Crum Rosa M, Chan Ya-Fen, Chen Li-Shiun, Storr Carla L, Anthony James C
The Johns Hopkins Medical Institutions, Welch Center for Prevention, Epidemiology and Clinical Research, 2024 East Monument Street, Suite 2-500, Baltimore, Maryland 21205, USA.
J Stud Alcohol. 2005 Nov;66(6):795-805. doi: 10.15288/jsa.2005.66.795.
Using prospectively gathered data, we assessed cumulative incidence of alcohol dependence using the Diagnostic Interview Schedule (DIS) based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R).
Probability samples of area residents were selected by census tracts and households in five communities of the Epidemiologic Catchment Area Survey program. The baseline interview for the Baltimore site was completed in 1981, and between 1993 and 1996 the original Baltimore site cohort was traced. After excluding individuals with current or prior history of alcohol dependence at the time of the baseline interview, we identified a cohort of 1,642 individuals who were at risk for alcohol dependence. Person-years of risk were calculated, cumulative incidence obtained, and survival analyses completed.
Several principal findings that confirm some from studies of shorter follow-up intervals are as follows: (1) incidence of alcohol dependence is consistently greater for men and generally decreases with age; (2) problem drinkers have the highest incidence of dependence, and the male-to-female ratio is attenuated in this group; (3) no differences were found for risk of dependence by racial group; and (4) predictors of alcohol dependence include male gender, young age, not being married and having a history of tobacco smoking.
The current study supplies data on the rate of development of DIS/DSM-III-R alcohol dependence in a population-based sample with an extended interval of follow-up. Methodological considerations in the analysis and interpretation of this type of prospectively gathered data are discussed.
我们使用前瞻性收集的数据，根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）的标准，采用诊断访谈表（DIS）评估酒精依赖的累积发病率。
在流行病学集水区调查项目的五个社区中，通过普查区和家庭选取地区居民的概率样本。巴尔的摩站点的基线访谈于1981年完成，1993年至1996年对巴尔的摩站点的原始队列进行了追踪。在排除基线访谈时已有酒精依赖或有酒精依赖既往史的个体后，我们确定了1642名有酒精依赖风险的个体队列。计算风险人年数，获得累积发病率，并完成生存分析。
一些主要发现证实了随访间隔较短的研究中的部分结果，如下：（1）男性酒精依赖的发病率始终较高，且一般随年龄增长而降低；（2）问题饮酒者的依赖发病率最高，且该组男女比例降低；（3）不同种族群体在依赖风险方面未发现差异；（4）酒精依赖的预测因素包括男性、年轻、未婚和有吸烟史。
本研究提供了基于人群样本且随访间隔延长的DIS/DSM-III-R酒精依赖发生率数据。讨论了分析和解释这类前瞻性收集数据时的方法学考虑因素。
