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Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions.
J Affect Disord. 2009 Jun; 115(3):367-75.JA

Abstract

BACKGROUND

Using alcohol or drugs to reduce emotional distress (self-medication) has been proposed as an explanation for the high comorbidity rates between anxiety and substance use disorders. Self-medication has been minimally studied in mood disorders despite equally high rates of alcohol and drug use.

METHODS

Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (n=43,093, age 18 years and older) nationally representative survey of mental illness in community-dwelling adults. Prevalence rates of self-medication were determined for DSM-IV mood disorders: dysthymia, major depressive disorder, bipolar I disorder, and bipolar II disorder. Multiple logistic regression generated odds ratios for the association between each category of self-medication and anxiety and personality disorders.

RESULTS

Almost one-quarter of individuals with mood disorders (24.1%) used alcohol or drugs to relieve symptoms. The highest prevalence of self-medication was seen in bipolar I disorder (41.0%). Men were more than twice as likely as women to engage in self-medication (Adjusted Odds Ratio=2.18; 95% Confidence Interval 1.90-2.49). After controlling for the effects of substance use disorders, self-medication was associated with higher odds of comorbid anxiety and personality disorders when compared to individuals who did not self-medicate.

LIMITATIONS

Cross-sectional design.

CONCLUSIONS

The use of alcohol and drugs to relieve affective symptoms is common among individuals with mood disorders in the general population, yet is associated with substantial psychiatric comorbidity. These findings may help clinicians identify a subgroup of people with mood disorders who suffer from a higher mental illness burden.

Authors+Show Affiliations

Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. jbolton@hsc.mb.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19004504

Citation

Bolton, James M., et al. "Self-medication of Mood Disorders With Alcohol and Drugs in the National Epidemiologic Survey On Alcohol and Related Conditions." Journal of Affective Disorders, vol. 115, no. 3, 2009, pp. 367-75.
Bolton JM, Robinson J, Sareen J. Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. J Affect Disord. 2009;115(3):367-75.
Bolton, J. M., Robinson, J., & Sareen, J. (2009). Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Affective Disorders, 115(3), 367-75. https://doi.org/10.1016/j.jad.2008.10.003
Bolton JM, Robinson J, Sareen J. Self-medication of Mood Disorders With Alcohol and Drugs in the National Epidemiologic Survey On Alcohol and Related Conditions. J Affect Disord. 2009;115(3):367-75. PubMed PMID: 19004504.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. AU - Bolton,James M, AU - Robinson,Jennifer, AU - Sareen,Jitender, Y1 - 2008/11/11/ PY - 2008/08/01/received PY - 2008/09/13/revised PY - 2008/10/03/accepted PY - 2008/11/14/pubmed PY - 2009/8/12/medline PY - 2008/11/14/entrez SP - 367 EP - 75 JF - Journal of affective disorders JO - J Affect Disord VL - 115 IS - 3 N2 - BACKGROUND: Using alcohol or drugs to reduce emotional distress (self-medication) has been proposed as an explanation for the high comorbidity rates between anxiety and substance use disorders. Self-medication has been minimally studied in mood disorders despite equally high rates of alcohol and drug use. METHODS: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (n=43,093, age 18 years and older) nationally representative survey of mental illness in community-dwelling adults. Prevalence rates of self-medication were determined for DSM-IV mood disorders: dysthymia, major depressive disorder, bipolar I disorder, and bipolar II disorder. Multiple logistic regression generated odds ratios for the association between each category of self-medication and anxiety and personality disorders. RESULTS: Almost one-quarter of individuals with mood disorders (24.1%) used alcohol or drugs to relieve symptoms. The highest prevalence of self-medication was seen in bipolar I disorder (41.0%). Men were more than twice as likely as women to engage in self-medication (Adjusted Odds Ratio=2.18; 95% Confidence Interval 1.90-2.49). After controlling for the effects of substance use disorders, self-medication was associated with higher odds of comorbid anxiety and personality disorders when compared to individuals who did not self-medicate. LIMITATIONS: Cross-sectional design. CONCLUSIONS: The use of alcohol and drugs to relieve affective symptoms is common among individuals with mood disorders in the general population, yet is associated with substantial psychiatric comorbidity. These findings may help clinicians identify a subgroup of people with mood disorders who suffer from a higher mental illness burden. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/19004504/Self_medication_of_mood_disorders_with_alcohol_and_drugs_in_the_National_Epidemiologic_Survey_on_Alcohol_and_Related_Conditions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(08)00400-X DB - PRIME DP - Unbound Medicine ER -