Anxiety Disorders: Hasin D

Hasin D, Katz H. · Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Box 123, New York, NY 10032, USA. · Psychosom Med. · Pubmed #18040097 No free full text.

Abstract: OBJECTIVE: To review the potential for diagnostic difficulties and overlap in a number of symptoms of somatoform disorders and symptoms of withdrawal from alcohol and drugs, and to review epidemiologic, family, and clinical studies addressing comorbidity between somatoform and substance use disorders. The comorbidity between somatoform disorders and substance use disorders has rarely been studied. METHODS: Symptoms of somatoform disorders and substance withdrawal were compared. A PubMed-based literature review was conducted. RESULTS: Somatoform and withdrawal symptoms overlap considerably. Few studies, however, have addressed comorbidity between somatoform and substance use disorders. Although results are inconsistent, a number of studies suggest that an association exists. CONCLUSION: More research on this type of comorbidity is warranted because the associations may be stronger than generally assumed. Such research should address methodological problems to produce studies with clearer findings.

Blanco C, Grant J, Petry NM, Simpson HB, Alegria A, Liu SM, Hasin D. · New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA. · Am J Psychiatry. · Pubmed #18381900 links to  free full text

Abstract: OBJECTIVE: This study presented nationally representative data on the lifetime prevalence, correlates, and comorbidity of shoplifting among adults in the United States. METHOD: Data were derived from a large national sample of the United States population. Face-to-face surveys of more than 43,000 adults ages 18 years and older residing in households were conducted during the 2001-2002 period. Diagnoses of mood, anxiety, and drug disorders as well as personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. RESULTS: The prevalence of lifetime shoplifting in the U.S. population was 11.3%. Associations between shoplifting and all antisocial behaviors were positive and significant. Besides stealing, the behaviors more strongly associated with shoplifting were making money illegally and scamming someone for money. Strong associations between shoplifting and all 12-month and lifetime comorbid psychiatric disorders were also found. The strongest associations with shoplifting were with disorders often associated with deficits in impulse control, such as antisocial personality disorder, substance use disorders, pathological gambling, and bipolar disorder. High rates of mental health service use were also identified in this population. CONCLUSIONS: Shoplifting is a relatively common behavior. A history of shoplifting is associated with substantial rates of comorbid disorders, psychosocial impairment, and mental health service use. Future research should identify the biological and environmental underpinnings of shoplifting and develop effective screening tools and interventions for individuals with shoplifting problems.

Morasco BJ, Pietrzak RH, Blanco C, Grant BF, Hasin D, Petry NM. · Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA. · Psychosom Med. · Pubmed #17132843 links to  free full text

Abstract: OBJECTIVE: Pathologic gambling is believed to be associated with adverse health consequences, but no prior studies have rigorously evaluated these relationships. We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling. METHOD: A total of 43,093 adults aged 18 years and older were evaluated in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions. Self-reported medical diagnoses and past-year medical services used were assessed. RESULTS: Pathologic gamblers were more likely than low-risk individuals to have been diagnosed with tachycardia (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.05-2.97), angina (OR = 2.35; 95% CI = 1.33-4.15), cirrhosis (OR = 3.90; 95% CI = 1.11-13.72), and other liver disease (OR = 2.98; 95% CI = 1.07-8.26). Gambling severity was also associated with higher rates of medical utilization with pathologic gamblers more likely than low-risk individuals to have been treated in the emergency room in the year before the survey (OR = 1.98; 95% CI = 1.27-3.09). Significant effects of gambling severity remained even after controlling for demographic characteristics (age, gender, ethnicity, marital status, education, income, and region of the country) and behavioral risk factors such as body mass index, alcohol abuse and dependence, nicotine dependence, and mood and anxiety disorders. CONCLUSIONS: A lifetime diagnosis of pathologic gambling is associated with several medical disorders and increased medical utilization, perhaps leading to a burden on healthcare costs in the United States.

Nunes EV, Liu X, Samet S, Matseoane K, Hasin D. · Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, NY, USA. · J Clin Psychiatry. · Pubmed #17107247 No free full text.

Abstract: OBJECTIVE: Clinicians frequently encounter patients presenting with both depression and substance abuse, and their diagnosis has been a source of controversy. The authors examined whether baseline and past diagnoses of DSM-IV primary (independent) or substance-induced depression or other psychiatric syndromes predict 1-year course of depression in substance-dependent patients. METHOD: Inpatients with current DSM-IV major depressive disorder (MDD) and DSM-IV alcohol, cocaine, or opiate dependence (N = 110) were evaluated with the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) and followed for 12 months after discharge. Logistic regression for repeated measures modeled the odds of MDD and depressed mood over time as a function of baseline diagnoses and past independent depression, controlling for demographics, substance use, and antidepressant treatment during the follow-up. Subject recruitment was conducted from July 25, 1995 to May 14, 1997. RESULTS: Over the 12 months, 88% of the patients experienced depressed mood for at least 1 week, and 57% experienced MDD. Depression during follow-up was equally likely among patients with current (baseline) DSM-IV independent or substance-induced MDD; in the latter group, past independent MDD increased the likelihood of MDD during the follow-up. Panic attacks, posttraumatic stress disorder (trend), borderline personality, and antisocial personality also significantly predicted depression during the follow-up. CONCLUSIONS: In substance-dependent patients, both DSM-IV primary and substance-induced MDD predict future depression, warranting consideration for specific treatment. The data suggest the importance of a careful psychiatric history that includes attention to past episodes of independent depression as well as anxiety and cluster B personality syndromes.

Schiff M, Benbenishty R, McKay M, Devoe E, Liu X, Hasin D. · Hebrew University of Jerusalem, School of Social Work and Social Welfare, Research Group: Mental Health and Well Being in Childhood and Adolescence, Jerusalem, Israel. · Am J Addict. · Pubmed #16923668 No free full text.

Abstract: This study examined the associations between physical and psychological proximity to terrorist attacks and post-traumatic symptoms (PTS), depressive symptoms, and alcohol use among Israeli youth. Self-administered questionnaires were completed under anonymous conditions by 1,150 high and junior high school students (51.3% boys and 48.7% girls) in a town in the Tel Aviv metropolitan area. Standardized, validated scales were used to measure psychological symptoms and alcohol use. High levels of exposure to terrorism were reported. Physical and psychological proximity to terrorist attacks were associated with more PTS symptoms and alcohol consumption. Physical proximity was also associated with symptoms of depression. The implications of terror-associated early drinking for later alcohol problems should be explored.

Hasin D, Samet S, Nunes E, Meydan J, Matseoane K, Waxman R. · Columbia University/New York State Psychiatric Institute, 1051 Riverside Dr., Box 123, New York, NY 10032, USA. · Am J Psychiatry. · Pubmed #16585445 links to  free full text

Abstract: OBJECTIVE: The authors used the Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV (PRISM-IV) to test the reliability of DSM-IV-defined disorders, including primary and substance-induced disorders, in substance-abusing subjects. METHOD: Substance-abusing patients (N=285) from substance abuse/dual-diagnosis treatment settings and mental health treatment settings participated in test and blind retest interviews with the PRISM-IV, which includes specific guidelines for assessment of substance abusers. RESULTS: Kappas for primary and substance-induced major depressive disorder ranged from 0.66 to 0.75. Reliability for psychotic disorders, eating disorders, antisocial personality disorder, and borderline personality disorder was in the same range. Reliability for most anxiety disorders was lower. Reliability was good to excellent (kappas >/=0.65) for most substance dependence disorders. Continuous measures (severity, age at onset) had intraclass correlation coefficients >0.70 with few exceptions. Reliability was better for primary than for substance-induced disorders, although not greatly so. CONCLUSION: Most DSM-IV psychiatric disorders can be assessed in substance-abusing subjects with acceptable to excellent reliability by using specifically designed procedures. Good reliability improves the likelihood of significant study results.