title: A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence.
abstract: OBJECTIVE
  Mood disorders and alcohol dependence frequently co-occur. Etiologic theories concerning the comorbidity often focus on drinking to self-medicate or cope with affective symptoms. However, there have been few, if any, prospective studies in population-based samples of alcohol self-medication of mood symptoms with the occurrence of alcohol dependence. Furthermore, it is not known whether these associations are affected by treatment or symptom severity.
  
  
  OBJECTIVE
  To evaluate the hypothesis that alcohol self-medication of mood symptoms increases the probability of subsequent onset and the persistence or chronicity of alcohol dependence.
  
  
  METHODS
  Prospective study using face-to-face interviews-the National Epidemiologic Survey on Alcohol and Related Conditions.
  
  
  METHODS
  Nationally representative survey of the US population.
  
  
  METHODS
  Drinkers at risk for alcohol dependence among the 43 093 adults surveyed in 2001 and 2002 (wave 1); 34 653 of whom were reinterviewed in 2004 and 2005 (wave 2).
  
  
  METHODS
  Association of alcohol self-medication of mood symptoms with incident and persistent DSM-IV alcohol dependence using logistic regression and the propensity score method of inverse probability of treatment weighting.
  
  
  RESULTS
  The report of alcohol self-medication of mood symptoms was associated with an increased odds of incident alcohol dependence at follow-up (adjusted odds ratio [AOR], 3.10; 95% CI, 1.55-6.19; P = .002) and persistence of dependence (AOR, 3.45; 95% CI, 2.35-5.08; P < .001). The population-attributable fraction was 11.9% (95% CI, 6.7%-16.9%) for incident dependence and 30.6% (95% CI, 24.8%-36.0%) for persistent dependence. Stratified analyses were conducted by age, sex, race/ethnicity, mood symptom severity, and treatment history for mood symptoms.
  
  
  CONCLUSIONS
  Drinking to alleviate mood symptoms is associated with the development of alcohol dependence and its persistence once dependence develops. These associations occur among individuals with subthreshold mood symptoms, with DSM-IV affective disorders, and for those who have received treatment. Drinking to self-medicate mood symptoms may be a potential target for prevention and early intervention efforts aimed at reducing the occurrence of alcohol dependence.
authors: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. rcrum@jhsph.edu
authors: Rosa M
authors: RM
authors: Crum
authors: Ramin
authors: R
authors: Mojtabai
authors: Samuel
authors: S
authors: Lazareck
authors: James M
authors: JM
authors: Bolton
authors: Jennifer
authors: J
authors: Robinson
authors: Jitender
authors: J
authors: Sareen
authors: Kerry M
authors: KM
authors: Green
authors: Elizabeth A
authors: EA
authors: Stuart
authors: Lareina
authors: L
authors: La Flair
authors: Anika A H
authors: AA
authors: Alvanzo
authors: Carla L
authors: CL
authors: Storr
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D012651:Self Medication / Q000523:psychology*; D014481:United States / Q000453:epidemiology
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