IMPORTANCE: 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. DESIGN: Prospective study using face-to-face interviews-the National Epidemiologic Survey on Alcohol and Related Conditions. SETTING: Nationally representative survey of the US population. PARTICIPANTS: 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). MAIN OUTCOMES AND MEASURES: 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 AND RELEVANCE: 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.
IMPORTANCE: 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. DESIGN: Prospective study using face-to-face interviews-the National Epidemiologic Survey on Alcohol and Related Conditions. SETTING: Nationally representative survey of the US population. PARTICIPANTS: 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). MAIN OUTCOMES AND MEASURES: 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 AND RELEVANCE: 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: Sarah W Feldstein Ewing; Francesca M Filbey; Lindsay D Chandler; Kent E Hutchison Journal: Alcohol Clin Exp Res Date: 2009-12-17 Impact factor: 3.455
Authors: Kristin L Tomlinson; Susan R Tate; Kristen G Anderson; Denis M McCarthy; Sandra A Brown Journal: Addict Behav Date: 2005-06-21 Impact factor: 3.913
Authors: Duncan B Clark; Michael D De Bellis; Kevin G Lynch; Jack R Cornelius; Christopher S Martin Journal: Drug Alcohol Depend Date: 2003-01-24 Impact factor: 4.492
Authors: Maggie Nellissery; Richard S Feinn; Jonathan Covault; Joel Gelernter; Raymond F Anton; Helen Pettinati; Darlene Moak; Timothy Mueller; Henry R Kranzler Journal: Alcohol Clin Exp Res Date: 2003-09 Impact factor: 3.455
Authors: David S Fink; M Shayne Gallaway; Marijo B Tamburrino; Israel Liberzon; Philip Chan; Gregory H Cohen; Laura Sampson; Edwin Shirley; Toyomi Goto; Nicole D'Arcangelo; Thomas Fine; Philip L Reed; Joseph R Calabrese; Sandro Galea Journal: Prev Sci Date: 2016-04
Authors: Justin J Anker; Miriam K Forbes; Zack W Almquist; Jeremiah S Menk; Paul Thuras; Amanda S Unruh; Matt G Kushner Journal: J Abnorm Psychol Date: 2017-02-09
Authors: Patrick J Hammett; Harry A Lando; Brent C Taylor; Rachel Widome; Darin J Erickson; Anne M Joseph; Barbara Clothier; Steven S Fu Journal: Drug Alcohol Depend Date: 2018-11-02 Impact factor: 4.492
Authors: Stephanie M Gorka; Stewart A Shankman; Thomas M Olino; John R Seeley; Derek B Kosty; Peter M Lewinsohn Journal: Drug Alcohol Depend Date: 2014-05-04 Impact factor: 4.492
Authors: Rosa M Crum; Kerry M Green; Elizabeth A Stuart; Lareina N La Flair; Marc Kealhofer; Andrea S Young; Noa Krawczyk; Kayla N Tormohlen; Carla L Storr; Anika A H Alvanzo; Ramin Mojtabai; Lauren R Pacek; Bernadette A Cullen; Beth A Reboussin Journal: Drug Alcohol Depend Date: 2018-04-10 Impact factor: 4.492