Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III.
Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III.
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DOI：
10.1001/jamapsychiatry.2015.0584
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发表时间：
2015-08
期刊：
影响因子：
25.8
通讯作者：
Hasin DS
中科院分区：
文献类型：
--
作者：
Grant BF;Goldstein RB;Saha TD;Chou SP;Jung J;Zhang H;Pickering RP;Ruan WJ;Smith SM;Huang B;Hasin DS
需要使用可靠、有效和统一的数据源，从最近收集的关于酒精使用障碍（AUD）新DSM-5分类的数据中获得国家流行病学信息。介绍DSM-5 AUD诊断的患病率、相关因素、精神病合并症、相关残疾和治疗的全国代表性结果，并根据严重程度（轻度、中度或重度）进行分析。我们对一个具有代表性的美国非制度化平民成年人（≥18岁）样本（N = 36 309）进行了面对面访谈，作为2012-2013年酒精和相关疾病国家流行病学调查III（NESARC-III）。数据收集于2012年4月至2013年6月，并于2014年10月进行分析。AUD的每月和终生患病率。AUD的十个月和终生患病率分别为13.9%和29.1%。男性的患病率通常最高（分别为17.6%和36.0%），白色（分别为14.0%和32.6%）和美洲原住民（分别为19.2%和43.4%）、受访者、以及年轻（分别为26.7%和37.0%）和以前结婚（分别为11.4%和27.1%）或从未结婚（分别为25.0%和35.5%）的成年人。12个月和终生严重AUD的患病率在收入水平最低的受访者中最高（分别为1.8%和1.5%）。严重残疾与12个月和终生AUD相关，并随着AUD的严重程度而增加。只有19.8%的终生AUD患者接受过治疗。在12个月和终生AUD与其他物质使用障碍、重性抑郁和双相I型障碍、反社会和边缘型人格障碍之间发现了显著的相关性，在所有AUD严重程度水平上，比值比范围为1.2（95%CI，1.08-1.36）至6.4（95%CI，5.76-7.22）。AUD与惊恐障碍、特定恐怖症和广泛性焦虑障碍之间的相关性是适度的（在大多数AUD严重程度水平上，比值比范围为1.2（95%CI，1.01-1.43）至1.4（95%CI，1.13-1.67）。由DSM-5标准定义的酒精使用障碍是一种高度流行、高度共病、致残的疾病，在美国经常未经治疗。NESARC-III数据表明，迫切需要教育公众和政策制定者了解AUD及其治疗方案，消除这种疾病的污名，并鼓励那些无法自行减少饮酒的人寻求治疗，尽管对自己和他人造成了重大伤害。
National epidemiologic information from recently collected data on the new DSM-5 classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed. To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, associated disability, and treatment of DSM-5 AUD diagnoses overall and according to severity level (mild, moderate, or severe). We conducted face-to-face interviews with a representative US noninstitutionalized civilian adult (≥18 years) sample (N = 36 309) as the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 through June 2013 and analyzed in October 2014. Twelve-month and lifetime prevalences of AUD. Twelve-month and lifetime prevalences of AUD were 13.9% and 29.1%, respectively. Prevalence was generally highest for men (17.6% and 36.0%, respectively), white (14.0% and 32.6%, respectively) and Native American (19.2% and 43.4%, respectively), respondents, and younger (26.7% and 37.0%, respectively) and previously married (11.4% and 27.1%, respectively) or never married (25.0% and 35.5%, respectively) adults. Prevalence of 12-month and lifetime severe AUD was greatest among respondents with the lowest income level (1.8% and 1.5%, respectively). Significant disability was associated with 12-month and lifetime AUD and increased with the severity of AUD. Only 19.8% of respondents with lifetime AUD were ever treated. Significant associations were found between 12-month and lifetime AUD and other substance use disorders, major depressive and bipolar I disorders, and antisocial and borderline personality disorders across all levels of AUD severity, with odds ratios ranging from 1.2 (95% CI, 1.08-1.36) to 6.4 (95% CI, 5.76-7.22). Associations between AUD and panic disorder, specific phobia, and generalized anxiety disorder were modest (odds ratios ranged from 1.2 (95% CI, 1.01-1.43) to 1.4 (95% CI, 1.13-1.67) across most levels of AUD severity. Alcohol use disorder defined by DSM-5 criteria is a highly prevalent, highly comorbid, disabling disorder that often goes untreated in the United States. The NESARC-III data indicate an urgent need to educate the public and policy makers about AUD and its treatment alternatives, to destigmatize the disorder, and to encourage those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment.