Canada’s mental health and substance-use disorders increasingly overlap

Co-occurring mood, anxiety, and substance use disorders in Canada 2022: prevalence, patterns, correlates, and changes over time.

Psychiatry research • • Moderately Relevant
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AI Summary

A national Canadian survey found that 16.4% of people aged 15 and older met criteria for at least one past-year mood, anxiety, or substance use disorder in 2022. Cannabis use disorder was included among the substance use disorders assessed, although the abstract does not provide a cannabis-specific prevalence. Among people with any disorder, 39.5% had two or more, and 10.6% had both a mood or anxiety disorder and a substance use disorder.

The overlap was especially notable among people with substance use disorders: 48.9% also had a mood or anxiety disorder. Youth, unemployed people, and those experiencing severe distress or suicidality had higher odds of concurrent disorders. Compared with 2012, substance-use-disorder-only cases declined, while mood/anxiety and concurrent disorders doubled. The findings support integrated mental health and substance-use services, particularly for youth and females, but they do not show that cannabis use causes mood or anxiety disorders.

💡 Key Findings

1
16.4% of Canadians aged 15 and older met criteria for a past-year mood, anxiety, or substance use disorder in 2022; cannabis use disorder was included in the substance-use category.
High
82%
2
Among people with at least one disorder, 39.5% had two or more disorders, including 10.6% with both a mood/anxiety disorder and a substance use disorder.
High
82%
3
Among people with a substance use disorder, 48.9% also had a mood or anxiety disorder, highlighting substantial overlap between mental health and substance-use concerns.
High
82%
4
From 2012 to 2022, substance-use-disorder-only cases declined, while mood/anxiety and concurrent disorders doubled.
Good
78%
5
The study calls for integrated mental health and substance-use services, with particular attention to youth and females who are disproportionately affected in some patterns of co-occurrence.
High
80%

📄 Original Abstract

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. 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. 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. 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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