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Meta-Analysis
. 2019 Jun;114(6):968-982.
doi: 10.1111/add.14575. Epub 2019 Mar 19.

Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies

Maddy L Dyer  1   2   3 , Kayleigh E Easey  1   2   3 , Jon Heron  2   3 , Matthew Hickman  2   3 , Marcus R Munafò  1   3
Affiliations
Meta-Analysis

Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies

Maddy L Dyer et al. Addiction. 2019 Jun.

Abstract

Background and aims: Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings.

Design and setting: We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later.

Participants: Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years.

Measurements: Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders).

Findings: The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87).

Conclusions: Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.

Keywords: Adolescence; alcohol; anxiety; childhood; longitudinal; meta-analysis; systematic review; young adulthood.

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Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta‐analyses (PRISMA) flow diagram of the literature search
Figure 2
Figure 2
Forest plot of associations between generalized anxiety and alcohol use disorder
See this image and copyright information in PMC

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