Anxiety linked to earlier alcohol involvement

Mental health and substance use disorders are common in the general population and the leading disorders within these are anxiety and alcohol use disorders, with approximately 20 – 30% of the population experiencing one during their lifetime. It is also know that problematic alcohol use and anxiety disorders often occur together with theories of self-medication hypothesising that individuals turn to alcohol in order to cope with symptoms of anxiety. Another key variable of interest is the age people first start to use alcohol, as an earlier age of first drinking alcohol has been linked to a range of negative outcomes in later life including an increased chance of developing an alcohol use disorder, truancy and suicidal behaviours.

Fig. 1. Cumulative lifetime probability of first alcohol use for persons with an early onset mood disorder vs no mood disorder

Fig. 1. Cumulative lifetime probability of first alcohol use for persons with an early onset mood disorder vs no mood disorder

To date little is known about how anxiety disorders and alcohol use first become linked in the general population and there has been no research on how anxiety disorders relate to age of first drinking alcohol. Given that early initiation of alcohol use is a necessary first step and marker for regular and problematic use, an understanding of the relationships between a pre-existing anxiety disorders and first alcohol use has the potential to guide preventative and early intervention efforts. We made use of a large nationally representative epidemiological dataset of the Australian population to examine how early onset anxiety disorders were related to age of first alcohol use.

After adjusting for other related variables we found that people who experienced an early onset anxiety disorder had a 27% increased odds of first alcohol use, when compared to those with no anxiety disorder.  When looking at the different types of anxiety disorders separately, early onset agoraphobia was the strongest predictor of transitioning to first alcohol use, increasing the odds by 60%. This effect was particularly strong for transitions to first alcohol use that occurred after the age of 13 years old and points to the fact that these relationships are likely to be different at different ages.

In conclusion, early onset anxiety disorders significantly predicted first alcohol use in the general population. These results point to the need for developmentally appropriate and integrated prevention programs that target anxiety and alcohol use together during adolescence. Preventative interventions aimed at delaying first alcohol use may benefit from incorporating messages specifically for those experiencing an anxiety disorder.



Anxiety disorders and first alcohol use in the general population. Findings from a nationally representative sample.
Birrell L, Newton NC, Teesson M, Tonks Z, Slade T.
J Anxiety Disord. 2015 Apr


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