Comorbidity of substance misuse with anxiety-related and depressive disorders : a genetically informative population study of 3 million individuals in Sweden

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Virtanen , S , Kuja-Halkola , R , Mataix-Cols , D , Jayaram-Lindström , N , D'Onofrio , B M , Larsson , H , Ruck , C , Suvisaari , J , Lichtenstein , P & Latvala , A 2020 , ' Comorbidity of substance misuse with anxiety-related and depressive disorders : a genetically informative population study of 3 million individuals in Sweden ' , Psychological Medicine , vol. 50 , no. 10 , 0033291719001788 , pp. 1706-1715 . https://doi.org/10.1017/S0033291719001788

Title: Comorbidity of substance misuse with anxiety-related and depressive disorders : a genetically informative population study of 3 million individuals in Sweden
Author: Virtanen, Suvi; Kuja-Halkola, Ralf; Mataix-Cols, David; Jayaram-Lindström, Nitya; D'Onofrio, Brian M.; Larsson, Henrik; Ruck, Christian; Suvisaari, Jaana; Lichtenstein, Paul; Latvala, Antti
Other contributor: University of Helsinki, Institute of Criminology and Legal Policy
University of Helsinki, Institute of Criminology and Legal Policy


Date: 2020-07
Language: eng
Number of pages: 10
Belongs to series: Psychological Medicine
ISSN: 0033-2917
DOI: https://doi.org/10.1017/S0033291719001788
URI: http://hdl.handle.net/10138/321278
Abstract: Background Causes of the comorbidity of substance misuse with anxiety-related and depressive disorders (anxiety/depression) remain poorly known. We estimated associations of substance misuse and anxiety/depression in the general population and tested them while accounting for genetic and shared environmental factors. Methods We studied individuals born in Sweden 1968–1997 (n = 2 996 398) with follow-up in nationwide register data for 1997–2013. To account for familial effects, stratified analyses were conducted within siblings and twin pairs. Substance misuse was defined as ICD-10 alcohol or drug use disorder or an alcohol/drug-related criminal conviction. Three dimensions of ICD-10 anxiety and depressive disorders and a substance misuse dimension were identified through exploratory factor analysis. Results Substance misuse was associated with a 4.5-fold (95% CI 4.50–4.58) elevated risk of lifetime generalized anxiety/depression, 4.7-fold (95% CI 4.63–4.82) elevated risk of panic disorder and agora/social phobia, and 2.9-fold elevated risk of phobias/OCD (95% CI 2.82–3.02) as compared to those without substance misuse. The associations were attenuated in within-family analyses but we found elevated risks in monozygotic twin pairs discordant for substance misuse as well as significant non-shared environmental correlations. The association between anxiety/depression and substance misuse was mainly driven by generalized anxiety/depression, whereas other anxiety/depression dimensions had minor or no independent associations with substance misuse. Conclusions Substance misuse and anxiety/depression are associated at the population level, and these associations are partially explained by familial liabilities. Our findings indicate a common genetic etiology but are also compatible with a potential partially causal relationship between substance misuse and anxiety/depression.
Subject: 3124 Neurology and psychiatry
515 Psychology
Alcohol
anxiety
cohort
depression
drug
family study
genetic
substance use
twins
ALCOHOL-USE DISORDERS
DRUG-USE DISORDERS
POSTTRAUMATIC-STRESS-DISORDER
NATIONAL EPIDEMIOLOGIC SURVEY
ENVIRONMENTAL RISK-FACTORS
DSM-IV MOOD
PSYCHIATRIC-DISORDERS
MENTAL-HEALTH
PREVALENCE
LIFETIME
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