BACKGROUND A range of negative experiences and circumstances that are common among people who inject drugs (PWID) are risk factors for developing mental disorders. Despite this, there has been no systematic review of the prevalence of mental health indicators among PWID. Thus, we aimed to estimate the prevalence of depression, post-traumatic stress disorder (PTSD), suicidality and self-harm among PWID. METHODS We searched the peer-reviewed and grey literature for data on depression, PTSD, suicidality and non-suicidal self-harm among PWID from sources published from 2008-2018. We pooled estimates of depression and suicidality using random-effects meta-analysis and provided a narrative summary of estimates of PTSD and self-harm. FINDINGS We found 23 studies that reported on these mental health indicators among PWID. The pooled estimate for current severe depressive symptomology was 42.0 % (95 % confidence interval [CI] = 21.3, 62.8 %), and for a depression diagnosis was 28.7 % (95 % CI = 20.8, 36.6 %). With much variation, the pooled lifetime prevalence of a suicide attempt was 22.1 % (95 % CI = 19.3, 24.9 %). There were only two studies each that reported on PTSD and non-suicidal self-harm among PWID. INTERPRETATION Recent data investigating these mental health indicators among PWID was limited, particularly from low- and middle-income countries. Even so, estimates were high and call for further research into the epidemiology of such mental health disorders and self-harming behaviours, as well as the promotion of integrated mental health and substance dependence treatment. Finally, incorporating suicide prevention strategies into services accessed by PWID must be considered as a harm reduction priority.

中文翻译：

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注射毒品者中的抑郁症，创伤后应激障碍，自杀和自残：系统评价和荟萃分析。

背景技术在注射毒品的人中常见的一系列负面经历和情况是发展为精神障碍的危险因素。尽管如此，尚未对PWID中心理健康指标的普遍性进行系统的审查。因此，我们旨在评估PWID患者中抑郁症，创伤后应激障碍（PTSD），自杀倾向和自我伤害的患病率。方法我们从2008-2018年发布的资料中检索了同行评审的灰色文献，以获取有关PWID中抑郁症，PTSD，自杀性和非自杀性自残的数据。我们使用随机效应荟萃分析汇总了对抑郁和自杀的估计，并提供了对PTSD和自我伤害的估计的叙述性摘要。结果我们发现23项研究报告了PWID中的这些心理健康指标。当前严重抑郁症状的合并评估为42.0％（95％置信区间[CI] = 21.3，62.8％），对于抑郁症诊断为28.7％（95％CI = 20.8，36.6％）。变化很大，自杀企图的终生患病率为22.1％（95％CI = 19.3，24.9％）。仅有两项研究报告了PWID中的PTSD和非自杀性自残。解释最近在PWID中调查这些心理健康指标的数据是有限的，特别是来自中低收入国家的数据。即便如此，估计仍很高，需要进一步研究此类精神健康疾病和自残行为的流行病学，以及促进综合精神健康和药物依赖治疗。最后，