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Use of Alcohol and Drugs to Self-Medicate Anxiety Disorders in a Nationally Representative Sample

Bolton, James MD; Cox, Brian PhD; Clara, Ian MA; Sareen, Jitender MD

The Journal of Nervous and Mental Disease: November 2006 - Volume 194 - Issue 11 - p 818-825
doi: 10.1097/01.nmd.0000244481.63148.98
Original Articles

This study examined the prevalence and correlates of self-medication of anxiety disorders with alcohol and drugs in a nationally representative sample (N = 5877). A modified version of the Composite International Diagnostic Interview was used to make DSM-III-R mental disorder diagnoses. Frequencies of self-medication ranged from 7.9% (social phobia, speaking subtype) to 35.6% (generalized anxiety disorder). Among respondents with an anxiety disorder, self-medication was significantly associated with an increased likelihood of comorbid mood disorders, substance use disorders, distress, suicidal ideation, and suicide attempts. Self-medication behavior remained significantly associated with an increased likelihood of suicidal ideation (adjusted odds ratio = 1.66; 1.17–2.36) as well as suicide attempts (adjusted odds ratio = 2.23; 1.50–3.31), even after adjusting for a number of sociodemographic and psychiatric variables. These results suggest that individuals with anxiety disorders who self-medicate their symptoms with alcohol or drugs may be at increased risk for mood and substance use disorders and suicidal behavior.

Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.

Preparation of this article was supported by a CIHR operating grant awarded to Dr. Cox, a Manitoba Research Council Establishment Grant awarded to Dr. Sareen, and a Health Sciences Centre Research Foundation grant awarded to Dr. Cox. The NCS was supported by grants from the National Institute of Mental Health, the National Institute of Drug and Alcohol Abuse, and the W. T. Grant Foundation.

Send reprint requests to Jitender Sareen, MD, PZ-430 771 Bannatyne Ave., Winnipeg, MB, Canada R3E 3N4.

© 2006 Lippincott Williams & Wilkins, Inc.