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Co-occurring mood, anxiety, and substance use disorders in Canada 2022: prevalence, patterns, correlates, and changes
Jillian Halladay1, Chris Ji2, Katholiki Georgiades3
1School of Nursing, McMaster University, 1200 Main St. West, Hamilton, ON, L8S 4K1, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L9C 0E3, Canada; Offord Centre for Child Studies, McMaster University, Ron Joyce Children's Health Centre, 325 Wellington St N, Hamilton, ON, L8L 8E7, Canada; Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Jane Foss Russell Building (G02), 2006, Australia.
Purpose:
To determine the 2022 prevalence and co-occurrence of past 12-month mood (major depressive episode, bipolar), anxiety (generalized anxiety, social phobia), and substance use disorders (alcohol, cannabis, drug) among Canadians aged 15+, and to assess changes from 2012 to 2022.
Methods:
Population-based data from the 2022 Mental Health and Access to Care Survey (n = 9861) and the 2012 Canadian Community Health Survey's Mental Health Component (n = 25,113) were analyzed. Mental disorders were assessed using the World Health Organization Composite International Diagnostic Interview. Multivariable multinomial regression examined demographic and clinical correlates, as well as changes over time, of mood/anxiety disorder(s) alone, SUD(s) alone, and concurrent disorders (mood/anxiety+SUD). Age (youth 15-24 vs adults 25+) and sex (females vs males) differences were explored through stratified analyses and interactions.
Results:
In 2022, 16.4% met criteria for a mood (8.4%), anxiety (9.9%), or substance use (3.5%) disorders. Of those with at least one disorder, co-occurrence was common: 39.5% had 2+ disorders with 10.6% experiencing concurrent SUD and mood/anxiety disorders. Among those with an SUD, 48.9% had a concurrent mood/anxiety disorder, while 15.2% and 9.6% of those with a mood and anxiety disorders respectively had a concurrent SUD. Youth, unemployed individuals, and those with high distress or suicidality had elevated odds of concurrent disorders. Males had higher overall concurrent disorder prevalences, but among those with SUDs, concurrent disorders were higher among females. While the odds of SUD-alone declined, mood/anxiety and concurrent disorders doubled from 2012 to 2022.
Conclusion:
There is an urgent need for integrated mental health and substance use services, particularly for youth and females, who are disproportionately affected.
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