Comorbidity Doesn’t Explain the Prevalence of Alcoholism in Native Americans

The
co-occurrence of anxiety or affective disorders and alcoholism in
Native Americans has not been well characterized. To determine the
prevalence of these co-occurring disorders, investigators interviewed
483 Southwest California Indians (known as Mission Indians) who
were at least one-sixteenth Native American and lived on contiguous
reservations.

• Subjects were demographically similar
  to Mission Indians as a whole, according to United States census
  figures (mean age 30 years). Sixty-six percent of the men and
  53% of the women had current or past alcohol dependence.
• The most common anxiety and affective
  disorders independent of substance use included major depressive
  disorder (12%), agoraphobia (7%), and social phobia (7%). The
  prevalences of these disorders did not differ significantly between
  people with and without alcohol dependence.
• The same was true for the prevalences
  of agoraphobia and social phobia overall (i.e., independent disorders
  and those concurrent with substance abuse).
• However, major depressive disorders
  overall (independent disorders and those concurrent with substance
  abuse) were significantly more common in people with alcohol dependence
  than in people without dependence (22% versus 11%).

Comments:

At least in this Native American population, anxiety and affective disorders independent of substance abuse were not more common in people with alcohol dependence. And even though major depressive disorders overall were more prevalent in those with dependence, they were much less common than was dependence. Affective and anxiety disorders remain important considerations in the treatment of Native Americans with alcohol dependence. However, they do not appear to explain the high prevalence of alcoholism in this group.

Richard Saitz, MD, MPH

Reference:

Gilder DA, Wall TL, Ehlers CL. Comorbidity of select anxiety and affective
disorders with alcohol dependence in southwest California Indians. Alcohol Clin Exp Res. 2004;28(12):1805–1813.