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.
- [Show abstract] [Hide abstract]
ABSTRACT: We examined factors associated with lifetime treatment of alcohol dependence in a nationwide sample of Korean adults. Of the 6510 respondents, aged 18–64, who participated in the Korean Epidemiologic Catchment Area study, we analyzed 458 who had a lifetime diagnosis of alcohol dependence. Lay interviewers administered a diagnostic assessment, based on the Korean version of the Composite International Diagnostic Interview, to each of the respondents. Of the 458 respondents with a lifetime diagnosis of alcohol dependence, 55 (12.0%) had been treated for psychiatric problems. Treated alcohol-dependent respondents were less likely to have a stable, dyadic relationship or a full-time job. In addition, they were more likely to have experienced alcohol withdrawal symptoms, given up important activities because of alcohol use, and continued alcohol use despite knowing they had an alcohol-associated physical or psychological problem and were less likely to have spent a great deal of time obtaining or drinking alcohol or recovering from its effects. Treated individuals were also more likely to have comorbid mood disorders, especially major depressive disorder, or comorbid anxiety disorders, especially post-traumatic stress disorder, social phobia, or obsessive–compulsive disorder. Alcohol-dependent persons significantly underuse mental health services. Patterns of alcohol use and comorbid psychiatric disorders, as well as socio-demographic factors, affected treatment-seeking by alcohol-dependent individuals in Korea.Addiction Research and Theory 02/2012; 20(2). · 1.03 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Most adults consume alcohol with relative impunity, but about 10-20% of users persist (or progress) in their consumption, despite mounting and serious repercussions. Identifying at-risk individuals before neuroadaptative changes associated with chronic use become well ingrained is thus a key step in mitigating and preventing the end stage disease and its devastating impacts. Explaining liability has been impeded, in part, by the absence of animal models for assessing initial sensitivity to the drug's reinforcing properties, an important endophenotype in the trajectory toward excessive drinking. Here we assess the initial rewarding effects of the drug in a novel application of the conditioned place preference paradigm. In contrast to previous studies that have all employed repeated drug administration, we demonstrated a robust preference for a context paired with a single exposure to 1.5 g/kg EtOH in male and female subjects of three strains. This model validates an assay of initial sensitivity to the subjective rewarding effects of alcohol, a widely used drug with multifarious impacts on both brain and society, and provides a new tool for theory-driven endophenotypic pharmacogenetic approaches to understanding and treating addiction.Frontiers in Neuroscience 11/2014;
- [Show abstract] [Hide abstract]
ABSTRACT: Objective: This study examined how effort to regulate alcohol use may interact with anxiety and affective disorders to influence long-term remission from alcohol dependence. Method: Using participants (n = 96; 73% male; 66% children of alcoholics; 71% non-Hispanic Caucasian; 26% Hispanic) from a high-risk community study who showed evidence of recovered alcohol dependence at baseline, this study examined whether effort to regulate alcohol use at the baseline assessment significantly influenced the likelihood of maintaining remission from alcohol dependence for a period of five years or more. This study also examined whether having an anxiety or affective disorder interacted with effort to regulate alcohol use. All analyses controlled for treatment history, baseline alcohol use, parent alcoholism, age and gender. Results: Results from logistic regressions showed that effort to regulate alcohol use had a significant unique main effect on long-term maintenance of remission from alcohol dependence. Having an affective and/or anxiety disorder did not have a significant main effect on the maintenance of remission. However, having an anxiety/affective disorder significantly moderated the influence of effort to regulate alcohol use such that the protective effect of effort to regulate use on remission from alcohol dependence was only significant for those without an affective or anxiety disorder. Conclusions: Individuals who try harder to limit their drinking are more likely to maintain long-term remission from alcohol dependence. However, affective and anxiety disorders may undermine the protective effect of effort to regulate alcohol use on long-term remission.Addiction Research and Theory 11/2013; · 1.03 Impact Factor