Baggio Stéphanie, Studer Joseph, Dupuis Marc, Gerhard Gmel
Life Course and Social Inequality Research Centre, University of Lausanne, Lausanne, Switzerland.
Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland.
Am J Addict. 2016 Aug;25(5):408-15. doi: 10.1111/ajad.12404. Epub 2016 Jul 19.
The DSM-5 defined alcohol use disorder (AUD) to better cover undiagnosed subthreshold alcohol users, but few studies have investigated this topic. This study aimed to test whether subthreshold problem drinkers were a distinct subgroup of undiagnosed drinkers according to the DSM-5 AUD classification by investigating drinking patterns and longitudinal trajectories.
Data were collected in the Cohort Study on Substance Use Risk Factors from young Swiss men in their early twenties (n = 4,630) at two time points. Participants responded to the 11 criteria of the DSM-5 AUD and to variables related to drinking patterns.
Among drinkers, 23.2% and 23.5% of the participants were subthreshold problem drinkers at baseline and follow-up, respectively. The trends showed that 29.4% of them remained subthreshold problem drinkers over time. Those who remained subthreshold problem drinkers or progressed to AUD status were likely to meet the same criterion/add a new one. Subthreshold problem drinkers showed concurrent and later drinking patterns that were in between those of symptom-free drinkers and AUD drinkers.
Subthreshold problem drinkers were an important subgroup of drinkers with risky drinking patterns, but they did not necessarily progress to later AUD status and did not appear to be a consistent subgroup over time.
Subthreshold problem drinkers did not seem to be a subgroup of undiagnosed problem drinkers in the current DSM-5 classification. The results showed that AUD appeared to be a dimensional construct, in which one additional criterion was associated with worse alcohol-related outcomes. (Am J Addict 2016;25:408-415).
《精神疾病诊断与统计手册》第五版（DSM - 5）对酒精使用障碍（AUD）进行了定义，以更好地涵盖未被诊断出的阈下酒精使用者，但很少有研究探讨这一主题。本研究旨在通过调查饮酒模式和纵向轨迹，根据DSM - 5酒精使用障碍分类来测试阈下问题饮酒者是否为未被诊断出的饮酒者中的一个独特亚组。
在一项针对20岁出头的瑞士年轻男性（n = 4630）的物质使用风险因素队列研究中，于两个时间点收集数据。参与者对DSM - 5酒精使用障碍的11项标准以及与饮酒模式相关的变量进行了回答。
在饮酒者中，分别有23.2%和23.5%的参与者在基线和随访时为阈下问题饮酒者。趋势显示，随着时间推移，其中29.4%的人仍为阈下问题饮酒者。那些仍为阈下问题饮酒者或进展为酒精使用障碍状态的人可能符合相同标准/新增一项标准。阈下问题饮酒者同时期及后期的饮酒模式介于无症状饮酒者和酒精使用障碍饮酒者之间。
阈下问题饮酒者是饮酒模式存在风险的饮酒者中的一个重要亚组，但他们不一定会进展为后期的酒精使用障碍状态，且随着时间推移似乎并非一个稳定的亚组。
在当前的DSM - 5分类中，阈下问题饮酒者似乎并非未被诊断出的问题饮酒者的一个亚组。结果表明，酒精使用障碍似乎是一种维度性结构，其中每增加一项标准都与更差的酒精相关后果相关。（《美国成瘾杂志》2016年；25:408 - 415）
