Age of alcohol-dependence onset: Associations with severity of dependence and seeking treatment
Age of alcohol-dependence onset: Associations with severity of dependence and seeking treatment
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DOI：
10.1542/peds.2006-0223
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发表时间：
2006-09-01
期刊：
影响因子：
8
通讯作者：
Winter, Michael R.
中科院分区：
文献类型：
--
作者：
Hingson, Ralph W.;Heeren, Timothy;Winter, Michael R.
目标。我们探讨了在年轻时就成为酒精依赖的人是否更有可能寻求酒精相关的帮助或治疗，或者经历慢性复发的依赖。2001-2002年，国家酒精滥用和酒精中毒研究所完成了一项面对面访谈调查，对43 093名年龄在18岁以上的成年人进行了多阶段概率抽样，回复率为81%。我们集中研究了4778名使用精神疾病诊断和统计手册第四版标准诊断为酒精依赖的人。Logistic回归检验了受访者是否曾寻求过与酒精相关的帮助或治疗，控制了受访者的人口统计数据、经历过的依赖症状数量、吸烟和非法药物使用、童年反社会人格和抑郁症、酗酒家族史和饮酒发病年龄。在曾经依赖酒精的人中，15%在18岁之前被诊断出来，47%在21岁之前，三分之二在25岁之前。28%的人报告了>= 2次依赖发作，45%的人经历了超过1年的发作，34%的人报告了6或7个依赖标准。相对于那些在30岁时首次依赖酒精的人，那些曾经依赖酒精的人中有21%，在18岁，20岁和25岁之前首次依赖酒精的人寻求帮助的几率更低。然而，在bb0 = 25岁时首次依赖的人经历多次依赖发作、发作超过1年以及更多依赖症状的几率显著增加。分析表明，先前报道的早期开始饮酒的人出现慢性复发性依赖特征的几率增加，可能是因为早期饮酒者更有可能在年轻时产生酒精依赖。这反过来又增加了他们经历多次和更长时间的酒精依赖发作并伴有更多症状的几率。青少年需要接受酒精筛查和咨询，治疗服务应通过延迟首次酒精依赖年龄的规划和政策得到加强。
OBJECTIVE. We explored whether people who become alcohol dependent at younger ages are more likely to seek alcohol-related help or treatment or experience chronic relapsing dependence.METHODS. In 2001-2002 the National Institute on Alcohol Abuse and Alcoholism completed a face-to-face interview survey with a multistage probability sample of 43 093 adults aged >= 18, with a response rate of 81%. We focused on 4778 persons diagnosable as alcohol dependent ever in their lives using Diagnositic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Logistic regression examined whether respondents ever sought alcohol-related help or treatment, controlling for respondent demographics, number of dependence symptoms experienced, smoking and illicit drug use, childhood antisocial personality and depression, family history of alcoholism, and age of drinking onset.RESULTS. Of persons ever alcohol dependent, 15% were diagnosable before age 18, 47% before age 21, and two thirds before age 25. Twenty-eight percent reported >= 2 dependence episodes, 45% experienced an episode exceeding 1 year, and 34% reported 6 or 7 dependence criteria. Relative to those first alcohol dependent at >= 30 years, 21% of those ever dependent, the odds of ever seeking help were lower among those first dependent before ages 18, 20, and 25. Yet, persons first dependent at >= 25 years had significantly greater odds of experiencing multiple dependence episodes, episodes exceeding 1 year, and more dependence symptoms. Analyses indicated that the previously reported increased odds that persons who start to drink at an early age develop features of chronic relapsing dependence may have resulted from early drinkers being more likely to develop alcohol dependence at younger ages. This, in turn, increased their odds of experiencing multiple and longer episodes of alcohol dependence with more symptoms.CONCLUSIONS. Adolescents need to be screened and counseled about alcohol, and treatment services should be reinforced by programs and policies to delay age of first alcohol dependence.