Nelson C B, Wittchen H U
Max-Planck Institute for Psychiatry, Clinical Psychology and Epidemiology, Munich, Germany.
Addiction. 1998 Jul;93(7):1065-77. doi: 10.1046/j.1360-0443.1998.937106511.x.
AIMS/DESIGNS: As part of the Early Developmental Stages of Psychopathology (EDSP) study, results from the baseline cross-sectional assessment of DSM-IV alcohol disorders are presented for a sample of 14-24-year-olds residents in Munich, Germany (N = 3021; 71% response rate).
Life-time prevalence of DSM-IV alcohol abuse (men: 15.1%; women; 4.5%) was found to be considerably more prevalent than dependence (men: 10.0%; women 2.5%) with few cases among respondents younger than 16 years of age; 12-month prevalence of abuse was 8.4% among men and 2.7% among women and of dependence was 7.3% among men and 2.2% among women. Results show that peak incidence of alcohol disorders occurs at 16-17 years of age and that early initiation into alcohol use is associated with an increasing odds of disorder onset, especially for dependence among women. Exploratory analysis of retrospectively assessed diagnostic stability show: a temporal progression to abuse and then dependence, that nearly half of past abuse diagnoses are in remission, abuse remission is more common than progression to dependence, and dependence is highly persistent, especially among women.
Alcohol disorders are frequent in adolescent and young adults being characterized by transient abuse and less prevalent but persistent dependence syndromes. The relatively high prevalence of dependence diagnoses in this young population wit few years of alcohol use is discussed with regard to the clinical validity of DSM-IV criteria in adolescents and young adults.
目的/设计：作为精神病理学早期发展阶段（EDSP）研究的一部分，本文呈现了对德国慕尼黑14至24岁居民样本（N = 3021；应答率71%）进行的DSM-IV酒精障碍基线横断面评估结果。
发现DSM-IV酒精滥用的终生患病率（男性：15.1%；女性：4.5%）明显高于酒精依赖（男性：10.0%；女性：2.5%），16岁以下的受访者中病例较少；滥用的12个月患病率男性为8.4%，女性为2.7%，依赖的12个月患病率男性为7.3%，女性为2.2%。结果表明，酒精障碍的发病高峰出现在16至17岁，过早开始饮酒与发病几率增加有关，尤其是女性的依赖。对回顾性评估的诊断稳定性进行的探索性分析显示：存在从滥用到依赖的时间进程，过去近一半的滥用诊断已缓解，滥用缓解比发展为依赖更常见，且依赖具有高度持续性，尤其是在女性中。
酒精障碍在青少年和年轻人中很常见，其特征是短暂的滥用以及不太常见但持续存在的依赖综合征。针对DSM-IV标准在青少年和年轻人中的临床有效性，讨论了在这个饮酒年限较短的年轻人群中依赖诊断相对较高的患病率。
