Abstract Objective: Anxiety and depression commonly co-occur with substance use disorders. Conceptual models would presume that changes in anxiety and depression should lead to changes in drug and alcohol craving during treatment for co-occurring disorders, but no longitudinal investigation has explored this assumption. This study examined the associations among craving, anxiety, and depression in a dual diagnosis program. Methods: In all, 93 adult patients at a community-based dual diagnosis program for substance use disorders and comorbid anxiety and mood disorders provided daily ratings of anxiety and depression. We examined whether these ratings predicted changes in craving and vice versa. Results: Using hierarchical linear modeling to examine day-to-day change over time, we observed that anxiety and depression ratings uniquely and independently predicted subsequent craving ratings, and craving ratings also predicted subsequent anxiety and depression ratings. Conclusions: These preliminary findings support mutual maintenance models of substance use and psychiatric comorbidity, thus providing preliminary support for integrated programs that simultaneously address both problems. Implications and future directions are discussed.

中文翻译：

---

在双重诊断程序中重复测量焦虑、抑郁和渴望的预测关联

摘要 目的：焦虑、抑郁常与物质使用障碍同时发生。概念模型假设焦虑和抑郁的变化会导致在治疗同时发生的疾病期间对药物和酒精的渴望发生变化，但没有纵向调查探讨这一假设。这项研究在双重诊断程序中检查了渴望、焦虑和抑郁之间的关联。方法：总共有 93 名成年患者在一个基于社区的物质使用障碍和共病焦虑和情绪障碍双重诊断计划中提供了每日焦虑和抑郁评分。我们检查了这些评级是否预测了渴望的变化，反之亦然。结果：使用分层线性建模来检查随时间的日常变化，我们观察到焦虑和抑郁评分独特且独立地预测了随后的渴望评分，渴望评分也预测了随后的焦虑和抑郁评分。结论：这些初步发现支持物质使用和精神共病的相互维持模型，从而为同时解决这两个问题的综合计划提供初步支持。讨论了影响和未来的方向。