Schuckit M A, Smith T L
Department of Psychiatry, School of Medicine, University of California-San Diego, San Diego, USA.
Arch Gen Psychiatry. 1996 Mar;53(3):202-10. doi: 10.1001/archpsyc.1996.01830030020005.
Between 1978 and 1988, 453 sons (age range, 18-29 years) of alcoholic and control subject were evaluated for their level of reaction (LR) to alcohol. This article presents the results of the 8.2-year follow-up of 450 of these men. The three goals were (1) to attempt to replicate results of the follow-up of the first 223 subjects, (2) to evaluate the potential impact of the quantity and frequency of drinking at the time of the original study on the relationship between LR and alcoholic outcome (ALC), and, most importantly, (3) to test if the relationship between family history (FH) and ALC might be mediated by LR in a subset of the sample.
Face-to-face structured follow-up interviews were carried out with the subjects and separately with an additional informant, and blood samples, as well as urine specimens, were obtained for determination of state markers of heavy drinking and drug toxicology screens.
First, the rate of development of DSM-III-R abuse and dependence on alcohol was 14.1% and 28.6%, respectively, for family history positive (FHP) subjects, compared with 6.6% and 10.8%, respectively, for family history negative (FHN) men. Second, neither consideration of the quantity nor the frequency of drinking at the time of the original study, nor their combination, effectively diminished the relationships between LR and ALC. Third, among men who drank and demonstrated the 15% highest and lowest scores of LR at about the age of 20 years (ie, 30% of the relevant population), the correlation between FH and ALC was greatly reduced when LR was considered, but the correlation between LR and ALC was not greatly diminished when the impact of FH was evaluated.
In this sample of moderately functional white men, the development of alcoholism occurred in relationship to an FH of alcoholism, but alcohol abuse or dependence was unrelated to prior psychiatric disorders. For this group, LR at the age of 20 years was associated with future alcoholism in a manner that was independent of the drinking practices at the time of the original study. At least among those men with clearly high and low LR scores, these data are consistent with the conclusion that LR might be a mediator of the alcoholism risk.
1978年至1988年间，对453名酗酒者和对照者的儿子（年龄范围为18 - 29岁）进行了酒精反应水平（LR）评估。本文介绍了其中450名男性8.2年随访的结果。三个目标是：（1）试图复制对最初223名受试者随访的结果；（2）评估原始研究时饮酒量和饮酒频率对LR与酒精性结局（ALC）之间关系的潜在影响；最重要的是，（3）检验在样本的一个子集中家族史（FH）与ALC之间的关系是否可能由LR介导。
对受试者以及另外一名信息提供者分别进行面对面的结构化随访访谈，并采集血样和尿样，用于测定大量饮酒的状态标志物和药物毒理学筛查。
首先，家族史阳性（FHP）受试者中，DSM - III - R酒精滥用和依赖的发生率分别为14.1%和28.6%，而家族史阴性（FHN）男性的这一发生率分别为6.6%和10.8%。其次，原始研究时饮酒量和饮酒频率的考量，以及两者的综合考量，均未能有效削弱LR与ALC之间的关系。第三，在大约20岁时饮酒且LR得分处于最高和最低15%的男性（即相关人群的30%）中，考虑LR时，FH与ALC之间的相关性大幅降低，但评估FH的影响时，LR与ALC之间的相关性并未大幅减弱。
在这个功能中等的白人男性样本中，酒精中毒的发生与酒精中毒家族史有关，但酒精滥用或依赖与既往精神障碍无关。对于这个群体，20岁时的LR与未来酒精中毒有关，且这种关联独立于原始研究时的饮酒习惯。至少在那些LR得分明显高和低的男性中，这些数据支持LR可能是酒精中毒风险介导因素的结论。
