Onset and course of alcoholism over 25 years in middle class men.

Onset and course of alcoholism over 25 years in middle class men.
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DOI:
10.1016/j.drugalcdep.2010.06.017
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发表时间:
2011-01-01
影响因子:
4.2
通讯作者:
Smith, Tom L.
Smith, Tom L.
中科院分区:
医学2区
文献类型:
--
作者:
Schuckit, Marc A.;Smith, Tom L.

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饮酒模式和酒精问题随着年龄的增长而变化。然而,很少有研究使用多个数据点和从成年早期到中年的详细历史。这项研究报告了圣地亚哥前瞻性研究中 373 名男性的此类数据。数据是在 20 岁时的基线 (T1) 生成的,并通过每 5 年一次对超过 90% 符合资格的白人和受教育程度相对较高的男性进行面对面的后续访谈。根据他们的病程,受试者被分为 4 组:62.5% 没有酒精使用障碍 (AUD); 17.2% AUD 发病年龄小于 30 岁且呈慢性病程; 6.7% 发病年龄≥30岁且无恢复; AUD 发病年龄<30 岁且在 25 年随访前维持缓解超过 5 年的患者为 13.7%。在单变量水平上,对酒精的低水平反应 (LR)、AUD 家族史和 20 岁左右较高的新鲜度寻求预测 AUD 在 30 岁之前发病(平均年龄约 25 岁),但其中只有 LR 也预测较晚发病(平均年龄 38 岁)。 AUD 的其他预测因素包括人口统计学(教育程度较低)以及 T1 之前更多地参与酒精、毒品和尼古丁。酗酒者的 AUD 持续缓解是通过 T1 和 T10 饮酒频率较低、T10 分居或离婚以及奖励依赖性较高的趋势来预测的。这些数据表明,十几岁到二十岁出头的可用信息可以帮助预测 AUD 的未来发病和病程,并强调物质使用障碍纵向研究的重要性。
Patterns of drinking and alcohol problems change with age. However, few studies use multiple data points and detailed history spanning early adulthood to middle age. This study reports such data from 373 men in the San Diego Prospective Study. Data were generated at baseline (T1) at ~age 20, and through face-to-face follow-up interviews ~every 5 years in >90% of these eligible Caucasian and relatively higher educated men. Subjects were placed into 4 groups regarding their course: 62.5% with no alcohol use disorder (AUD); 17.2% with AUD onset <age 30 and a chronic course; 6.7% with onset ≥age 30 and no recovery; and 13.7% with AUD onset <age 30 and maintained remission for >5 years before the 25-year followup. On a univariate level, low level of response (LR) to alcohol, family history of AUDs, and higher Novelty Seeking at ~age 20 predicted AUDs with onset before age 30 (mean age ~25), but among these only LR predicted later onset (mean age 38) as well. Additional predictors of AUDs included demography (lower education), and greater involvement with alcohol, drugs, and nicotine prior to T1. Sustained remission from AUDs among alcoholics was predicted by lower T1 and T10 drinking frequencies, and being separated or divorced at T10, along with a trend for higher Reward Dependence. These data indicate that information available in the late teens to early 20’s can help predict the future onset and course of AUDs, and underscore the importance of longitudinal studies in substance use disorders.
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