Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Instituto Nacional de Psiquiatría Ramón de La Fuente Muñiz, Calzada México-Xochimilco 101, San Lornenzo Huipulco, CDMX, 14370, Mexico City, Mexico.
Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Eur Child Adolesc Psychiatry. 2022 Jul;31(7):1-11. doi: 10.1007/s00787-020-01712-3. Epub 2021 Mar 16.
The first year of college may carry especially high risk for onset of alcohol use disorders. We assessed the one-year incidence of alcohol use disorders (AUD) among incoming first-year students, predictors of AUD-incidence, prediction accuracy and population impact. A prospective cohort study of first-year college students (baseline: N = 5843; response rate = 51.8%; 1-year follow-up: n = 1959; conditional response rate = 41.6%) at a large university in Belgium was conducted. AUD were evaluated with the AUDIT and baseline predictors with the Composite International Diagnostic Interview Screening Scales (CIDI-SC). The one-year incidence of AUD was 3.9% (SE = 0.4). The most important individual-level baseline predictors of AUD incidence were being male (OR = 1.53; 95% CI = 1.12-2.10), a break-up with a romantic partner (OR = 1.67; 95% CI = 1.08-2.59), hazardous drinking (OR = 3.36; 95% CI = 1.31-8.63), and alcohol use characteristics at baseline (ORs between 1.29 and 1.38). Multivariate cross-validated prediction (cross-validated AUC = 0.887) shows that 55.5% of incident AUD cases occurred among the 10% of students at highest predicted risk (20.1% predicted incidence in this highest-risk subgroup). Four out of five students with incident AUD would hypothetically be preventable if baseline hazardous drinking was to be eliminated along with a reduction of one standard deviation in alcohol use characteristics scores, and another 15.0% would potentially be preventable if all 12-month stressful events were eliminated. Screening at college entrance is a promising strategy to identify students at risk of transitioning to more problematic drinking and AUD, thus improving the development and deployment of targeted preventive interventions.
大学一年级可能特别容易出现酒精使用障碍。我们评估了刚入学的一年级学生中酒精使用障碍（AUD）的一年发病率、AUD 发病率的预测因素、预测准确性和人群影响。在比利时一所大型大学进行了一项针对一年级大学生的前瞻性队列研究（基线：N=5843；应答率=51.8%；1 年随访：n=1959；条件应答率=41.6%）。使用 AUDIT 评估 AUD，使用复合国际诊断访谈筛查量表（CIDI-SC）评估基线预测因子。AUD 的一年发病率为 3.9%（SE=0.4）。AUD 发病率的最重要个体基线预测因素是男性（OR=1.53；95%CI=1.12-2.10）、与恋爱伴侣分手（OR=1.67；95%CI=1.08-2.59）、危险饮酒（OR=3.36；95%CI=1.31-8.63）和基线时的饮酒特征（OR 在 1.29 和 1.38 之间）。多元交叉验证预测（交叉验证 AUC=0.887）显示，在预测风险最高的 10%学生中，有 55.5%的新发病例发生（该最高风险亚组中预测发病率为 20.1%）。如果消除基线危险饮酒以及将酒精使用特征评分降低一个标准差，那么假设 4/5 的新发病例是可以预防的，而如果消除所有 12 个月的压力事件，则可能预防 15.0%。在大学入学时进行筛查是一种很有前途的策略，可以识别有风险向更严重饮酒和 AUD 转变的学生，从而改善有针对性的预防干预措施的制定和实施。
