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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: [email protected] through the mental
health program of the Netherlands Organization for Health Research
(ZonMW) and matching funds from participating institutes.H
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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.
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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?
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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
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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
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BASELINE SAMPLE652 healthy controls
356 lifetime anxiety disorder only
557 lifetime depressive disorder only 1416 both lifetime anxiety
and depression
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ALCOHOL ABUSEOverall p=.43
- ALCOHOL DEPENDENCEOverall p
- TEMPORAL SEQUENCING ADOverall p
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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 (
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RISK INDICATORS AD
Socio-demographicOR95% CIpMale gender2.191.72-2.79
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RISK INDICATORS AD
AddictionOR95% CIpSmoking: Former3.132.10-4.66
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PRIMARY VS SECONDARY ADPrimary alcohol dependence:Male
genderExtraversion
Secondary alcohol dependence:NeuroticismLoneliness
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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.
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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)
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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!
*