Comorbidity of Alcohol Dependence with Anxiety or Mood Disorders: Relationship with Age of Onset

Authors

• JP Amodio
• ML Schwandt
• M Farokhnia
• MR Lee
• LA Farinelli
• L Leggio

Abstract

Psychiatric disorders and alcohol dependence (AD) commonly occur together. The reasons for comorbidity are complex and the temporal sequence of disease onset may play an important role. Data on the chronology of anxiety/AD comorbidity suggests that anxiety often precedes the onset of AD. Conversely, for depression and AD, the AD typically precedes the onset of depression. In a sample of AD individuals who also received a diagnosis of an anxiety or mood disorder, we examined the temporal relationship between the development of anxiety disorders and AD as well as the onset of depressive disorders and AD. We examined 269 consecutive admissions of civilian treatment and non-treatment seeking AD individuals enrolled in the NIAAA clinical program from 2009-2013. We found that in our sample of alcoholic individuals with comorbid psychiatric disorders, anxiety disorders tended to precede the onset of AD and mood disorders tended to occur after the AD onset. This suggests that anxiety disorders drive later AD and AD precipitates future mood symptoms. We also found that the groups in our study defined by temporal relationship of disorder onset differed in several alcohol-related outcomes. For example, the Family Score from the Alcohol Severity Index was significantly different between the four groups, and the group with AD preceding a mood disorder had the highest score (indicating more family-related problems). Altogether, these findings suggest that mood disorders might have a greater environmental basis than anxiety disorders, and individuals with stressful family environments are more susceptible to AD and later mood disorders.

Scientific Focus Area: Epidemiology

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