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Comorbid Patterns with Alcohol Use Disorders

The overall goals for this project are to assess patterns of alcohol use disorders with comorbid anxiety and mood conditions, to examine whether transition to alcohol dependence is altered by the presence of specific psychiatric disorders and symptoms, and if these patterns differ among gender and race-ethnicity subgroups.

Although prior population-based and clinical studies have provided evidence for the comorbid occurrence of alcohol and with both mood and anxiety disorders, there have been little assessment of patterns of these co-occurrences, their relationship with transition to alcohol dependence, and whether these patterns differ for specific subgroups of the population. Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) dataset, we propose to 1) assess the comorbid prevalence and strength of association of alcohol use disorders with anxiety symptoms and disorders (panic, social phobia, specific phobia and generalized anxiety disorder), and 2) mood symptoms and disorders (major depression, dysthymia, mania, and hypomania). In addition, using data from the National Longitudinal Alcohol Epidemiologic Survey (NLAES), 3) we aim to assess whether prevalence and comorbid trends of alcohol abuse and dependence with major depression have changed during the decade between the two surveys (NLAES (1991-92), and NESARC (2001-02)). Using survival analyses, 4) we intend to assess whether age of (a) onset of alcohol use disorders, (b) first symptom of excessive alcohol use, and (c) alcohol use initiation varies by presence and type of anxiety and mood condition. Using latent class analysis, 5) we also aim to examine the relationship of anxiety and mood disorders with patterns of excessive alcohol use symptoms, and using latent transition analyses to 6) assess patterns of transition to alcohol dependence. The proposed analyses should further our understanding of the co-morbid patterns and relationships of alcohol, anxiety and mood symptoms and disorders.