Rubio Gabriel, Manzanares Jorge, Jiménez Mónica, Rodríguez-Jiménez Roberto, Martínez Isabel, Iribarren Miguel M, Jiménez-Arriero Miguel A, Ponce Guillermo, Palomo Tomás
Alcoholism Research Program, Mental Health Center of Retiro, Madrid, Spain.
J Clin Psychiatry. 2008 Apr;69(4):563-70. doi: 10.4088/jcp.v69n0407.
The development of alcohol dependence is associated with specific individual personality traits and previous consumption of other drugs of abuse. However, there is little information on these risk factors in heavy drinkers before and after they meet the criteria for alcohol dependence. This study examined the influence of cocaine use and the role of impulsivity in the development of DSM-IV alcohol dependence in nondependent drinkers in a 4-year follow-up study.
A prospective cohort study was conducted to establish the risk factors associated with DSM-IV alcohol dependence. Four hundred seventy-one (nondependent) heavy drinkers were enrolled in a prospective study. At baseline, 280 were classified as heavy drinkers (HD) and 191 as heavy drinkers who also used cocaine (HD + Co). Clinical variables related to alcohol and cocaine use were assessed at 2 years and at the end of the 4-year follow-up period. The study was conducted from September 2001 until September 2006 in Madrid, Spain.
At the 4-year follow-up assessment, 67.9% of the HD + Co group met DSM-IV criteria for alcohol dependence compared to 13.6% of the HD group. Odds ratios for alcohol dependence were 12.3 and 7.0 for male and female cocaine users, respectively. Clinical and psychological variables related to impulsivity were associated with the development of alcohol dependence. The amount of cocaine used during follow-up was associated with a more rapid progression to alcohol dependence.
This study revealed that cocaine use or an impulsive personality in heavy drinkers increased the risk of developing DSM-IV alcohol dependence by 3.8 and 12.6 times, respectively. These results may be useful in designing new strategies for preventing the development of alcohol dependence.
酒精依赖的发展与特定的个人性格特征以及先前使用其他滥用药物有关。然而，关于重度饮酒者在符合酒精依赖标准前后这些风险因素的信息却很少。本研究在一项为期4年的随访研究中，考察了可卡因使用的影响以及冲动性在非依赖饮酒者发展为DSM-IV酒精依赖过程中的作用。
进行了一项前瞻性队列研究，以确定与DSM-IV酒精依赖相关的风险因素。471名（非依赖）重度饮酒者参与了一项前瞻性研究。在基线时，280人被归类为重度饮酒者（HD），191人被归类为同时使用可卡因的重度饮酒者（HD + Co）。在2年和4年随访期结束时，评估了与酒精和可卡因使用相关的临床变量。该研究于2001年9月至2006年9月在西班牙马德里进行。
在4年随访评估时，HD + Co组中有67.9%符合DSM-IV酒精依赖标准，而HD组为13.6%。男性和女性可卡因使用者酒精依赖的优势比分别为12.3和7.0。与冲动性相关的临床和心理变量与酒精依赖的发展有关。随访期间使用的可卡因量与更快发展为酒精依赖有关。
本研究表明，重度饮酒者使用可卡因或具有冲动性人格会使发展为DSM-IV酒精依赖的风险分别增加3.8倍和12.6倍。这些结果可能有助于设计预防酒精依赖发展的新策略。
