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减少非戒酒者世界卫生组织饮酒风险水平和抑郁/焦虑障碍:美国普通人群的 3 年随访结果。

Reduction in non-abstinent WHO drinking risk levels and depression/anxiety disorders: 3-year follow-up results in the US general population.

机构信息

Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.

New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.

出版信息

Drug Alcohol Depend. 2019 Apr 1;197:228-235. doi: 10.1016/j.drugalcdep.2019.01.009. Epub 2019 Feb 14.

Abstract

BACKGROUND

Non-abstinent drinking reductions that predict improvement in how individuals feel or function, such as the World Health Organization (WHO) drinking risk levels, may be useful outcomes in clinical trials for alcohol use disorders (AUD).

METHODS

Current drinkers in a U.S. national survey (n = 22,005) were interviewed in 2001-02 (Wave 1) and re-interviewed 3 years later (Wave 2). WHO drinking risk levels, a 4- level categorization system (very-high-risk, high-risk, moderate-risk, and low-risk drinkers) defined using estimated mean ethanol consumption (grams) per day in the prior 12 months, and DSM-IV depressive and anxiety disorders were assessed at both waves. Logistic regression was used to produce adjusted odds ratios (aOR) testing the associations of changes between Wave 1 and Wave 2 WHO risk levels to the presence or persistence of depression and/or anxiety disorder by each initial Wave 1 risk level.

RESULTS

Among Wave 1 very-high-risk drinkers, lower odds of depression and/or anxiety disorders at Wave 2 were predicted by reductions in WHO risk levels of one-, two- or three-levels (aOR = 0.42, 0.37, 0.67, p-values 0.04-<.0001), as was the persistence of depression and/or anxiety disorders among those with such disorders at Wave 1 (aOR = 0.37, 0.29, 0.51, p-values .03-<.0001). Results were less consistent for participants initially drinking at lower risk levels.

CONCLUSIONS

Among very-high-risk drinkers, reductions in the WHO drinking risk categories were associated with lower risk of depression and/or anxiety disorders. These results add to findings indicating reductions in WHO risk levels are a meaningful indicator of how individuals feel and function.

摘要

背景

非戒酒性饮酒量减少,例如世界卫生组织(WHO)的饮酒风险水平,可以预测个体感觉或功能的改善,这可能是酒精使用障碍(AUD)临床试验中的有用结果。

方法

我们对美国全国性调查中的当前饮酒者(n=22005)进行了访谈,时间为 2001-02 年(第 1 波),并在 3 年后(第 2 波)进行了重新访谈。WHO 饮酒风险水平是一个四级分类系统(极高风险、高风险、中风险和低风险饮酒者),根据过去 12 个月中每天估计的平均乙醇摄入量(克)进行定义,DSM-IV 抑郁和焦虑障碍在两波中均进行了评估。使用逻辑回归产生调整后的优势比(aOR),检验了第 1 波和第 2 波之间 WHO 风险水平的变化与每个初始第 1 波风险水平的抑郁和/或焦虑障碍的存在或持续存在之间的关联。

结果

在第 1 波极高风险饮酒者中,WHO 风险水平降低一级、两级或三级与第 2 波抑郁和/或焦虑障碍的可能性降低相关(aOR=0.42、0.37、0.67,p 值 0.04-<.0001),而在第 1 波存在此类疾病的患者中,抑郁和/或焦虑障碍的持续存在也是如此(aOR=0.37、0.29、0.51,p 值 0.03-<.0001)。对于最初处于较低风险水平的参与者,结果则不太一致。

结论

在极高风险饮酒者中,WHO 饮酒风险类别减少与抑郁和/或焦虑障碍的风险降低相关。这些结果增加了表明 WHO 风险水平降低是个体感觉和功能的重要指标的发现。

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