Montane-Jaime L Karelia, Shafe Samuel, Joseph Roma, Moore Shelley, Gilder David A, Crooks Helene, Ramcharan Celia, Ehlers Cindy L
Department of Psychiatry and Pharmacology Unit, Department of Para-Clinical Sciences, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
J Stud Alcohol Drugs. 2008 Nov;69(6):834-9. doi: 10.15288/jsad.2008.69.834.
The clinical course of alcoholism has been described as a series of distinct, alcohol-related life events that occur in an orderly sequence. However, whether that sequence differs, depending on ethnicity and country of origin, is less clear. The purposes of this study were to investigate the sequence and progression of alcohol-related life events in individuals of East Indian (Indo) and African (Afro) heritage on the islands of Trinidad and Tobago, and compare those results with data reported previously by the Collaborative study for the Genetics of Alcoholism (COGA).
Participants who were alcohol dependent (based on Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria) and of Afro-Trinidadian and Tobagonian ancestry or Indo-Trinidadian ancestry were recruited from inpatient treatment facilities. A total of 148 alcohol-dependent men and women completed the Semi-Structured Assessment of the Genetics of Alcoholism, which assessed the physical, psychological, and social manifestations of alcohol dependence and other psychiatric disorders.
A high degree of similarity in the sequence of alcohol-related life events was found between Indo-Trinidadian, Afro-Trinidadian and Tobagonian, and COGA participants. However, Trinidadian and Tobagonian alcoholics were more likely to endorse severe alcohol drinking in the form of binges (2 or more days of intoxication), blackouts, withdrawal, and medical consequences; however, they were less likely to endorse aggressive acts associated with drinking. Progression to alcohol dependence was significantly slower in Trinidadian and Tobagonian alcoholics than in the U.S. population of alcoholics, but severe alcohol symptoms were more commonly endorsed in Trinidadian and Tobagonians.
Identifying ethnic and country of origin differences in the clinical course of alcohol dependence may assist in the development of culturally sensitive intervention and prevention programs.
酗酒的临床病程被描述为一系列按有序顺序发生的、与酒精相关的不同生活事件。然而，该顺序是否因种族和原籍国不同而有所差异尚不清楚。本研究的目的是调查特立尼达和多巴哥岛上东印度裔（印裔）和非洲裔（非裔）个体中与酒精相关生活事件的顺序和进展情况，并将这些结果与先前酒精中毒遗传学协作研究（COGA）报告的数据进行比较。
从住院治疗机构招募符合酒精依赖标准（基于《精神疾病诊断与统计手册》第三版修订版标准）且为特立尼达和多巴哥非裔或印裔血统的参与者。共有148名酒精依赖的男性和女性完成了酒精中毒遗传学半结构化评估，该评估对酒精依赖和其他精神障碍的身体、心理和社会表现进行了评估。
在印裔特立尼达和多巴哥人、非裔特立尼达和多巴哥人以及COGA参与者之间，发现与酒精相关生活事件的顺序有高度相似性。然而，特立尼达和多巴哥的酗酒者更倾向于认可以狂饮（连续2天或更长时间醉酒）、失忆、戒断反应和医学后果等形式出现的严重饮酒行为；然而，他们不太认可与饮酒相关的攻击性行为。特立尼达和多巴哥的酗酒者发展为酒精依赖的进程明显比美国酗酒人群慢，但特立尼达和多巴哥人更常认可严重的酒精症状。
识别酒精依赖临床病程中的种族和原籍国差异可能有助于制定具有文化敏感性的干预和预防方案。
