Onaemo Vivian N, Chireh Batholomew, Fawehinmi Timothy O, D'Arcy Carl
Division of Public Health and Preventive Medicine, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada.
EPID@Work Research Institute, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada; Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada.
J Affect Disord. 2024 Mar 1;348:8-16. doi: 10.1016/j.jad.2023.12.016. Epub 2023 Dec 7.
Major depressive disorders (MDD) and substance use disorders (SUDs) are commonly linked to disability, but there is a lack of research on the risk of disability among individuals who have both SUDs and MD in the general population. This study aimed to investigate the associated risk of disability in people with comorbid SUDs- specifically cannabis use disorder, alcohol use disorder, other drug (except cannabis) use disorder, and a major depressive episode using a nationally representative sample.
The 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data were analyzed using multilevel logistic regression models. The survey included a nationally representative sample of Canadians aged 15 years and older (n = 25,113) residing in the ten Canadian provinces from January to December 2012. The diagnoses of major depressive episodes (MDE) and the SUDs were derived from the DSM-IV diagnostic criteria using a modified WHO-CIDI instrument, while disability was assessed using the World Health Organization Disability Assessment Score (WHODAS) 2.0.
The strongest predictor of disability was found to be comorbidity. Individuals diagnosed with both a SUD and MDE were 4 to 9 times more likely to experience disability, depending on the substance used, compared to those without either diagnosis.
The study's cross-sectional design limits causal inferences.
Our research discovered that individuals who have both SUD and MDE are at a significantly higher risk of experiencing disability. This highlights the importance of integrating mental health and addiction services to mitigate the risk of disability and improve overall treatment outcomes.
重度抑郁症（MDD）和物质使用障碍（SUDs）通常与残疾相关，但在一般人群中，对于同时患有物质使用障碍和重度抑郁症的个体的残疾风险缺乏研究。本研究旨在使用具有全国代表性的样本，调查患有共病物质使用障碍（具体为大麻使用障碍、酒精使用障碍、其他药物（大麻除外）使用障碍）和重度抑郁发作的人群的相关残疾风险。
使用多级逻辑回归模型分析2012年加拿大社区健康调查 - 心理健康（CCHS - MH）数据。该调查包括2012年1月至12月居住在加拿大十个省份的15岁及以上加拿大人的具有全国代表性样本（n = 25,113）。重度抑郁发作（MDE）和物质使用障碍的诊断采用经修改的世界卫生组织复合国际诊断访谈工具（WHO - CIDI），依据《精神疾病诊断与统计手册》第四版（DSM - IV）诊断标准得出，而残疾状况则使用世界卫生组织残疾评估量表（WHODAS）2.0进行评估。
发现残疾的最强预测因素是共病。与未被诊断出任何一种疾病的个体相比，被诊断出同时患有物质使用障碍和重度抑郁发作的个体，根据所使用的物质不同，出现残疾的可能性要高出4至9倍。
该研究的横断面设计限制了因果推断。
我们的研究发现，同时患有物质使用障碍和重度抑郁发作的个体出现残疾的风险显著更高。这凸显了整合心理健康和成瘾服务以降低残疾风险并改善总体治疗效果的重要性。
