Comorbid Alcohol Dependence and Anxiety Disorders: A National Survey

Background. This study examined the patterns of familial aggregation and co-morbidity of alcoholism and anxiety disorders in the relatives of 165 probands selected for alcoholism and/or anxiety disorders compared to those of 61 unaffected controls.Methods. Probands were either selected from treatment settings or at random from the community. DSM-III-R diagnoses were obtained for all probands and their 1053 first-degree relatives, based on direct interview or family history information.Results. The findings indicate that: (1) alcoholism was associated with anxiety disorders in the relatives, particularly among females; (2) both alcoholism and anxiety disorders were highly familial; (3) the familial aggregation of alcoholism was attributable to alcohol dependence rather than to alcohol abuse, particularly among male relatives; and (4) the pattern of co-aggregation of alcohol dependence and anxiety disorders in families differed according to the subtype of anxiety disorder; there was evidence of a partly shared diathesis underlying panic and alcoholism, whereas social phobia and alcoholism tended to aggregate independently.Conclusions. The finding that the onset of social phobia tended to precede that of alcoholism, when taken together with the independence of familial aggregation of social phobia and alcoholism support a self-medication hypothesis as the explanation for the co-occurrence of social phobia and alcoholism. In contrast, the lack of a systematic pattern in the order of onset of panic and alcoholism among subjects with both disorders as well as evidence for shared underlying familial risk factors suggests that co-morbidity between panic disorder and alcoholism is not a consequence of self-medication of panic symptoms. The results of this study emphasize the importance of examining co-morbid disorders and subtypes thereof in identifying sources of heterogeneity in the pathogenesis of alcoholism.

Download Full-text

Family history of alcohol dependence modulates functional neurophysiology in mood/anxiety disorders

Psychological Medicine ◽

10.1017/s003329171200222x ◽

2012 ◽

Vol 43 (7) ◽

pp. 1487-1497 ◽

Cited By ~ 2

Author(s):

Z. Sjoerds ◽

M.-J. van Tol ◽

W. van den Brink ◽

N. J. A. van der Wee ◽

A. Aleman ◽

...

Keyword(s):

Family History ◽

Anxiety Disorders ◽

Alcohol Dependence ◽

Treatment Success ◽

Blood Oxygen Level Dependent ◽

Blood Oxygen Level ◽

Task Load ◽

Mood And Anxiety Disorders ◽

Increased Risk ◽

History Of

BackgroundA family history (FH) of alcohol dependence (AD) not only increases the risk for AD, but is also associated with an increased risk for mood and anxiety disorders. However, it is unknown how a FH of AD affects neural substrates in patients with mood and anxiety disorders. In this study we examined the effects of an alcoholic FH on cognitive and emotional functions in these patients using functional magnetic resonance imaging (fMRI).MethodIn a sample of non-alcoholic patients with depressive and/or anxiety disorders from the Netherlands Study of Depression and Anxiety (NESDA) neuroimaging study, patients with a first-degree FH of AD (FH + ; n = 31) were compared with patients without a FH (FH–; n = 77) on performance and brain activation during visuospatial planning and emotional word encoding. Results were compared with those of healthy controls (HCs) without a FH of AD (n = 31).ResultsFH+ patients performed slower during planning with increasing task load, coupled with stronger blood oxygen level-dependent responses in dorsal prefrontal areas compared with FH− patients and HCs. FH was not associated with performance differences during word encoding, but right insula activation during positive word encoding was present in FH+ patients, comparable with HCs, but absent in FH− patients.ConclusionsThis study demonstrates subtle impairments during planning in FH+ compared with FH− patients and HCs, whereas activation during mood-incongruent stimuli in FH+ patients was similar to HCs but not FH− patients, suggesting that the presence of a FH of AD is a useful marker for the neurophysiological profile in mood/anxiety disorders and possible predictor for treatment success.

Download Full-text

Affective and Anxiety Disorders and their Relationship with Chronic Physical Conditions in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048674.2011.614590 ◽

2011 ◽

Vol 45 (11) ◽

pp. 939-946 ◽

Cited By ~ 32

Author(s):

Maree Teesson ◽

Philip B. Mitchell ◽

Mark Deady ◽

Sonja Memedovic ◽

Tim Slade ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

National Survey ◽

Physical Condition ◽

Service Use ◽

Health And Wellbeing ◽

Physical Conditions ◽

Chronic Physical Conditions ◽

Nationally Representative

Objective: The aim of this study was to report nationally representative data on the prevalence and patterns of 12 month comorbidity of chronic physical conditions (diabetes, asthma, coronary heart disease, stroke, cancer, arthritis) and DSM-IV affective and anxiety disorders in Australian adults. Method: The 2007 National Survey of Mental Health and Wellbeing (NSMHWB) was a nationally representative household survey of 8841 Australian adults (16–85 years) assessing symptoms of ICD-10 mental disorders and the presence of chronic physical conditions. Results: Prevalence of at least one National Health Priority Area chronic physical condition was 32.2% (95%CI = 30.9%–33.5%). Among those with chronic physical conditions 21.9% had an affective or anxiety disorder. Affective and anxiety disorders were more common among people with physical conditions than among people without chronic physical conditions (affective OR 1.5; anxiety OR 1.8). Of those with a 12 month affective or anxiety disorder, 45.6% had a chronic physical condition. Physical disorders were more common in those with an affective or anxiety disorder than among people without an affective or anxiety disorder (affective OR 1.6; anxiety OR 2.0). Disability was high in those with an anxiety disorder, an affective disorder and a physical condition and 43.4% were classified as high service users. Conclusions: Comorbidity between chronic physical conditions and affective and anxiety disorders is widespread and is associated with high levels of disability and service use.

Download Full-text

Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being

The British Journal of Psychiatry ◽

10.1192/bjp.181.4.306 ◽

2002 ◽

Vol 181 (4) ◽

pp. 306-314 ◽

Cited By ~ 122

Author(s):

Gavin Andrews ◽

Tim Slade ◽

Cathy Issakidis

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Anxiety Disorders ◽

National Survey ◽

Well Being ◽

Service Utilisation ◽

Epidemiological Surveys ◽

Common Causes ◽

Symptom Level ◽

Health And Well Being

BackgroundComorbidity in epidemiological surveys of mental disorders is common and of uncertain importance.AimsTo explore the correlates of current comorbidity.MethodData from the Australian National Survey of Mental Health and Well-Being were used to evaluate the relationships between comorbidity, disability and service utilisation associated with particular mental disorders.ResultsThe number of current comorbid disorders predicted disability, distress, neuroticism score and service utilisation. Comorbidity is more frequent than expected, which might be due to the effect of one disorder on the symptom level of another, or to the action of common causes on both. The combination of affective and anxiety disorders was more predictive of disability and service utilisation than any other two or three group combinations. When people nominated their principal disorder as the set of symptoms that troubled them the most, the affective and anxiety disorders together were associated with four-fifths of the disability and service utilisation.ConclusionsTo make clinical interventions more practical, current comorbidity is best reduced to a principal disorder and subsidiary disorders.

Download Full-text