UCLA Department of Psychology, University of California-Los Angeles, 405 Hilgard Ave., LosAngeles, CA 90024, United States.
Addict Behav. 2012 Aug;37(8):982-5. doi: 10.1016/j.addbeh.2012.03.026. Epub 2012 Mar 29.
A large body of epidemiological research indicates that anxiety and mood disorders are highly comorbid with substance use disorders (SUDs). However, longitudinal research regarding their temporal relations is limited. The goal of this study was to assess whether emotional disorders (i.e., anxiety and mood disorders) predict the onset of SUDs, whether SUDs predict the onset of emotional disorders, or both.
The current study used data from baseline assessment (N=627) and four years of follow-up assessments from the NU/UCLA Youth Emotion Project to examine this question.
In line with the self-medication hypothesis of emotional disorder/SUDs comorbidity, anxiety and unipolar mood disorders at baseline assessment were associated with later onsets of SUDs. In particular, social anxiety disorder (SAD) at baseline predicted onset of alcohol use disorders and PTSD predicted the onset of all SUDs. SUDs did not predict any anxiety or unipolar mood disorders with the exception that alcohol use disorders predicted the onset of obsessive compulsive disorder (OCD).
These findings, as well as the clinical implications and future directions for research, are discussed.
大量流行病学研究表明，焦虑症和心境障碍与物质使用障碍（SUD）高度共病。然而，关于它们时间关系的纵向研究有限。本研究旨在评估情绪障碍（即焦虑症和心境障碍）是否预测 SUD 的发病，SUD 是否预测情绪障碍的发病，或者两者兼而有之。
本研究使用了来自 NU/UCLA 青年情绪项目基线评估（N=627）和四年随访评估的数据，来检验这个问题。
与情绪障碍/SUD 共病的自我治疗假说一致，基线评估时的焦虑症和单相心境障碍与后来 SUD 的发病有关。具体而言，社交焦虑障碍（SAD）在基线时预测酒精使用障碍的发病，创伤后应激障碍（PTSD）预测所有 SUD 的发病。SUD 没有预测任何焦虑或单相心境障碍，除了酒精使用障碍预测强迫症（OCD）的发病。
讨论了这些发现，以及对临床的影响和未来研究的方向。
