Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: A systematic review and meta-analysis
Open accessAbstract
Background Comorbidity is highly prevalent between substance use disorders (SUDs), mood and anxiety disorders. We conducted a systematic review and meta-analysis to determine the strength of association between SUDs, mood and anxiety disorders in population-based epidemiological surveys.Methods A comprehensive literature search of Medline, EMBASE, CINAHL, PsychINFO, Web of Science, and Scopus was conducted from 1990 to 2014. Sources were chosen on the basis that they contained original research in non-clinical populations conducted in randomly selected adults living within defined boundaries. Prevalence of comorbid SUDs, mood and anxiety disorders and odds ratios (ORs) were extracted.Results There were 115 articles identified by electronic searches that were reviewed in full text which yielded 22 unique epidemiological surveys to extract lifetime and 12-month prevalence data for psychiatric illness in respondents with an SUD. Meta-analysis indicated the strongest associations were between illicit drug use disorder and major depression (pooled OR 3.80, 95% CI 3.02-4.78), followed by illicit drug use and any anxiety disorder (OR 2.91, 95% CI 2.58-3.28), alcohol use disorders and major depression (OR 2.42, 95% CI 2.22-2.64) and alcohol use disorders and any anxiety disorder (OR 2.11, 95% CI 2.03-2.19). ORs for dependence were higher than those for abuse irrespective to diagnoses based on lifetime or 12-month prevalence.Conclusions This review confirms the strong association between SUDs, mood and anxiety disorders. The issue has now been recognised worldwide as a factor that affects the profile, course, patterns, severity and outcomes of these disorders.
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Patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse.
“Previous studies have consistently found that patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse [80,81,82,83,84,85,86,87,88,89,90].”
The relationship between anxiety and depression and substance abuse in general and opioid misuse in particular is well-documented.
“The relationship between anxiety and depression and substance abuse in general [81] and opioid misuse in particular is a well-documented finding [82,83]”
Prevalence rates of comorbid conditions in this sample were similar to those in other studies.
“However, the prevalence rates of comorbid conditions in this sample were similar to those obtained in other studies (for a meta-analysis, see Lai et al., 2015), somewhat mitigating this concern.”
From Optimizing screening for depression, anxiety disorders, and post-traumatic stress disorder in inpatient addiction treatment: A preliminary investigation (2021) · cites this paper as Lai et al., 2015
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- Authors
- Lai, H. M. X., Cleary, M., Sitharthan, T., & Hunt, G. E.
- Affiliations
- The University of Sydney (AU)
- Western Sydney University (AU)
- Corresponding author
- Hunt, Glenn E.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 154
- Pages
- 1-13
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W1494270537
- Cited by
- 941
- References
- 113
- Citations by year
- 2026: 86 · 2025: 96 · 2024: 101 · 2023: 92 · 2022: 91 · 2021: 102 · 2020: 150 · 2019: 85 · 2018: 60 · 2017: 43 · 2016: 26 · 2015: 7 · 2014: 1
- FWCI
- 5.89
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- substance use disorders, psychiatric comorbidity, mood disorders, anxiety disorders, major depressive disorder, illicit drug use, alcoholism, substance dependence, substance abuse, prevalence, lifetime prevalence, 12-month prevalence
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Major, Major Depressive Disorder, Humans, Comorbidity, Prevalence, Odds Ratio, Substance-Related Disorders, Alcohol-Related Disorders
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