Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
Level 4 - case-series / case-control
Cross-sectional nationally representative survey
PubMed 16566620 · doi:10.4088/jcp.v67n0211
What was done
Data were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 43,093 noninstitutionalized United States civilian adults aged 18 years and older. Diagnoses of lifetime mood disorders, anxiety disorders, and eight specific drug use disorders (evaluated separately for abuse and dependence) were determined using face-to-face interviews with the structured Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV).
What was found
Associations between specific mood and anxiety disorders and specific drug use disorders were virtually all positive and statistically significant (p < .05). Associations were generally stronger for dependence than for abuse, stronger for mood than anxiety disorders, and in some instances stronger among women than men (p < .05). Large odds ratios were also reported for individuals with comorbid mood and anxiety disorders. Specific numerical prevalence rates and effect sizes were not provided in the abstract.
Why it matters
The study demonstrates pervasive lifetime co-occurrence of mood and anxiety disorders with specific illicit drug use disorders in the general population. It emphasizes that drug treatment and prevention programs should systematically address co-occurring psychiatric conditions and incorporate psychiatric comorbidity into drug disorder phenotypes.
Limits
The cross-sectional design cannot establish causality or determine the temporal sequence of disorder onset. Findings rely on retrospective self-report via structured diagnostic interviews. Institutionalized individuals were excluded, and exact numerical point estimates and confidence intervals are not reported in the abstract.
Cited by
- supports Individuals with co-occurring psychiatric disorders are at an increased risk of developing addiction.