Co-occurrence patterns of anxiety, depression and alcohol use disorders
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Co-occurrence of anxiety and depressive symptoms with alcohol consumption/abuse was analyzed in a sample of 2,302 adults in Bahia, Brazil. A cross-sectional household survey collected self-reported information on social and personal health, as well as individual psychological status, with standardized techniques and trained examiners. Twelve-month prevalence was 15% for anxiety, 12% for depressive disorders and 7% for alcohol abuse/dependence. Symptom co-occurrence was more frequent for depression (94% of cases co-occurring with other diagnoses), followed by anxiety disorders (82%), and alcoholism (only 20%). There was a 74% proportion of anxiety symptoms among depressed, and a 61% proportion of depressed among anxiety sufferers. The combination of depression plus anxiety was the most prevalent in both gender groups, ranging from 17% for women to 5% for men. Comorbid combinations of alcoholism yielded low prevalences, the smallest (around 1%) being the triple combo alcoholism+anxiety+depression. Gender ratios increased substantially in the absence of comorbidity, reaching peaks in depression (F:M ratio = 13.8) and alcoholism (M:F ratio = 11.8). Set component analyses indicate strong overlapping of anxiety and depression and complementarity between depression and alcoholism, modulated by gender (women depressed, men alcoholic).
Keywordscomorbidity anxiety alcoholism depression depressive spectrum
CNPq (National Research Council of Brazil) and CAPES (Commission for Advanced Training of University Personnel) at the Ministry of Education granted Senior Research Fellowships for N.A.F., I.L. and J.J.M. in different moments of the fieldwork, data analysis and manuscript writing. The authors want to thank Diorlene Oliveira for statistical assistance. There are no financial involvements by the authors that may be affected by material in this paper. Data collection for this study was sponsored by the National Epidemiology Center (CENEPI) at the National Health Foundation, Brazilian Ministry of Health. Data analysis was supported by a Pan-American Health Organization/Harvard Center for Society and Health Award for Research on Health Inequalities.
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