Prevalence of Mental Disorders Among People With Opioid Use Disorder: A Systematic Review and Meta-Analysis

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

Theme: Epidemiology & Public Health Research Year: 2022

Opioid use disorder (OUD) and mental disorders are major public health issues and comorbidity is
common. To our knowledge, this is the first systematic review and meta-analysis to estimate the
prevalence of mental disorders among people with OUD.
We searched Embase, MEDLINE, and PsycInfo to identify studies of people with OUD with mental
disorder data from January 1990 to July 2021. Observational studies of people with OUD that
assessed depression, anxiety, bipolar, personality, attention-deficit, and other pre-specified mental
disorders among people with OUD were included. We extracted prevalence of each mental disorder,
sample characteristics, and methodological factors from each publication. Random-effects metaanalyses were used to pool prevalence estimates for each disorder with 95% Confidence Intervals
(CIs). Meta-regressions and stratified analyses were used to assess differences in mental disorder
prevalence estimates by 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 disorder
was 20.9% (95%CI 15.7–26.2%), post-traumatic stress disorder 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, such as participant sex and recruitment setting, were associated with variance in pooled estimates for specific disorders.
Mental disorders were far more common among people with OUD than the general population,
which provides further evidence of the rates of comorbidity between these disorders. Our findings
emphasise the need for access to mental disorder treatment among this population. Results may
inform clinical guidelines, treatment services, and future research among this people with OUD.
Disclosure of Interest Statement
LD has received investigator-initiated untied educational grants for studies of opioid
medications in Australia from Indivior and Seqirus. GC has received investigator-initiated
untied educational grants for studies of opioid medications in Australia from Indivior.

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