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发病后最初几年饮酒模式的变化:基于酒精及相关疾病国家流行病学调查(NESARC)数据的潜在转变分析

Changes in drinking patterns in the first years after onset: a latent transition analysis of National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data.

作者信息

McBride Orla, Adamson Gary, Cheng Hui G, Slade Tim

机构信息

School of Psychology.

Shanghai Mental Health Centre, Shanghai Jiao Tong University.

出版信息

Psychol Addict Behav. 2014 Sep;28(3):696-709. doi: 10.1037/a0035069. Epub 2014 May 19.

Abstract

This study examined adult drinking patterns in the first year after onset and whether these patterns changed after 3 years. We also investigated whether specific demographic characteristics or DSM-IV alcohol use disorder symptoms were related to drinking transitions. Data from National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. "Newly onset alcohol users" (NOAUs; n = 854) were adults who initiated drinking in the year prior to Wave 1 (2001-2002) and who were followed-up at Wave 2 (2004-2005). Latent class models were estimated for 10 frequency-type drinking patterns at both waves. Latent transition analysis explored changes in drinking patterns from baseline to follow-up. Three drinker classes emerged at Wave 1: (a) low risk (41%); (b) sporadic hazardous (35%); and (c) regular hazardous (24%). One in 5 (18%) NOAUs stopped drinking by Wave 2 and were assigned to an "abstainer" class. The transition probability into the "abstainer" class was highest for the Wave 1 low risk drinkers (86%). The remaining NOAUs (82%) continued to drink at Wave 2. Of these, 70% of regular hazardous drinkers at Wave 1 maintained this drinking pattern at Wave 2, with approximately 30% reducing their pattern of drinking. One third of sporadic hazardous drinkers at Wave 1 remained at this level of drinking at Wave 2; the remainder escalated the drinking. Tolerance, larger/longer, cut down/quit and withdrawal were common among regular hazardous drinkers. Adult drinkers who engage in a low frequency and quantity drinking pattern are most likely to stop drinking soon after onset. Drinking patterns adopted in the first year after onset were indicative of drinking involvement 3 years later.

摘要

本研究调查了发病后第一年的成人饮酒模式,以及这些模式在3年后是否发生了变化。我们还研究了特定的人口统计学特征或DSM-IV酒精使用障碍症状是否与饮酒转变有关。对来自国家酒精及相关疾病流行病学调查(NESARC)的数据进行了分析。“新发病酒精使用者”(NOAUs;n = 854)是指在第1波调查(2001 - 2002年)前一年开始饮酒,并在第2波调查(2004 - 2005年)接受随访的成年人。对两波调查中的10种频率型饮酒模式估计了潜在类别模型。潜在转变分析探讨了从基线到随访期间饮酒模式的变化。在第1波调查中出现了三类饮酒者:(a)低风险(41%);(b)偶发性危险饮酒者(35%);(c)经常性危险饮酒者(24%)。五分之一(18%)的新发病酒精使用者在第2波调查时停止饮酒,并被归为“戒酒者”类别。第1波调查中的低风险饮酒者转变为“戒酒者”类别的概率最高(86%)。其余的新发病酒精使用者(82%)在第2波调查时仍继续饮酒。其中,第1波调查中的经常性危险饮酒者有70%在第2波调查时维持了这种饮酒模式,约30%减少了饮酒量。第1波调查中的偶发性危险饮酒者有三分之一在第2波调查时仍维持在该饮酒水平;其余的则饮酒量增加。耐受性、饮酒量增加/饮酒时间延长、减少饮酒量/戒酒和戒断症状在经常性危险饮酒者中很常见。开始饮酒频率和量较低的成年饮酒者在发病后不久最有可能停止饮酒。发病后第一年采用的饮酒模式预示着3年后的饮酒情况。

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