Comorbid Patterns with Alcohol Use Disorders

酒精使用障碍的共病模式

基本信息

批准号：
8207257
负责人：
Rosa M. Crum
金额：
$ 36.59万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-01-01 至 2014-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8207257
关键词：
African American Age Age of Onset Alcohol abuse Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcohols Anxiety Anxiety Disorders Behavior Characteristics Classification Clinical Clinical Research Complex Conduct Disorder Country DSM-IV Data Data Analyses Data Set Dependence Development Diagnosis Diagnostic Disease Drug usage Dysthymic Disorder Epidemiology Ethnic Origin Event Family Female Gender Generalized Anxiety Disorder Goals Grant Health Health Insurance Hispanics Immigration Incidence Individual Major Depressive Disorder Manic Mediator of activation protein Mental Depression Mental disorders Methods Mexican Americans Mood Disorders Moods NIH Program Announcements National origin Not Hispanic or Latino Outcome Panic Disorder Pathway interactions Pattern Personality Population Prevalence Preventive Intervention Probability Psyche structure Psychiatric Diagnosis Race Raspberries Recording of previous events Relative (related person)Reporting Risk Sample Size Sampling Sampling Studies Selection Bias Social Functioning Social Phobia Specific Phobia Staging Structure Subgroup Substance Use Disorder Surveys Survival Analysis Symptoms Syndrome Techniques Testing Time Tobacco use United States Variant Woman Work addiction alcohol epidemiology alcohol involvement alcohol related problem alcohol use disorder alcohol use initiation disability drinking drinking behavior ethnic minority population high risk hypomania improved information gathering male men population based prevent racial and ethnic response sex time use trend

项目摘要

This revised R01 application is in response to the Program Announcement (PA-07-071) for "Secondary Analysis of Existing Alcohol Epidemiology Data". The overall goals for this application are to assess patterns of alcohol use disorders (AUD) with comorbid anxiety and mood conditions, to examine whether transition to alcohol dependence is altered by the presence of specific psychiatric disorders and symptoms, and if these patterns differ among gender and race-ethnicity subgroups. Although prior population-based and clinical studies have provided evidence for the comorbid occurrence of alcohol and with both mood and anxiety disorders, there have been little assessment of patterns of these co-occurrences, their relationship with transition to alcohol dependence, and whether these patterns differ for specific subgroups of the population. Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) dataset, we propose to 1) assess the comorbid prevalence, incidence and strength of association of AUD with anxiety symptoms and disorders (panic, social phobia, specific phobia and generalized anxiety disorder), and 2) mood symptoms and disorders (major depression, dysthymia, mania, and hypomania). In addition, using data from the National Longitudinal Alcohol Epidemiologic Survey (NLAES), 3) we aim to assess whether prevalence and comorbid trends of alcohol abuse and dependence with major depression have changed during the intervals between the NLAES (1991-92), and with wave 1 (2001-02) and wave 2 NESARC (2004-05). Using survival analyses, 4) we intend to assess whether age of (a) onset of AUD, (b) first symptom of excessive alcohol use, and (c) alcohol use initiation varies by presence and type of anxiety and mood condition. Using latent class analysis, 5) we also aim to examine the relationship of anxiety and mood disorders with patterns of excessive alcohol use symptoms, and using latent transition analyses to 6) assess patterns of transition to alcohol dependence. In addition, 7) for each specific aim, we will examine the bidirectional assessment of these associations. The proposed analyses should further our understanding of the comorbid patterns and relationships of alcohol, anxiety and mood symptoms and disorders. Assessment of patterns of these comorbid conditions potentially will improve our ability to identify high risk groups which may provide targets for early prevention and intervention efforts. Alcohol, mood and anxiety disorders together constitute some of the largest groups of mental and substance use conditions worldwide. Yet, the ability to examine the relationship of these conditions in a population-based sample (reducing potential selection biases), providing DSM-IV diagnostic criteria, within a sample large enough to assess potentially diverse associations among gender and race-ethnicity subgroups until now has been quite limited. The proposed analyses should fill in many gaps in our understanding of these co-occurring conditions.

此修订后的R01申请是响应“次要的计划公告（PA-07-071）对现有酒精流行病学数据的分析”。此应用的总体目标是评估与合并焦虑和情绪状况的酒精使用障碍（AUD），以检查是否过渡到酒精依赖性因特定的精神疾病和症状而改变，如果这些疾病和症状性别和种族种族亚组的模式不同。虽然先前基于人群和临床研究提供了证据证明酒精的合并症以及情绪和焦虑疾病，几乎没有评估这些共发生的模式，它们与过渡到酒精依赖性，以及这些模式是否在人群的特定亚组中有所不同。使用国家酒精和相关条件的国家流行病学调查（NESARC）数据集，我们建议到1）评估合并症的患病率，发病率和与焦虑症状的相关性和疾病（恐慌，社会恐惧症，特定恐惧症和普遍焦虑症），2）情绪症状和疾病（重度抑郁症，心律失常，躁狂和躁狂症）。此外，使用国家的数据纵向酒精流行病学调查（NLAE），3）我们旨在评估患病率和合并症是否酗酒趋势和与重度抑郁症的依赖趋势在间隔之间发生了变化 Nlaes（1991-92），以及Wave 1（2001-02）和Wave 2 Nesarc（2004-05）。使用生存分析，4）我们打算评估（a）aud的年龄，（b）过度饮酒的第一个症状；（c）酒精使用启动随着焦虑和情绪状况的存在而有所不同。使用潜在类分析，5）我们还旨在检查焦虑和情绪障碍与过度饮酒模式的关系症状，并使用潜在的过渡分析到6）评估过渡到酒精依赖的模式。在补充7）对于每个特定目标，我们将检查这些关联的双向评估。这建议的分析应进一步了解我们对酒精的合并模式和关系的理解，焦虑和情绪症状和疾病。可能会评估这些合并条件的模式将提高我们识别高风险群体的能力，这可能为早期预防提供目标和干预工作。酒精，情绪和焦虑症共同构成了一些最大的群体全球精神和物质使用条件。但是，检查这些条件关系的能力在基于人群的样本（减少潜在的选择偏见）中，提供了DSM-IV诊断标准一个足够大的样本可以评估性别和种族子组之间的潜在多样化关联到目前为止一直有限。提议的分析应填补我们对这些分析的理解空白同时出现的条件。