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Objective: To examine how early onset anxiety disorders are related to age of first alcohol use in a general population sample., Method: Discrete time survival analysis was used to model the odds of first alcohol use among those with, vs without, early onset anxiety disorders. Data came from the 2007 Australian National Survey of Mental Health and Wellbeing., Results: After adjusting for the effects of family history of alcohol/drug use, sex, age cohort and education, people who experienced an early onset anxiety disorder had a 27% increased odds of first alcohol use in any given year, when compared to those with no anxiety disorder. This effect was particularly strong for transitions to first alcohol use that occurred after the age of 13 years., Conclusions: Early onset anxiety disorders significantly predict first alcohol use in the general population and this relationship appears to be related to change over time. These results point to the need for developmentally appropriate and integrated prevention programs that target anxiety and alcohol use together., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents., Methods/design: Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined., Discussion: Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge., Trial Registration: This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000723785.