UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Addiction. 2019 Jun;114(6):968-982. doi: 10.1111/add.14575. Epub 2019 Mar 19.
Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings.
We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later.
Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years.
Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders).
The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87).
Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
尽管有大量文献，但焦虑与饮酒行为之间的关系仍不清楚。我们检验了儿童和青少年时期的焦虑与之后的饮酒行为和障碍是否存在（a）正相关或（b）负相关，以及（b）研究特征是否可以解释结果的不一致性。
我们对来自 11 个国家的 51 项前瞻性队列研究进行了系统综述。有 3 项研究纳入了荟萃分析。我们检索了 PubMed、Scopus、Web of Science 和 PsycINFO 数据库，只有符合以下标准的研究才被纳入：英文发表、人类参与者、儿童或青少年时期的焦虑暴露（预测变量）以及至少 6 个月后出现的酒精结局。
研究样本量从 110 到 11157 人不等。焦虑暴露年龄从 3 岁到 24 岁不等，酒精结局年龄从 11 岁到 42 岁不等。
51 项研究中的 97 项关联根据焦虑暴露情况（广泛性焦虑障碍、内化障碍、其他焦虑障碍、强迫症、惊恐障碍、分离焦虑障碍、社交焦虑障碍和特定恐惧症）和酒精使用结局（饮酒频率/量、 binge drinking 和酒精使用障碍）进行了分类。
叙述性综述结果表明，焦虑与之后的酒精使用障碍之间存在一定程度的正相关证据。焦虑与之后的饮酒频率/量和 binge drinking 的关联并不一致。焦虑的类型和发展阶段、随访时间、样本量以及考虑的混杂因素似乎都无法解释不一致的发现。荟萃分析也没有明确证据表明广泛性焦虑障碍与之后的酒精使用障碍之间存在关联（比值比=0.94，95%置信区间=0.47-1.87）。
迄今为止的证据虽然有提示性，但远不能确定儿童和青少年时期的焦虑与之后的酒精使用障碍之间存在正相关关系。
