Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Addiction. 2012 Sep;107(9):1639-40. doi: 10.1111/j.1360-0443.2012.03860.x. Epub 2012 Apr 17.
To identify independent risk factors of the recurrence of alcohol dependence (AD) in people with a remitted disorder at baseline and persistence of AD in people with a current disorder at baseline.
Prospective cohort study with assessments at baseline and 2-year follow-up.
Recruitment from the general population, primary care and out-patient mental health-care services.
People with remitted AD (n = 253) and current AD (n = 135).
Recurrence and persistence of AD during 2-year follow-up were established using the Composite International Diagnostic Interview (CIDI) interview based on DSM-IV. Logistic regression analyses were performed to explore the role of potential risk factors (i.e. baseline severity of alcohol problems, measures for depression and anxiety, socio-demographics, vulnerability factors and addiction-related factors) as independent predictors of a negative course.
Overall recurrence and persistence rates of AD were 14.6 and 40.7%, respectively, and were highly conditional on the severity of alcohol problems [adjusted odds ratio (OR) per standard deviation (SD) increase: OR = 3.64, 95% confidence interval (CI): 2.21-6.01 and OR = 2.12, 95% CI: 1.32-3.40, respectively). Severity of depressive/anxiety symptoms was an additional independent predictor of the recurrence of AD, whereas male gender and high education were significant independent risk factors of the persistence of AD.
Alcohol dependence has a dynamic course, with only moderate levels of diagnostic stability. Both recurrence and persistence of alcohol dependence are highly dependent on severity of baseline alcohol problems, whereas severity of depressive/anxiety symptoms predicts only the recurrence of alcohol dependence. Both measures may be useful in identifying people at an increased risk of a negative course and who could be targeted by prevention strategies.
确定基线时缓解障碍和基线时现患障碍的人群中，酒精依赖（AD）复发的独立风险因素。
前瞻性队列研究，在基线和 2 年随访时进行评估。
从一般人群、初级保健和门诊精神保健服务中招募。
缓解期 AD 患者（n=253）和现患 AD 患者（n=135）。
使用基于 DSM-IV 的复合国际诊断访谈（CIDI）访谈，在 2 年随访期间确定 AD 的复发和持续情况。进行逻辑回归分析，以探索潜在风险因素（即基线酒精问题严重程度、抑郁和焦虑测量、社会人口统计学、脆弱性因素和成瘾相关因素）作为不良病程的独立预测因子的作用。
AD 的总体复发和持续率分别为 14.6%和 40.7%，高度取决于酒精问题的严重程度[每增加一个标准差的调整比值比（OR）：OR=3.64，95%置信区间（CI）：2.21-6.01 和 OR=2.12，95%CI：1.32-3.40]。抑郁/焦虑症状严重程度是 AD 复发的另一个独立预测因子，而男性性别和高教育程度是 AD 持续存在的显著独立危险因素。
酒精依赖具有动态病程，仅具有中度诊断稳定性。AD 的复发和持续都高度依赖于基线酒精问题的严重程度，而抑郁/焦虑症状的严重程度仅预测 AD 的复发。这两个指标都可能有助于识别处于不良病程风险增加的人群，并可作为预防策略的目标。
