OUD. We pooled current and lifetime estimates of each disorder using random-effects meta-analyses with 95% Confidence Intervals (CIs). Meta-regressions and stratified analyses were used to assess heterogeneity of prevalence estimates by methodological factors and sample characteristics. Findings Of the 36,971 publications identified, we included data from 345 studies and 104,135 people with OUD in at least one pooled estimate. Among people with OUD, the prevalence of current depression was 36.1% (95%CI 32.4–39.7%), anxiety was 29.1% (95%CI 24.0–33.3%), attention-deficit/hyperactivity disorder was 20.9% (95%CI 15.7–26.2%), PTSD was 18.1% (95%CI 15.4–20.9%), and bipolar disorder was 8.7% (95%CI 6.7–10.7%). Lifetime prevalence of anti-social personality disorder was 33.6% (95%CI 29.1–38.0%) and borderline personality disorder was 18.2% (95% CI 13.4–23.1%). Sample characteristics and methodological factors, including sex, were associated with variance of multiple prevalence estimates. Interpretation Our findings emphasise the need for access to mental disorder treatment among people with OUD. Specific mental disorder estimates may inform clinical guidelines, treatment services, and future research for people with OUD, including subpopulations with distinct treatment needs. Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of specific mental disorders among people with OUD. We searched Embase, MEDLINE, and PsycInfo from 1990 to 2021 for observational studies of depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, personality, and other pre-specified mental disorders among people with OUD. We pooled current and lifetime estimates of each disorder using random-effects meta-analyses with 95% Confidence Intervals (CIs). Meta-regressions and stratified analyses were used to assess heterogeneity of prevalence estimates by methodological factors and sample characteristics. Of the 36,971 publications identified, we included data from 345 studies and 104,135 people with OUD in at least one pooled estimate. Among people with OUD, the prevalence of current depression was 36.1% (95%CI 32.4-39.7%), anxiety was 29.1% (95%CI 24.0-33.3%), attention-deficit/hyperactivity disorder was 20.9% (95%CI 15.7-26.2%), PTSD was 18.1% (95%CI 15.4-20.9%), and bipolar disorder was 8.7% (95%CI 6.7-10.7%). Lifetime prevalence of anti-social personality disorder was 33.6% (95%CI 29.1-38.0%) and borderline personality disorder was 18.2% (95% CI 13.4-23.1%). Sample characteristics and methodological factors, including sex, were associated with variance of multiple prevalence estimates. Our findings emphasise the need for access to mental disorder treatment among people with OUD. Specific mental disorder estimates may inform clinical guidelines, treatment services, and future research for people with OUD, including subpopulations with distinct treatment needs. Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of specific mental disorders among people with OUD.BACKGROUNDOpioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of specific mental disorders among people with OUD.We searched Embase, MEDLINE, and PsycInfo from 1990 to 2021 for observational studies of depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, personality, and other pre-specified mental disorders among people with OUD. We pooled current and lifetime estimates of each disorder using random-effects meta-analyses with 95% Confidence Intervals (CIs). Meta-regressions and stratified analyses were used to assess heterogeneity of prevalence estimates by methodological factors and sample characteristics.METHODSWe searched Embase, MEDLINE, and PsycInfo from 1990 to 2021 for observational studies of depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, personality, and other pre-specified mental disorders among people with OUD. We pooled current and lifetime estimates of each disorder using random-effects meta-analyses with 95% Confidence Intervals (CIs). Meta-regressions and stratified analyses were used to assess heterogeneity of prevalence estimates by methodological factors and sample characteristics.Of the 36,971 publications identified, we included data from 345 studies and 104,135 people with OUD in at least one pooled estimate. Among people with OUD, the prevalence of current depression was 36.1% (95%CI 32.4-39.7%), anxiety was 29.1% (95%CI 24.0-33.3%), attention-deficit/hyperactivity disorder was 20.9% (95%CI 15.7-26.2%), PTSD was 18.1% (95%CI 15.4-20.9%), and bipolar disorder was 8.7% (95%CI 6.7-10.7%). Lifetime prevalence of anti-social personality disorder was 33.6% (95%CI 29.1-38.0%) and borderline personality disorder was 18.2% (95% CI 13.4-23.1%). Sample characteristics and methodological factors, including sex, were associated with variance of multiple prevalence estimates.FINDINGSOf the 36,971 publications identified, we included data from 345 studies and 104,135 people with OUD in at least one pooled estimate. Among people with OUD, the prevalence of current depression was 36.1% (95%CI 32.4-39.7%), anxiety was 29.1% (95%CI 24.0-33.3%), attention-deficit/hyperactivity disorder was 20.9% (95%CI 15.7-26.2%), PTSD was 18.1% (95%CI 15.4-20.9%), and bipolar disorder was 8.7% (95%CI 6.7-10.7%). Lifetime prevalence of anti-social personality disorder was 33.6% (95%CI 29.1-38.0%) and borderline personality disorder was 18.2% (95% CI 13.4-23.1%). Sample characteristics and methodological factors, including sex, were associated with variance of multiple prevalence estimates.Our findings emphasise the need for access to mental disorder treatment among people with OUD. Specific mental disorder estimates may inform clinical guidelines, treatment services, and future research for people with OUD, including subpopulations with distinct treatment needs.INTERPRETATIONOur findings emphasise the need for access to mental disorder treatment among people with OUD. Specific mental disorder estimates may inform clinical guidelines, treatment services, and future research for people with OUD, including subpopulations with distinct treatment needs. Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are associated with poorer health outcomes. To our knowledge, this is the first systematic review and meta-analysis to estimate prevalence of specific mental disorders among people with OUD. We searched Embase, MEDLINE, and PsycInfo from 1990 to 2021 for observational studies of depression, anxiety, post-traumatic stress disorder (PTSD), bipolar, personality, and other pre-specified mental disorders among people with OUD. We pooled current and lifetime estimates of each disorder using random-effects meta-analyses with 95% Confidence Intervals (CIs). Meta-regressions and stratified analyses were used to assess heterogeneity of prevalence estimates by methodological factors and sample characteristics. Of the 36,971 publications identified, we included data from 345 studies and 104,135 people with OUD in at least one pooled estimate. Among people with OUD, the prevalence of current depression was 36.1% (95%CI 32.4–39.7%), anxiety was 29.1% (95%CI 24.0–33.3%), attention-deficit/hyperactivity disorder was 20.9% (95%CI 15.7–26.2%), PTSD was 18.1% (95%CI 15.4–20.9%), and bipolar disorder was 8.7% (95%CI 6.7–10.7%). Lifetime prevalence of anti-social personality disorder was 33.6% (95%CI 29.1–38.0%) and borderline personality disorder was 18.2% (95% CI 13.4–23.1%). Sample characteristics and methodological factors, including sex, were associated with variance of multiple prevalence estimates. Our findings emphasise the need for access to mental disorder treatment among people with OUD. Specific mental disorder estimates may inform clinical guidelines, treatment services, and future research for people with OUD, including subpopulations with distinct treatment needs. •We estimated prevalence of mental disorders among people with OUD.•Depression (36%), anxiety (29%), & PTSD (18%) were common.•Prevalence of anti-social (34%) & borderline personality disorder (18%) was high.•ADHD (21%), bipolar disorder (9%), dysthymia (7%), & OCD (7%) were also examined.•Depression, anxiety, and PTSD was more common among women. |
| ArticleNumber | 109551 |
| Author | Santo, Thomas Campbell, Gabrielle Gisev, Natasa Degenhardt, Louisa Tran, Lucy Thi Wilson, Jack Colledge-Frisby, Samantha Martino-Burke, Daniel Clark, Brodie |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35797876$$D View this record in MEDLINE/PubMed |
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| Snippet | Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental disorders are... Background Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is common. Among people with OUD, comorbid mental... |
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| SubjectTerms | Antisocial personality disorder Anxiety Anxiety disorders Anxiety Disorders - epidemiology Attention deficit hyperactivity disorder Bipolar disorder Borderline personality disorder Clinical practice guidelines Comorbidity Drug abuse Drug addiction Estimates Health problems Health status Heterogeneity Humans Hyperactivity Mental depression Mental disorders Mental Disorders - epidemiology Meta-analysis Mood disorders Narcotics Observational studies Opioid use disorders Opioid-Related Disorders - epidemiology Opioids Personality Personality disorders Post traumatic stress disorder Prevalence Psychological stress Public health Stress Disorders, Post-Traumatic - drug therapy Stress Disorders, Post-Traumatic - epidemiology Subpopulations Substance use disorder Systematic review Treatment needs |
| Title | Prevalence of mental disorders among people with opioid use disorder: A systematic review and meta-analysis |
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