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Comorbidity between mood and substance-related disorders: A systematic review and meta-analysis

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

DOI

  • Sukanta Saha, University of Queensland, Queensland Centre for Mental Health Research
  • ,
  • Carmen C.W. Lim, University of Queensland, Queensland Centre for Mental Health Research
  • ,
  • Louisa Degenhardt, University of New South Wales
  • ,
  • Danielle L. Cannon, Queensland Centre for Mental Health Research
  • ,
  • Monique Bremner, Queensland Centre for Mental Health Research
  • ,
  • Finley Prentis, Queensland Centre for Mental Health Research
  • ,
  • Zoe Lawrence, Queensland Centre for Mental Health Research
  • ,
  • Ed Heffernan, University of Queensland, Metro North Hospital and Health Service, Queensland Centre for Mental Health Research
  • ,
  • Carla Meurk, University of Queensland, Queensland Centre for Mental Health Research
  • ,
  • John Reilly, Queensland Health
  • ,
  • John J. McGrath

Background and Objectives: Evidence indicates that mood disorders often co-occur with substance-related disorders. However, pooling comorbidity estimates can be challenging due to heterogeneity in diagnostic criteria and in the overall study design. The aim of this study was to systematically review and, where appropriate, meta-analyse estimates related to the pairwise comorbidity between mood disorders and substance-related disorders, after sorting these estimates by various study designs. Methods: We searched PubMed (MEDLINE), Embase, CINAHL and Web of Science for publications between 1980 and 2017 regardless of geographical location and language. We meta-analysed estimates from original articles in 4 broadly defined mood and 35 substance-related disorders. Results: After multiple eligibility steps, we included 120 studies for quantitative analysis. In general, regardless of variations in diagnosis type, temporal order or use of adjustments, there was substantial comorbidity between mood and substance-related disorders. We found a sixfold elevated risk between broadly defined mood disorder and drug dependence (odds ratio = 5.7) and fivefold risk between depression and cannabis dependence (odds ratio = 4.9) while the highest pooled estimate, based on period prevalence risk, was found between broadly defined dysthymic disorder and drug dependence (odds ratio = 11.3). Based on 56 separate meta-analyses, all pooled odds ratios were above 1, and 46 were significantly greater than 1 (i.e. the 95% confidence intervals did not include 1). Conclusion: This review found robust and consistent evidence of an increased risk of comorbidity between many combinations of mood and substance-related disorders. We also identified a number of under-researched mood and substance-related disorders, suitable for future scrutiny. This review reinforces the need for clinicians to remain vigilant in order to promptly identify and treat these common types of comorbidity.

OriginalsprogEngelsk
TidsskriftAustralian and New Zealand Journal of Psychiatry
Vol/bind56
Nummer7
Sider (fra-til)757-770
Antal sider14
ISSN0004-8674
DOI
StatusUdgivet - jul. 2022

Bibliografisk note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The project is supported by the Danish National Research Foundation (Niels Bohr Professorship to J.J.M.) as well as John Cade Fellowship APP1056929 (awarded to J.J.M.) from the National Health and Medical Research Council, Australia.

Publisher Copyright:
© The Royal Australian and New Zealand College of Psychiatrists 2021.

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