Co-occurrence patterns of anxiety, depression and alcohol use disorders

Co-occurrence of anxiety and depressive symptoms with alcohol consumption/abuse was analyzed in a sample of 2,302 adults in Bahia, Brazil. A cross-sectional household survey collected self-reported information on social and personal health, as well as individual psychological status, with standardized techniques and trained examiners. Twelve-month prevalence was 15% for anxiety, 12% for depressive disorders and 7% for alcohol abuse/ dependence. Symptom co-occurrence was more frequent for depression (94% of cases co-occurring with other diagnoses), followed by anxiety disorders (82%), and alcoholism (only 20%). There was a 74% proportion of anxiety symptoms among depressed, and a 61% proportion of depressed among anxiety sufferers. The combination of depression plus anxiety was the most prevalent in both gender groups, ranging from 17% for women to 5% for men. Comorbid combinations of alcoholism yielded low prevalences, the smallest (around 1%) being the triple combo alcoholism+anxiety+depression. Gender ratios increased substantially in the absence of comorbidity, reaching peaks in depression (F:M ratio = 13.8) and alcoholism (M:F ratio = 11.8). Set component analyses indicate strong overlapping of anxiety and depression and complementarity between depression and alcoholism, modulated by gender (women depressed, men alcoholic).