Associations of common mental disorder with alcohol use in the adult general population: a systematic review and meta-analysis.

BACKGROUND AND AIMS Research has shown that alcohol use and common mental disorders (CMDs) co-occur; however, little is known about how the global prevalence of alcohol use compares across different CMDs. We aimed to i) report global associations of alcohol use (alcohol use disorder (AUD), binge-drinking and consumption) comparing those with and without a CMD, ii) examine how this differed among those with and without specific types of CMDs, and iii) examine how results may differ by study characteristics. METHODS A systematic review and meta-analysis. Cross-sectional, cohort, prospective, longitudinal and case-control studies reporting the prevalence of alcohol use among those with and without a CMD in the general population were identified using PsycINFO, MEDLINE, PsyARTICLES, PubMed, Scopus and Web of Science until March 2020. Depression, anxiety and phobia were included as a CMD. Studies were included if they used a standardised measure of alcohol use. A random effects meta-analysis was conducted to generate pooled prevalence and associations of AUD with CMD with 95% confidence intervals (CI). A narrative review is provided for binge-drinking and alcohol consumption. RESULTS 512 full-texts were reviewed, 51 included in our final review and 17 in our meta-analyses (N=382,201). Individuals with a CMD had a two-fold increase in the odds of reporting an AUD (odds ratio (OR)=2.02, 95% CI=1.72-2.36). The odds of having an AUD were similar when stratified by the type of CMD (mood disorder: OR=2.00, 95%CI=1.62-2.47; anxiety/phobic disorder: OR=1.94, 95%CI=1.35-2.78). An analysis of study characteristics did not reveal any clear explanations for between-study heterogeneity (I2 >80%). There were no clear patterns for associations between having a CMD and binge-drinking, or alcohol consumption, respectively. CONCLUSIONS People with common mental disorders (depression, anxiety, phobia) are twice as likely to report an alcohol use disorder than people without common mental disorders.