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In the largest comorbidity study ever conducted in the US, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) reported in the current Archives of General Psychiatry that an estimated 19.4 million American adults (9.4 percent) meet the clinical criteria for a substance use disorder--either an alcohol or drug use disorder or both. The study was conducted by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health and surveyed more than 43,000 U.S. civilian noninstitutionalized individuals aged 18 years and older.
Other interesting data show that 19.2 million adults (9.2 percent) meet the diagnostic criteria for independent mood disorders (including major depression, dysthymia, mania, and hypomania) and 23 million (11.08 percent) meet criteria for independent anxiety disorders (including panic disorder, generalized anxiety disorder, and specific and social phobias). They define independent mood and anxiety disorders as those NOT arising from alcohol and/or drug withdrawal or intoxication. The distinction is important because the diagnosis of current mood and anxiety disorders among active substance abusers is complicated by the fact that many symptoms of intoxication and withdrawal from alcohol and other substances resemble the symptoms of mood and anxiety disorders and thus, the additional psychiatric disorder may be overlooked.
This study is the first national epidemiologic survey to use the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) definitions of independent mood and anxiety disorders to examine the co-occurrence, of mental health disorders. It lays the ground work for additional studies that can delineate more details about the comorbidities. These findings also suggest that treatment professionals should be prepared to treat or refer patients in stable remission from substance use for comorbid mood and anxiety disorders.
Arch Gen Psychiatry. 2004;61:807-816.
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