The impact of comorbid anxiety and depression on alcohol treatment outcomes

Burns, Lucy; Teesson, Maree; O’Neill, Katy

doi:10.1111/j.1360-0443.2005.001069.x

Cited by 165 publications

(127 citation statements)

References 49 publications

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“…Keywords mouse; strain; ethanol; sedation; gene; drinking; swim stress; preference; two-bottle choice There is a strong epidemiological link between stress-related psychiatric disorders and alcoholism. Individuals suffering from depression or anxiety disorders, conditions often associated with stress, are more likely to abuse alcohol and become alcoholic, and tend to respond less well to therapeutic interventions [8,9,29,54]. Moreover, a history of adverse life events positively correlates with increased rates of alcoholism; although, interestingly, a proportion of individuals become abstinent following stress [19,35,46,51].…”

Section: Introductionmentioning

confidence: 99%

Effects of chronic swim stress on EtOH-related behaviors in C57BL/6J, DBA/2J and BALB/cByJ mice

Boyce-Rustay

Janos

Holmes

2008

Behavioural Brain Research

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There is a strong clinical relationship between stress and stress-related disorders and the incidence of alcohol abuse and alcoholism, and this relationship appears to be partly genetic in origin. There are marked strain differences in ethanol (EtOH)-related behaviors and reactivity to stress, but little investigation of the interaction between the two. The present study assessed the effects of chronic exposure to swim stress on EtOH-related behavior in three common inbred strains of mice, C57BL/ 6J, DBA/2J and BALB/cByJ. After establishing baseline (10%) EtOH self-administration in a twobottle free choice test, mice were exposed to daily swim stress for 14 consecutive days and EtOH consumption measured as a percent of baseline both during stress and for 10 days afterwards. A separate experiment examined the effects of 14 days of swim stress on sensitivity to the sedative/ hypnotic effects of an acute injection of 4 g/kg EtOH. Results showed that stress produced a marked and prolonged decrease in EtOH consumption in DBA/2J and BALB/cByJ, but not C57BL/6J mice. By contrast, stress increased sensitivity to the sedative/hypnotic effects of EtOH across all 3 strains. These findings demonstrate that chronic swim stress produces reductions in EtOH self-administration in a strain-dependent manner, and that these effects may be restricted to low-consuming strains. Present data also indicate a dissociation between effects of this stressor on EtOH self-administration and sensitivity to EtOH's sedative/hypnotic effects. In conclusion, strain differences, that are likely in large part genetic in nature, modify the effects of this stressor on EtOH's effects in a behaviorspecific manner. Keywords mouse; strain; ethanol; sedation; gene; drinking; swim stress; preference; two-bottle choice There is a strong epidemiological link between stress-related psychiatric disorders and alcoholism. Individuals suffering from depression or anxiety disorders, conditions often associated with stress, are more likely to abuse alcohol and become alcoholic, and tend to respond less well to therapeutic interventions [8,9,29,54]. Moreover, a history of adverse life events positively correlates with increased rates of alcoholism; although, interestingly, a proportion of individuals become abstinent following stress [19,35,46,51]. These clinic data lend support to the influential hypothesis that stress represent a significant risk factor for alcoholism [12,28]. *Corresponding author: R4N5 AP9A-L018, Abbott Laboratories, 100 Abbott Park Rd, Abbott Park, IL 60064, Ph. +1-847-937-2559, Fax +1-847-938-0072, E-mail: janel.boyce-rustay@abbott.com. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered wh...

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Section: Introductionmentioning

confidence: 99%

Effects of chronic swim stress on EtOH-related behaviors in C57BL/6J, DBA/2J and BALB/cByJ mice

Boyce-Rustay

Janos

Holmes

2008

Behavioural Brain Research

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“…Although these disorders are often conceptualized as belonging to distinct classes of psychopathology (e.g., Krueger et al, 2002), epidemiologic studies of pastyear diagnoses of AUDs (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]; American Psychiatric Association, 1994) have shown that individuals with an AUD, relative to those without, have 2.3 and 1.9 times greater odds of meeting criteria for major depression and generalized anxiety disorders, respectively (Grant et al, 2004). Further, those with past-year diagnoses of AUDs and a comorbid internalizing disorder, relative to those with AUDs only, receive more care but have greater disability after treatment (Burns et al, 2005). The current study investigated potential shared etiologic mechanisms for AUD and internalizing disorders, which may help explain their co-occurrence and inform intervention efforts.…”

mentioning

confidence: 98%

Brief Report: Cognitive Control Helps Explain Comorbidity Between Alcohol Use Disorder and Internalizing Disorders

Ellingson¹,

Richmond‐Rakerd²,

Slutske³

2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Alcohol use and internalizing problems frequently co-occur. Cognitive control has been implicated in their etiology, but no studies have tested whether this construct helps explain the co-occurrence of these disorders. Method: A total of 1,313 undergraduate students completed assessments of cognitive control, negative emotionality, and symptoms of alcohol use disorder (AUD), depression, and generalized anxiety disorder. Structural equation models examined the extent to which overlap between AUD and internalizing problems was explained by variance specifi c to cognitive control and negative emotionality, as well as variance shared by both constructs. Results: Symptoms of AUD and internalizing disorders were modestly correlated (depression: r = .16; anxiety: r = .14). Variance specifi c to cognitive control explained a signifi cant proportion of the correlation between AUD and both depression and generalized anxiety (depression: 19%; generalized anxiety: 18%), as did variance common to cognitive control and negative emotionality (depression: 24%; generalized anxiety: 31%). Consistent with previous work, variance specifi c to negative emotionality also explained a large and statistically signifi cant proportion of the correlation between AUD and internalizing disorder symptoms. Of note, the residualized correlation for AUD symptom endorsement with both depression and generalized anxiety problems was not statistically significant after accounting for both cognitive control and negative emotionality. Conclusions: This study provides new evidence that cognitive control may help explain the overlap between AUD and internalizing disorders while further supporting the contribution of negative emotionality to this overlap. Results have implications for intervention efforts aimed at reducing comorbid alcohol use disorder and internalizing disorders, as well as general psychopathology. (J. Stud. Alcohol Drugs, 76, 89-94, 2015)

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“…Ein gemeinsames Auftreten von Alkoholabhängigkeit und komorbider Angst bzw. Depression scheint sich negativ auf den Behandlungserfolg im ambulanten Therapiesetting auszuwirken [Burns et al, 2005]. Bisher existieren jedoch nur wenige Untersuchungen und gemischte Befunde in Bezug auf die Auswirkungen komorbiden riskanten Trinkverhaltens auf den Therapieerfolg bzw.…”

Section: Theoretischer Hintergrundunclassified

Häufigkeit und Risikofaktoren des Therapieabbruchs in einer verhaltenstherapeutischen Hochschulambulanz: Der Einfluss von riskantem Alkoholkonsum zu Therapiebeginn

Schawohl¹,

Odenwald²

2018

Verhaltenstherapie

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Hintergrund: Zu Therapieabbrüchen in der ambulanten Verhaltenstherapie und damit verbundenen Risikofaktoren existieren bisher nur wenige und gemischte Ergebnisse. In dieser Studie wurden Risikofaktoren für Therapieabbrüche erfasst und untersucht, ob sich ein riskanter Alkoholkonsum (bei Therapiebeginn) auf die Therapieabbrüche in einer verhaltenstherapeutischen Hochschulambulanz auswirkt. Patienten und Methoden: 178 Patienten wurden unterteilt in a) Completer (reguläre Beendigung der Psychotherapie) und b) Dropouts (vorzeitiger Abbruch). Als Risikofaktoren wurden soziodemografische und klinische Variablen untersucht (z.B. Brief-Symptom-Inventar, Beck-Depressions-Inventar, Alcohol Use Disorders Identification Test (AUDIT) usw.). Ergebnisse: 93 Patienten (52%) schlossen die Psychotherapie regulär ab (Completer), 85 (48%) brachen vorzeitig ab (Dropouts; davon 45 in Probatorik und 40 danach). Die Dropouts waren bei Therapiebeginn älter als die Completer (M = 35,33 vs. M = 29.08 Jahre; p = 0,001), waren häufiger beschäftigt (64 vs. 45%; p = 0,014), hatten häufiger komorbide Diagnosen (55 vs. 34%; p = 0,005), waren stärker psychisch belastet (Global Severity Index: M = 1,25 vs. 1,01; p = 0,007) und wiesen einen riskanteren Alkoholkonsum auf (AUDIT: M = 10,49 vs. M = 5,01; p ≤ 0,001). Das Alkoholkonsum-Verhalten bei Therapiebeginn prädizierte einen vorzeitigen Therapieabbruch (b = 0,11; p = 0,001). Ein riskantes Alkoholkonsum-Verhalten war mit einem Dropout in der Probatorik assoziiert (p = 0,005). Schlussfolgerungen: Ein riskanter Alkoholkonsum ist bei ambulanten Psychotherapiepatienten mit vorzeitigem Therapieabbruch korreliert. Komorbides riskantes Trinkverhalten sollte zu Beginn der ambulanten Psychotherapie erfasst und inhaltlich thematisiert werden.

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The impact of comorbid anxiety and depression on alcohol treatment outcomes

Abstract: Further research is needed to determine the most appropriate model of care for alcohol treatment seekers with comorbid DSM-IV anxiety and/or depression.

Cited by 165 publications

References 49 publications

Effects of chronic swim stress on EtOH-related behaviors in C57BL/6J, DBA/2J and BALB/cByJ mice

Effects of chronic swim stress on EtOH-related behaviors in C57BL/6J, DBA/2J and BALB/cByJ mice

Brief Report: Cognitive Control Helps Explain Comorbidity Between Alcohol Use Disorder and Internalizing Disorders

Häufigkeit und Risikofaktoren des Therapieabbruchs in einer verhaltenstherapeutischen Hochschulambulanz: Der Einfluss von riskantem Alkoholkonsum zu Therapiebeginn

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