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Anxiety is assessed with GAD-7 and associations with alcohol misuse, defined by AUDIT-C, are estimated using segmented linear mixed models. Gender and perceived loneliness at baseline are evaluated as effect modifiers. Among 1868 participants, alcohol misuse links to higher anxiety beginning the second lockdown in women and in those with high perceived loneliness, highlighting vulnerable groups for targeted mental health support.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/effects-of-alcohol-misuse-on-the-evolution-of-anxiety-during-the-covid-19-pandemic-in-france-results-from-confins-cohort/455130/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/effects-of-alcohol-misuse-on-the-evolution-of-anxiety-during-the-covid-19-pandemic-in-france-results-from-confins-cohort/455130.png","ImageObject",300,407,{"name":92,"@type":93},"Muffet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How was anxiety measured in the CONFINS cohort analysis?","Question",{"text":112,"@type":113},"Anxiety was measured using the Generalised Anxiety Disorder-7 items (GAD-7).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was alcohol misuse defined for the study?",{"text":117,"@type":113},"Alcohol misuse was defined using the AUDIT-C score and evaluated for associations with anxiety outcomes.",{"name":119,"@type":110,"acceptedAnswer":120},"Which groups showed the clearest increase in anxiety after alcohol misuse?",{"text":121,"@type":113},"In women, anxiety scores increased significantly starting from the second lockdown; a similar pattern was observed among participants with high perceived loneliness.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455130,1791099495,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090768927,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Open access Original research  \nTo cite: Galesne C, Arsandaux J, Macalli M, et al. Effects of alcohol misuse on the evolution of anxiety during the COVID-19 pandemic in France: results from CONFINS cohort. BMJ Open 2026;16:e105567 . doi:10 . 1136/ bmjopen-2025-105567  \n► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2025-105567](bmjopen-2025-105567)) .  \nReceived 23 May 2025  \nAccepted 16 December 2025  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY.  \nPublished by BMJ Group. 1Bordeaux Population Health, University of Bordeaux College of Health Sciences, Bordeaux, France  \n2Laboratoire de psychologie des Pays de la Loire, Nantes University, Nantes, France 3Kappa Santé, Paris, France 4Kap Code, Paris, France 5Department of General Practice, University of Bordeaux College of Health Sciences, Bordeaux, France  \nCorrespondence to  \nDr Shérazade Kinouani; sherazade. kinouani@u[bordeaux.fr](bordeaux.fr)  \nEffects of alcohol misuse on the evolution of anxiety during the COVID-19 pandemic in France: results from CONFINS cohort  \nCharline Galesne,1 Julie Arsandaux,2 Mélissa Macalli,1 Nathalie Texier,3,4 Stéphane Schück,3,4 Christophe Tzourio  ,1 Shérazade Kinouani  1,5  \nABSTRACT  \nObjectives to describe the evolution of anxiety during the COVID-19 pandemic in France and to assess whether it differed according to pre-existing alcohol misuse.  \nDesign A prospective longitudinal study.  \nSetting A French online cohort: CONFINS. Data has been collected since the first lockdown in April–May 2020 until January 2022.  \nParticipants 1868 participants being at least 18 years of age and who had been confined in France by government measures.  \nPrimary outcome measure The primary outcome was anxiety, measured through Generalised Anxiety Disorder– seven items (GAD-7) . Its association with alcohol misuse (defined using AUDIT-C score) was estimated using segmented linear mixed models. Interactions with gender and perceived loneliness at baseline were evaluated. Results Of the 1868 included participants, 729 responded to at least one follow-up questionnaire (median followup time: 46 weeks) . We identified 58% as having preexisting alcohol misuse. Alcohol misuse was significantly associated with an increased GAD-7 score starting at the second lockdown in women (β=0 .30; p=0 .014) and in participants having a high perceived loneliness (β=0.59; p=0 .011) .  \nConclusions Pre-existing alcohol misuse appeared to bea risk factor for anxiety during the COVID-19 pandemic, particularly for women and those with high perceived loneliness. Mental health support should be proposed to these vulnerable groups in the event of a future health crisis.  \nINTRODUCTION  \nAlcohol misuse is the term used to describe different types of alcohol consumption that may be harmful to mental or physical health because of the frequency of use, the amount consumed per occasion or the risks taken atthe time of consumption. Beyond the individual health consequences, alcohol misuse has significant social repercussions, contributing to relationship difficulties, professional problems and an increase in accidentsand violence.1 In France, the burden of  \nSTRENGTHS AND LIMITATIONS OF THIS STUDY   \n⇒ A longitudinal design: Data were collected during the three French lockdowns and a few months afterwards.  \n⇒ A broad adjustment: tending to estimate unbiased association.  \n⇒ A sensitivity analysis: to partly estimate the direction of the association between alcohol misuse and anxiety.  \n⇒ A convenience sample, not representative of the French population.  \n⇒ A high attrition rate during follow-up.  \nalcohol use is high, with nearly 50 000 deaths attributed to alcohol consumption in 2009, representing 13% of total mortality among men and 5% among women.2  \nThe bidirectional rel","cbCaivgrxweeCFNK","https://ap.wps.com/l/cbCaivgrxweeCFNK","pdf",570428,11,"English","# Abstract\n## Objectives\n## Design and setting\n## Participants\n## Primary outcome and methods\n## Results\n## Conclusions\n# Introduction\n## Alcohol misuse and mental health context\n## COVID-19 lockdowns and anxiety evolution\n## Perceived loneliness and alcohol use","[{\"question\":\"How was anxiety measured in the CONFINS cohort analysis?\",\"answer\":\"Anxiety was measured using the Generalised Anxiety Disorder-7 items (GAD-7).\"},{\"question\":\"How was alcohol misuse defined for the study?\",\"answer\":\"Alcohol misuse was defined using the AUDIT-C score and evaluated for associations with anxiety outcomes.\"},{\"question\":\"Which groups showed the clearest increase in anxiety after alcohol misuse?\",\"answer\":\"In women, anxiety scores increased significantly starting from the second lockdown; a similar pattern was observed among participants with high perceived loneliness.\"}]","Effects of alcohol misuse on the evolution of anxiety during the COVID-19 pandemic in France: results from CONFINS cohort | PDF",1790742187,28]