Assessing the magnitude of mental health and substance use comorbidity among young adults in East Africa: a systematic review, 2024

Co-occurring substance use and other mental health disorders are prevalent among adolescents who access mental health services and substance abuse treatment, reflecting the growing recognition of multimorbidity across all healthcare settings. Young people with concurrent disorders have substantial issues with their mental health as well as their substance use behavior. This makes it difficult for them to function on a daily basis. The goal of this systematic review is to review the extent of mental illness and substance use comorbidity in East Africa. This systematic review and meta-analysis were conducted in line with the PRISMA guidelines. We conducted a search of 5 bibliographic databases (PubMed, science direct, Cochrane library, AAU repository, and Google scholar) from 2005 until December 2023. The results of eligible studies have been summarized descriptively and organized by three broad categories including: studies evaluating the epidemiology of substance use among mentally ill patients, studies evaluating the epidemiology of mental illness among substance use and studies evaluating the epidemiology of comorbidity of substance use and mental illness. The quality of the included studies was assessed with Agency for Healthcare Research and Quality tool. Among the 15 eligible studies, eleven focused on examining the extent of mental illness in individuals with substance use, while nine explored the prevalence of substance use among those with mental illnesses. Almost all articles were published by male researchers. Ten studies delved into the coexistence of substance use and mental illness. Limited research has been conducted on the epidemiology of severe mental illness, perinatal mental illness, hallucinogen use, injectable drug use, and prescription medication. Vulnerable populations, including pregnant women, children, and individuals with physical disabilities, have been inadequately represented. The majority of studies indicated there was a significant burden of alcohol use and depression disorder in the adult population. Prioritizing integrated approaches within all rehabilitation centres is crucial to addressing the distinctive needs and challenges encountered by individuals with mental illness.