Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, New York.
Alcohol Clin Exp Res. 2013 Oct;37(10):1696-705. doi: 10.1111/acer.12158. Epub 2013 Jun 13.
An extensive clinical literature has noted gender differences in the etiology and clinical characteristics of individuals with alcohol dependence (AD). Despite this knowledge, many important questions remain.
Using the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093), we examined differences in sociodemographic characteristics, psychiatric and medical comorbidities, clinical correlates, risk factors, and treatment-utilization patterns of men (N = 2,974) and women (N = 1,807) with lifetime AD.
Men with lifetime AD were more likely than women to be diagnosed with any substance use disorder and antisocial personality disorder, whereas women were more likely to have mood and anxiety disorders. After adjusting for sociodemographic characteristics and gender differences in psychiatric comorbidity in the general population, AD was associated with externalizing disorders and any mood disorder among women only. Men with AD met more criteria, had longer episodes, and were younger at the age of first drink. There were no gender differences in remission rates. Women with AD were more likely to have a family and a spouse with history of alcohol use disorders. Treatment rates were low for both genders, and women were more likely to report social stigmatization as a treatment barrier.
There are important gender differences in the psychiatric comorbidities, risk factors, clinical characteristics, and treatment-utilization patterns among individuals with lifetime AD.
大量临床文献指出,在酒精依赖(AD)个体的病因和临床特征方面存在性别差异。尽管有这些知识,但仍有许多重要问题悬而未决。
我们使用 2001 年至 2002 年全国酒精和相关情况流行病学调查(n = 43,093),检查了有终身 AD 的男性(N = 2,974)和女性(N = 1,807)在社会人口统计学特征、精神和医学共病、临床相关性、风险因素和治疗利用模式方面的差异。
与女性相比,有终身 AD 的男性更有可能被诊断为任何物质使用障碍和反社会人格障碍,而女性更有可能患有情绪和焦虑障碍。在调整一般人群中的社会人口统计学特征和精神共病的性别差异后,AD 仅与女性的外化障碍和任何情绪障碍有关。AD 男性符合更多标准,发作时间更长,首次饮酒年龄更小。缓解率没有性别差异。有 AD 的女性更有可能有酗酒史的家庭和配偶。两性的治疗率都很低,而且女性更有可能将社会污名视为治疗障碍。
在有终身 AD 的个体中,精神共病、风险因素、临床特征和治疗利用模式存在重要的性别差异。