Follow-up Study of Anxiety Disorder and Alcohol Dependence in Comorbid Alcoholism Treatment Patients
ABSTRACT Anxiety disorders are present in a high percentage of alcoholism treatment patients. We tested the prediction that having a comorbid anxiety disorder increases the prospective risk for relapse to drinking after alcoholism treatment. We also explored the prospective associations of specific anxiety syndromes (and depression) with drinking and anxiety outcomes.
We assessed the diagnostic status and daily drinking patterns of 82 individuals approximately one week after they entered alcoholism treatment (baseline) and again approximately 120 days later (follow-up) (n=53).
Consistent with study predictions, those with a baseline anxiety disorder (approximately 55%) were significantly more likely than others to meet various definitions of drinking relapse over the course of the follow-up. Regression models showed that baseline social phobia was the single best predictor of a return to any drinking after treatment, whereas panic disorder was the single best predictor of a relapse to alcohol dependence after treatment. Having multiple anxiety disorders (versus any specific anxiety disorder) at the baseline was the strongest predictor of having at least one active ("persistent") anxiety disorder at the follow-up. Cross-sectional analysis at the follow-up showed that anxiety disorder persisted in the absence of a relapse to alcohol dependence far more often than relapse to alcohol dependence occurred in the absence of a persistent anxiety disorder.
Screening for comorbid anxiety disorder in alcoholism treatment patients is warranted and, where found, should be considered a marker of high relapse risk relative to that of noncomorbid patients. The capacity of specific anxiety treatment to mitigate relapse risk among comorbid patients remains an open question.
Full-textDOI: · Available from: Kenneth B Abrams, Aug 26, 2015
- SourceAvailable from: PubMed Central
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- "Additionally, the risk of relapse after treatment for AUD increases if people have concurrent conditions, such as anxiety or stress sensitivity (Kushner et al. 2005; Sinha et al. 2011). "
ABSTRACT: Chronic alcohol-related neuroadaptations in key neural circuits of emotional and cognitive control play a critical role in the development of, and recovery from, alcoholism. Converging evidence in the neurobiological literature indicates that neuroplastic changes in the prefrontal-striatal-limbic circuit, which governs emotion regulation and decisionmaking and controls physiological responses in the autonomic nervous system and hypothalamic-pituitary-adrenal axis system, contribute to chronic alcoholism and also are significant predictors of relapse and recovery. This paper reviews recent evidence on the neuroplasticity associated with alcoholism in humans, including acute and chronic effects, and how these neurobiological adaptations contribute to alcohol recovery, along with the discussion of relevant clinical implications and future research directions.09/2015; 37(1):143-152.
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- "Elyakoubi, Millet, Drapier, Robin, D. y Moirand, 2013; Kushner, Abrams, Thuras, Hanson, Brekke y Sletten, 2005). Diversos estudios concluyen que los pacientes con trastorno de ansiedad presentan 2,5 a 4,3 veces más riesgo para presentar un abuso de alcohol que la población general (Chignon y Papeta, 1999). "
DESCRIPTION: The influence of high levels of anxiety prior to surgery has been sufficiently researched as a symptom to be considered in all surgical processes. It is necessary to observe its possible influence in patients as well as in the different surgery protocols. Alcoholics frequently suffer psychiatric syndromes, particularly anxiety and depression. The objective of this work is to examine the possible relationship between anxiety and alcohol abuse in patients that are about to undergo a surgical procedure. The study was based on the voluntary participation of 42 hospital patients awaiting surgery at the Infanta Cristina Hospital in Badajoz, Spain. They completed the State-Trait-Anxiety-Inventory (STAI) and the MCMII-II questionnaire before the surgical intervention took place. Results indicated that scores on the alcohol abuse scale are higher in patients with a greater degree of anxiety.
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- "E-mail: email@example.com & O'Neill, 2005; Kushner et al., 2005), suggesting that mental illness poses health risks for persons with substance use disorders. For instance, bloodborne infections including the humanimmunodeficiency virus (HIV), substance use, and involvement in HIV-risk sexual behavior have been reported among persons with severe mental illnesses (e.g., schizophrenia, bipolar and major mood disorders) in multisite investigations (Rosenberg et al., 2003). "
ABSTRACT: Abstract Objective: The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use) and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity), to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Methods: Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110, 110/266), while 27.8% reported using cocaine (n = 74, 74/266) and 12.8% reported using alcohol (n = 34, 34/266). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Results: Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not frequency of unprotected behavior), such that those higher in psychiatric severity and higher in substance use had a greater number of sexual partners. The model including this interaction term accounted for 63.4% of the variance in number of partners. Conclusions: Findings suggest psychiatric severity is an underlying risk factor for HIV-risk sexual behavior among persons with substance use disorders who have various psychiatric comorbidities.Journal of Dual Diagnosis 12/2014; 11(1). DOI:10.1080/15504263.2014.990802 · 0.80 Impact Factor