Nadkarni Abhijit, Weiss Helen A, Bhat Bhargav, Patel Vikram
Sangath, H No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez 403501, Goa, India.
London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Alcohol Alcohol. 2017 Sep 1;52(5):557-563. doi: 10.1093/alcalc/agx038.
The aim of this study was to examine trajectories of Alcohol Use Disorders (AUD) over a 6 year period and compare the bio-psycho-social correlates between these trajectories.
Community-based cohort of 1899 adult men were interviewed in 2006-2008 and 2012-2014. AUD were assessed using the Alcohol Use Disorder Identification Test, and potential correlates including psycho-social problems, morbidity and physiological parameters were measured at follow-up. Logistic regression was conducted to estimate odds ratios (ORs) for the association of persistent and incident AUD, respectively, with the potential correlates. Analyses were weighted to account for sampling design, number of adults aged 18-49 years in the household and non-response.
Compared with men who had recovered from AUD, there was strong evidence (P < 0.001) that men with persistent AUD were more likely to have marital problems, tobacco use, and raised Gamma Glutamyl Transferase (GGT) and strong evidence (0.001 < P < 0.01) that they were more likely to have workplace problems, social problems, increased healthcare contact and raised Mean Corpuscular Volume (MCV). Compared with men who did not have AUD at baseline and follow-up, there was strong evidence (P < 0.001) that men with incident AUD were more likely to have workplace problems, social problems, marital problems, tobacco use, and raised GGT and strong evidence (0.001 < P < 0.01) that they were more likely to have hypertension, accident and injuries and Common Mental Disorders (CMD).
This community-based longitudinal study of AUD, the first from a low and middle income country, clearly demonstrates significant health and social consequences of AUD in men and highlights the need for interventions for their treatment and prevention.
Compared to persistent AUD, recovery from AUD has several benefits in health and social domains. Compared to developing new AUD, not having AUD has several benefits in health and social domains. Sustaining the state of not having AUD or recovery can lead to accumulation of health and social capital over time.
本研究旨在考察6年期间酒精使用障碍(AUD)的发展轨迹,并比较这些轨迹之间的生物心理社会相关因素。
2006 - 2008年以及2012 - 2014年对1899名成年男性组成的社区队列进行了访谈。使用酒精使用障碍识别测试评估AUD,并在随访时测量包括心理社会问题、发病率和生理参数在内的潜在相关因素。进行逻辑回归以分别估计持续性AUD和新发AUD与潜在相关因素关联的比值比(OR)。分析进行了加权,以考虑抽样设计、家庭中18 - 49岁成年人数量以及无应答情况。
与已从AUD康复的男性相比,有充分证据(P < 0.001)表明持续性AUD男性更有可能存在婚姻问题、吸烟、γ-谷氨酰转移酶(GGT)升高,并有充分证据(0.001 < P < 0.01)表明他们更有可能存在工作场所问题、社交问题、医疗接触增加以及平均红细胞体积(MCV)升高。与在基线和随访时均无AUD的男性相比,有充分证据(P < 0.001)表明新发AUD男性更有可能存在工作场所问题、社交问题、婚姻问题、吸烟、GGT升高,并有充分证据(0.001 < P < 0.01)表明他们更有可能患有高血压、意外事故和伤害以及常见精神障碍(CMD)。
这项基于社区的AUD纵向研究是来自低收入和中等收入国家的首个此类研究,清楚地表明了AUD对男性的重大健康和社会后果,并突出了对其进行治疗和预防干预的必要性。
与持续性AUD相比,从AUD康复在健康和社会领域有诸多益处。与新发AUD相比,没有AUD在健康和社会领域有诸多益处。维持没有AUD或康复的状态可随着时间推移积累健康和社会资本。