The Association Between Alcohol Use and Panic Disorder: A Cross-sectional Study Among US Adults

Background: The present cross-sectional study explores the relationship between alcohol use and panic disorder among adults in the United States. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2004 were analyzed. Adults aged 18 years and older who completed the mental health and alcohol use components during these survey cycles were considered eligible for inclusion. Participants with missing data on panic disorder assessments, alcohol consumption, or key covariates required for multivariable analysis were excluded from the final sample. The NHANES is a comprehensive survey that gathers health and nutrition data from a nationally representative sample. A modified version of the World Health Organization Composite International Diagnostic Interview, version 2.1 (CIDI-Auto 2.1) was administered to assess panic disorder. Multiple demographic and lifestyle variables, including alcohol use, were collected through standardized questionnaires. Results: The study included 2,222 participants. Individuals diagnosed with panic disorder were more likely to be female, unmarried/single, have lower education and income levels, have higher smoking rates, engage less in physical activity, and consume more alcohol. Univariate analysis revealed a significant association between alcohol consumption and increased odds of panic disorder [OR = 2.19, 95% CI (1.04, 4.60)] and sudden panic attacks [OR = 2.31, 95% CI (1.15, 4.62)]. Smoking was also associated with higher odds of panic disorder and panic attacks. Multivariable logistic regression confirmed a robust association between alcohol use and panic disorder [OR = 2.60, 95% CI (1.10, 6.11)] as well as sudden panic attacks [OR = 3.07, 95% CI (1.50, 6.26)], after adjusting for potential confounders. These effect sizes suggest a clinically meaningful association between panic disorder and sudden panic attacks among alcohol users. Conclusions: This study provides evidence of a significant relationship between alcohol use and panic disorder among US adults. These findings highlight the importance of considering alcohol consumption in the context of panic disorder assessment and intervention. However, due to the cross-sectional nature of the data, causality cannot be inferred. Further longitudinal studies are needed to clarify the direction and mechanisms underlying this association.