Indexing the 'dark side of addiction': substance-induced affective symptoms and alcohol use disorders.
Adolescent
Adult
Affective Symptoms
/ psychology
Aged
Aged, 80 and over
Alcoholism
/ psychology
Anxiety
/ psychology
Anxiety Disorders
/ psychology
Bipolar Disorder
/ psychology
Cross-Sectional Studies
Depression
/ psychology
Depressive Disorder
/ psychology
Depressive Disorder, Major
/ psychology
Disease Progression
Female
Humans
Male
Middle Aged
Neuroticism
Retrospective Studies
Severity of Illness Index
Suicidal Ideation
Suicide, Attempted
/ psychology
United States
Young Adult
Affective disorders
American Indians
Mexican Americans
alcohol use disorders
anxiety disorders
comorbidity
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
16
03
2018
revised:
13
06
2018
accepted:
20
08
2018
pubmed:
29
8
2018
medline:
7
3
2020
entrez:
29
8
2018
Statut:
ppublish
Résumé
The emergence of negative affective symptoms during the course of alcohol use disorders (AUDs) (e.g. 'dark side' symptoms) has been suggested theoretically; however, the description of their occurrence is limited. This study operationalized two negative affect symptoms and tested the strength of association between these phenotypes and (1) indicators of the clinical course of the severity of AUD, (2) comorbid Axis I psychiatric disorders, suicidal behaviors and trait neuroticism and (3) whether participants reported drinking to relieve the negative affective symptoms. A retrospective cross-sectional study was used to evaluate associations, using logistic regression, between the two negative affective symptoms and clinical measures of AUD severity and progression as well as comorbidity with other psychiatric disorders and conditions, adjusted for demographic characteristics. US community-based studies. A total of 2568 individuals with AUDs obtained from larger population studies that targeted individuals of European American (n = 1663), Mexican American and American Indian (n = 905) ancestry. Semi-Structured Assessment for the Genetics of Alcoholism was used to ascertain the two 'dark side' phenotypes, clinical diagnoses, the clinical course of AUD and associated symptoms. The two phenotypes were: (1) being anxious or depressed when trying to cut down or stop drinking and (2) experiencing disabling depression for more than 24 hours while drinking. Both phenotypes were found to be rare in mild and moderate use disorder and highly prevalent in severe AUDs. Having an independent anxiety or affective disorder and elevated scores on trait neuroticism were also associated significantly with the occurrence of both symptoms, as was alcohol 'craving', elevated treatment-seeking, suicidal behaviors and drinking to relieve the symptoms. Affective symptoms are common in severe alcohol use disorders are associated with a history of independent affective/anxiety disorders, neuroticism and suicidal behaviors; and may promote further heavy drinking.
Sections du résumé
BACKGROUND AND AIMS
The emergence of negative affective symptoms during the course of alcohol use disorders (AUDs) (e.g. 'dark side' symptoms) has been suggested theoretically; however, the description of their occurrence is limited. This study operationalized two negative affect symptoms and tested the strength of association between these phenotypes and (1) indicators of the clinical course of the severity of AUD, (2) comorbid Axis I psychiatric disorders, suicidal behaviors and trait neuroticism and (3) whether participants reported drinking to relieve the negative affective symptoms.
DESIGN
A retrospective cross-sectional study was used to evaluate associations, using logistic regression, between the two negative affective symptoms and clinical measures of AUD severity and progression as well as comorbidity with other psychiatric disorders and conditions, adjusted for demographic characteristics.
SETTING
US community-based studies.
PARTICIPANTS
A total of 2568 individuals with AUDs obtained from larger population studies that targeted individuals of European American (n = 1663), Mexican American and American Indian (n = 905) ancestry.
MEASUREMENTS
Semi-Structured Assessment for the Genetics of Alcoholism was used to ascertain the two 'dark side' phenotypes, clinical diagnoses, the clinical course of AUD and associated symptoms. The two phenotypes were: (1) being anxious or depressed when trying to cut down or stop drinking and (2) experiencing disabling depression for more than 24 hours while drinking.
FINDINGS
Both phenotypes were found to be rare in mild and moderate use disorder and highly prevalent in severe AUDs. Having an independent anxiety or affective disorder and elevated scores on trait neuroticism were also associated significantly with the occurrence of both symptoms, as was alcohol 'craving', elevated treatment-seeking, suicidal behaviors and drinking to relieve the symptoms.
CONCLUSIONS
Affective symptoms are common in severe alcohol use disorders are associated with a history of independent affective/anxiety disorders, neuroticism and suicidal behaviors; and may promote further heavy drinking.
Identifiants
pubmed: 30153346
doi: 10.1111/add.14431
pmc: PMC6320236
mid: NIHMS1003080
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
139-149Subventions
Organisme : NIDA NIH HHS
ID : R01 DA030976
Pays : United States
Organisme : National Institute of Alcohol Abuse and Alcoholism (NIAAA)
Pays : International
Organisme : NIAAA NIH HHS
ID : R01 AA010201
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA026248
Pays : United States
Organisme : NIAAA NIH HHS
ID : R37 AA010201
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA027316
Pays : United States
Organisme : NIAAA NIH HHS
ID : P60 AA006420
Pays : United States
Informations de copyright
© 2018 Society for the Study of Addiction.
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