Don't Blame Substance Use for Mood and Anxiety Disorders
Mood and anxiety disorders produce symptoms similar to those of substance intoxication and withdrawal, and therefore may be difficult to diagnose among patients who use substances. To tease out mood and anxiety disorders that are substance-induced from those that are independent of use, researchers analyzed data from a nationally representative survey of 43,093 adults in the United States.
- The 12-month prevalences of independent mood and anxiety disorders were 9.2% and 11.1%, respectively.
- Less than 1% of adults with a mood or anxiety disorder had episodes that were substance-induced (i.e., episodes that began after withdrawal or intoxication but either were not associated with at least 1 month of abstinence or did not persist for more than 1 month after the cessation of withdrawal or intoxication).
- Independent mood and anxiety disorders were strongly and consistently associated with substance dependence (odds ratios from 2.2 to 13.9), and less consistently associated with substance abuse (odds ratios from 0.8 to 4.2).
This study suggests that most mood and anxiety disorders—despite being associated with substance dependence—are independent of substance intoxication and withdrawal. This finding challenges the assumption that mood and anxiety symptoms will resolve with abstinence from substance use. The implication, for which there is growing empirical support, is that mood and anxiety disorders in patients with substance use disorders, especially substance dependence, should be treated early and comprehensively.Peter D. Friedmann, MD, MPH
Grant BF, Stinson FS,
Dawson DA, et al. Prevalence and co-occurrence
of substance use disorders and independent mood and anxiety
disorders: results from the National Epidemiologic Survey
on Alcohol and Related Conditions. Arch Gen Psychiatry.