Family Practice Advance Access first published online on August 27, 2008
This version published online on September 8, 2008
Family Practice, doi:10.1093/fampra/cmn049
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The association between anxiety and alcohol versus cannabis abuse disorders among adolescents in primary care settings
a Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1
b Mills College, Oakland, CA, USA
c Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
d Department of Psychiatry and the Center for Health Services Research in Primary Care, University of California, Sacramento, CA, USA
Correspondence to Nancy C Low, Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1; Email: nancy.low{at}mcgill.ca
Received 17 January 2008; Revised 19 July 2008; Accepted 29 July 2008.
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Abstract |
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Background. Both clinical and population-based studies show that anxiety disorders and substance misuse frequently co-occur in adults, whereas among adolescents, less examination of this association has been done. Adolescence is frequently the time of substance use initiation and its subsequent interaction with anxiety disorders has not been fully explored. It is unknown in adolescents whether anxiety is more related to alcohol abuse versus cannabis abuse. In addition, as depression has been implicated in adolescents with both anxiety and substance misuse, its role in the association should also be considered.
Objective. To test the association between current anxiety with alcohol versus cannabis abuse disorders.
Method. Cross-sectional, clinician-administered, structured assessment—using the Primary Care Evaluation of Mental Disorders—to evaluate anxiety, mood and substance abuse disorders among 632 adolescents recruited from primary care settings.
Results. Results show a strong association between current anxiety and alcohol [odds ratio = 3.8; 95% confidence interval (CI) 1.2–11.8], but not cannabis (odds ratio = 1.4; 95% CI 0.4–4.7) abuse.
Conclusion. This association in adolescents reflects the importance for increased awareness of anxiety symptoms and alcohol use patterns in primary care. The lack of association of anxiety with cannabis abuse in this group may reflect differences in cannabis’ anxiolytic properties or that this young group has had less exposure thus far. Given adolescence is a time of especially rapid psychosocial, hormonal and brain development, primary care may provide an opportunity for further investigation and, potentially, early screening and intervention.
Keywords. Adolescents, alcohol abuse, anxiety, cannabis abuse, family medicine, primary care.
Low NC, Lee SS, Johnson JG, Williams JB and Harris ES. The association between anxiety and alcohol versus cannabis abuse disorders among adolescents in primary care settings. Family Practice 2008; Pages 1–7 of 7.