Rush Brian, Urbanoski Karen, Bassani Diego, Castel Saulo, Wild T Cameron, Strike Carol, Kimberley Dennis, Somers Julian
Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Toronto, Ontario.
Can J Psychiatry. 2008 Dec;53(12):800-9. doi: 10.1177/070674370805301206.
Population health surveys around the world have studied the epidemiology of comorbid substance use disorders (SUDs) and other mental disorders as part of larger efforts to assess needs and direct integrated planning and delivery of services. This study presents the first national assessment in Canada of the prevalence of co-occurring SUDs and other mental disorders, with attention to differences by substance problem severity, sex, age, and region.
This work is a secondary analysis of data from the 2002 Canadian Community Health Survey: Mental Health and Well-Being. The sample was obtained using a multistage stratified cluster design (n = 36,984, response rate = 77%).
The 12-month population prevalence of co-occurring disorders was 1.7%. The 12-month prevalence of other mental disorders was higher among those with illicit drug, relative to alcohol, problems and among those with dependence, compared with those with less severe problems. Sex and age differences mirrored population differences in pure disorders. Salient regional differences included the higher rate of co-occurring disorders in British Columbia and the lower rates in Quebec.
Cross-study comparisons are hampered by methodological differences; however, these Canadian rates are at the lower end of the range reported internationally. This might have resulted from the exclusion of several disorders known to be highly comorbid with SUDs. Nonetheless, prevalence is high in certain subgroups, and efforts under way to improve Canada's substance abuse and mental health services should continue to ensure that adequate attention is directed to the needs of people with co-occurring disorders.
世界各地的人群健康调查研究了共病物质使用障碍（SUDs）和其他精神障碍的流行病学情况，作为评估需求以及指导综合服务规划与提供的更大努力的一部分。本研究首次对加拿大共病SUDs和其他精神障碍的患病率进行了全国性评估，并关注了物质问题严重程度、性别、年龄和地区的差异。
这项工作是对2002年加拿大社区健康调查：心理健康与幸福感数据的二次分析。样本采用多阶段分层整群设计获得（n = 36,984，应答率 = 77%）。
共病障碍的12个月人群患病率为1.7%。与酒精问题者相比，非法药物问题者中其他精神障碍的12个月患病率更高；与问题较轻者相比，依赖者中其他精神障碍的12个月患病率更高。性别和年龄差异反映了单纯障碍人群中的差异。显著的地区差异包括不列颠哥伦比亚省共病障碍发生率较高，魁北克省较低。
方法学差异阻碍了跨研究比较；然而，这些加拿大的患病率处于国际报告范围的较低水平。这可能是由于排除了几种已知与SUDs高度共病的障碍。尽管如此，某些亚组中的患病率较高，正在进行的改善加拿大物质滥用和心理健康服务的努力应继续确保充分关注共病障碍患者的需求。
