Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.
Alcohol Clin Exp Res. 2021 Oct;45(10):2059-2068. doi: 10.1111/acer.14683. Epub 2021 Oct 26.
Diagnostic and Statistical Manual (DSM) alcohol use disorder (AUD) criteria are written in broad enough terms to apply to diverse populations. The current analyses evaluate whether the endorsement of criteria changes with increasing age in individuals with persistent AUDs.
Data regarding AUDs persisting across 3 timepoints between average ages of 31 and 43 were gathered about every 5 years from 318 interviews for 106 San Diego Prospective Study (SDPS) AUD male probands. Similar data regarding persistent AUDs across 2 timepoints were obtained from 136 interviews with 68 SDPS AUD offspring between average ages of 21 and 27. Changes in the endorsement of each AUD criterion were evaluated using Cochran's Q test.
For AUD probands across time, significant decreases were observed in the proportions endorsing 4 criteria (tolerance, withdrawal, failure to fulfill obligations, and using alcohol in hazardous situations). Increased rates of endorsement were documented for 3 criteria (drinking alcohol in higher amounts or for longer periods of time, spending a great deal of time regarding alcohol, and continued use despite social or interpersonal problems). Significant increases in rates of endorsements for offspring were seen for spending a great deal of time regarding alcohol and giving up or reducing important activities in order to drink.
These data indicate that the salience of many DSM AUD criterion items changed significantly with age in both SDPS generations among individuals with persistent AUDs. The current results support the need for additional systematic research to determine whether specific criterion items might need to be weighted differently in evaluating older and younger individuals with persistent AUDs.
诊断和统计手册(DSM)酒精使用障碍(AUD)标准的措辞非常宽泛,可以适用于不同的人群。目前的分析评估了在持续 AUD 个体中,随着年龄的增长,标准的认可是否会发生变化。
从平均年龄在 31 岁至 43 岁之间的 318 次访谈中,收集了关于持续存在的 AUD 的数据,这些数据跨越了 3 个时间点,时间间隔为每 5 年一次。关于持续存在的 AUD 的类似数据是从平均年龄在 21 岁至 27 岁之间的 136 次访谈中获得的,这些数据涉及 68 名 SDPS AUD 后代。使用 Cochran's Q 检验评估了每个 AUD 标准的认可变化。
对于 AUD 患者,随着时间的推移,4 个标准的认可比例显著下降(耐受性、戒断、未能履行义务和在危险情况下使用酒精)。3 个标准的认可率增加,分别为饮酒量或时间增加、大量时间关注酒精以及尽管存在社交或人际关系问题仍继续使用。后代对大量时间关注酒精和为了喝酒而放弃或减少重要活动的认可率显著增加。
这些数据表明,在 SDPS 两代持续 AUD 个体中,许多 DSM AUD 标准项目的显著性随着年龄的增长而显著变化。目前的结果支持需要进行更多的系统研究,以确定在评估持续 AUD 的老年和年轻个体时,是否需要对特定的标准项目进行不同的加权。