Gender-specific effects of comorbid depression and anxiety on the propensity to drink in negative emotional states.
Gender-specific effects of comorbid depression and anxiety on the propensity to drink in negative emotional states.
复制标题
DOI：
10.1111/add.13386
复制
发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Mrazek DA
中科院分区：
文献类型：
--
作者：
Karpyak VM;Biernacka JM;Geske JR;Abulseoud OA;Brunner MD;Chauhan M;Hall-Flavin DK;Lewis KA;Loukianova LL;Melnyk GJ;Onsrud DA;Proctor BD;Schneekloth TD;Skime MK;Wittkopp JE;Frye MA;Mrazek DA
抑郁和焦虑常常与酗酒并存，并导致酗酒和酗酒。我们的目的是估计终生诊断出重度抑郁症（MDD）、物质诱发的抑郁症（SID）、焦虑症（AnxD）和物质诱发的焦虑（SIA）的患病率，这些合并症对消极情绪状态（消极渴望）饮酒倾向的影响，并测试这些影响是否因性别而异。对阿坎酸反应的药物遗传学预测因子的单臂研究中收集的基线数据进行二次分析。美国中西部地区的学术医疗中心和附属社区治疗项目。共有 287 名男性和 156 名女性，年龄在 18-80 岁，符合 DSM-IV 酒精依赖标准。主要结果指标是“在负面情绪情况下饮酒的倾向”（由吸毒情况清单确定），关键预测因子/协变量是性别和精神合并症，包括 MDD、SID、AnxD 和 SIA（由物质和情绪障碍的精神病学研究访谈确定）。与男性相比，女性 MDD、SID 和 AnxD 的患病率较高（分别为 33.1% vs 18.4%、44.8% vs 26.4% 和 42.2 vs 27.4%；均 P < 0.01），而 SIA 很少见（3.3%），并且不存在性别差异。消极情绪情况下饮酒倾向的增加与共病 MDD（β = 6.6，P = 0.013）和 AnxD（β = 4.8，P = 0.042）以及 SID × 性别相互作用效应（P = 0.003）相关，表明 SID 与消极情绪情况下饮酒倾向的关联因性别而异，并且在男性中更强（β = 7.9，P = 0.009）与女性（β = -6.6，P = 0.091）相比。与男性酗酒者相比，女性共病抑郁症和焦虑症以及在消极情绪情况下饮酒的倾向似乎更高。物质引起的抑郁症似乎对男性在消极情绪情况下饮酒的风险增加具有性别特异性影响。
Depression and anxiety are often comorbid with alcoholism and contribute to craving and relapse. We aimed to estimate the prevalence of life‐time diagnoses of major depressive disorder (MDD), substance‐induced depression (SID), anxiety disorder (AnxD) and substance‐induced anxiety (SIA), the effects of these comorbidities on the propensity to drink in negative emotional states (negative craving), and test whether these effects differ by sex. Secondary analyses of baseline data collected in a single‐arm study of pharmacogenetic predictors of acamprosate response. Academic medical center and affiliated community‐based treatment programs in the American upper mid‐west. A total of 287 males and 156 females aged 18–80 years, meeting DSM‐IV criteria for alcohol dependence. The primary outcome measure was ‘propensity to drink in negative emotional situations’ (determined by the Inventory of Drug Taking Situations) and the key predictors/covariates were sex and psychiatric comorbidities, including MDD, SID, AnxD and SIA (determined by Psychiatric Research Interview of Substance and Mood Disorders). The prevalence of the MDD, SID and AnxD was higher in females compared with males (33.1 versus 18.4%, 44.8 versus 26.4% and 42.2 versus 27.4%, respectively; P < 0.01, each), while SIA was rare (3.3%) and did not differ by sex. Increased propensity to drink in negative emotional situations was associated with comorbid MDD (β = 6.6, P = 0.013) and AnxD (β = 4.8, P = 0.042) as well as a SID × sex interaction effect (P = 0.003), indicating that the association of SID with propensity to drink in negative emotional situations differs by sex and is stronger in males (β = 7.9, P = 0.009) compared with females (β = −6.6, P = 0.091). There appears to be a higher prevalence of comorbid depression and anxiety disorders as well as propensity to drink in negative emotional situations in female compared with male alcoholics. Substance‐induced depression appears to have a sex‐specific effect on the increased risk for drinking in negative emotional situations in males.