Skip to main content Accessibility help
×
×
Home

Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males

  • H. G. Cheng (a1) (a2), M. R. Phillips (a1) (a3) (a4), X. Li (a4), J. Zhang (a5), Q. Shi (a6), G. Xu (a7), Z. Song (a8), Z. Ding (a9) and S. Pang (a10)...

Abstract

Background

Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries.

Methods

A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity.

Results

Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4–0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3–1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders.

Conclusions

Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: M. R. Phillips, 3210 Humin Rd., Shanghai 201108, China. (Email: mphillipschina@outlook.com)

Footnotes

Hide All

These authors contributed equally to the work.

Footnotes

References

Hide All
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders., 4th edn TR.
Andrews, G, Slade, T, Issakidis, C (2002). Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being. British Journal of Psychiatry 181, 306314.
Boden, JM, Fergusson, DM (2011). Alcohol and depression. Addiction 106, 906914.
Bolton, JM, Pagura, J, Enns, MW, Grant, B, Sareen, J (2010). A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder. Journal of Psychiatric Research 44, 817826.
Bolton, JM, Robinson, J, Sareen, J (2009). Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Affective Disorders 115, 367375.
Cheng, HG, Chen, S, McBride, O, Phillips, MR (2016). Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: results from the China Health and Retirement Longitudinal Study (CHARLS). Journal of Affective Disorders 195, 136143.
Cheng, HG, Deng, F, Xiong, W, Phillips, MR (2015). Prevalence of alcohol use disorders in mainland China: a systematic review. Addiction 110, 761774.
Chou, SP, Lee, HK, Cho, MJ, Park, JI, Dawson, DA, Grant, BF (2012). Alcohol use disorders, nicotine dependence, and co-occurring mood and anxiety disorders in the United States and South Korea-a cross-national comparison. Alcoholism: Clinical and Experimental Research 36, 654662.
Cochrane, J, Chen, H, Conigrave, KM, Hao, W (2003). Alcohol use in China. Alcohol and Alcoholism 38, 537542.
Degenhardt, L, Hall, W, Lynskey, M (2001). Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis. Addiction 96, 16031614+1689.
Edwards, G (1986). The alcohol dependence syndrome: a concept as stimulus to enquiry. British Journal of Addiction 81, 171183.
Edwards, G (2012). ‘The evil genius of the habit’: DSM-5 seen in historical context. Journal of Studies on Alcohol and Drugs 73, 699701.
Engels, RCME, Knibbe, RA, Drop, MJ (1997). Inconsistencies in adolescents’ self-reports of initiation of alcohol and tobacco use. Addictive Behaviors 22, 613623.
Farrell, M (2001). Nicotine, alcohol and drug dependence and psychiatric comorbidity: results of a national household survey. British Journal of Psychiatry 179, 432437.
Fergusson, DM, Boden, JM, Horwood, LJ (2009). Tests of causal links between alcohol abuse or dependence and major depression. Archives of General Psychiatry 66, 260266.
Flensborg-Madsen, T, Mortensen, EL, Knop, J, Becker, U, Sher, L, Gronbaek, M (2009). Comorbidity and temporal ordering of alcohol use disorders and other psychiatric disorders: results from a Danish register-based study. Comprehensive Psychiatry 50, 307314.
Goedde, HW, Agarwal, DP, Fritze, G, Meier-Tackmann, D, Singh, S, Beckmann, G, Bhatia, K, Chen, LZ, Fang, B, Lisker, R, Paik, YK, Rothhammer, F, Saha, N, Segal, B, Srivastava, LM, Czeizel, A (1992). Distribution of ADH2 and ALDH2 genotypes in different populations. Human Genetics 88, 344346.
Goldberg, P, Williams, P (1988). A User's Guide to the GHQ. NFER-Nelson: Windsor, UK.
Hasin, DS, O’Brien, CP, Auriacombe, M, Borges, G, Bucholz, K, Budney, A, Compton, WM, Crowley, T, Ling, W, Petry, NM, Schuckit, M, Grant, BF (2013). DSM-5 criteria for substance use disorders: recommendations and rationale. American Journal of Psychiatry 170, 834851.
Hasin, DS, Stinson, FS, Ogburn, E, Grant, BF (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 64, 830842.
Kessler, RC, Chiu, WT, Demler, O, Walters, EE, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617627.
Koob, G, Kreek, MJ (2007). Stress, dysregulation of drug reward pathways, and the transition to drug dependence. American Journal of Psychiatry 164, 11491159.
Krueger, RF, Chentsova-Dutton, YE, Markon, KE, Goldberg, D, Ormel, J (2003). A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting. Journal of Abnormal Psychology 112, 437447.
Liang, K-Y, Zeger, SL (1986). Longitudinal data analysis using generalized linear models. Biometrika 73, 1322.
Lopes, MA, Furtado, EF, Ferrioli, E, Litvoc, J, De Campos Bottino, CM (2010). Prevalence of alcohol-related problems in an elderly population and their association with cognitive impairment and dementia. Alcoholism: Clinical and Experimental Research 34, 726733.
Markon, KE (2010). Modeling psychopathology structure: a symptom-level analysis of Axis I and II disorders. Psychological Medicine 40, 273288.
McCarty, CA, Wymbs, BT, King, KM, Mason, WA, Vander Stoep, A, McCauley, E, Baer, J (2012). Developmental consistency in associations between depressive symptoms and alcohol use in early adolescence. Journal of Studies on Alcohol and Drugs 73, 444453.
McMillan, KA, Enns, MW, Cox, BJ, Sareen, J (2009). Comorbidity of Axis I and II Mental Disorders with Schizophrenia and Psychotic Disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie 54, 477486.
Phillips, MR, Cheng, HG, Li, X, Zhang, J, Shi, Q, Xu, G, Song, Z, Ding, Z, Pang, S (2017). Prevalence, correlates, comorbidity, and age of onset of alcohol use disorders in adult males from five provinces in China. Drug and Alcohol Dependence 173, 170177.
Phillips, MR, Liu, X (2011). In Translated and adapted Chinese version of Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P) (eds First, MB, Spitzer, RL, Gibbon, M, Williams, JBW), Suicide Research and Prevention Center, Shanghai Mental Health Center: Shanghai.
Phillips, MR, Zhang, J, Shi, Q, Song, Z, Ding, Z, Pang, S, Li, X, Zhang, Y, Wang, Z (2009). Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 373, 20412053.
Pirkola, SP, Isometsä, E, Suvisaari, J, Aro, H, Joukamaa, M, Poikolainen, K, Koskinen, S, Aromaa, A, Lönnqvist, JK (2005). DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population. Results from the Health 2000 Study. Social Psychiatry and Psychiatric Epidemiology 40, 110.
Streiner, DL, Patten, SB, Anthony, JC, Cairney, J (2009). Has ‘lifetime prevalence’ reached the end of its life? An examination of the concept. International Journal of Methods in Psychiatric Research 18, 221228.
Thomasson, HR, Edenberg, HJ, Crabb, DW, Mai, XL, Jerome, RE, Li, TK, Wang, SP, Lin, YT, Lu, RB, Yin, SJ (1991). Alcohol and aldehyde dehydrogenase genotypes and alcoholism in Chinese men. American Journal of Human Genetics 48, 677681.
Wu, LT, Blazer, DG, Gersing, KR, Burchett, B, Swartz, MS, Mannelli, P (2013). Comorbid substance use disorders with other Axis I and II mental disorders among treatment-seeking Asian Americans, Native Hawaiians/Pacific Islanders, and mixed-race people. Journal of Psychiatric Research 47, 19401948.
Yang, G, Wang, Y, Zeng, Y, Gao, GF, Liang, X, Zhou, M, Wan, X, Yu, S, Jiang, Y, Naghavi, M, Vos, T, Wang, H, Lopez, AD, Murray, CJL (2013). Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 381, 19872015.
Yang, T, Huang, L, Wu, Z (2003). The application of Chinese health questionnaire for mental disorder screening in community settings in mainland China. Zhonghua Liu Xing Bing Xue Za Zhi 24, 769773.
Zhou, RY, Zhang, YH, Peng, B, Lie, XHZC (1997). Comparison of three diagnostic criteria for the diagnosis of schizophrenia and mood disorders. Chinese Journal of Psychiatry 1, 4549.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Cheng supplementary material
Cheng supplementary material 1

 Word (21 KB)
21 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed