title: Origin of the comorbidity of anxiety disorders and alcohol dependence: findings of a general population study.
abstract: A representative general population sample (n = 7,076) was used to study retrospectively and prospectively the nature of the relationship between co-morbid alcohol dependence and anxiety disorders. Four different models were tested: (1) anxiety disorders increase the risk of alcohol dependence; (2) alcohol dependence increases the risk of anxiety disorders; (3) family history or childhood traumatisation increase the risk of both alcohol dependence and anxiety disorders, and (4) comorbid conditions are a separate psychopathological entity. The data show that alcohol dependence does not precede the onset of anxiety disorders, that anxiety disorders do precede the onset of alcohol dependence, that family history is not very likely to be the third factor explaining the elevated comorbidity, and that in women childhood trauma might be partially responsible for the association between both disorders. The data are inconsistent with regard to comorbidity as a distinct psychopathological entity. These findings are of great importance for treatment planning in patients with alcohol dependence and comorbid anxiety disorders.
authors.affiliation: Department of Psychiatry and Institute for Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Loes A
authors.initials: LA
authors.lastname: Marquenie
authors.forename: Annemiek
authors.initials: A
authors.lastname: Schadé
authors.forename: Anton J L M
authors.initials: AJ
authors.lastname: van Balkom
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Wilma
authors.initials: W
authors.lastname: Vollebergh
authors.forename: Richard
authors.initials: R
authors.lastname: van Dyck
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
mesh_terms: D000328:Adult; D017668:Age of Onset; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology