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Data has been collected since the first lockdown in April\u2013May 2020 until January 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>1868 participants being at least 18 years of age and who had been confined in France by government measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>\n                      The primary outcome was anxiety, measured through\n                      <jats:italic>Generalised Anxiety Disorder \u2013 seven<\/jats:italic>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1868 included participants, 729 responded to at least one follow-up questionnaire (median follow-up time: 46 weeks). We identified 58% as having pre-existing alcohol misuse. Alcohol misuse was significantly associated with an increased GAD-7 score starting at the second lockdown in women (\u03b2=0.30; p=0.014) and in participants having a high perceived loneliness (\u03b2=0.59; p=0.011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-existing alcohol misuse appeared to be a 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105567","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:30:14Z","timestamp":1767774614000},"page":"e105567","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of alcohol misuse on the evolution of anxiety during the COVID-19 pandemic in France: results from CONFINS cohort"],"prefix":"10.1136","volume":"16","author":[{"given":"Charline","family":"Galesne","sequence":"first","affiliation":[{"name":"Bordeaux Population Health, University of Bordeaux College of Health Sciences, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Arsandaux","sequence":"additional","affiliation":[{"name":"Laboratoire de psychologie des Pays de la Loire, Nantes University, Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e9lissa","family":"Macalli","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health, University of Bordeaux College of Health Sciences, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Texier","sequence":"additional","affiliation":[{"name":"Kappa Sant\u00e9, Paris, France"},{"name":"Kap Code, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Sch\u00fcck","sequence":"additional","affiliation":[{"name":"Kappa Sant\u00e9, Paris, France"},{"name":"Kap Code, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6517-2984","authenticated-orcid":false,"given":"Christophe","family":"Tzourio","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health, University of Bordeaux College of Health Sciences, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2921-008X","authenticated-orcid":false,"given":"Sh\u00e9razade","family":"Kinouani","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health, University of Bordeaux College of Health Sciences, Bordeaux, France"},{"name":"Department of General Practice, University of Bordeaux College of Health Sciences, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"2026010700300526000_16.1.e105567.1","doi-asserted-by":"crossref","unstructured":"Rehm J , Manthey J , Shield KD . 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