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The role of mental disorders in the risk and speed of transition to alcohol use disorders among community youth

  • S. Behrendt (a1), K. Beesdo-Baum (a1), P. Zimmermann (a2), M. Höfler (a1), A. Perkonigg (a1), G. Bühringer (a1) (a3), R. Lieb (a2) (a4) and H.-U. Wittchen (a1) (a2)...

Abstract

Background

Among adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are inter-individual differences in the speed of transition from initial alcohol use (AU) to AUD. AUDs are highly co-morbid with other mental disorders. The factors associated with rapid transition from first AU to AUD remain unknown and the role of mental disorders in rapid transitions is unclear. Given this background we examined (1) whether prior anxiety, mood, externalizing and non-alcohol substance use disorders are related to the risk and speed of transition from first AU to DSM-IV alcohol abuse (AA) and alcohol dependence (AD) and (2) whether early age of onset of prior mental disorders (PMDs) is a promoter of rapid transition.

Method

A total of 3021 community subjects (97.7% lifetime AU) aged 14–24 years at baseline were followed up prospectively for up to 10 years. AU and mental disorders were assessed with the DSM-IV/M-CIDI.

Results

Among subjects with lifetime AU, several PMDs, such as specific phobia, bipolar disorder and nicotine dependence, were associated with an increased risk of AUD independent of externalizing disorders. Associations of PMDs with the speed of transition to AUDs were mostly weak and inconsistent. Only social phobia and externalizing disorders were associated with faster transitions to AD even after adjustment for other PMDs. Earlier age of onset of PMD was not associated with rapid transition.

Conclusions

Mental disorders are associated with the risk of AUD. With the possible exception of social phobia and externalizing disorders, they do not promote rapid transition, even if they occur particularly early. Future research needs to identify factors relevant to rapid transition to AUD.

Copyright

Corresponding author

*Address for correspondence: S. Behrendt, Ph.D., Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany. (Email: silke.behrendt@psychologie.tu-dresden.de)

References

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Acarturk, C, de Graaf, R, van Straten, A, ten Have, M, Cuijpers, P (2008). Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking. A population-based study. Social Psychiatry and Psychiatric Epidemiology 43, 273279.
Beesdo, K, Bittner, A, Pine, DS, Stein, MB, Höfler, M, Lieb, R, Wittchen, H-U (2007). Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Archives of General Psychiatry 64, 903912.
Beesdo, K, Pine, DS, Lieb, R, Wittchen, H-U (2010). Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Archives of General Psychiatry 67, 4757.
Behrendt, S, Wittchen, H-U, Höfler, M, Lieb, R, Beesdo, K (2009). Transitions from first substance use to substance use disorders in adolescence: is early onset associated with a rapid escalation? Drug and Alcohol Dependence 99, 6878.
Bittner, A, Goodwin, RD, Wittchen, H-U, Beesdo, K, Höfler, M, Lieb, R (2004). What characteristics of primary anxiety disorders predict subsequent major depressive disorder? Journal of Clinical Psychiatry 65, 618626.
Blazer, DG, Kessler, RC, McGonagle, KA, Swartz, MS (1994). The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. American Journal of Psychiatry 151, 979986.
Bonomo, YA, Bowes, G, Coffey, C, Carlin, JB, Patton, GC (2004). Teenage drinking and the onset of alcohol dependence: a cohort study over seven years. Addiction 99, 15201528.
Brückl, TM, Wittchen, H-U, Höfler, M, Pfister, H, Schneider, S, Lieb, R (2007). Childhood separation anxiety and the risk of subsequent psychopathology: results from a community study. Psychotherapy and Psychosomatics 76, 4756.
Buckner, JD, Schmidt, NB, Lang, AR, Small, JW, Schlauch, RC, Lewinsohn, PM (2008 a). Specificity of social anxiety disorder as a risk factor for alcohol and cannabis dependence. Journal of Psychiatric Research 42, 230239.
Buckner, JD, Timpano, KR, Zvolensky, MJ, Sachs-Ericsson, N, Schmidt, NB (2008 b). Implications of comorbid alcohol dependence among individuals with social anxiety disorder. Depression and Anxiety 25, 10281037.
Buckner, JD, Turner, RJ (2009). Social anxiety disorder as a risk factor for alcohol use disorders: a prospective examination of parental and peer influences. Drug and Alcohol Dependence 100, 128137.
Burns, L, Teesson, M (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence 68, 299307.
Crum, RM, Green, KM, Storr, CL, Chan, Y-F, Ialongo, N, Stuart, EA, Anthony, JC (2008 a). Depressed mood in childhood and subsequent alcohol use through adolescence and young adulthood. Archives of General Psychiatry 65, 702712.
Crum, RM, Pratt, LA (2001). Risk of heavy drinking and alcohol use disorders in social phobia: a prospective analysis. American Journal of Psychiatry 158, 16931700.
Crum, RM, Storr, CL, Ialongo, N, Anthony, JC (2008 b). Is depressed mood in childhood associated with an increased risk for initiation of alcohol use during early adolescence? Addictive Behaviors 33, 2440.
de Graaf, R, Bijl, RV, Spijker, J, Beekman, ATF, Vollebergh, WAM (2003). Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders. Findings from the Netherlands Mental Health Survey and Incidence Study. Social Psychiatry and Psychiatric Epidemiology 38, 111.
DeWit, DJ, Adlaf, EM, Offord, DR, Ogborne, AC (2000). Age at first alcohol use: a risk factor for the development of alcohol disorders. American Journal of Psychiatry 157, 745750.
Dubow, EF, Boxer, P, Huesmann, LR (2008). Childhood and adolescent predictors of early and middle adulthood alcohol use and problem drinking: the Columbia County Longitudinal Study. Addiction 103, 3647.
Elkins, IJ, McGue, M, Iacono, WG (2007). Prospective effects of attention-deficit/hyperactivity disorder, conduct disorder, and sex on adolescent substance use and abuse. Archives of General Psychiatry 64, 11451152.
Fehm, L, Beesdo, K, Jacobi, F, Fiedler, A (2008). Social anxiety disorder above and below the diagnostic threshold: prevalence, comorbidity and impairment in the general population. Social Psychiatry and Psychiatric Epidemiology 43, 257265.
Gilman, SE, Abraham, HD (2001). A longitudinal study of the order of onset of alcohol dependence and major depression. Drug and Alcohol Dependence 63, 277286.
Goodwin, RD, Lieb, R, Höfler, M, Pfister, H, Bittner, A, Beesdo, K, Wittchen, HU (2004). Panic attack as a risk factor for severe psychopathology. American Journal of Psychiatry 161, 22072214.
Grant, BF, Dawson, DA, Stinson, FS, Chou, SP, Dufour, MC, Pickering, RP (2004 a). The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug and Alcohol Dependence 74, 223234.
Grant, BF, Hasin, DS, Dawson, DA (1996). The relationship between DSM-IV alcohol use disorders and DSM-IV major depression: examination of the primary-secondary distinction in a general population sample. Journal of Affective Disorders 38, 113128.
Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Dufour, MC, Compton, W, Pickering, RP, Kaplan, K (2004 b). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders. Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 807816.
Hammen, C, Brennan, PA, Keenan-Miller, D, Herr, NR (2008). Early onset recurrent subtype of adolescent depression: clinical and psychosocial correlates. Journal of Child Psychology and Psychiatry 49, 433440.
Hasin, DS, Stinson, FS, Ogburn, E, Grant, BF (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States. Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 64, 830842.
Hayatbakhsh, MR, McGee, TR, Bor, W, Najman, JM, Jamrozik, K, Mamun, AA (2008). Child and adolescent externalizing behavior and cannabis use disorders in early adulthood: an Australian prospective birth cohort study. Addictive Behaviors 33, 422438.
Haynes, JC, Farrell, M, Singleton, N, Meltzer, H, Araya, R, Lewis, G, Wiles, NJ (2005). Alcohol consumption as a risk factor for anxiety and depression. Results from the longitudinal follow-up of the National Psychiatric Morbidity Survey. British Journal of Psychiatry 187, 544551.
Hingson, RW, Heeren, T, Winter, MR (2006). Age of alcohol-dependence onset: associations with severity of dependence and seeking treatment. Pediatrics 118, 755763.
John, U, Meyer, C, Rumpf, HJ, Hapke, U (2004). Self-efficacy to refrain from smoking predicted by major depression and nicotine dependence. Addictive Behaviors 29, 857866.
Keenan-Miller, D, Hammen, CL, Brennan, PA (2007). Health outcomes related to early adolescent depression. Journal of Adolescent Health 41, 256262.
Kendler, KS, Prescott, CA, Myers, J, Neale, MC (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry 60, 929937.
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.
King, SM, Iacono, WG, McGue, M (2004). Childhood externalizing and internalizing psychopathology in the prediction of early substance use. Addiction 99, 15481559.
Kliegel, M, Ropeter, A, Mackinlay, R (2006). Complex prospective memory in children with ADHD. Child Neuropsychology 12, 407419.
Krueger, RF (1999). The structure of common mental disorders. Archives of General Psychiatry 56, 921926.
Kushner, MG, Sher, KJ, Erickson, DJ (1999). Prospective analysis of the relation between DSM-III anxiety disorders and alcohol use disorders. American Journal of Psychiatry 156, 723732.
Lachner, G, Wittchen, H-U, Perkonigg, A, Holly, A, Schuster, P, Wunderlich, U, Türk, D, Garczynski, E, Pfister, H (1998). Structure, content and reliability of the Munich Composite International Diagnostic Interview (M-CIDI) substance use sections. European Addiction Research 4, 2841.
Lieb, R, Isensee, B, von Sydow, K, Wittchen, H-U (2000). The Early Developmental Stages of Psychopathology Study (EDSP): a methodological update. European Addiction Research 6, 170182.
McGue, M, Iacono, WG (2008). The adolescent origins of substance use disorders. International Journal of Methods in Psychiatric Research 17 (Suppl. 1), S30S38.
Nelson, CB, Wittchen, H-U (1998). DSM-IV alcohol disorders in a general population sample of adolescents and young adults. Addiction 93, 10651077.
Pitkänen, T, Kokko, K, Lyyra, A-L, Pulkkinen, L (2008). A developmental approach to alcohol drinking behaviour in adulthood: a follow-up study from age 8 to age 42. Addiction 103, 4868.
Poelen, EAP, Scholte, RHJ, Engels, RCME, Boomsma, DI, Willemsen, G (2005). Prevalence and trends of alcohol use and misuse among adolescents and young adults in the Netherlands from 1993 to 2000. Drug and Alcohol Dependence 79, 413421.
Ramsawh, HJ, Stein, MB, Belik, SL, Jacobi, F, Sareen, J (2009). Relationship of anxiety disorders, sleep quality, and functional impairment in a community sample. Journal of Psychiatric Research 43, 926933.
Randall, CL, Roberts, JS, Del Boca, FK, Carroll, KM, Connors, GJ, Mattson, ME (1999). Telescoping of landmark events associated with drinking: a gender comparison. Journal of Studies on Alcohol 60, 252260.
Reed, V, Gander, F, Pfister, H, Steiger, A, Sonntag, H, Trenkwalder, C, Sonntag, A, Hundt, W, Wittchen, H-U (1998). To what degree does the Composite International Diagnostic Interview (CIDI) correctly identify DSM-IV disorders? Testing validity issues in a clinical sample. International Journal of Methods in Psychiatric Research 7, 142155.
Rehm, J, Taylor, B, Room, R (2006). Global burden of disease from alcohol, illicit drugs, and tobacco. Drug and Alcohol Review 25, 503513.
Royall, RM (1986). Model robust confidence intervals using maximum likelihood estimators. Statistical Review 54, 221226.
Sansone, RA, Sansone, LA (2009). Early- versus late-onset dysthymia: a meaningful clinical distinction? Psychiatry (Edgmont) 6, 1417.
Sihvola, E, Rose, RJ, Dick, DM, Pulkkinen, L, Marttunen, M, Kaprio, J (2008). Early-onset depressive disorders predict the use of addictive substances in adolescence: a prospective study of adolescent Finnish twins. Addiction 103, 20452053.
StataCorp (2009). Stata Statistical Software: Release 11.0. StataCorp LP: College Station, TX.
Stinson, FS, Dawson, DA, Chou, SP, Smith, A, Goldstein, RB, Ruan, WJ, Grant, BF (2007). The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine 37, 10471059.
Sung, M, Erkanli, A, Angold, A, Costello, EJ (2004). Effects of age at first substance use and psychiatric comorbidity on the development of substance use disorders. Drug and Alcohol Dependence 75, 287299.
Therneau, T, Grambsch, P (2000). Modeling Survival Data: Extending the Cox Model. Springer: New York.
Thomas, SE, Randall, CL, Carrigan, MH (2003). Drinking to cope in socially anxious individuals: a controlled study. Alcoholism, Clinical and Experimental Research 27, 19371943.
van Zundert, RMP, van Der Vorst, H, Vermulst, AA, Engels, RCME (2006). Pathways to alcohol use among Dutch students in regular education and education for adolescents with behavioral problems: the role of parental alcohol use, general parenting practices, and alcohol specific parenting practices. Journal of Family Psychology 20, 456467.
Wagner, FA, Anthony, JC (2002). From first drug use to drug dependence: developmental periods of risk for dependence upon marijuana, cocaine, and alcohol. Neuropsychopharmacology 26, 479488.
Wagner, FA, Anthony, JC (2007). Male-female differences in the risk of progression from first use to dependence upon cannabis, cocaine and alcohol. Drug and Alcohol Dependence 86, 191198.
Wilhelm, K, Mitchell, P, Slade, T, Brownhill, S, Andrews, G (2003). Prevalence and correlates of DSM-IV major depression in an Australian national survey. Journal of Affective Disorders 75, 155162.
Wittchen, H-U, Behrendt, S, Höfler, M, Perkonigg, A, Lieb, R, Bühringer, G, Beesdo, K (2008). What are the high risk periods for incident substance use and transitions to abuse and dependence? Implications for early intervention and prevention. International Journal of Methods in Psychiatric Research 17, 1629.
Wittchen, H-U, Lachner, G, Wunderlich, U, Pfister, H (1998 a). Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Social Psychiatry and Psychiatric Epidemiology 33, 568578.
Wittchen, H-U, Lieb, R, Schuster, P, Oldehinkel, AJ (1999 a). When is onset? Investigations into early developmental stages of anxiety and depressive disorders. In Childhood Onset of ‘Adult’ Psychopathology, Clinical and Research Advances (ed. Rapoport, J. L.), pp. 259302. American Psychiatric Press: Washington, DC.
Wittchen, H-U, Nelson, CB, Lachner, G (1998 b). Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Medicine 28, 109126.
Wittchen, H-U, Perkonigg, A, Lachner, G, Nelson, CB (1998 c). Early Developmental Stages of Psychopathology Study (EDSP): objectives and design. European Addiction Research 4, 1827.
Wittchen, H-U, Pfister, H (1997). Instruction Manual for the DIA-X-Interview [in German]. Swets & Zeitlinger: Frankfurt.
Wittchen, H-U, Semmler, G (1990). Composite International Diagnostic Interview (CIDI). Beltz: Weinheim.
Wittchen, HU, Stein, MB, Kessler, RC (1999 b). Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and co-morbidity. Psychological Medicine 29, 309323.
Zimmermann, P, Wittchen, H-U, Pfister, H, Kessler, RC, Lieb, R (2003). Primary anxiety disorders and the development of subsequent alcohol use disorder: a 4-year community study of adolescents and young adults. Psychological Medicine 33, 12111222.
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