Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment

Smith, Joshua P.; Book, Sarah W.

doi:10.1016/j.addbeh.2009.07.002

Cited by 117 publications

(113 citation statements)

References 15 publications

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…In other words, patients who have anxious complaints or symptoms during or after SUD treatment might carry risks for using various substances to alleviate anxiety symptoms. As Smith and Book reported in their study, GAD interferes with SUD treatment [17]. In Oumete et al's follow-up study, comorbid AD impaired engagement in SUD treatment, and comorbid AD-SUD patients had worse results in functioning and symptom measures when compared with patients with SUD alone.…”

Section: Prognosis In Comorbiditymentioning

confidence: 82%

“…In patients with opiate dependency, Rosen et al found the prevalence of PTSD and generalised anxiety disorder (GAD) as 27.8 and 29.7%, respectively [16]. Smith and Book analysed 56 patients with substance use disorder and postulated that 32% of the patient group met criteria for GAD [17]. Goldner et al made…”

Section: Diagnostic Tools Resultsmentioning

confidence: 99%

“…In all models, individuals use substances in order to reduce their anxiety levels and therefore, in most of the studies evaluating AD-SUD comorbidity, results indicate AD precedes the SUD. Smith and Book found GAD preceding to SUD in their study [17].…”

Section: Development and Maintenance Of Substance Use-anxiety Comorbimentioning

confidence: 99%

See 2 more Smart Citations

Complex Comorbidity of Substance Use Disorders with Anxiety Disorders: Diagnosis and Treatment

Yılmaz¹,

Dılbaz²

2016

New Developments in Anxiety Disorders

View full text Add to dashboard Cite

Substance use disorders is a worldwide public health problem that commonly ocur together with our psychiatric and medical disorders. Along with etiologic origins, prognosis of anxiety disorders intercepts with substance use disorders. Due to overlapping symptoms and complaints, it is always diicult for clinicians to recognise these disorders separately. In addition, selecting the best treatment approach is challenging because of the relative risk for developing anxiety disorders in substance use patients or vice versa. In this chapter, authors are focused on adding new aspects to the clinicians for evaluating, treating and following patients with comorbid substance use disorder and anxiety disorder.

show abstract

Section: Prognosis In Comorbiditymentioning

confidence: 82%

Section: Diagnostic Tools Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Complex Comorbidity of Substance Use Disorders with Anxiety Disorders: Diagnosis and Treatment

Yılmaz¹,

Dılbaz²

2016

New Developments in Anxiety Disorders

View full text Add to dashboard Cite

show abstract

“…The co-occurrence of generalized anxiety disorder (GAD) and alcohol use disorder (AUD) disorder with the rate of comorbidity ranging from 8.3% to 56.2% is well documented [45]. GAD was also found to be a relevant factor among individuals with alcohol use disorder seeking outpatient substance abuse treatment [46].…”

Section: Epidemiological Discussionmentioning

confidence: 99%

Discovering predictors of mental health service utilization with k-support regularized logistic regression

Sidahmed

Prokofyeva

Blaschko

2016

Information Sciences

View full text Add to dashboard Cite

Many epidemiological studies are undertaken with a use of large epidemiological databases, which involves the simultaneous evaluation of a large number of variables. Epidemiologists face a number of problems when dealing with large data sets: multicolinearity (when variables are correlated to each other), confounding factors (when risk factor is correlated with both exposure and outcome variable), and interactions (when the direction or magnitude of an association between two variables differs due to the effect of a third variable). Correct variable selection helps to address these issues and helps to obtain unbiased results. Selection of relevant variables is a complicated and a time consuming task. Flawed variable selection methods still prevail in the scientific literature; there is a need to demonstrate the usability of new algorithms using real data. In this paper we propose to use a novel machine learning method, k-support regularized logistic regression, for discovering predictors of mental health service utilization in the National Epidemiologic Survey for Alcohol and Related Conditions (NESARC). We show that k-support regularized logistic regression yields better prediction accuracy than 1 or 2 regularized logistic regression as well as several baseline methods on this task, and we qualitatively evaluate the top weighted variates. The selected variables are supported by related epidemiological research, and give important cues for public policy.

show abstract

“…6 Rates of unemployment and social isolation are high, 4 as is concomitant alcohol and substance misuse in an attempt to alleviate symptoms. 7 People with GAD have high numbers of general practitioner (GP) visits and secondary care contacts, both because of associated physical/somatic symptoms and because GAD is often comorbid with chronic physical health problems. 8 The 2011 National Institute for Health and Care Excellence (NICE) guidelines entitled Generalised Anxiety Disorder and Panic Disorder (With or Without Agoraphobia) in Adults: Management in Primary, Secondary and Community Care 9 established good evidence for the effectiveness of low-intensity psychological interventions in GAD.…”

Section: Clinical Backgroundmentioning

confidence: 99%

Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological treatments as defined by the National Institute for Health and Care Excellence guidelines

Buszewicz

Cape

Serfaty

et al. 2017

Health Technol Assess

View full text Add to dashboard Cite

Background Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. Objectives To assess clinical effectiveness and cost-effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE-defined low-intensity psychological interventions. Design Participant randomised trial comparing treatment with sertraline with high-intensity CBT for patients with GAD who had not responded to low-intensity psychological interventions. Setting Community-based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. Participants People considered likely to have GAD and not responding to low-intensity psychological interventions identified at review by IAPT psychological well-being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder-7 (GAD-7) anxiety measure were asked to consider involvement in the trial. Inclusion criteria Aged ≥ 18 years, a score of ≥ 10 on the GAD-7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE-defined low-intensity interventions. Exclusion criteria Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing greater distress than GAD, significant dependence on alcohol or illicit drugs, comorbid psychotic disorder, received antidepressants in past 8 weeks or high-intensity psychological therapy in previous 6 months and any contraindications to treatment with sertraline. Randomisation Consenting eligible participants randomised via an independent, web-based, computerised system. Interventions (1) The SSRI sertraline prescribed in therapeutic doses by the patient’s general practitioner for 12 months and (2) 14 (± 2) CBT sessions delivered by high-intensity IAPT psychological therapists in accordance with a standardised manual designed for GAD. Main outcome measures The primary outcome was the Hospital Anxiety and Depression Scale – Anxiety component at 12 months. Secondary outcomes included measures of depression, social functioning, comorbid anxiety disorders, patient satisfaction and economic evaluation, collected by postal self-completion questionnaires. Results Only seven internal pilot participants were recruited against a target of 40 participants at 7 months. Far fewer potential participants were identified than anticipated from IAPT services, probably because PWPs rarely considered GAD the main treatment priority. Of those identified, three-quarters declined participation; the majority (30/45) were reluctant to consider the possibility of randomisation to medication. Limitations Poor recruitment was the main limiting factor, and the trial closed prematurely. Conclusions It is unclear how much of the recruitment difficulty was a result of conducting the trial within a psychological therapy service and how much was possibly a result of difficulty identifying participants with primary GAD. Future work It may be easier to answer this important question by recruiting people from primary care rather than from those already engaged in a psychological treatment service. Trial registration Current Controlled Trials ISCRTN14845583. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 45. See the NIHR Journals Library website for further project information.

show abstract

Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment

Cited by 117 publications

References 15 publications

Complex Comorbidity of Substance Use Disorders with Anxiety Disorders: Diagnosis and Treatment

Complex Comorbidity of Substance Use Disorders with Anxiety Disorders: Diagnosis and Treatment

Discovering predictors of mental health service utilization with k-support regularized logistic regression

Contact Info

Product

Resources

About