Discipline of Psychiatry and Addiction Medicine, Concord Hospital, University of Sydney, NSW Australia.
Discipline of Psychiatry and CADE Clinic, Royal North Shore Hospital, University of Sydney, NSW Australia.
J Affect Disord. 2020 Apr 1;266:288-304. doi: 10.1016/j.jad.2020.01.141. Epub 2020 Jan 26.
Comorbidity between Substance Use Disorders (SUDs) and major depression is highly prevalent. This systematic review and meta-analysis aimed to estimate the prevalence of SUDs in subjects diagnosed with a major depressive disorder (MDD) in community, inpatient and outpatient settings.
A comprehensive literature search of Medline, EMBASE, PsycINFO and CINAHL databases was conducted from 1990 to 2019. Prevalence of co-morbid SUDs and MDD were extracted and odds ratios (ORs) were calculated using random effects meta-analysis.
There were 48 articles identified by electronic searches with a total sample size of 348,550 subjects that yielded 14 unique epidemiological studies, 2 national case registry studies, 7 large cohort studies and 20 clinical studies using in- or out-patients. The prevalence of any SUD in individuals with MDD was 0.250. Maximum prevalence was found with alcohol use disorder (0.208), followed by illicit drug use disorder (0.118) and cannabis use disorder (0.117). Meta-analysis showed the pooled variance of any AUD in men with MDD was 36%, which was significantly higher than that for females with MDD (19%, OR 2.628 95% CI 2.502, 2.760).
Few studies were published over the last decade so current prevalence rates of SUD in MDD are needed. Meta-analysis revealed that SUDs in MDD are highly prevalent and rates have not changed over time. The persistently high prevalence suggests there is an urgent need for more informative studies to help develop better prevention and treatment options for reducing prevalence of SUDs in persons with major depression and co-morbid disorders.
物质使用障碍（SUDs）与重度抑郁症并存的情况非常普遍。本系统评价和荟萃分析旨在估计社区、住院和门诊环境中诊断为重度抑郁症（MDD）的患者中 SUD 的患病率。
从 1990 年到 2019 年，对 Medline、EMBASE、PsycINFO 和 CINAHL 数据库进行了全面的文献检索。提取合并 SUD 和 MDD 的患病率，并使用随机效应荟萃分析计算比值比（ORs）。
通过电子搜索共确定了 48 篇文章，总样本量为 348550 人，其中有 14 项独特的流行病学研究、2 项国家病例登记研究、7 项大型队列研究和 20 项使用门诊或住院患者的临床研究。MDD 患者中任何 SUD 的患病率为 0.250。最高的患病率见于酒精使用障碍（0.208），其次是非法药物使用障碍（0.118）和大麻使用障碍（0.117）。荟萃分析显示，MDD 男性中任何 AUD 的汇总方差为 36%，显著高于 MDD 女性（19%，OR 2.628 95%CI 2.502, 2.760）。
过去十年中发表的研究较少，因此需要了解目前 MDD 中 SUD 的患病率。荟萃分析显示，MDD 中的 SUD 患病率很高，且患病率随时间没有变化。持续高患病率表明，迫切需要开展更具信息量的研究，以帮助制定更好的预防和治疗方案，降低患有重度抑郁症和合并症患者的 SUD 患病率。
