The comorbidity of alcoholism with anxiety and depressive disorders in four geographic communities
The comorbidity of alcoholism with anxiety and depressive disorders in four geographic communities
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DOI：
10.1016/s0010-440x(98)90058-x
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发表时间：
1998-07-01
影响因子：
7.3
通讯作者：
Angst, J
中科院分区：
文献类型：
--
作者：
Swendsen, JD;Merikangas, KR;Angst, J
酒精中毒与焦虑和抑郁障碍的合并症在不同地理位置的四项流行病学调查中进行了检查。尽管这些疾病的终生患病率存在差异，但在共病的程度和具体模式上存在很强的跨部位一致性。酒精滥用或依赖的个体通常会经历两到三倍的焦虑和抑郁障碍风险增加。恐惧症通常先于酒精中毒发作，但没有观察到惊恐或抑郁障碍的系统模式。还观察到有关合并症对指数障碍症状的影响的相当大的异质性。虽然共病性焦虑或抑郁障碍的存在始终与酒精滥用或依赖症状的中度增加有关，但酒精中毒与抑郁症状数量的大量增加有关，而恐惧症症状的增加很少或没有增加。研究结果在自我用药假说和这些形式的共病在一般人群的病因异质性方面进行了讨论。版权所有(C) 1998由W.B. Saunders公司。
The comorbidity of alcoholism with anxiety and depressive disorders was examined in four epidemiologic investigations from diverse geographic sites. Despite variability in lifetime prevalence rates for these disorders, there was strong cross-site consistency in the magnitude and specific patterns of comorbidity. Individuals with alcohol abuse or dependence generally experienced a twofold to threefold increased risk of anxiety and depressive disorders. Phobic conditions typically preceded the onset of alcoholism, but no systematic pattern was observed for panic or depressive disorders. Considerable heterogeneity was also observed concerning the impact of comorbid conditions on symptoms of the index disorder. While the presence of comorbid anxiety or depressive disorders was consistently associated with moderate increases in the symptoms of alcohol abuse or dependence, alcoholism was associated with large increases in the number of depressive symptoms and little or no increase in phobic symptoms. The findings are discussed in terms of the self-medication hypothesis and the etiologic heterogeneity of these forms of comorbidity in the general population. Copyright (C) 1998 by W.B. Saunders Company.