title: The prevalence and clinical implications of self-medication among individuals with anxiety disorders.
abstract: Alcohol dependence (AD) is more likely to occur among individuals with rather than without an anxiety disorder. Self-medication theory (SMT) holds that drinking behavior is negatively reinforced when alcohol temporarily reduces anxiety and that the resulting escalation of drinking increases the risk for AD. We set out to empirically scrutinize SMT using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) dataset. We found that only a minority (about 20%) of anxiety disordered individuals endorsed drinking to control anxiety symptoms. This minority drank more alcohol, had a higher cross-sectional rate of AD, and was at higher risk for developing new AD over four years compared to anxiety disordered non-self-medicators and individuals with no anxiety disorder. Consistent with SMT, increased prospective risk for AD among self-medicators is partially mediated by an increased level of alcohol use. Understanding the processes that promote and inhibit self-medication should be a priority for anxiety disorder researchers.
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States.
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Menary
authors.forename: Matt G
authors.initials: MG
authors.lastname: Kushner
authors.forename: Eric
authors.initials: E
authors.lastname: Maurer
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D012651:Self Medication / Q000523:psychology / Q000706:statistics & numerical data*