Farmer Richard F, Seeley John R, Kosty Derek B, Gau Jeff M, Duncan Susan C, Sher Kenneth J, Lewinsohn Peter M
Oregon Research Institute, Eugene, Oregon.
Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, Oregon.
J Stud Alcohol Drugs. 2017 Mar;78(2):222-231. doi: 10.15288/jsad.2017.78.222.
Emotional disorders and alcohol use disorders (AUDs) frequently demonstrate significant 12-month and lifetime comorbid associations. This comorbidity has been incorporated into influential theories of addiction processes that posit direct or indirect causal associations between these disorder categories. There is currently no consensus, however, about the sequencing of these disorders. In this research, longitudinal data from a regionally representative community sample were used to evaluate whether emotional disorders constitute a proximal antecedent, concomitant, or short-term consequence of first episode (or index) AUDs.
Participants were 131 persons with index AUD episodes lasting 12 months or more and 131 matched controls. For each participant with an AUD, the presence or absence of an emotional disorder was coded for three time intervals: (a) the 12 months preceding full syndrome AUD episode onset; (b) the last 12 months of the AUD episode; and (c) the 12 months following complete symptom AUD episode offset. These intervals, referenced to participant age, were matched to those of control participants, and emotional disorder rate comparisons subsequently performed both within and between groups.
Findings indicated an absence of significant within- or between-subject differences in emotional disorder rates, suggesting that the association between AUDs and emotional disorders is neither directional nor systematic. There was also no indication that the length of the AUD episode increased risk for an emotional disorder in the year following AUD offset.
Overall, this research suggests that emotional disorders are generally independent events in relation to the index AUD episode.
情绪障碍与酒精使用障碍（AUDs）常常表现出显著的12个月和终生共病关联。这种共病情况已被纳入成瘾过程的有影响力的理论中，这些理论假定这些障碍类别之间存在直接或间接的因果关联。然而，目前对于这些障碍的先后顺序尚无共识。在本研究中，来自具有区域代表性的社区样本的纵向数据被用于评估情绪障碍是否构成首次发作（或索引）AUDs的近端前因、伴随因素或短期后果。
参与者包括131名患有持续12个月或更长时间的索引AUD发作的人以及131名匹配的对照组。对于每一名患有AUD的参与者，在三个时间间隔内对情绪障碍的存在与否进行编码：（a）AUD综合征完全发作前的12个月；（b）AUD发作的最后12个月；以及（c）AUD症状完全缓解后的12个月。这些与参与者年龄相关的时间间隔与对照组参与者的时间间隔相匹配，随后在组内和组间进行情绪障碍发生率比较。
研究结果表明，在情绪障碍发生率方面，受试者内部或之间均无显著差异，这表明AUDs与情绪障碍之间的关联既无方向性也无系统性。也没有迹象表明AUD发作的时长会增加AUD缓解后一年内出现情绪障碍的风险。
总体而言，本研究表明，相对于索引AUD发作，情绪障碍通常是独立事件。
