eCite Digital Repository

Prevalence of comorbid substance use in major depressive disorder in community and clinical settings, 19902019: systematic review and meta-analysis


Hunt, GE and Malhi, GS and Lai, HMX and Cleary, M, Prevalence of comorbid substance use in major depressive disorder in community and clinical settings, 1990-2019: systematic review and meta-analysis, Journal of Affective Disorders, 266 pp. 288-304. ISSN 0165-0327 (2020) [Refereed Article]

Copyright Statement

2020 Elsevier B.V. All rights reserved.

DOI: doi:10.1016/j.jad.2020.01.141


Background: Comorbidity between Substance Use Disorders (SUDs) and major depression is highly prevalent. This systematic review and meta-analysis aimed to estimate the prevalence of SUDs in subjects diagnosed with a major depressive disorder (MDD) in community, inpatient and outpatient settings.

Methods: A comprehensive literature search of Medline, EMBASE, PsycINFO and CINAHL databases was conducted from 1990 to 2019. Prevalence of co-morbid SUDs and MDD were extracted and odds ratios (ORs) were calculated using random effects meta-analysis.

Results: There were 48 articles identified by electronic searches with a total sample size of 348,550 subjects that yielded 14 unique epidemiological studies, 2 national case registry studies, 7 large cohort studies and 20 clinical studies using in- or out-patients. The prevalence of any SUD in individuals with MDD was 0.250. Maximum prevalence was found with alcohol use disorder (0.208), followed by illicit drug use disorder (0.118) and cannabis use disorder (0.117). Meta-analysis showed the pooled variance of any AUD in men with MDD was 36%, which was significantly higher than that for females with MDD (19%, OR 2.628 95% CI 2.502, 2.760).

Conclusions: Few studies were published over the last decade so current prevalence rates of SUD in MDD are needed. Meta-analysis revealed that SUDs in MDD are highly prevalent and rates have not changed over time. The persistently high prevalence suggests there is an urgent need for more informative studies to help develop better prevention and treatment options for reducing prevalence of SUDs in persons with major depression and co-morbid disorders.

Item Details

Item Type:Refereed Article
Keywords:major depression, prevalence, co-morbidity, substance use disorders, meta-analysis
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Mental health services
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Mental health services
UTAS Author:Cleary, M (Professor Michelle Cleary)
ID Code:137119
Year Published:2020
Web of Science® Times Cited:50
Deposited By:Nursing
Deposited On:2020-02-03
Last Modified:2021-01-27

Repository Staff Only: item control page