Longitudinal associations of childhood anxiety and emotional problems with substance misuse : a prospective twin study

• Anxiety and depression are linked to subsequent substance misuse, but it remains unclear to what extent these associations are explained by shared underlying liabilities. We investigated associations of childhood anxiety and emotional problems with subsequent substance misuse accounting for familial factors, and estimated genetic and environmental contributions to the association between emotional problems and substance misuse.In the Swedish longitudinal CATSS study, parents rated their twin children (n = 12,412) on anxiety (range: 0–3) and emotional problems (0–12) at age 9/12 years. Substance misuse was defined as (1) AUDIT score exceeding cut-off at age 18, and (2) register-based ICD-10 alcohol/drug use disorder diagnosis or alcohol/drug-related criminal conviction.Childhood anxiety symptoms were associated with a lower risk of high AUDIT score at age 18 (one-unit increase: OR = 0.71 [95% CI 0.51–0.98]). The association was similar in within-pair analyses of dizygotic twin pairs (OR = 0.57 [0.37–0.88]) and slightly higher and non-significant in monozygotic twins (OR = 0.82 [0.39–1.75]). Emotional problems were not associated with AUDIT score. Anxiety symptoms were associated with a lower risk (HR = 0.76 [0.58–0.98]) and emotional problems with a higher risk (HR = 1.23 [1.15–1.31]) of register-based substance misuse. The associations were non-sig-nificant in within-family models. The best-fitting bivariate quantitative genetic model for any emotional problems and register-based substance misuse included additive genetic and individual-specific environmental components and a shared genetic pathway explaining the covariance (rG= 0.21). Childhood anxiety and emotional problems have opposite associations with subsequent substance misuse. The association with emotional problems is mainly explained by genetic factors.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

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