1 Alcohol Use and Psychiatric Alcohol Use and Psychiatric Comorbidity: Comorbidity: A Phenotypic perspective A Phenotypic perspective K. Thennarasu, Kathleen K Bucholz and Rosalind J K. Thennarasu, Kathleen K Bucholz and Rosalind J Neuman Neuman Department of Psychiatry, Department of Psychiatry, Washington University School of Medicine, Washington University School of Medicine, St. Louis, MO St. Louis, MO
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1 Alcohol Use and Psychiatric Comorbidity: A Phenotypic perspective K. Thennarasu, Kathleen K Bucholz and Rosalind J Neuman Department of Psychiatry, Washington.
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Alcohol Use and Psychiatric Comorbidity: Alcohol Use and Psychiatric Comorbidity: A Phenotypic perspectiveA Phenotypic perspective
K. Thennarasu, Kathleen K Bucholz and Rosalind J K. Thennarasu, Kathleen K Bucholz and Rosalind J NeumanNeuman
Department of Psychiatry, Department of Psychiatry, Washington University School of Medicine,Washington University School of Medicine,
St. Louis, MOSt. Louis, MO
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ObjectivesObjectives
• To establish homogeneous alcohol user To establish homogeneous alcohol user classes based on comorbidities using latent classes based on comorbidities using latent class analysis.class analysis.
• To validate latent phenotypic classes using To validate latent phenotypic classes using external covariates.external covariates.
• To find similarity between latent phenotypic To find similarity between latent phenotypic classes using multi dimensional scaling. classes using multi dimensional scaling.
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Data SourceData Source• National Epidemiologic Survey on Alcohol and National Epidemiologic Survey on Alcohol and
Related Conditions (NESARC), 2000-2001.Related Conditions (NESARC), 2000-2001.
• NIAAA Alcohol Use Disorder and Associated NIAAA Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV)(AUDADIS-IV)
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• NESARC data were divided in to five discrete groupsNESARC data were divided in to five discrete groups Abstainers No alcohol diagnosis Abuse only Dependence only Abuse and dependence only
• Used the following 9 comorbid diagnosis to determine Used the following 9 comorbid diagnosis to determine latent structure of each of the above groupslatent structure of each of the above groups
Major Depressive Disorder Panic Disorder and Agoraphobia Social Phobia Specific Phobia Generalized Anxiety Disorder Obsessive Compulsive Disorder Antisocial Personality Disorder Nicotine dependence Other drug dependence
Methods* IMethods* I
* All diagnosis are based on DSM IV
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Methods IIMethods II
• External validatorsExternal validators Gender Age Education Ethnicity Mental health scale Physical function scale* Family history of alcohol problem Age at onset of alcohol use* Age at onset of everyday smoking
* Results not shown in this display
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Prevalence of co-morbiditiesPrevalence of co-morbiditiesin each groupin each group
0
10
20
30
40
50
60
MDD Panic Social Phobia SpecificPhobia
Anxity OCD Nicotinedependence
ASPD Otherdependence
Abstainers No alco Dx Abuse Depend Abuse&dep Total
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Model selection: BIC comparisonModel selection: BIC comparison
Two Two ThreeThree FourFour FiveFive sixsix SevenSeven