Suvi Virtanen1,2, Ralf Kuja-Halkola2, David Mataix-Cols3,4, Nitya Jayaram-Lindström3,4, Brian M D'Onofrio2,5, Henrik Larsson2,6, Christian Rück3,4, Jaana Suvisaari7, Paul Lichtenstein2, Antti Latvala1,2. 1. Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland. 2. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 4. Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden. 5. Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA. 6. School of Medical Sciences, Örebro University, Örebro, Sweden. 7. National Institute for Health and Welfare, Helsinki, Finland.
Abstract
BACKGROUND: Causes of the comorbidity of substance misuse with anxiety-related and depressive disorders (anxiety/depression) remain poorly known. We estimated associations of substance misuse and anxiety/depression in the general population and tested them while accounting for genetic and shared environmental factors. METHODS: We studied individuals born in Sweden 1968-1997 (n = 2 996 398) with follow-up in nationwide register data for 1997-2013. To account for familial effects, stratified analyses were conducted within siblings and twin pairs. Substance misuse was defined as ICD-10 alcohol or drug use disorder or an alcohol/drug-related criminal conviction. Three dimensions of ICD-10 anxiety and depressive disorders and a substance misuse dimension were identified through exploratory factor analysis. RESULTS: Substance misuse was associated with a 4.5-fold (95% CI 4.50-4.58) elevated risk of lifetime generalized anxiety/depression, 4.7-fold (95% CI 4.63-4.82) elevated risk of panic disorder and agora/social phobia, and 2.9-fold elevated risk of phobias/OCD (95% CI 2.82-3.02) as compared to those without substance misuse. The associations were attenuated in within-family analyses but we found elevated risks in monozygotic twin pairs discordant for substance misuse as well as significant non-shared environmental correlations. The association between anxiety/depression and substance misuse was mainly driven by generalized anxiety/depression, whereas other anxiety/depression dimensions had minor or no independent associations with substance misuse. CONCLUSIONS: Substance misuse and anxiety/depression are associated at the population level, and these associations are partially explained by familial liabilities. Our findings indicate a common genetic etiology but are also compatible with a potential partially causal relationship between substance misuse and anxiety/depression.
BACKGROUND: Causes of the comorbidity of substance misuse with anxiety-related and depressive disorders (anxiety/depression) remain poorly known. We estimated associations of substance misuse and anxiety/depression in the general population and tested them while accounting for genetic and shared environmental factors. METHODS: We studied individuals born in Sweden 1968-1997 (n = 2 996 398) with follow-up in nationwide register data for 1997-2013. To account for familial effects, stratified analyses were conducted within siblings and twin pairs. Substance misuse was defined as ICD-10 alcohol or drug use disorder or an alcohol/drug-related criminal conviction. Three dimensions of ICD-10 anxiety and depressive disorders and a substance misuse dimension were identified through exploratory factor analysis. RESULTS: Substance misuse was associated with a 4.5-fold (95% CI 4.50-4.58) elevated risk of lifetime generalized anxiety/depression, 4.7-fold (95% CI 4.63-4.82) elevated risk of panic disorder and agora/social phobia, and 2.9-fold elevated risk of phobias/OCD (95% CI 2.82-3.02) as compared to those without substance misuse. The associations were attenuated in within-family analyses but we found elevated risks in monozygotic twin pairs discordant for substance misuse as well as significant non-shared environmental correlations. The association between anxiety/depression and substance misuse was mainly driven by generalized anxiety/depression, whereas other anxiety/depression dimensions had minor or no independent associations with substance misuse. CONCLUSIONS: Substance misuse and anxiety/depression are associated at the population level, and these associations are partially explained by familial liabilities. Our findings indicate a common genetic etiology but are also compatible with a potential partially causal relationship between substance misuse and anxiety/depression.
Authors: Suvi Virtanen; Ralf Kuja-Halkola; Anna Sidorchuk; Lorena Fernández de la Cruz; Christian Rück; Sebastian Lundström; Jaana Suvisaari; Henrik Larsson; Paul Lichtenstein; David Mataix-Cols; Antti Latvala Journal: JAMA Netw Open Date: 2022-06-01
Authors: Aleksander A Mathé; Pia Steensland; Philippe A Melas; Malin Wirf; Helder André; Nitya Jayaram-Lindström Journal: Sci Rep Date: 2021-06-04 Impact factor: 4.379