Comorbid Patterns with Alcohol Use Disorders

酒精使用障碍的共病模式

• 批准号: 8016018
• 负责人: Rosa M. Crum
• 金额: $ 36.61万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8016018
• 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

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: Anxiety and mood problems are among the most common mental health disorders worldwide. These problems may increase the chance that other conditions occur such as addictions to alcohol. Using information gathered from one of the largest surveys to evaluate the presence of these symptoms among residents of the United States, we will study these relationships by different groups, in order to help understand if some individuals are more or less vulnerable to these conditions. This study aims to evaluate the complex relationships that may be occurring between mood, anxiety and drinking behavior with the hope that understanding these relationships better will help us identify improved methods for preventing and intervening with these conditions.

描述(申请人提供)：本次修订的R01申请是对计划公告(PA-07-071)“现有酒精流行病学数据的二次分析”的回应。该应用程序的总体目标是评估伴有焦虑和情绪状况的酒精使用障碍(AUD)的模式，检查向酒精依赖的过渡是否因特定精神障碍和症状的存在而改变，以及这些模式是否在性别和种族亚群中有所不同。尽管之前的基于人群的研究和临床研究已经提供了酒精以及情绪和焦虑障碍共存的证据，但很少有人评估这些共存的模式，它们与酒精依赖过渡的关系，以及这些模式是否在人群中的特定亚群中有所不同。使用全国酒精及相关疾病流行病学调查(NESARC)数据集，我们建议1)评估AUD与焦虑症状和障碍(惊恐、社交恐惧症、特殊恐惧症和广泛性焦虑障碍)以及2)情绪症状和障碍(严重抑郁、恶劣心境、躁狂和轻躁狂)的共患率、发生率和强度。此外，使用国家纵向酒精流行病学调查(NLAES)的数据，3)我们的目标是评估在NLAES(1991-92)、第一波(2001-02)和第二波NESARC(2004-05)之间的时间间隔内，酗酒和依赖与严重抑郁症的流行率和共存趋势是否发生了变化。使用生存分析，4)我们打算评估年龄是否(A)AUD的开始，(B)过度饮酒的首发症状，和(C)酒精使用的开始因焦虑和情绪状况的存在和类型而不同。利用潜在类别分析，5)我们还旨在检验焦虑和情绪障碍与过度饮酒症状模式的关系，并使用潜在转换分析来评估向酒精依赖转变的模式。此外，对于每个具体目标，我们将审查对这些协会的双向评估。拟议的分析应该会加深我们对酒精、焦虑、情绪症状和障碍的共病模式和关系的理解。评估这些并存情况的模式可能会提高我们识别高危人群的能力，这可能会为早期预防和干预工作提供目标。酒精、情绪和焦虑症共同构成了世界上一些最大的精神和物质使用疾病群体。然而，到目前为止，在一个足够大的样本中审查这些疾病之间的关系(减少潜在的选择偏见)，在一个足够大的样本中提供DSM-IV诊断标准以评估性别和种族-族裔亚群之间潜在的不同联系的能力是相当有限的。拟议的分析应该会填补我们对这些共存条件的理解上的许多空白。公共卫生相关性：焦虑和情绪问题是全球最常见的精神健康障碍之一。这些问题可能会增加其他情况发生的可能性，比如酗酒。使用从最大的调查之一收集的信息来评估这些症状在美国居民中的存在，我们将按不同的群体研究这些关系，以帮助了解一些人是否更容易受到这些疾病的影响。这项研究旨在评估情绪、焦虑和饮酒行为之间可能发生的复杂关系，希望更好地了解这些关系将有助于我们找到更好的方法来预防和干预这些情况。