Psychological Medicine



Primary anxiety disorders and the development of subsequent alcohol use disorders: a 4-year community study of adolescents and young adults


P. ZIMMERMANN a1, H.-U. WITTCHEN a1, M. HÖFLER a1, H. PFISTER a1, R. C. KESSLER a1 and R. LIEB a1c1
a1 Max-Planck Institute of Psychiatry, Clinical Psychology and Epidemiology, Munich and Technical University of Dresden, Clinical Psychology and Psychotherapy, Dresden, Germany; and Harvard Medical School, Department of Health Care Policy, Boston, MA, USA

Article author query
zimmermann p   [PubMed][Google Scholar] 
wittchen h-u   [PubMed][Google Scholar] 
hofler m   [PubMed][Google Scholar] 
pfister h   [PubMed][Google Scholar] 
kessler r   [PubMed][Google Scholar] 
lieb r   [PubMed][Google Scholar] 

Abstract

Background. Cross-sectional findings in community surveys of adults suggest that adolescent anxiety disorders are strong predictors of the subsequent onset of alcohol use, abuse and dependence. However, prospective data that follow a sample of adolescents into adulthood are needed to confirm these associations.

Method. Baseline and 4-year follow-up data from the EDSP-Study, a prospective community survey of 3021 (2548 at follow-up) adolescents and young adults aged 14 to 24 years at baseline carried out in Munich, were used. DSM-IV anxiety disorders, alcohol use and alcohol use disorders were assessed with the Munich-Composite-International-Diagnostic-Interview (M-CIDI). Multiple logistic regression analysis, controlling for age, gender, other mental disorders, substance use disorders and antisocial behaviour was used to study the associations of baseline anxiety disorders with the subsequent onset and course of alcohol use and alcohol disorders.

Results. Baseline social phobia significantly predicts the onsets of regular use and hazardous use and the persistence of dependence. Panic attacks significantly predict the onsets of hazardous use and abuse as well as the persistence of combined abuse/dependence. Panic disorder significantly predicts the persistence of combined abuse/dependence. Other anxiety disorders do not significantly predict any of the outcomes.

Conclusions. Panic and social phobia are predictors of subsequent alcohol problems among adolescents and young adults. Further studies are needed to investigate the underlying mechanisms and the potential value of targeted early treatment of primary panic and social phobia to prevent secondary alcohol use disorders.


Correspondence:
c1 Dr Roselind Lieb, Max-Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Kraepelinstrasse 2, 80804 München, Germany.


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