Comorbidity of Anxiety and Depression with Substance Use Disorders

Stewart, Sherry H.; Grant, Valerie V.; Mackie, Clare; Conrod, Patricia J.

doi:10.1093/oxfordhb/9780199381708.013.19

Cited by 23 publications

(47 citation statements)

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“…One of these suggested that SUD patients often expose themselves to dangerous or trauma-prone environments (high-risk hypothesis; Stewart & Conrod, 2008). It was assumed that when this trauma exposure happens after initial substance use, substance use aggravates.

And, indeed, you meet severely addicted people who often expose themselves to dangerous situations which increases the risk for trauma.

…”

Section: Resultsmentioning

confidence: 99%

Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

Gielen

Krumeich

Havermans

et al. 2014

European Journal of Psychotraumatology

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BackgroundHealthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD) while there is empirical evidence to do so.ObjectiveThis study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients.MethodA qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer.ResultsDespite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported.ConclusionsIt is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD.

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And, indeed, you meet severely addicted people who often expose themselves to dangerous situations which increases the risk for trauma.

…”

Section: Resultsmentioning

confidence: 99%

Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

Gielen

Krumeich

Havermans

et al. 2014

European Journal of Psychotraumatology

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“…Common practice typically encourages patients with comorbid substance use and mental health problems to seek addiction treatment first, a practice that may lead to untreated mental health problems (17). Recent models suggest that treating anxiety and alcohol use disorders in an integrated approach may be preferable both from clinical (7, 20–22) and public health perspectives, as this model is in line with recommendations from the Affordable Care Act (23–25). …”

mentioning

confidence: 78%

“…Providing treatment for the underlying negative affect may prevent alcohol problems from persisting and worsening. This is an area of growing research attention, which has led to the development of models aiming to treat alcohol and anxiety concurrently (20–22). Still, ongoing efforts have focused on providing joint treatment to patients primarily seen as alcohol patients in alcohol treatment settings.…”

Section: Discussionmentioning

confidence: 99%

The impact of alcohol use severity on anxiety treatment outcomes in a large effectiveness trial in primary care

Wolitzky-Taylor

Brown

Roy‐Byrne

et al. 2015

Journal of Anxiety Disorders

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Objective The presence of anxiety disorders is associated with poorer alcohol use disorder treatment outcomes, but little is known about the impact of alcohol use problems on anxiety disorder treatment outcomes despite their high comorbidity. The current study examined the impact of alcohol use symptom severity on anxiety disorder treatment outcomes in a multi-site primary care effectiveness study of anxiety disorder treatment. Method Data came from the Coordinated Anxiety Learning and Management (CALM) effectiveness trial. Participants (N = 1004) were randomized to an evidence-based anxiety intervention (including cognitive behavioral therapy and medications) or usual care in primary care. Participants completed measures of alcohol use, anxiety, and depression a baseline, 6-mo, 12-mo, and 18-mo follow-up periods. Patients with alcohol dependence were excluded. Results There were no significant moderating (Treatment Group x Alcohol Use Severity) interactions. The majority of analyses revealed no predictive effects of alcohol use severity on outcome; however, alcohol problems at baseline were associated with somewhat higher anxiety and depression symptoms at the 18-mo follow-up. Conclusions These data indicate that patients with alcohol problems in primary care can be effectively treated for anxiety disorders. Baseline alcohol problems were associated with some poorer long-term outcomes, but this was evident across CALM and usual care. These findings provide preliminary evidence that there may be no need to postpone treatment of anxiety disorders until alcohol problems are addressed, at least among those who have mild to moderate alcohol problems. Replication with more severe alcohol use disorders is needed.

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“…High comorbidity rates exist between SUD and AD. [35][36][37] Studies had shown that high AD is related to increased use of substances, increased severity of alcohol withdrawal, and higher relapse rates following substance abuse treatment, 15,[38][39][40] as well as HADDAD ET AL.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross‐sectional study

Haddad¹,

Darwich

Obeïd

et al. 2019

Perspect Psychiatr Care

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Objectives: Estimate the rate of anxiety disorders (AD) and associated factors among patients with substance use disorder (SUD) in Lebanon. Methods: A cross-sectional study, conducted between April and September 2017, enrolled 57 inpatients with SUD. Results: The rate of AD in patients with SUD was 61.4%. The university level of education compared to the primary level of education (ORa = 0.221) was significantly associated with lower anxiety among patients with SUD. Being sexually abused and having a family history of depression tended to significance. Practical Implications: AD is widespread in Lebanon and high rates of anxiety in patients with SUD were found, warranting the implementation of strategic interventions and establishing national policies and legislation for mental health services to provide optimal care. K E Y W O R D S addiction, anxiety disorder, risk factors, substance use disorder 1 | INTRODUCTION Anxiety disorders (AD) are among the most commonly occurring mental disorders worldwide, estimated to have a lifetime prevalence up to 33% 1 and a global prevalence ranging from 4.8 to 10.9%. 2 In Lebanon, 11.2% of the people suffer from an anxiety disorder, which represents around 560 000 inhabitants out of a total of about 5 million. 3,4 Lebanon witnessed a series of wars, local armed combats, and terrorist attacks, 5 in addition to a series of crises including clean water penury, electrical power failure, and waste management problems that had overwhelmed the country. 5 Moreover, a high number of Syrian refugees had led to high levels of unemployment and competition for employment with locals. This is concurrent with the lack of public awareness about these Souheil Hallit and Fouad Tahan are last co-authors. This work has been done in the frame of the "Behavioral and Cognitive Neuroscience Master 2 Program," Faculty of Sciences, Lebanese University.

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Comorbidity of Anxiety and Depression with Substance Use Disorders

Cited by 23 publications

References 0 publications

Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

The impact of alcohol use severity on anxiety treatment outcomes in a large effectiveness trial in primary care

Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross‐sectional study

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