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（由申请人提供）：此修订后的R01申请是对“现有酒精流行病学数据的二次分析”项目公告（PA-07-071）的回应。本应用的总体目标是评估伴随焦虑和情绪状况的酒精使用障碍（AUD）的模式，检查特定精神障碍和症状的存在是否改变了向酒精依赖的过渡，以及这些模式是否在性别和种族-民族亚组中有所不同。尽管先前的基于人群的临床研究已经提供了酒精与情绪和焦虑障碍共病发生的证据，但对这些共病的模式、它们与过渡到酒精依赖的关系以及这些模式是否在特定人群中有所不同的评估很少。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（恐慌、社交恐惧症、特定恐惧症和广泛性焦虑障碍）的共病患病率、发病率和关联强度，以及2)情绪症状和障碍（重度抑郁、心境恶劣、躁狂和轻躁狂）。此外，利用国家纵向酒精流行病学调查（NLAES）的数据，我们旨在评估在NLAES（1991-92）和NESARC第1波（2001-02）和第2波（2004-05）之间的间隔时间内，酒精滥用和重度抑郁症依赖的患病率和共病趋势是否发生了变化。通过生存分析，我们打算评估(a) AUD的发病年龄，(b)过度饮酒的首次症状，以及(c)酒精使用的开始年龄是否因焦虑和情绪状况的存在和类型而异。使用潜在类别分析，我们还旨在检查焦虑和情绪障碍与过度酒精使用症状模式的关系，并使用潜在转变分析来评估过渡到酒精依赖的模式。此外，对于每个具体目标，我们将检查这些关联的双向评估。所提出的分析应进一步加深我们对酒精、焦虑和情绪症状和障碍的共病模式和关系的理解。评估这些合并症的模式可能会提高我们识别高风险人群的能力，从而为早期预防和干预工作提供目标。酒精、情绪和焦虑障碍共同构成世界上最大的精神和物质使用状况群体。然而，在以人口为基础的样本（减少潜在的选择偏差）中检查这些条件之间关系的能力，提供DSM-IV诊断标准，在足够大的样本中评估性别和种族-民族亚组之间潜在的不同关联的能力，到目前为止还相当有限。提出的分析应该填补我们对这些共同发生的条件的理解中的许多空白。公共卫生相关性：焦虑和情绪问题是世界上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机会，比如酒精成瘾。利用从最大的调查之一收集的信息来评估美国居民中这些症状的存在，我们将按不同群体研究这些关系，以帮助了解某些人是否更容易受到这些情况的影响。这项研究旨在评估情绪、焦虑和饮酒行为之间可能存在的复杂关系，希望更好地理解这些关系将有助于我们找到预防和干预这些疾病的改进方法。