Self Medication as a Marker of Risk of DSM Diagnosis along Axes I and II

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Feb 03, 09 Self Medication as a Marker of Risk of DSM Diagnosis along Axes I and II


Self Medication as a Marker of Risk of DSM Diagnosis along Axes I and II
A Review of:
Robinson, J., Sareen, J., Cox, B. J., & Bolton, J. (2009). Self-medication of anxiety disorders with alcohol and drugs: Results from a nationally representative sample. Journal of Anxiety Disorders 23 (2009) 38–45.
by Major, C. T.

Earlier studies that correlated anxiety and substance abuse typically treated these conditions as overarching categories, and often hypothesized that self medication for anxiety may cause the substance abuse disorder. In contrast, Robinson et al. (2009) have available the results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a longitudinal study that surveys self-medication as a behavior separate from comorbid DSM disorders including substance abuse. As a result, the authors observe that self medication may be a significant marker of risk of diagnosis of various DSM disorders. The potential clinical value of such a finding is that the data might support adding questions about self medication to instruments that detect the presence of, or rate the severity of, certain DSM disorders.

The authors’ calculations of adjusted-odds ratios (AOR) for risk of disorder are striking. For example, merely by learning that a person self medicates for anxiety using both alcohol and some other drug, the odds are nearly 1 in 20 that such a person is diagnosable as also suffering from paranoid personality disorder (AOR = 4.88 (3.27–7.27) where p < .001). Such a ratio is approximately double the prevalence of that condition in the general population, thus potentially making report of self medication useful as an adjunct measure of probability of comorbidity. In the largest sense the study reveals the utility of gathering data along as many dimensions as possible (per NESARC), and that multivariate analysis of such a data set can reveal new correlations that may have practical clinical value in predicting and measuring comorbidity of disorder and severity of condition. Self medication as a variable appears to be such a marker.
To cite this review, please use this reference:
Major, C. T. (2009). Self Medication as a Marker of Risk of DSM Diagnosis along Axes I and II (3). http://psychologyalert.com/2009/02/self-medication-as-marker-of-risk-of.html