Alcohol Abuse Dependence Research Articles

Alcoholism and depression in a Swedish female population: co‐morbidity andrisk factors

Our aims were to study associations between depressive disorders and alcohol dependence/abuse (ADA) in a female population-based sample, and to identify risk indicators common to both depressive disorders and ADA. Three hundred and sixteen women in a stratified randomized sample were interviewed face to face. They were asked about their childhood/adolescence and alcohol habits. Clinical lifetime diagnoses according to DSM-III-R were made. Depressive disorders includes different mood disorders. Half the women with ADA also had a depressive disorder, and 25% of the women with depressive disorders also had ADA. Alcohol intoxication before the age of 15 and psychological and/or psychiatric problems before the age of 18 years increased the risk for ADA and depressive disorders in our study. Our results support previous findings of an association between depressive disorders and ADA, beginning early in life.

Sick-leave in women with alcohol dependence or abuse: effects of additional psychiatric disorders.

The study objective was to assess sick-leave among women investigated in a general population survey of alcohol dependence/abuse (ADA). A total of 399 women, selected by stratified random sampling, were interviewed and diagnosed according to DSM-III-R. Data on sick-leave were obtained by linkage with the Social Insurance records. The study found that women with ADA but without other psychiatric disorders had an increased number of annual sick-leave spells--1.82 compared with 1.47 in the reference population-whereas the mean duration was similar. Women with ADA and other psychiatric disorders had 2.38 annual spells, but also considerably longer spells (mean 16.54 days vs 9.70). Socio-economic differences were large, with the less privileged groups having both more and longer spells. Stepwise multiple regression showed that both ADA and other psychiatric disorders contributed to high sick-leave incidence and duration, as, to a lesser extent, did low education and low social group (the last variable only affected duration of the spells). The frequency of disability pension/long sickness spells was higher in women with ADA (odds ratio of 2.95). We concluded that there is a strong association between ADA and sick-leave, which increases considerably in the presence of additional psychiatric disorders.

The familial aggregation of common psychiatric and substance use disorders in the National Comorbidity Survey: a family history study.

Most family studies of psychiatric disorders examine one syndrome at a time, and identify probands in clinical rather than epidemiological settings. In the National Comorbidity Survey, 5877 respondents were asked about the history of five psychiatric disorders in their parents: major depression (MD), generalised anxiety disorder (GAD), antisocial personality disorder (ASP), alcohol abuse/dependence (AAD) and drug abuse/dependence (DAD). Significant familial aggregation was seen for all disorders. Controlling for other disorders produced only modest reductions in the odds ratios for MD, GAD and AAD and larger reductions for ASP and DAD. The familial transmission of these disorders can be explained by underlying vulnerabilities to internalising and to externalising disorders transmitted across generations with moderate fidelity. Familial aggregation of common psychiatric and substance use disorders is substantial in epidemiologic samples. The examined environmental adversities account for little of the observed parent-offspring transmission of these conditions.

Factors in childhood and youth predicting alcohol dependence and abuse in Swedish women: findings from a general population study.

The aim was to assess risk factors during childhood and youth for alcohol dependence/abuse (ADA) in a population-based study of Swedish women. A total of 316 women were interviewed after stratified random sampling in the general population and a screening questionnaire. The interviews focused on social, psychological and behaviour characteristics as well as on early substance use patterns. Alcohol diagnoses were made according to DSM-III-R and CIDI-SAM. Experiences of sexual abuse before the age of 13 years, a history of psychological or psychiatric problems, early deviant behaviour and an episode of alcohol intoxication before the age of 15 years were significantly associated with ADA in a logistic model. General indicators of low social class were not associated with increased risk of ADA in a multivariate analysis. Sexual abuse in childhood was the strongest predictor of ADA. This association has potential public health importance, and should be addressed in future studies on women and alcohol.

Occupational Stress and the Risk of Alcohol Abuse and Dependence

Using prospective data, we examined the relationship between occupational stress and risk for alcohol disorders. Consistent with the Demand/Control model for psychosocial work environments, we hypothesized that individuals working in high-strain occupations (jobs with high demands and low control) would be at increased risk for alcohol abuse-dependence relative to those in low-strain occupations (jobs with low demands and high control). We classified high occupational strain into two categories: (1) jobs with high psychological demands and low control, and (2) those with high physical demands and low control. A total of 18,571 study subjects were selected in 1980-1984 by taking probability samples of adult household residents at five sites of the Epidemiologic Catchment Area Program. At baseline, participants completed standardized interviews that measured sociodemographic variables and assessed whether they had met diagnostic criteria for currently or formerly active alcohol abuse-dependence syndromes. The interviews were readministered 1 year later to identify cases among the participants. Subjects were sorted into risk sets by age and residence census tract, and persons with a previous history of alcohol abuse or dependence, as well as those who were over 64 years or had no history of full-time employment, were excluded. Among the 507 participants included in the risk sets, there were 126 incident cases of alcohol abuse-dependence and 381 age and residence-matched noncases.(ABSTRACT TRUNCATED AT 250 WORDS)

Aggressivity in adolescent alcohol abusers: relationship with conduct disorder.

Several longitudinal and retrospective studies have documented an association between premorbid aggression and an increased risk for an alcohol-use disorder in adulthood. However, few data are available examining the relationship between trait aggressivity, alcohol use behavior, and the presence of an early-onset alcohol use disorder diagnosis among the adolescent population. To address this deficiency, this study had three goals. First, the relationship between aggressivity and adolescent alcohol consuming behavior was examined. Second, the presence and magnitude of trait aggressivity were determined among adolescents who met psychiatric diagnostic criteria for alcohol abuse/dependence (ALC), while controlling for the presence of a conduct disorder (CD). Third, because CD is overrepresented among adolescent alcohol abuse cases and is a priori defined by the presence of certain aggressive behaviors, the simultaneous contributions of CD and ALC on trait aggressivity were also investigated through structural equation modeling. The results confirm the salience of heightened aggressivity as an essential feature of this early-onset alcohol-abusing population and indicate the importance of addressing this behavioral domain in prevention and treatment efforts.

Screening and diagnosis of "alcohol abuse and dependence" in older adults.

A literature review reveals that research is warranted to improve screening for "alcohol abuse" in older adults and women. An examination of diagnostic criteria for "alcohol abuse dependence" reveals that older adults provide unique challenges to classification systems. There is a need to evaluate the sensitivity and specificity of several new screening instruments for the identification of "alcohol abuse" in the elderly. Routine screening of elderly and women presenting in primary care settings should be a priority for researchers and clinicians.

The risk of alcohol abuse and dependence in adulthood: the association with educational level.

In this analysis of prospectively gathered data, the authors sought to estimate the degree to which risk of alcohol abuse and dependence might be elevated among adults who attended but did not complete high school and among those who attended college without earning a degree. Study subjects were selected in 1980-1984 by taking probability samples of adult household residents at five sites of the Epidemiologic Catchment Area Program: New Haven, Connecticut; Baltimore, Maryland; St. Louis, Missouri; Durham-Piedmont, North Carolina; and Los Angeles, California. At baseline, participants completed standardized interviews that measured sociodemographic variables and assessed whether they had met diagnostic criteria for currently or formerly active alcohol abuse-dependence syndromes. The interviews were readministered 1 year later to identify incident cases among the 13,673 participants. After subjects were sorted into risk sets by age and residence census tract and after persons with a prior history of alcohol abuse or dependence were excluded, there were in 156 risk sets 160 incident cases and 526 subjects at risk for future occurrence of alcohol syndromes. Compared with adults who had earned a college degree, those who had attended high school without completion were at increased risk (relative risk (RR) = 6.23, 95 percent confidence interval (CI) 2.41-16.09) as were adults who had attended college without earning a degree (RR = 3.25, 95 percent CI 1.36-7.76). In contrast, risk of alcohol disorders among adults with a high school diploma but no college was not reliably greater than the level of risk for those with a college degree (RR = 1.88, 95 percent CI 0.79-4.47).

Sex and age effects on the inheritance of alcohol problems: a twin study.

Male monozygotic cotwins of probands with Alcohol Abuse-Dependence (n = 85) were more likely than male same-sex dizygotic cotwins (n = 96) to report alcohol, drug, and conduct disorder problems. For women, rates of problem behavior did not differ between monozygotic (n = 44) and same-sex dizygotic (n = 43) cotwins. Opposite-sex dizygotic twin data (n = 88) revealed significant cross-sex transmission; alcohol problems were greatest among male cotwins of female probands. For men, proportion of liability variance associated with additive genetic factors was significantly greater when proband had an early (h2 = .73 +/- .18) rather than late (h2 = .30 +/- .26) age of onset. For women, heritability did not vary as a function of proband's age of onset, and the pooled estimate suggested little genetic influence (h2 = .00, SE not computable). Findings suggest that genetic influences may be substantial only in the etiology of early-onset male alcoholism.