Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
Depress Anxiety. 2019 Jun;36(6):522-532. doi: 10.1002/da.22886. Epub 2019 Mar 5.
It is unknown whether social anxiety disorder (SAD) has a unique association with alcohol use disorder (AUD) over and beyond that of other anxiety disorders, how the associations develop over time, and whether the associations are likely to be causal.
Diagnoses of AUD, SAD, generalized anxiety disorder, panic disorder, agoraphobia, and specific phobias were assessed twice using the Composite International Diagnostic Interview among 2,801 adult Norwegian twins. The data were analyzed using logistic regression analyses and multivariate biometric structural equation modeling.
SAD had the strongest association with AUD, and SAD predicted AUD over and above the effect of other anxiety disorders. In addition, SAD was prospectively associated with AUD, whereas other anxiety disorders were not. AUD was associated with a slightly elevated risk of later anxiety disorders other than SAD. Biometric modeling favored a model where SAD influenced AUD compared to models where the relationship was reversed or due to correlated risk factors. Positive associations between AUD and other anxiety disorders were fully explained by shared genetic risk factors.
Unlike other anxiety disorders, SAD plausibly has a direct effect on AUD. Interventions aimed at prevention or treatment of SAD may have an additional beneficial effect of preventing AUD, whereas interventions aimed at other anxiety disorders are unlikely to have a similar sequential effect on AUD.
目前尚不清楚社交焦虑障碍（SAD）是否与酒精使用障碍（AUD）存在独特的关联，超过了其他焦虑障碍的关联，以及这些关联是如何随着时间的推移发展的，以及这些关联是否可能具有因果关系。
在 2801 名挪威成年双胞胎中，使用复合国际诊断访谈两次评估 AUD、SAD、广泛性焦虑障碍、惊恐障碍、广场恐怖症和特定恐惧症的诊断。使用逻辑回归分析和多变量生物计量结构方程模型对数据进行分析。
SAD 与 AUD 的关联最强，并且 SAD 在其他焦虑障碍的影响之外预测 AUD。此外，SAD 与 AUD 存在前瞻性关联，而其他焦虑障碍则没有。AUD 与除 SAD 以外的后期焦虑障碍的风险略有升高有关。生物计量模型倾向于 SAD 影响 AUD 的模型，而不是相反的关系或由于相关的风险因素。AUD 与其他焦虑障碍之间的正相关完全由共同的遗传风险因素解释。
与其他焦虑障碍不同，SAD 可能对 AUD 有直接影响。旨在预防或治疗 SAD 的干预措施可能对预防 AUD 有额外的有益效果，而旨在治疗其他焦虑障碍的干预措施不太可能对 AUD 产生类似的顺序效果。
