Dawson Deborah A, Grant Bridget F, Stinson Frederick S, Chou Patricia S, Huang Boji, Ruan W June
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
Addiction. 2005 Mar;100(3):281-92. doi: 10.1111/j.1360-0443.2004.00964.x.
To investigate the prevalence and correlates of recovery from Diagnostic and Statistical Manual version IV (DSM-IV) alcohol dependence by examining the past-year status of individuals who met the criteria for prior-to-past-year (PPY) dependence.
Cross-sectional, retrospective survey of a nationally representative sample of US adults 18 years of age and over (first wave of a planned longitudinal survey).
This analysis is based on data from the 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which data were collected in personal interviews conducted with one randomly selected adult in each sample household. A subset of the NESARC sample (total n = 43 093), consisting of 4422 US adults 18 years of age and over classified with PPY DSM-IV alcohol dependence, were evaluated with respect to their past-year recovery status: past-year dependence, partial remission, full remission, asymptomatic risk drinking, abstinent recovery (AR) and non-abstinent recovery (NR). Correlates of past-year status were examined in bivariate analyses and using multivariate logistic regression models.
Of people classified with PPY alcohol dependence, 25.0% were still classified as dependent in the past year; 27.3% were classified as being in partial remission; 11.8% were asymptomatic risk drinkers who demonstrated a pattern of drinking that put them at risk of relapse; 17.7% were low-risk drinkers; and 18.2% were abstainers. Only 25.5% of people with PPY dependence ever received treatment. Being married was associated positively with the odds of both AR and NR, and ethanol intake was negatively associated with both. Severity of dependence increased the odds of AR but decreased the odds of NR. The odds of AR (but not NR) increased with age and female gender but were decreased by the presence of a personality disorder. Treatment history modified the effects of college attendance/graduation, age at onset and interval since onset on the odds of recovery.
There is a substantial level of recovery from alcohol dependence. Information on factors associated with recovery may be useful in targeting appropriate treatment modalities.
通过检查符合去年之前（PPY）酒精依赖标准的个体的去年状况，调查从《精神疾病诊断与统计手册》第四版（DSM-IV）酒精依赖中恢复的患病率及其相关因素。
对18岁及以上美国成年人的全国代表性样本进行横断面回顾性调查（计划中的纵向调查的第一波）。
本分析基于2001 - 2002年全国酒精及相关疾病流行病学调查（NESARC）的数据，其中数据通过对每个样本家庭中随机选择的一名成年进行个人访谈收集。NESARC样本的一个子集（总数n = 43093），由4422名18岁及以上被归类为PPY DSM-IV酒精依赖的美国成年人组成，就其去年的恢复状况进行评估：去年的依赖状况、部分缓解、完全缓解、无症状风险饮酒、戒酒恢复（AR）和非戒酒恢复（NR）。在双变量分析中并使用多变量逻辑回归模型检查去年状况的相关因素。
在被归类为PPY酒精依赖的人群中，25.0%在过去一年仍被归类为依赖；27.3%被归类为部分缓解；11.8%是无症状风险饮酒者，其饮酒模式使他们有复发风险；17.7%是低风险饮酒者；18.2%是戒酒者。只有25.5%的PPY依赖者接受过治疗。已婚与AR和NR的几率呈正相关，而乙醇摄入量与两者均呈负相关。依赖的严重程度增加了AR的几率，但降低了NR的几率。AR（而非NR）的几率随年龄和女性性别增加，但因人格障碍的存在而降低。治疗史改变了大学入学/毕业、发病年龄和发病后间隔对恢复几率的影响。
酒精依赖有相当程度的恢复。与恢复相关的因素信息可能有助于确定合适的治疗方式。
