VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California, San Diego, CA 92093, USA.
VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California, San Diego, CA 92093, USA.
Drug Alcohol Depend. 2022 Feb 1;231:109240. doi: 10.1016/j.drugalcdep.2021.109240. Epub 2021 Dec 27.
Alcohol use disorder (AUD) is a prevalent public health concern in the U.S. that disproportionately affects veterans relative to civilians. Given changes to the demographic composition of the veteran population and AUD diagnostic criteria in the DSM-5, updated knowledge regarding the epidemiology of DSM-5 AUD in a national sample of veterans is critical to informing the population-based burden of this disorder.
Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4069 U.S. veterans. Lifetime DSM-5 AUD (mild, moderate, severe) and past-year DSM-5 AUD were assessed using validated self-report measures, and sociodemographic, military, and psychiatric characteristics associated with lifetime and past-year AUD were evaluated.
Prevalences of lifetime and past-year DSM-5 AUD were 40.8% (95% confidence interval [CI]=39.2-42.3%) and 10.5% (95%CI=9.6-11.5%), respectively. Lifetime prevalences of mild, moderate, and severe AUD were 20.5%, 8.3%, and 12.0%, respectively. Veterans with lifetime AUD had elevated rates of psychiatric disorders and suicidal behavior, which generally increased as a function of AUD severity. Lifetime AUD was also associated with being younger, male, white, unmarried, retired and experiencing more adverse childhood experiences and traumas. For past-year AUD, being younger, male, white, having more adverse childhood experiences, and experiencing lifetime PTSD were significant correlates.
AUD is highly prevalent among U.S. veterans and associated with substantial psychopathology, including elevated odds of suicidal behaviors. Results underscore the importance of comprehensive screening and preventive efforts for AUD, and interventions that concurrently target overlapping alcohol use and psychiatric difficulties.
在美国，酒精使用障碍（AUD）是一个普遍存在的公共卫生问题，与平民相比，退伍军人受其影响的比例更大。鉴于退伍军人人口的人口结构变化和 DSM-5 中的 AUD 诊断标准，更新关于全国退伍军人样本中 DSM-5 AUD 流行病学的知识对于了解该疾病的人群负担至关重要。
本研究数据来自美国退伍军人健康与韧性研究，该研究对 4069 名美国退伍军人进行了全国代表性样本调查。使用经过验证的自我报告测量方法评估终生 DSM-5 AUD（轻度、中度、重度）和过去一年 DSM-5 AUD，评估与终生和过去一年 AUD 相关的社会人口统计学、军事和精神科特征。
终生和过去一年 DSM-5 AUD 的患病率分别为 40.8%（95%置信区间[CI]=39.2-42.3%）和 10.5%（95%CI=9.6-11.5%）。轻度、中度和重度 AUD 的终生患病率分别为 20.5%、8.3%和 12.0%。有终生 AUD 的退伍军人精神疾病和自杀行为的发生率较高，这些疾病通常随着 AUD 严重程度的增加而增加。终生 AUD 还与年龄较小、男性、白人、未婚、退休以及经历更多不良童年经历和创伤有关。对于过去一年 AUD，年龄较小、男性、白人、有更多不良童年经历以及经历终生 PTSD 是显著相关因素。
AUD 在美退伍军人中患病率很高，与大量精神病理学有关，包括自杀行为的风险增加。结果强调了对 AUD 进行全面筛查和预防的重要性，以及同时针对重叠的酒精使用和精神科困难进行干预的重要性。
