Electronic Thesis/Dissertation

 

A Triple Threat: Alcohol Use Disorders in the Presence of Comorbid Chronic Pain Conditions and Depressive Disorders in the Collaborative Psychiatric Epidemiology Surveys, 2001-2003 Open Access

Downloadable Content

Download PDF

BackgroundPatients with chronic pain conditions frequently have comorbid depressive disorders. The relationship between the diagnoses is often bidirectional, with the effects of one condition exacerbating the effects of the other. Alcohol use disorders are also independently associated with both conditions. This study aims to determine the prevalence of alcohol use disorders among patients with comorbid chronic pain conditions and depressive disorders in a nationally representative sample of US adults and to ascertain the characteristics of patients with all three diagnoses.MethodsThis cross-sectional study utilizes the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. The outcome is a dichotomous measure of past 12 month alcohol use disorder, meeting Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. The exposure variable is a categorical variable with three levels representing a range of past 12 month comorbid chronic pain condition(s) and DSM-IV depressive disorder(s). Prevalence odds ratios were obtained using logistic regression analysis accounting for survey weights.ResultsThe crude, unadjusted model showed that participants with comorbid chronic pain conditions and depressive disorders during the past 12 months had 1.941 (0.394, 9.569) times the odds of having an alcohol use disorder during the past 12 months than participants without chronic pain conditions or depressive disorders during the past 12 months. The same model determined that participants with at least one chronic pain condition but no depressive disorders during the past 12 months had 0.333 (0.068, 1.63) times the odds of having an alcohol use disorder during the past 12 months than participants without chronic pain conditions or depressive disorders during the past 12 months. Neither of these associations were statistically significant at α=0.05. The adjusted model that included age, the only statistically relevant confounder, determined that participants with comorbid chronic pain conditions and depressive disorders during the past 12 months had 2.464 (0.529, 11.477) times the odds of having an alcohol use disorder during the past 12 months than participants without chronic pain conditions or depressive disorders during the past 12 months, after adjusting for age. Participants with at least one chronic pain condition but no depressive disorders during the past 12 months had 0.676 (0.149, 3.046) times the odds of having an alcohol use disorder during the past 12 months than participants without chronic pain conditions or depressive disorders during the past 12 months, after adjusting for age. Again, these results fail to achieve statistical significance. Age [POR=0.941, (0.918, 0.965)], however, has a significant impact on past 12 month alcohol use disorder, after adjusting for chronic pain and depressive disorder comorbidity status. One defining characteristic of the group of participants with comorbid chronic pain conditions and depressive disorders is that males constitute only 33.7% (S.E. = 3.0) of this category.Conclusions Despite the failure to achieve statistically significant results, the elevated odds of past 12 month alcohol use disorders among participants with comorbid chronic pain conditions and depressive disorders during the past 12 months, in combination with the established, independent associations between alcohol use disorder, chronic pain, and depressive disorders suggest that patients presenting with both depression and chronic pain should be carefully evaluated and monitored for signs of alcohol use disorder. The results from this study should be interpreted with caution due to the potential effect of categories with few observations and the methodological limitations of the dataset.

Author Language Keyword Date created Type of Work Rights statement GW Unit Degree Advisor Committee Member(s) Persistent URL
License

Relationships

Items