Age and ethnic differences in the onset, persistence and recurrence of alcohol use disorder
Age and ethnic differences in the onset, persistence and recurrence of alcohol use disorder
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DOI：
10.1111/j.1360-0443.2011.03721.x
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发表时间：
2012-04-01
期刊：
影响因子：
6
通讯作者：
Bucholz, Kathleen K.
中科院分区：
文献类型：
--
作者：
Grant, Julia D.;Verges, Alvaro;Bucholz, Kathleen K.
目的在一个发展框架中估计酒精使用障碍和酒精依赖过程（发病、持续和复发）的三个组成部分的种族差异。设计来自全国酒精及相关疾病流行病学调查（NESARC）的纵向数据，采用面对面访谈收集。年龄在18岁及以上的非收容美国平民人口，以西班牙裔、黑人和18-24岁的人口为过采样对象。参与者：完成NESARC两项评估的个体，不是终身戒酒者，白人（n = 17458）、黑人（n = 4995）、美国出生的西班牙裔（n = 2810）或美国以外出生的西班牙裔（n = 2389）。酒精依赖（AD）和酒精使用障碍（AUD；滥用或依赖）的发生、持续和复发使用DSM-IV版酒精使用障碍和相关残疾访谈表进行检查。在男性中：相对于18-29岁的白人，仅在40岁及以上的美国出生的西班牙裔男性中，AUD的发病和持续时间升高；对于所有非美国出生的西班牙裔、年龄较大的白人、大多数黑人和年龄在30-39岁的美国出生的西班牙裔，患病几率降低。对于阿尔茨海默病，所有年轻的少数族裔男性的发病风险都升高，只有非美国出生的40岁以上的西班牙裔男性发病风险降低。对于女性：与年轻白人相比，非美国出生的西班牙裔女性患AUD和AD的风险较低；老年黑人和在美国出生的西班牙裔人群中，AUD和AD的发病和持续时间增加。结论：在美国，酒精障碍转变（发病、持续和复发）的种族差异因年龄、性别和使用广义（酒精使用障碍）或狭义（酒精依赖）酒精定义而异。少数群体中某些过渡风险增加的证据表明，应注意酒精使用障碍的过程，不应认为患病率的差异反映了具体过渡的差异。
Aims To estimate ethnic differences in three components of alcohol use disorder and alcohol dependence course (onset, persistence and recurrence) in a developmental framework. Design Longitudinal data from The National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), collected using face-to-face interviews. Setting Civilian non-institutionalized US population aged 18 years and older, with oversampling of Hispanics, blacks and those aged 18-24 years. Participants Individuals who completed both NESARC assessments, were not life-long abstainers and were either white (n = 17 458), black (n = 4995), US-born Hispanic (n = 2810) or Hispanic-born outside the United States (n = 2389). Measurements Alcohol dependence (AD) and alcohol use disorder (AUD; abuse or dependence) onset, persistence and recurrence were examined using the Alcohol Use Disorders and Associated Disabilities Interview Schedule, DSM-IV version. Findings Among men: relative to whites aged 18-29, AUD onset and persistence were elevated only in US-born Hispanics aged 40 years and older; odds were reduced for all non-US-born Hispanics, older whites, most blacks and US-born Hispanics aged 30-39. For AD, onset risk was elevated for all younger minority men and only reduced among non-US-born aged Hispanics 40 or older. For women: compared to young whites, non-US-born Hispanics were at decreased AUD and AD onset risk; AUD and AD onset and persistence were increased for older blacks and US-born Hispanics. Conclusions In the United States, ethnic differences in alcohol disorder transitions (onset, persistence, and recurrence) vary across age, gender and whether a broad (alcohol use disorder) or narrow (alcohol dependence) alcohol definition is used. Evidence of increased risk for some transitions in minority groups suggests that attention should be paid to the course of alcohol use disorders, and that differences in prevalence should not be assumed to reflect differences in specific transitions.