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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    • "Depressive symptoms and other aspects of emotional disturbance have been linked to variability in both stimulant abuse risk and acute AMPH response. Data from clinical studies indicate that a relatively large proportion of individuals with a history of stimulant use disorders (including amphetamines and cocaine) have comorbid symptoms of depression and anxiety (Ross et al. 1988; Grant et al. 2004; Hall et al. 1996; Glasner-Edwards et al. 2010), and there is evidence that some of these symptoms predate the development of substance use disorders in general (Buckner et al. 2013; De Graaf et al. 2003). Furthermore, the severity of depression and anxiety symptoms has been positively associated with both the frequency of methamphetamine use and the severity of methamphetamine dependence (Darke et al. 2008, 2011). "
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    ABSTRACT: Background: Previous research on emotional correlates of individual differences in subjective responses to D-amphetamine has focused on relatively broad personality traits. Yet, emotional functioning is best characterized by several narrow subcomponents, each of which may contribute uniquely to amphetamine response. Here, we examine several specific subdomains of emotional functioning in relation to acute amphetamine response. Method: At a baseline session, healthy stimulant-naive volunteers (N = 97) completed measures of several subdomains of baseline trait emotional functioning and then completed two counterbalanced experimental sessions during which they received a single oral dose of 20 mg D-amphetamine or placebo. Acute subjective drug response measures were completed at repeated intervals before and after drug administration. Data from subjective measures that were significantly modulated by amphetamine were reduced using principal component analysis (amphetamine or placebo) into three higher-order factors of "positive mood," "arousal," and "drug high." Amphetamine did not significantly alter any "negative" subjective states. Separate multiple regression analyses were conducted regressing these three drug factors on baseline trait emotional functioning scales. Results: The combined set of trait emotional functioning indicators accounted for approximately 22 % of the variance in acute amphetamine-induced positive mood changes. Greater anticipatory pleasure and greater anxious distress each uniquely predicted greater amphetamine-induced positive mood. Trait emotional functioning did not significantly predict amphetamine-induced changes in arousal or drug high. Discussion: Emotional traits appear to moderate drug-induced positive mood but not other dimensions of amphetamine effects. Different facets of emotional functioning may differentially modulate amphetamine's subjective effect profile.
    Psychopharmacology 10/2015; 156. DOI:10.1007/s00213-015-4091-y · 3.88 Impact Factor
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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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