Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, Pickering RP, Kaplan K. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions

Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA.
Archives of General Psychiatry (Impact Factor: 14.48). 09/2004; 61(8):807-16. DOI: 10.1001/archpsyc.61.8.807
Source: PubMed


Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders.
To present nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition).
Face-to-face survey.
The United States.
Household and group quarters' residents.
Prevalence and associations of substance use disorders and independent mood and anxiety disorders.
The prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant (P<.05).
Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.

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    • "A national study of more than 6000 transgender people found that 63% had experienced a serious act of discrimination (e.g., medical service denial, eviction, bullying, or physical/sexual assault; Grant et al., 2011). Transgender people who, due to physical attributes that reveal their transgender status, are unable to " pass " (i.e., to be societally affirmed in the gender with which they identify) may be particularly vulnerable to victimization (Grant et al., 2011; Nemoto et al., 2004; Operario and Nemoto, 2010). Experiencing psychological or physical abuse as a result of one's nonconforming gender expression or identity is associated with a three-to four-fold higher odds of alcohol, marijuana, or cocaine use, as well as an 8-times higher odds of any drug use, among transgender women (Nuttbrock et al., 2014b). "
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    ABSTRACT: Transgender people have elevated substance use prevalence compared with the U.S. general population, however no studies have comprehensively examined the relationship of psychosocial risk factors to substance use and substance use disorder (SUD) treatment among both male-to-female (MTF) and female-to-male (FTM) transgender adults. Secondary data analysis of a 2013 community-based survey of transgender adults in Massachusetts (N=452) was conducted. Adjusted multivariable logistic regression models were fit to examine the relationship of four risk factor domains with SUD treatment history and recent substance use: (1) demographics; (2) gender-related characteristics; (3) mental health; (4) socio-structural factors. Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (95% CI) were estimated. Ten percent of the sample reported lifetime SUD treatment. Factors associated with significant increase in odds of lifetime SUD treatment alongside recent substance use (all p<0.05) were: (1) older age (aOR=1.02; 95% CI=1.01-1.04), higher educational attainment (aOR=3.59; 95% CI=2.35-5.50), low income (aOR=0.58; 95% CI=0.39-0.86); (2) MTF identity (aOR=3.03; 95% CI=1.95-4.67), gender-affirming medical care (aOR=1.99; 95% CI=1.32-3.00); (3) intimate partner violence (aOR=1.68; 95% CI=1.13-2.49), posttraumatic stress disorder (aOR=2.56; 95% CI=1.69-3.88), depression (aOR=2.30; 95% CI=1.58-3.35), mental health treatment (aOR=1.65; 95% CI=1.11-2.45); (4) discrimination (aOR=1.90; 95% CI=1.22-2.95), unstable housing (aOR=1.80; 95% CI=1.21-2.67), and sex work (aOR=2.48; 95% CI=1.24-4.95). Substance use and SUD treatment among transgender adults are associated with demographic, gender-related, mental health, and socio-structural risk factors. Studies are warranted that identify SUD treatment barriers, and integrate SUD treatment with psychosocial and structural interventions for a diverse spectrum of transgender adults. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Drug and alcohol dependence 04/2015; 152. DOI:10.1016/j.drugalcdep.2015.04.008 · 3.42 Impact Factor
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    • "The high comorbidity rate of Substance Use Disorders (SUD) with other mental health disorders has been highlighted in a number of trials conducted in clinical samples and in general population (Grant et al., 2004; Kessler et al., 1994; Kessler et al., 1996; Regier et al., 1990; Swendsen and Merikangas, 2000). The link between heroin addiction and bipolar disorder is generally accepted both in inpatient and outpatient settings (Maremmani Contents lists available at ScienceDirect journal homepage: "
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    ABSTRACT: Recent celebrity deaths have been widely reported in the media and turned the public attention to the coexistence of mood, psychiatric and substance-abuse disorders. These tragic and untimely deaths motivated us to examine the scientific and clinical data, including our own work in this area. The self-medication hypothesis states that individuals with psychiatric illness tend to use heroin to alleviate their symptoms. This study examined the correlations between heroin use, mood and psychiatric disorders, and their chronology in the context of dual diagnosis.
    Journal of Affective Disorders 04/2015; 179:156-160. DOI:10.1016/j.jad.2015.03.046 · 3.38 Impact Factor
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    • "For example, acute alcohol consumption reduces anxiety-like behaviors, while withdrawal from alcohol can increase anxiety measures (Valdez et al., 2002; Prediger et al., 2006; McCool et al., 2010; Koob, 2013). Moreover, human epidemiological studies suggest a high degree of comorbidity between anxiety and addiction (Grant et al., 2004; Balogun et al., 2014; Tsai et al., 2014), and this relationship can be effectively recapitulated in animal models (Ciccocioppo et al., 2006; Besheer et al., 2013; Chappell et al., 2013; Butler et al., 2014). Perhaps not surprisingly , pharmacological agents that reduce anxiety-like behaviors are often efficacious at attenuating ethanol consumption (Petrakis et al., 2012; Skelly and Weiner, 2014). "
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    ABSTRACT: The basolateral amygdala (BLA) plays a critical role in the etiology of anxiety disorders and addiction. Pyramidal neurons, the primary output cells of this region, display increased firing following exposure to stressors and it is thought that this increase in excitability contributes to stress responsivity and the expression of anxiety-like behaviors. However, much remains unknown about the underlying mechanisms that regulate the intrinsic excitability of BLA pyramidal neurons. Ex vivo gramicidin perforated patch recordings were conducted in current clamp mode where hyper- and depolarizing current steps were applied to BLA pyramidal neurons to assess the effects of adenosine A2A receptor modulation on intrinsic excitability. Activation of adenosine A2A receptors with the selective A2A receptor agonist CGS-21680 significantly increased the firing rate of BLA pyramidal neurons in rat amygdala brain slices, likely via inhibition of the slow afterhyperpolarization potential. Both of these A2A receptor-mediated effects were blocked by pre-application of a selective A2A receptor antagonist (ZM-241685) or by intra-pipette infusion of a PKA inhibitor, suggesting a postsynaptic locus of A2A receptors on BLA pyramidal neurons. Interestingly, bath application of the A2A receptor antagonist alone significantly attenuated BLA pyramidal cell firing, consistent with a role for tonic adenosine in the regulation of the intrinsic excitability of these neurons. Collectively, these data suggest that adenosine, via activation of A2A receptors, may directly facilitate BLA pyramidal cell output, providing a possible balance for the recently described inhibitory effects of adenosine A1 receptor activation on glutamatergic excitation of BLA pyramidal cells. © The Author 2014. Published by Oxford University Press on behalf of CINP.
    The International Journal of Neuropsychopharmacology 02/2015; 18(6). DOI:10.1093/ijnp/pyv017 · 4.01 Impact Factor
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