Alcohol use disorders and the course of depressive and anxiety disorders.
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.


OBJECTIVE
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.


METHODS
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.
Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands. l.boschloo@ggzingeest.nl
Lynn
L
Boschloo
Nicole
N
Vogelzangs
Wim
W
van den Brink
Johannes H
JH
Smit
Dick J
DJ
Veltman
Aartjan T F
AT
Beekman
Brenda W J H
BW
Penninx
D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000523:psychology; D000437:Alcoholism / Q000523:psychology*; D001008:Anxiety Disorders / Q000209:etiology*; D002908:Chronic Disease; D003866:Depressive Disorder / Q000209:etiology*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult