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Citation
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Karpyak VM, Biernacka JM, Geske JR, Abulseoud OA, Brunner MD, Chauhan M, Hall-Flavin DK, Lewis KA, Loukianova LL, Melnyk GJ, Onsrud DA, Proctor BD, Schneekloth TD, Skime MK, Wittkopp JE, Frye MA, Mrazek DA. Addiction 2016; 111(8): 1366-1375. |
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Affiliation
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Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA. |
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Abstract
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BACKGROUND AND AIMS: Depression and anxiety are often comorbid with alcoholism and contribute to craving and relapse. We aimed to estimate the prevalence of lifetime diagnoses of major depressive disorder (MDD), substance-induced depression (SID), anxiety disorder (AnxD) and substance induced anxiety (SIA), the effects of these comorbidities on the propensity to drink in negative emotional states (negative craving), and test whether these effects differ by sex.
DESIGN: Secondary analyses of baseline data collected in a single-arm study of pharmacogenetic predictors of acamprosate response. SETTING: Academic medical center and affiliated community-based treatment programs in American upper mid-west. PARTICIPANTS: 287 males and 156 females aged 18-80, meeting DSM-IV criteria for alcohol dependence. MEASUREMENTS: The primary outcome measure was "propensity to drink in negative emotional situations" (determined by the Inventory of Drug Taking Situations) and the key predictors/covariates were sex and psychiatric comorbidities including, MDD, SID, AnxD and SIA (determined by Psychiatric Research Interview of Substance and Mood Disorders).
FINDINGS: The prevalence of the MDD, SID, and AnxD was higher in females compared with males (33.1% vs 18.4%, 44.8% vs 26.4%, 42.2% vs 27.4%, respectively; p < 0.01, each), while SIA was rare (3.3%) and did not differ by sex. Increased propensity to drink in negative emotional situations was associated with comorbid MDD (β = 6.6, p = 0.013) and AnxD (β = 4.8, p = 0.042) as well as a SID-by-sex interaction effect (p = 0.003), indicating that the association of SID with propensity to drink in negative emotional situations differs by sex and is stronger in males (β = 7.9, p = 0.009) compared with females (β = -6.6, p = 0.091).
CONCLUSIONS: There appears to be a higher prevalence of comorbid depression and anxiety disorders as well as propensity to drink in negative emotional situations in female compared with male alcoholics. Substance-induced depression appears to have a sex-specific effect on the increased risk for drinking in negative emotional situations in males. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Language: en |