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ALCOHOL USE DISORDERS IN PERSONS WITH ANXIETY AND/OR DEPRESSIVE DISORDERS

ALCOHOL USE DISORDERS IN PERSONS WITH ANXIETY AND/OR DEPRESSIVE DISORDERS.

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ALCOHOL USE DISORDERS IN PERSONS WITH ANXIETY AND/OR DEPRESSIVE DISORDERS

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  1. ALCOHOL USE DISORDERS IN PERSONS WITHANXIETY AND/OR DEPRESSIVE DISORDERS 1 Department of Psychiatry, 2 EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, 3 AMC Academic Psychiatric Center, AIAR, Amsterdam, The Netherlands, 4 Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands 5 Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands, *Corresponding author: l.boschloo@vumc.nl Lynn Boschloo, MSc 1,2 *, Nicole Vogelzangs, MSc 1,2, Johannes H. Smit, PhD 1,2, Wim van den Brink, MD, PhD 3, Dick J Veltman, MD, PhD 1,3, Aartjan TF Beekman, MD, PhD 1,2, Brenda WJH Penninx, PhD 1,2,4,5 funded through the mental health program of the Netherlands Organization for Health Research (ZonMW) and matching funds from participating institutes. H

  2. BACKGROUND Persons with anxiety or depressive disorders have an increased risk of comorbid alcohol use disorders, but only few studies distinguish between alcohol abuse and alcohol dependence. Knowledge on risk indicators is limited and inconsistent, with only very few studies distinguishing between primary and secondary alcohol use disorders.

  3. RESEARCH QUESTIONS • What is the comorbidity of alcohol use disorders with anxiety and/or depressive disorders? • What are risk indicators of comorbid alcohol use disorders among anxious and/or depressed persons? • What is the temporal sequencing of disorders? Specific risk indicators?

  4. NESDA DESIGN AND SAMPLE Design: • Naturalistic cohort study • Assessments at baseline and after 1, 2, 4, 6, 8 years Baseline sample: • 2,981 persons:♀1979,♂1002, 18-65 years • Recruited in community, primary care and mental health care organizations

  5. CIDI-BASED PSYCHOPATHOLOGY • Anxiety disorder: Generalized anxiety disorder, social phobia, panic disorder, agoraphobia • Depressive disorder: Major depressive disorder, dysthymia • Alcohol use disorder: Alcohol abuse, alcohol dependence

  6. BASELINE SAMPLE • 652 healthy controls • 356 lifetime anxiety disorder only • 557 lifetime depressive disorder only • 1416 both lifetime anxiety and depression

  7. ALCOHOL ABUSE Overall p=.43

  8. ALCOHOL DEPENDENCE Overall p<.001

  9. TEMPORAL SEQUENCING AD Overall p<.001

  10. EXAMINED RISK INDICATORS Socio-demographic: gender, age, education. Vulnerability: family history (anxiety/depression and alc dep), personality, childhood trauma/life-events, other social factors. Addiction-related: smoking, illicit drug use, benzodiazepine use. Anxiety/depression-related: early (<25 years) onset, duration, severity

  11. RISK INDICATORS AD

  12. RISK INDICATORS AD

  13. PRIMARY VS SECONDARY AD Primary alcohol dependence: Male gender Extraversion Secondary alcohol dependence: Neuroticism Loneliness

  14. DISCUSSION Alcohol dependence, and NOT alcohol abuse, is associated with anxiety/depression. Alcohol dependence is common in persons with anxiety/depression; in persons with anxiety and depression even 1 in 5. Alcohol dependence tends to follow anxiety and/or depressive disorders.

  15. DISCUSSION Addiction-related characteristics and vulnerability are the most important risk indicators of alcohol dependence, with considerable variation depending on temporal sequencing. Screening instrument for alcohol dependence. Cross-sectional data Causality Longitudinal data (NESDA)

  16. THANK YOU FOR YOUR ATTENTION! Netherlands Study of Depression and Anxiety www.nesda.nl funded through the mental health program of the Netherlands Organization for Health Research (ZonMW) and matching funds from participating institutes

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