The role of mental disorders in the risk and speed of transition to alcohol use disorders among community youth

• Published in: Psychological medicine 2011-05, Vol.41 (5), p.1073-1085
• Main Authors: Behrendt, S., Beesdo-Baum, K., Zimmermann, P., Höfler, M., Perkonigg, A., Bühringer, G., Lieb, R., Wittchen, H.-U.
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adolescent; Adult and adolescent clinical studies; Age of Onset; Alcohol Drinking - epidemiology; Alcohol Drinking - psychology; Alcohol related disorders; Alcoholism; Alcoholism - epidemiology; Alcoholism - prevention & control; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Comorbidity; Externalizing problems; Female; Germany - epidemiology; Humans; Kaplan-Meier Estimate; Male; Medical sciences; Mental disorders; Mental Disorders - epidemiology; Moods; Prevalence; Proportional Hazards Models; Prospective Studies; Psychiatric disorders; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; Sex Factors; Social phobia; Substance-Related Disorders - epidemiology; Teenagers; Time Factors; Toxicology; Young Adult; Young adults
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291710001418

Among adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are inter-individual differences in the speed of transition from initial alcohol use (AU) to AUD. AUDs are highly co-morbid with other mental disorders. The factors associated with rapid transition from first AU to AUD remain unknown and the role of mental disorders in rapid transitions is unclear. Given this background we examined (1) whether prior anxiety, mood, externalizing and non-alcohol substance use disorders are related to the risk and speed of transition from first AU to DSM-IV alcohol abuse (AA) and alcohol dependence (AD) and (2) whether early age of onset of prior mental disorders (PMDs) is a promoter of rapid transition. A total of 3021 community subjects (97.7% lifetime AU) aged 14-24 years at baseline were followed up prospectively for up to 10 years. AU and mental disorders were assessed with the DSM-IV/M-CIDI. Among subjects with lifetime AU, several PMDs, such as specific phobia, bipolar disorder and nicotine dependence, were associated with an increased risk of AUD independent of externalizing disorders. Associations of PMDs with the speed of transition to AUDs were mostly weak and inconsistent. Only social phobia and externalizing disorders were associated with faster transitions to AD even after adjustment for other PMDs. Earlier age of onset of PMD was not associated with rapid transition. Mental disorders are associated with the risk of AUD. With the possible exception of social phobia and externalizing disorders, they do not promote rapid transition, even if they occur particularly early. Future research needs to identify factors relevant to rapid transition to AUD.