Epidemiological Perspectives on Co-Occurring Anxiety Disorder and Substance Use Disorder
Epidemiological Perspectives on Co-Occurring Anxiety Disorder and Substance Use Disorder
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DOI：
10.1007/978-0-387-74290-8_1
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发表时间：
2008-01-01
期刊：
影响因子：
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通讯作者：
Peterson, Jill
中科院分区：
文献类型：
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作者：
Kushner, Matt G.;Krueger, Robert;Peterson, Jill
本章的目的是从流行病学的角度回顾焦虑症与物质使用障碍（SUD）（“共病”）共存的问题。一般来说，流行病学是研究影响特定人群中疾病、伤害和其他健康相关事件的发生、分布、预防和控制的各种因素。典型的流行病学研究的准实验方法比较自然发生组之间的结果率非常适合于共病问题。例如，在有代表性的社区样本中收集的流行病学数据避免了机构/临床样本中共病研究中存在的许多偏见。在分配共病疾病之间的结局状态方面，此类数据也比临床数据更灵活。例如，从流行病学的角度来看，哪种共病被指定为结果，哪种被指定为假定的风险因素，在分析上是任意的。相比之下，临床样本中的结局状态通常是固定的（即，所有SUD治疗患者均患有SUD）。最基本的流行病学问题是，焦虑症或SUD（同样，预测结果安排在分析上是任意的）在多大程度上调节了一个人患另一种疾病的风险。流行病学研究也可以记录早期存在的指标障碍（如焦虑障碍）所导致的后来发展为共病障碍（如SUD）的风险变化。除了量化的有用服务之外，
The purpose of this chapter is to review the issue of anxiety disorders cooccurring with substance use disorders (SUDs)(‘‘co-morbidity’’) from an epidemiological perspective. Generally speaking, epidemiology pertains to the study of the various factors influencing the occurrence, distribution, prevention and control of disease, injury and other health-related events in defined human populations. The quasi-experimental methodology of the typical epidemiological study–contrasting the rates of an outcome between naturally occurring groups–is well suited to the problem of co-morbidity. For instance, epidemiological data collected in representative communitybased samples avoid many of the biases built into studies of co-morbidity in institutional/clinical samples. Such data are also more flexible than are clinical data in assigning the status of outcome between co-morbid disorders. From the epidemiological perspective, for example, which co-morbid disorder is designated as the outcome and which as a putative risk factor is analytically arbitrary. By contrast, outcome status in clinical samples is typically fixed (ie, all SUD treatment patients have an SUD). The most basic epidemiological question asks to what extent having either an anxiety disorder or SUD (again, the predictor-outcome arrangement is analytically arbitrary) modulates one’s risk for the other disorder. Epidemiological studies can also document changes in risk for the later development of a comorbid disorder (eg, SUD) conferred by the earlier presence of an index disorder (eg, anxiety disorder). Beyond the useful service of quantifying the