Prevalence of mental disorders among people with opioid use disorder: A systematic review and meta-analysis

Thomas Santo Jr; Gabrielle Campbell; Natasa Gisev; Daniel Martino-Burke; Jack Wilson; Samantha Colledge-Frisby; Brodie Clark; Lucy Thi Tran; Louisa Degenhardt

doi:10.1016/j.drugalcdep.2022.109551

Prevalence of mental disorders among people with opioid use disorder: A systematic review and meta-analysis

Drug Alcohol Depend. 2022 Sep 1:238:109551. doi: 10.1016/j.drugalcdep.2022.109551. Epub 2022 Jul 1.

Authors

Thomas Santo Jr¹, Gabrielle Campbell², Natasa Gisev³, Daniel Martino-Burke³, Jack Wilson⁴, Samantha Colledge-Frisby³, Brodie Clark³, Lucy Thi Tran³, Louisa Degenhardt³

Affiliations

¹ National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: t.santo@unsw.edu.au.
² National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW 2052, Australia; School of Psychology, The University of the Queensland, Brisbane, QLD 4072, Australia; National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD Australia.
³ National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW 2052, Australia.
⁴ Matilda Centre, The University of the Sydney, Sydney, NSW 2006, Australia.

PMID: 35797876
DOI: 10.1016/j.drugalcdep.2022.109551

Abstract

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.

Keywords: Anxiety disorders; Mental disorders; Meta-analysis; Mood disorders; Opioid use disorders; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety Disorders / epidemiology
Comorbidity
Humans
Mental Disorders* / epidemiology
Opioid-Related Disorders* / epidemiology
Prevalence
Stress Disorders, Post-Traumatic* / drug therapy
Stress Disorders, Post-Traumatic* / epidemiology