National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW 2052, Australia.
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.
Drug Alcohol Depend. 2022 Sep 1;238:109551. doi: 10.1016/j.drugalcdep.2022.109551. Epub 2022 Jul 1.
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.
阿片类药物使用障碍（OUD）和精神障碍是主要的公共卫生问题，共病很常见。在患有 OUD 的人群中，共患精神障碍与较差的健康结果相关。据我们所知，这是第一项评估 OUD 患者特定精神障碍患病率的系统评价和荟萃分析。
我们从 1990 年至 2021 年在 Embase、MEDLINE 和 PsycInfo 中搜索了关于 OUD 患者中抑郁、焦虑、创伤后应激障碍（PTSD）、双相、人格和其他预先指定的精神障碍的观察性研究。我们使用随机效应荟萃分析和 95%置信区间（CI）汇总了每种疾病的当前和终生估计值。我们使用荟萃回归和分层分析来评估患病率估计值因方法因素和样本特征而产生的异质性。
在 36971 篇出版物中，我们纳入了来自 345 项研究和至少一项汇总估计值的 104135 名 OUD 患者的数据。在患有 OUD 的人群中，当前抑郁的患病率为 36.1%（95%CI 32.4-39.7%），焦虑为 29.1%（95%CI 24.0-33.3%），注意力缺陷/多动障碍为 20.9%（95%CI 15.7-26.2%），PTSD 为 18.1%（95%CI 15.4-20.9%），双相障碍为 8.7%（95%CI 6.7-10.7%）。反社会人格障碍的终生患病率为 33.6%（95%CI 29.1-38.0%），边缘型人格障碍为 18.2%（95%CI 13.4-23.1%）。样本特征和方法因素，包括性别，与多种患病率估计值的差异有关。
我们的研究结果强调了需要为 OUD 患者提供精神障碍治疗。特定的精神障碍估计值可以为 OUD 患者的临床指南、治疗服务和未来研究提供信息，包括具有不同治疗需求的亚人群。
