Directional Effects of Anxiety and Depressive Disorders with Substance Use: a Review of Recent Prospective Research
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EMOTION AND ADDICTION (K MORIE, SECTION EDITOR)
Directional Effects of Anxiety and Depressive Disorders with Substance Use: a Review of Recent Prospective Research Lorra Garey 1 & Hannah Olofsson 1 & Tatyana Garza 1 & Andrew H. Rogers 1 & Brooke Y. Kauffman 1 & Michael J. Zvolensky 1,2,3
# Springer Nature Switzerland AG 2020
Abstract Purpose of Review Anxiety and depressive disorders are highly prevalent, frequently comorbid, and contribute to high rates of disability and death globally. They also commonly co-occur with substance use, including alcohol, cigarettes, and cannabis. Yet, the directionality for the onset and progression of these conditions is not fully understood. The present review highlights key findings from recent longitudinal studies on the prospective associations between anxiety and depressive disorders and the most commonly used substances (alcohol, tobacco, and cannabis). Additionally, this article reviews the potential of each condition to affect the outcome, course, and treatment of the other. Recent Findings The current literature remains mostly inconclusive on the temporal associations between anxiety and depressive disorders and substance use and reverse causality, with some studies supporting the self-medication hypothesis and other work supporting the substance-induced hypothesis or the shared-vulnerability hypothesis. Summary Future prospective work that utilizes sophisticated research designs to test proposed causality is crucial to inform treatment of comorbid anxiety/depressive disorders and substance use. Keywords Comorbidity . Anxiety disorders . Depressive disorders . Tobacco . Cannabis . Alcohol
Anxiety and depressive disorders are the most common psychiatric disorders globally [1]. A staggering 284 million people globally (3.6% of the total population) meet criteria for a past-year anxiety disorder, with an estimated 6.3% of adults in the USA experiencing a current anxiety disorder [1]. Equally high, the past-year prevalence rate for a depressive disorder is 4.4% globally (exceeding 300 million people), and as high as 5.9% in the USA [1]. These disorders are frequently chronic, highly comorbid, and associated with substantial individual and societal costs [1–3]. Notably, anxiety and depressive
This article is part of the Topical Collection on Emotion and Addiction * Lorra Garey [email protected] 1
Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126 Heyne Building, Houston, TX 77204, USA
2
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
3
HEALTH Institute, University of Houston, Houston, TX 77204, USA
disorders often co-occur with substance use at high rates [4–7]. According to the Anxiety and Depression Association of America [8], 20% of Americans with an anxiety or depressive disorder have a substance use disorder, and about 20% of those with a substance use disorder also have an anxiety or depressive disorder. Indeed, high rates of co-occurrence have been consistently demonstrated across pop
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