Department of Psychiatry, University of Minnesota--Twin Cities Campus, Box 282 2A-West, 2450 Riverside Avenue, Minneapolis, Minnesota 55454, USA.
J Stud Alcohol Drugs. 2011 Nov;72(6):1019-27. doi: 10.15288/jsad.2011.72.1019.
The frequent co-occurrence of alcohol dependence and anxiety disorder is a long-standing clinical conundrum. An underdeveloped perspective on this issue concerns the impact of a co-occurring anxiety disorder on the sequence and developmental course of alcohol-related milestones. Extrapolating from the body of basic science indicating overlap in the neurobiological processes associated with both anxiety disorder and alcohol dependence-particularly those involving the hypothalamic-pituitary-adrenal axis and elements of the amygdala- we hypothesized that anxiety-disordered individuals are vulnerable to the rapid development of alcohol dependence. Specifically, we predicted that the time from pre-dependence alcohol milestones (e.g., age at which regular drinking began) to post-dependence alcohol milestones would be briefer ("telescoped") among those with an anxiety disorder.
Seventy-eight individuals with alcohol dependence who had recently begun a chemical dependency treatment program underwent a diagnostic interview to determine the presence of current anxiety disorders and to establish the age at which several alcohol use and dependence milestones were first achieved.
We found that, compared with others in the sample, anxiety-disordered individuals transitioned significantly more quickly from the time they first began drinking regularly and first began getting drunk regularly to the onset of alcohol dependence, as well as from most pre-dependence alcohol milestones to the point at which their alcohol dependence was most severe.
Individuals with anxiety disorders transition from regular drinking to alcohol dependence more rapidly than do individuals without anxiety disorders. These findings contribute to an improved understanding of the etiology of comorbidity and suggest novel directions for future research.
酒精依赖和焦虑障碍的频繁共病是一个长期存在的临床难题。对此问题的一个欠发达的观点涉及到共病焦虑障碍对酒精相关里程碑的顺序和发展过程的影响。从表明与焦虑障碍和酒精依赖都相关的神经生物学过程重叠的基础科学研究中推断-特别是那些涉及下丘脑-垂体-肾上腺轴和杏仁核的部分-我们假设焦虑障碍个体容易迅速发展为酒精依赖。具体而言，我们预测在有焦虑障碍的个体中，从无依赖期的酒精里程碑（例如，开始定期饮酒的年龄）到依赖期的酒精里程碑的时间会更短（“缩短”）。
78 名最近开始接受化学依赖治疗计划的酒精依赖患者接受了诊断访谈，以确定当前是否存在焦虑障碍，并确定首次达到几种饮酒和依赖里程碑的年龄。
我们发现，与样本中的其他人相比，焦虑障碍个体从首次开始定期饮酒和首次开始定期醉酒到酒精依赖发作的过渡速度明显更快，从大多数无依赖期的酒精里程碑到其酒精依赖最严重的阶段也是如此。
有焦虑障碍的个体从规律饮酒到酒精依赖的转变速度快于没有焦虑障碍的个体。这些发现有助于更好地理解共病的病因，并为未来的研究提供了新的方向。
