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Background <p>Alcohol Use Disorder (AUD) is a major global contributor to disability and mortality, significantly adding to the overall disease burden. It is particularly prevalent among individuals with severe mental illnesses (SMI), such as bipolar disorder (BD), schizophrenia (SCZ), and major depressive disorder (MDD), and is often accompanied by comorbid psychiatric conditions that further exacerbate its effects. Due to impairments in memory, cognitive control, mood regulation, impulsivity, and emotional stability, individuals with mental health disorders—including schizophrenia and mood disorders—are at an increased risk of developing AUD. This review aims to determine the pooled prevalence of AUD and identify its associated factors among individuals with severe mental illness in Africa.</p> Methods <p>Primary studies were systematically retrieved from PubMed/MEDLINE, Scopus, African Journals Online, PsycINFO, EMBASE, CINAHL, and the Cochrane Library. This review included twenty original research articles that examined the prevalence of Alcohol Use Disorder (AUD) among individuals with severe mental illness in Africa. Data extraction and article evaluation were independently performed by two reviewers to ensure accuracy and minimize bias. All studies included in the meta-analysis underwent a rigorous quality assessment, and only those with a score of 5 or higher on the evaluation criteria were incorporated into the final analysis. Given the heterogeneity among the included studies, a random-effects meta-analysis was employed, and potential publication bias was evaluated using Egger’s weighted regression test, funnel plots, and trim-and-fill plots. The review protocol was prospectively registered with PROSPERO (<b>ID: CRD42024535636</b>).</p> Results <p>This review included 20 primary studies encompassing a total of 7,540 participants. The pooled prevalence of Alcohol Use Disorder (AUD) among individuals with severe mental illness (SMI) was 33.26% (95% CI: 26.41–40.12). Factors significantly associated with AUD included male sex (OR = 3.45; 95% CI: 2.13–5.59), younger adults (OR = 3.12; 95% CI: 1.92–5.08), participants reporting current cigarette use (OR = 4.80; 95% CI: 3.03–7.69), and a family history of alcohol use (OR = 3.25; 95% CI: 2.82–4.65).</p> Conclusion <p>This review reveals that Alcohol Use Disorder is highly prevalent among individuals with severe mental illness in Africa. The findings indicate that being male, younger adults, participants reporting current cigarette use, or having a family history of alcohol use significantly increases the risk of AUD. These results emphasize the importance of incorporating targeted screening, early intervention, and integrated treatment approaches into mental health services to effectively address and reduce the impact of AUD within this population.</p>

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Alcohol use disorder and associated factors among individuals with severe mental illnesses in Africa: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年3月6日

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  • Mulualem Kelebie,
  • Getasew Kibralew,
  • Gebresilassie Tadesse,
  • Girum Nakie,
  • Girmaw Medfu Takelle,
  • Dawed Ali,
  • Fanuel Gashaw,
  • Mulu Muche,
  • Yeneneh Workie,
  • Zemene Yiglet,
  • Setegn Fentahun

摘要

Background

Alcohol Use Disorder (AUD) is a major global contributor to disability and mortality, significantly adding to the overall disease burden. It is particularly prevalent among individuals with severe mental illnesses (SMI), such as bipolar disorder (BD), schizophrenia (SCZ), and major depressive disorder (MDD), and is often accompanied by comorbid psychiatric conditions that further exacerbate its effects. Due to impairments in memory, cognitive control, mood regulation, impulsivity, and emotional stability, individuals with mental health disorders—including schizophrenia and mood disorders—are at an increased risk of developing AUD. This review aims to determine the pooled prevalence of AUD and identify its associated factors among individuals with severe mental illness in Africa.

Methods

Primary studies were systematically retrieved from PubMed/MEDLINE, Scopus, African Journals Online, PsycINFO, EMBASE, CINAHL, and the Cochrane Library. This review included twenty original research articles that examined the prevalence of Alcohol Use Disorder (AUD) among individuals with severe mental illness in Africa. Data extraction and article evaluation were independently performed by two reviewers to ensure accuracy and minimize bias. All studies included in the meta-analysis underwent a rigorous quality assessment, and only those with a score of 5 or higher on the evaluation criteria were incorporated into the final analysis. Given the heterogeneity among the included studies, a random-effects meta-analysis was employed, and potential publication bias was evaluated using Egger’s weighted regression test, funnel plots, and trim-and-fill plots. The review protocol was prospectively registered with PROSPERO (ID: CRD42024535636).

Results

This review included 20 primary studies encompassing a total of 7,540 participants. The pooled prevalence of Alcohol Use Disorder (AUD) among individuals with severe mental illness (SMI) was 33.26% (95% CI: 26.41–40.12). Factors significantly associated with AUD included male sex (OR = 3.45; 95% CI: 2.13–5.59), younger adults (OR = 3.12; 95% CI: 1.92–5.08), participants reporting current cigarette use (OR = 4.80; 95% CI: 3.03–7.69), and a family history of alcohol use (OR = 3.25; 95% CI: 2.82–4.65).

Conclusion

This review reveals that Alcohol Use Disorder is highly prevalent among individuals with severe mental illness in Africa. The findings indicate that being male, younger adults, participants reporting current cigarette use, or having a family history of alcohol use significantly increases the risk of AUD. These results emphasize the importance of incorporating targeted screening, early intervention, and integrated treatment approaches into mental health services to effectively address and reduce the impact of AUD within this population.