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Purpose of Review <p>This systematic review examines the association between co-occurring psychotic disorders and Opioid Agonist Therapy (OAT) outcomes in Opioid Use Disorder (OUD).</p> Recent Findings <p>We searched eight databases and reference lists up to March 20, 2024, for observational studies comparing OAT outcomes in patients with OUD with and without psychotic disorders. 21 studies with 17,623 participants were included, all exhibiting a low to moderate overall risk of bias. The results suggested that patients with OUD and psychotic disorders had significantly poorer OAT retention than those with OUD without psychotic disorders [odds ratio (OR) = 0.65; 95% confidence interval (CI): 0.57–0.74; <i>P</i> &lt; 0.05]. Subgroup analysis identified study period as a source of heterogeneity, with no significant publication bias. No significant evidence suggested that co-occurring psychotic disorders were associated with illicit drug use, including opioids (OR = 1.05; 95% CI: 0.50–2.23; <i>P</i> = 0.90), amphetamines [relative risk (RR) = 1.09; 95% CI: 0.45–2.67; <i>P</i> = 0.84], cannabis (OR = 1.48; 95% CI: 0.99–2.21; <i>P</i> = 0.06), cocaine (RR = 1.19; 95% CI: 0.43–3.25; <i>P</i> = 0.74), and polydrug use (OR = 1.05; 95% CI: 0.40–2.72; <i>P</i> = 0.93). Sensitivity analysis confirmed the robustness of all pooled results except for cannabis use.</p> Summary <p>Analyzing data from 21 studies involving 17,623 participants, we found that patients with OUD and psychotic disorders had significantly poorer OAT retention compared to those with OUD without psychotic disorders. However, no significant association was found between co-occurring psychotic disorders and illicit drug use.</p>

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The Association of Concurrent Psychotic Disorders with Outcomes of Opioid Agonist Therapy in Individuals with Opioid Use Disorder: A Systematic Review and Meta-Analysis of Observational Studies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月19日

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  • Yangyang Li,
  • Solja Niemelä,
  • Alexander Denissoff

摘要

Purpose of Review

This systematic review examines the association between co-occurring psychotic disorders and Opioid Agonist Therapy (OAT) outcomes in Opioid Use Disorder (OUD).

Recent Findings

We searched eight databases and reference lists up to March 20, 2024, for observational studies comparing OAT outcomes in patients with OUD with and without psychotic disorders. 21 studies with 17,623 participants were included, all exhibiting a low to moderate overall risk of bias. The results suggested that patients with OUD and psychotic disorders had significantly poorer OAT retention than those with OUD without psychotic disorders [odds ratio (OR) = 0.65; 95% confidence interval (CI): 0.57–0.74; P < 0.05]. Subgroup analysis identified study period as a source of heterogeneity, with no significant publication bias. No significant evidence suggested that co-occurring psychotic disorders were associated with illicit drug use, including opioids (OR = 1.05; 95% CI: 0.50–2.23; P = 0.90), amphetamines [relative risk (RR) = 1.09; 95% CI: 0.45–2.67; P = 0.84], cannabis (OR = 1.48; 95% CI: 0.99–2.21; P = 0.06), cocaine (RR = 1.19; 95% CI: 0.43–3.25; P = 0.74), and polydrug use (OR = 1.05; 95% CI: 0.40–2.72; P = 0.93). Sensitivity analysis confirmed the robustness of all pooled results except for cannabis use.

Summary

Analyzing data from 21 studies involving 17,623 participants, we found that patients with OUD and psychotic disorders had significantly poorer OAT retention compared to those with OUD without psychotic disorders. However, no significant association was found between co-occurring psychotic disorders and illicit drug use.