Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Strasse 46, Dresden, Germany.
Psychol Med. 2011 May;41(5):1073-85. doi: 10.1017/S0033291710001418. Epub 2010 Jul 21.
Among adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are inter-individual differences in the speed of transition from initial alcohol use (AU) to AUD. AUDs are highly co-morbid with other mental disorders. The factors associated with rapid transition from first AU to AUD remain unknown and the role of mental disorders in rapid transitions is unclear. Given this background we examined (1) whether prior anxiety, mood, externalizing and non-alcohol substance use disorders are related to the risk and speed of transition from first AU to DSM-IV alcohol abuse (AA) and alcohol dependence (AD) and (2) whether early age of onset of prior mental disorders (PMDs) is a promoter of rapid transition.
A total of 3021 community subjects (97.7% lifetime AU) aged 14-24 years at baseline were followed up prospectively for up to 10 years. AU and mental disorders were assessed with the DSM-IV/M-CIDI.
Among subjects with lifetime AU, several PMDs, such as specific phobia, bipolar disorder and nicotine dependence, were associated with an increased risk of AUD independent of externalizing disorders. Associations of PMDs with the speed of transition to AUDs were mostly weak and inconsistent. Only social phobia and externalizing disorders were associated with faster transitions to AD even after adjustment for other PMDs. Earlier age of onset of PMD was not associated with rapid transition.
Mental disorders are associated with the risk of AUD. With the possible exception of social phobia and externalizing disorders, they do not promote rapid transition, even if they occur particularly early. Future research needs to identify factors relevant to rapid transition to AUD.
在患有 DSM-IV 酒精使用障碍（AUD）的青少年和年轻人中，从最初饮酒（AU）到 AUD 的转变速度存在个体间差异。AUD 与其他精神障碍高度共病。与从首次 AU 到 AUD 的快速转变相关的因素尚不清楚，精神障碍在快速转变中的作用也不清楚。鉴于此，我们研究了（1）先前的焦虑、情绪、外化和非酒精物质使用障碍是否与从首次 AU 到 DSM-IV 酒精滥用（AA）和酒精依赖（AD）的风险和转变速度相关，以及（2）先前精神障碍（PMD）的发病年龄是否是快速转变的促进因素。
共有 3021 名年龄在 14-24 岁的社区受试者（97.7%有终生 AU）在基线时进行前瞻性随访，最长可达 10 年。AU 和精神障碍使用 DSM-IV/M-CIDI 进行评估。
在有终生 AU 的受试者中，几种 PMD，如特定恐惧症、双相情感障碍和尼古丁依赖，与 AUD 的风险增加独立于外化障碍有关。PMD 与 AUD 转变速度的关联大多较弱且不一致。只有社交恐惧症和外化障碍与 AD 的快速转变有关，即使在调整了其他 PMD 后也是如此。PMD 的发病年龄较早与快速转变无关。
精神障碍与 AUD 的风险相关。除了社交恐惧症和外化障碍外，它们不会促进快速转变，即使它们发生得特别早。未来的研究需要确定与 AUD 快速转变相关的因素。
