Prevalence and Temporal Trends of Mental Disorders in Persons with Opioid Use Disorder and Concurrent Mental Disorders in British Columbia, Canada, Using Population-Level Administrative Data, 2013 to 2021: Prévalence et tendances temporelles des troubles mentaux chez les personnes souffrant d'un trouble lié à la consommation d'opioïdes et de troubles mentaux concomitants en Colombie-Britannique, au Canada, à partir de données administratives au niveau de la population, entre 2013 et 2021

Abstract

ObjectiveOpioid use is a major public health issue and associated with a broad range of comorbid mental disorders. Globally, there is considerable variability in reported rates of mental disorders among individuals with opioid use disorder (OUD), limiting timely intervention and evidence-based treatment among this population. We estimate the prevalence of specific mental disorders among individuals with a concurrent OUD using population-level administrative data in British Columbia, Canada.MethodA population-based retrospective observational study using individual-level linked health administrative data in British Columbia, Canada. Individuals with an OUD and concurrent mental disorder between January 1, 2013, and August 31, 2021, were included and followed from their first indication of OUD until censoring (death, administrative loss to follow-up, or August 31, 2021). We reported annual period (2013-2021) prevalence rates and age-standardized prevalence rates per 100,000 population (stratified by sex).ResultsThe population included 73,855 individuals (female 40.6%, median age, 36 [27-48]) with an OUD and concurrent mental disorder. During the observation period anxiety disorders were the most prevalent (91.7%) mental disorders followed by depression (73.6%), bipolar disorder (35.3%), schizophrenia spectrum disorders (20.4%), and personality disorders (19.5%). Among the population, the annual period prevalence of any mental disorder increased from 35,603 in 2013 to 60,940 in 2021, with an average annual percent difference of 7.0%, driven by increases in schizophrenia spectrum disorders and attention deficit/hyperactivity disorder. Overall, the annual age-standardized prevalence of any mental disorder was higher among males.ConclusionsOur findings demonstrate a steadily growing prevalence of people with OUD and a concurrent mental disorder and emphasize the need for access to mental disorder treatment among this population. Estimating specific mental disorder prevalence is a pragmatic step toward informing clinical guidelines, service needs, and health system planning.

Keywords: anxiety; depression; epidemiology prevalence; mental disorders; opioid use disorder; population data.

Figure 1.

Annual prevalence^a of mental disorders among people with opioid use disorder in British Columbia, 2013-2021.^b

Figure 2.

Age-standardized annual prevalence rate (per 100,000 population)^a of mental disorders (stratified by sex) and 95% Wald confidence interval (CI) among people with opioid use disorder in British Columbia, 2013-2021.^b