Family history of alcoholism and gender: Their combined effects on DSM-IV alcohol dependence and major depression
Family history of alcoholism and gender: Their combined effects on DSM-IV alcohol dependence and major depression
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DOI：
10.15288/jsa.1998.59.97
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发表时间：
1998-01-01
期刊：
影响因子：
--
通讯作者：
Grant, BF
中科院分区：
文献类型：
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作者：
Dawson, DA;Grant, BF
目的：使用来自美国成年人代表性样本的数据来评估熟悉的酗酒程度，以检查其与 DSM-IV 终生酒精依赖、重度抑郁症及其共病发生几率的关联，并确定这种关联的程度在男性和女性中是否不同。方法：通过多重逻辑回归模型对 42,862 名 18 岁及以上美国成年人（25,043 名女性）样本的自我报告数据进行分析，该模型预测 DSM-IV 酒精依赖和重度抑郁症的各种组合的几率。结果：通过多重逻辑回归调整潜在的混杂因素后，家族史饱和度仅与依赖性、抑郁症以及这两种疾病的所有原发性-继发性并发组合的几率增加相关。估计对共病依赖性和抑郁症的影响最大，对仅依赖性的影响次之最高，对仅抑郁症的影响最低。这些群体之间的比值比差异随着家族史饱和度的增加而增加，但在所有饱和度水平上均具有统计学意义。对于原发性抑郁症和继发性依赖的结果，家族史对男性的影响大于女性，但仅限于较高的饱和度。在患有终生重度抑郁症的人中，酗酒家族史与经历共病酒精依赖的条件几率呈正向独立相关。它与共病抑郁症的几率有较弱但仍然显着的关联，条件是经历过依赖，而且这种关联在男性中比在女性中更强。对于大多数结局，家族史对父亲男性和母亲女性亲属的影响比对父亲女性和母亲男性亲属的影响更大。结论：这些发现支持了先前的研究，即有依赖性和抑郁症共病的人比单独有依赖性的人有更多的家族性酗酒现象。性别差异支持了纯粹抑郁症和抑郁谱系疾病之间所提出的区别。
Objective: Data from a representative sample of U.S. adults were used to assess the extent of familiar alcoholism to examine its association with the odds of DSM-IV lifetime alcohol dependence, major depression, and their comorbid occurrence, and to determine whether the magnitude of this association was different for men and women. Method: Self-report data from a sample of 42,862 U.S. adults (25,043 women) 18 years of age and over were analyzed by means of multiple logistic regression models that predicted the odds of various combinations of DSM-IV alcohol dependence and major depression. Results: After adjusting for potential confounders through multiple logistic regression, family history saturation was associated with increased odds of dependence only, depression only, and all primary-secondary concurrent combinations of these two disorders. The estimated effects were greatest for comorbid dependence and depression, next highest for dependence only and lowest for depression only. Differences in odds ratios among these groups increased with degree of family history saturation but were statistically significant at all levels of saturation. The effects of family history were greater for men than women for the outcome of primary depression followed by secondary dependence, but only at the higher levels of saturation. Among persons with lifetime major depression, family history of alcoholism had a positive independent association with the conditional odds of having experienced comorbid alcohol dependence. It had a weaker but still significant association with the odds of comorbid depression, conditional upon having experienced dependence, and this association was stronger among men than among women. For most outcomes, family history effects were stronger for paternal male and maternal female relatives than for paternal female and maternal male relatives. Conclusions: These findings supported prior research showing more familial alcoholism among persons with comorbid dependence and depression than among those with dependence alone. Gender differences were supportive of the proposed distinction between pure depression and depressive-spectrum disease.