Alcohol use disorders and the course of depressive and anxiety disorders
van den Brink, Wim
Smit, Johannes H.
Veltman, Dick J.
Beekman, Aartjan T. F.
Diagnosis, Dual (Psychiatry)
SUBSTANCE USE DISORDERS
NATIONAL EPIDEMIOLOGIC SURVEY
The British Journal of Psychiatry, 200, 476 - 484. Cambridge University Press
British Journal of Psychiatry, 200(6), 476 - 84. Royal College of Psychiatrists
British journal of psychiatry, 200(6), 476 - 484. Royal College of Psychiatrists
British Journal of Psychiatry, 200(6), 476 - 484. Royal College of Psychiatrists
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BACKGROUND: Inconsistent findings have been reported on the role of comorbid alcohol use disorders as risk factors for a persistent course of depressive and anxiety disorders. AIMS: To determine whether the course of depressive and/or anxiety disorders is conditional on the type (abuse or dependence) or severity of comorbid alcohol use disorders. METHOD: In a large sample of participants with current depression and/or anxiety (n = 1369) we examined whether the presence and severity of DSM-IV alcohol abuse or alcohol dependence predicted the 2-year course of depressive and/or anxiety disorders. RESULTS: The persistence of depressive and/or anxiety disorders at the 2-year follow-up was significantly higher in those with remitted or current alcohol dependence (persistence 62% and 67% respectively), but not in those with remitted or current alcohol abuse (persistence 51% and 46% respectively), compared with no lifetime alcohol use disorder (persistence 53%). Severe (meeting six or seven diagnostic criteria) but not moderate (meeting three to five criteria) current dependence was a significant predictor as 95% of those in the former group still had a depressive and/or anxiety disorder at follow-up. This association remained significant after adjustment for severity of depression and anxiety, psychosocial factors and treatment factors. CONCLUSIONS: Alcohol dependence, especially severe current dependence, is a risk factor for an unfavourable course of depressive and/or anxiety disorders, whereas alcohol abuse is not.