Work

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

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: 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.

Source: Current Addiction Reports

DOI: 10.1007/s40429-025-00642-x

Authors: Yangyang Li, Solja Niemelä, Alexander Denissoff

Institution: University of Turku

Language: English

Topic: Opioid Use Disorder Treatment

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,790