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Association of Comorbid Generalized Anxiety Disorder and Alcohol Use Disorder Symptoms with Health-Related Quality of Life: Results From the National Epidemiological Survey on Alcohol and Related Conditions

Cullen, Bernadette A. MB, BCh, BAO; La Flair, Lareina N. PhD, MPH; Storr, Carla L. ScD; Green, Kerry M. PhD; Alvanzo, Anika A. H. MD; Mojtabai, Ramin MD, PhD, MPH; Pacek, Lauren R. BS; Crum, Rosa M. MD, MHS

doi: 10.1097/ADM.0b013e31829faa1c
Original Research

Background: Although prior studies have documented the co-occurrence of generalized anxiety disorder (GAD) and alcohol use disorder (AUD) disorder, there is a paucity of research assessing the patterns of alcohol involvement among individuals with GAD symptoms. This study investigated subtypes, or classes, of comorbid AUD and GAD symptoms, and assessed the association of class membership with health-related quality of life.

Methods: Using data from the Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, a latent class analysis was performed on the subset of individuals who were current drinkers and had reported ever experiencing a 6-month episode of feeling tense, nervous, or worried most of the time. We examined the association of these latent classes with physical and mental health-related quality of life measured by the Short Form-12, version 2.

Results: Latent class analysis identified a 5-class model of AUD and GAD symptoms. A significant graded relationship was observed between the ordered classes and severity of impairment on the mental health scale of the Short Form-12, version 2, but no significant relationship was found with the physical health scale.

Conclusions: Mental, but not physical, health-related quality of life in this population is associated with both the number and pattern of comorbid GAD and AUD symptoms.

From the Department of Psychiatry and Behavioral Sciences (BAC, RM, RMC), Johns Hopkins School of Medicine, Baltimore, MD; Department of Mental Health (BAC, LNLF, CLS, RM, LRP, RMC), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Family and Community Health (CLS), University of Maryland Baltimore School of Nursing, Baltimore, MD; Department of Behavioral and Community Health (KMG), University of Maryland School of Public Health, College Park, MD; Division of General Internal Medicine (AAHA), Johns Hopkins School of Medicine, Baltimore, MD; and Department of Epidemiology (RMC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Send correspondence and reprint requests to Bernadette Cullen, MD, Assistant Professor of Psychiatry, Director, Community Psychiatry Program, Meyer 186, 600 Nth Wolfe St., Baltimore, MD 21210. E-mail:

Supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA016346), and the National Institute on Drug Abuse (DA030460). Preparation of this article also was supported by a Johns Hopkins School of Medicine Clinician Scientist Award (AA).

The authors declare no conflicts of interest.

Received February 13, 2013

Accepted June 08, 2013

© 2013 American Society of Addiction Medicine