Sociodemographic predictors of transitions across stages of alcohol use, disorders, and remission in the National Comorbidity Survey Replication

• Published in: Comprehensive psychiatry 2009-07, Vol.50 (4), p.299-306
• Main Authors: Kalaydjian, Amanda, Swendsen, Joel, Chiu, Wai-Tat, Dierker, Lisa, Degenhardt, Louisa, Glantz, Meyer, Merikangas, Kathleen R, Sampson, Nancy, Kessler, Ronald
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Age Factors; Age of Onset; Alcohol Drinking - epidemiology; Alcohol Drinking - psychology; Alcohol use; Alcohol-Related Disorders - epidemiology; Alcohol-Related Disorders - psychology; Alcoholism; Alcoholism - epidemiology; Alcoholism - psychology; Biological and medical sciences; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Disease Progression; Female; Health Surveys; Humans; Male; Medical sciences; Mental disorders; Middle Aged; Prevalence; Prognosis; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; Sex Factors; Studies; Survival Analysis; United States - epidemiology
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2008.09.012

Abstract Background Although much is known about risk factors for the initiation of alcohol use, abuse, and dependence, few population-based studies have examined the predictors of transitions across these stages. Aim The aim of this study is to examine the sociodemographic predictors of transitions across 6 stages of alcohol use in the National Comorbidity Survey Replication, a nationally representative household survey of the US population. Methods A lifetime history of alcohol use, regular use (at least 12 drinks in a year), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol abuse and dependence with abuse was collected in 5692 National Comorbidity Survey Replication respondents using the World Health Organization Composite International Diagnostic Interview, Version 3.0. Results Lifetime prevalence estimates were 91.7% for lifetime alcohol use, 72.9% for regular use, 13.2% for abuse, and 5.4% for dependence with abuse. Male sex, young age, non-Hispanic white race/ethnicity, low education, student status, and never being married predicted the onset of alcohol use, the transition from use to regular use, and from regular use to abuse. An early age of onset of alcohol use also predicted the latter transition. The transition from abuse to dependence was associated with an early age of onset of regular alcohol use, being previously married, and student status. Remission was predicted by young age and a later age of onset of alcohol abuse. Conclusion The reduced number and magnitude of factors associated with transitions to dependence and remission suggest qualitatively different risk factors at these stages relative to other stages of progression. Further knowledge is needed concerning the mechanisms underlying these differences to guide selective and indicated prevention programs.