Gonçalves Priscila Dib, Schuckit Marc A, Smith Tom L
Department of Psychiatry, University of California, San Diego, La Jolla, California.
Institute of Psychiatry, Psychology and Neuropsychology Service and Institute of Psychiatry, Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), University of São Paulo, São Paulo, Brazil.
J Stud Alcohol Drugs. 2017 Jul;78(4):512-520. doi: 10.15288/jsad.2017.78.512.
Although alcohol use disorders (AUDs) are prevalent among older individuals, few studies have examined the course and predictors of AUDs from their onset into the person's 50s. This study describes the AUD course from ages 50 to 55 in participants who developed AUDs according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), during the San Diego Prospective Study (SDPS).
Among the 397 university students in the SDPS who were followed about every 5 years from age 20 (before AUD onset), 165 developed AUDs, 156 of whom were interviewed at age 55. Age 50-55 outcomes were compared regarding age 20-50 characteristics. Variables that differed significantly across outcome groups were evaluated using binary logistic regression analyses predicting each outcome type.
Between ages 50 and 55, 16% had low-risk drinking, 36% had high-risk drinking, 38% met DSM-5 AUD criteria, and 10% were abstinent. Baseline predictors of outcome at ages 50-55 included earlier low levels of response to alcohol predicting DSM-5 AUDs and abstinence, higher drinking frequency predicting DSM-5 diagnoses and lower predicting low-risk drinking, higher participation in treatment and/or self-help groups predicting abstinence and lower predicting DSM-5 AUDs, later ages of AUD onset predicting high-risk drinking, and cannabis use disorders predicting abstinent outcomes.
Despite the high functioning of these men, few were abstinent or maintained low-risk drinking during the recent 5 years, and 38% met DSM-5 AUD criteria. The data may be helpful to both clinicians and researchers predicting the future course of AUDs in their older patients and research participants.
尽管酒精使用障碍(AUDs)在老年人中普遍存在,但很少有研究考察从发病到50多岁时AUDs的病程及预测因素。本研究描述了在圣地亚哥前瞻性研究(SDPS)中,根据《精神疾病诊断与统计手册》第四版(DSM-IV)标准患上AUDs的参与者在50至55岁期间的AUD病程。
在SDPS中从20岁(AUD发病前)开始大约每5年随访一次的397名大学生中,165人患上了AUDs,其中156人在55岁时接受了访谈。比较了50 - 55岁时的结果与20 - 50岁时的特征。使用二元逻辑回归分析评估在不同结果组之间有显著差异的变量,以预测每种结果类型。
在50至55岁之间,16%的人饮酒风险低,36%的人饮酒风险高,38%符合DSM - 5酒精使用障碍标准,10%戒酒。50 - 55岁时结果的基线预测因素包括:早期对酒精的低反应水平预测DSM - 5酒精使用障碍和戒酒,较高的饮酒频率预测DSM - 5诊断,较低的饮酒频率预测低风险饮酒,较高的参与治疗和/或自助小组的程度预测戒酒,较低的参与程度预测DSM - 5酒精使用障碍,较晚的AUD发病年龄预测高风险饮酒,以及大麻使用障碍预测戒酒结果。
尽管这些男性功能良好,但在最近5年中很少有人戒酒或保持低风险饮酒,38%符合DSM - 5酒精使用障碍标准。这些数据可能对临床医生和研究人员预测老年患者和研究参与者中AUDs的未来病程有所帮助。