title: Alcohol use, anxiety, and insomnia in older adults with generalized anxiety disorder.
abstract: OBJECTIVE
  To examine alcohol consumption among older primary care patients with generalized anxiety disorder (GAD); its relationship to demographic variables, insomnia, worry, and anxiety; and its moderating role on the anxiety-insomnia relationship. We expected alcohol use to be similar to previous reports, correlate with higher anxiety and insomnia, and worsen the anxiety-insomnia relationship.
  
  
  METHODS
  Baseline data from a randomized controlled trial.
  
  
  METHODS
  Michael E. DeBakey VA Medical Center and Baylor College of Medicine.
  
  
  METHODS
  223 patients, 60 years and older, with GAD.
  
  
  METHODS
  Frequency of alcohol use, insomnia (Insomnia Severity Index), worry (Penn State Worry Questionnaire - Abbreviated, Generalized Anxiety Disorder Severity Scale), and anxiety (State-Trait Anxiety Inventory - Trait subscale, Structured Interview Guide for the Hamilton Anxiety Rating Scale [SIGH-A]).
  
  
  RESULTS
  Most patients endorsed alcohol use, but frequency was low. Presence and frequency were greater than in previous reports of primary care samples. Alcohol use was associated with higher education, female gender, less severe insomnia, and lower worry (Generalized Anxiety Disorder Severity Scale) and anxiety (State-Trait Anxiety Inventory-Trait subscale; SIGH-A). Whites reported more drinks/week than African-Americans. More drinks/week were associated with higher education and lower anxiety (SIGH-A). Weaker relationships between worry/anxiety and insomnia occurred for those drinking. Drink frequency moderated the positive association between the Penn State Worry Questionnaire-Abbreviated and insomnia, which was lower with higher frequency of drinking.
  
  
  CONCLUSIONS
  Older adults with GAD use alcohol at an increased rate, but mild to moderate drinkers do not experience sleep difficulties. A modest amount of alcohol may minimize the association between anxiety/worry and insomnia among this group.
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX.
authors: M Cristina
authors: MC
authors: Ivan
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX.
authors: Amber B
authors: AB
authors: Amspoker
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX.
authors: Michael R
authors: MR
authors: Nadorff
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX.
authors: Mark E
authors: ME
authors: Kunik
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX.
authors: Jeffrey A
authors: JA
authors: Cully
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX.
authors: Nancy
authors: N
authors: Wilson
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX.
authors: Jessica
authors: J
authors: Calleo
authors: Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX.
authors: Cynthia
authors: C
authors: Kraus-Schuman
authors: Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX. Electronic address: mstanley@bcm.edu.
authors: Melinda A
authors: MA
authors: Stanley
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology*; D001007:Anxiety / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000150:complications* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology
keywords: Alcohol use; generalized anxiety disorder; insomnia
references: Am J Geriatr Psychiatry. 2006 Mar;14(3):292
references: 16505134
references: J Consult Clin Psychol. 2003 Apr;71(2):309-19
references: 12699025
references: Am J Geriatr Psychiatry. 2012 Aug;20(8):707-16
references: 22828172
references: Behav Res Ther. 1990;28(6):487-95
references: 2076086
references: Chest. 2005 Apr;127(4):1205-11
references: 15821196
references: J Anxiety Disord. 1997 Jan-Feb;11(1):33-47
references: 9131880
references: Gen Hosp Psychiatry. 2005 Mar-Apr;27(2):100-12
references: 15763121
references: J Gen Intern Med. 2007 Jan;22(1):92-7
references: 17351846
references: Depress Anxiety. 2006;23(2):77-82
references: 16411185
references: Sleep Med Rev. 2001 Aug;5(4):287-297
references: 12530993
references: Med Care. 2002 Sep;40(9):771-81
references: 12218768
references: Am J Psychiatry. 2005 Jan;162(1):146-50
references: 15625213
references: Psychol Assess. 2003 Jun;15(2):173-83
references: 12847777
references: Am J Geriatr Psychiatry. 2011 Jan;19(1):88-97
references: 20808113
references: Addiction. 2009 Aug;104(8):1293-302
references: 19438836
references: Depress Anxiety. 2010 Feb;27(2):190-211
references: 20099273
references: Am J Geriatr Psychiatry. 2005 Feb;13(2):150-6
references: 15703324
references: Am J Geriatr Psychiatry. 2008 Oct;16(10):813-8
references: 18827227
references: Sleep. 1997 May;20(5):370-6
references: 9381061
references: Am J Geriatr Psychiatry. 2011 Mar;19(3):292-9
references: 20808122
references: J Anxiety Disord. 2006;20(8):1036-54
references: 16387472
references: Curr Psychiatry Rep. 2010 Feb;12(1):13-9
references: 20425305
references: Am J Geriatr Psychiatry. 2009 Feb;17(2):136-43
references: 19155746
references: Experientia. 1992 Oct 15;48(10):941-54
references: 1426145
references: J Geriatr Psychiatry Neurol. 2008 Dec;21(4):223-31
references: 19017779
references: JAMA. 1994 Dec 14;272(22):1749-56
references: 7966923
references: J Psychosom Res. 2001 Dec;51(6):745-55
references: 11750297
references: Prog Neurobiol. 1995 Mar;45(4):347-60
references: 7624482
references: JAMA. 2009 Apr 8;301(14):1460-7
references: 19351943
references: Depress Anxiety. 2001;13(4):166-78
references: 11413563
references: Am J Geriatr Psychiatry. 2012 Nov;20(11):963-72
references: 22549369
references: Sleep Med. 2001 Jul;2(4):297-307
references: 11438246
references: Am J Geriatr Psychiatry. 2009 Jun;17(6):465-72
references: 19472436
references: Subst Abus. 2005 Mar;26(1):1-13
references: 16492658
references: Depress Anxiety. 2009;26(1):E10-5
references: 18839400
references: J Stud Alcohol. 1983 May;44(3):515-23
references: 6645531
references: J Consult Clin Psychol. 2003 Feb;71(1):31-40
references: 12602423