Transitions Through Stages of Alcohol Use, Use Disorder and Remission: Findings from Te Rau Hinengaro, The New Zealand Mental Health Survey.

Autor:	Rapsey CM; Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, 464 Cumberland St., Dunedin, New Zealand., Wells JE; Department of Population Health, University of Otago, Christchurch, New Zealand., Bharat MC; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia., Glantz M; Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), 6001 Executive Boulevard, Suite 5185 MSC 9589, Bethesda, MD, USA., Kessler RC; Harvard Medical School, Department of Health Care Policy, 180 Longwood Ave, Boston MA, USA., Scott KM; Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, 464 Cumberland St., Dunedin, New Zealand.
Jazyk:	angličtina
Zdroj:	Alcohol and alcoholism (Oxford, Oxfordshire) [Alcohol Alcohol] 2019 Jan 01; Vol. 54 (1), pp. 87-96.
DOI:	10.1093/alcalc/agy069
Abstrakt:	Aims: To understand transitions from alcohol use to disorder, we examine timing of transitions between stages of alcohol use and associations between transitions and socio-demographic factors. Short Summary: Using nationally representative data, we found that the majority of alcohol use disorders develop by age 25. Increased alcohol use within a participant's cohort was associated with subsequent transition across all stages of alcohol use and disorder. Fifty percent of dependence cases had not remitted after 9 years. Methods: A nationally representative sample with a 73% response rate included 12,992 participants aged 16 and older. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess age at initial alcohol consumption, commencement of regular consumption, symptoms of alcohol abuse and dependence, and year-long remission. Alcohol consumption in an age- and gender-matched cohort, education, gender and age at commencement of use were investigated as covariates. Results: Among all respondents, 94.6% used alcohol, 85.1% used alcohol regularly, 11.4 and 4.6% had developed alcohol abuse and dependence disorders, respectively. Of those with an abuse or dependence disorder, 79.9 and 67.2% had remitted, respectively. Increased alcohol use within a participant's cohort was associated with subsequent transition across all stages. The majority of disorders had developed by age 25. Considerable time was spent with disorder; 50% of dependence cases had not remitted after 9 years. Men were at greater risk of disorder and less likely to remit. Conclusions: Interventions should target young people and cohort-specific consumption with resources also allocated to long-term treatment provision for alcohol dependency.
Databáze:	MEDLINE
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