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

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

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.nlfunded through the mental health program of the Netherlands Organization for Health Research (ZonMW) and matching funds from participating institutes.H

BACKGROUNDPersons 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.

RESEARCH QUESTIONSWhat 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?

NESDA DESIGN AND SAMPLEDesign:Naturalistic cohort studyAssessments at baseline and after 1, 2, 4, 6, 8 years

Baseline sample:2,981 persons:1979,1002, 18-65 yearsRecruited in community, primary care and mental health care organizations

CIDI-BASED PSYCHOPATHOLOGYAnxiety disorder:Generalized anxiety disorder, social phobia, panic disorder, agoraphobia

Depressive disorder: Major depressive disorder, dysthymia

Alcohol use disorder:Alcohol abuse, alcohol dependence

BASELINE SAMPLE652 healthy controls

356 lifetime anxiety disorder only

557 lifetime depressive disorder only 1416 both lifetime anxiety and depression

ALCOHOL ABUSEOverall p=.43

ALCOHOL DEPENDENCEOverall p

TEMPORAL SEQUENCING ADOverall p

EXAMINED RISK INDICATORSSocio-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 (

RISK INDICATORS AD

Socio-demographicOR95% CIpMale gender2.191.72-2.79

RISK INDICATORS AD

AddictionOR95% CIpSmoking: Former3.132.10-4.66

PRIMARY VS SECONDARY ADPrimary alcohol dependence:Male genderExtraversion

Secondary alcohol dependence:NeuroticismLoneliness

DISCUSSIONAlcohol 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.

DISCUSSIONAddiction-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)

Netherlands Study of Depression and Anxietywww.nesda.nl

funded through the mental health program of the Netherlands Organization for Health Research (ZonMW) and matching funds from participating institutes

THANK YOU FOR YOUR ATTENTION!

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