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Friday, August 2, 2013

Lifetime and Current Mood and Anxiety Disorders in Short-Term and Long-Term Abstinent Alcoholics

A high prevalence of comorbid mood and anxiety disorders has been demonstrated in alcoholics. We examined lifetime and current mood and anxiety diagnoses and symptoms in long-term (mean 7.6 years; n = 110) and short-term (mean 10.1 weeks; n = 101) abstinent alcoholics (LTAA and STAA) and nonsubstance abusing controls (NSAC; n = 82). All alcoholics met DSM-IV lifetime alcohol dependence criteria. About half of each alcoholic group had lifetime drug dependence.
Alcohol use was assessed using timeline follow-back methodology, and drug and alcohol use disorders were diagnosed using the AUDADIS-IV. Lifetime and current mood and anxiety disorder diagnoses and symptom counts were gathered using the computerized Diagnostic Interview Schedule.
Over 60% of STAA and LTAA had a lifetime internalizing diagnosis versus about 15% of NSAC, with no difference between STAA and LTAA. The group effect on lifetime diagnoses was independent of comorbid drug dependence or gender and was of comparable size for mood and anxiety disorders. Current diagnoses showed a similar pattern, except that STAA had more current mood diagnoses than LTAA. Excluding individuals with lifetime internalizing diagnoses, alcoholics still had more mood and anxiety symptoms than controls.
(i) The presence of a lifetime mood or anxiety diagnosis or of a current anxiety diagnosis did not differ between STAA and LTAA, suggesting that such diagnoses do not impact one's ability to achieve or maintain abstinence. (ii) Prevalence of mood and anxiety diagnoses was unaffected by presence of a comorbid substance use disorder, and (iii) excluding individuals with a mood or anxiety diagnosis does not eliminate mood and anxiety symptom count differences between groups.

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