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

Published online by Cambridge University Press:  21 July 2010

S. Behrendt ,
K. Beesdo-Baum ,
P. Zimmermann ,
M. Höfler ,
A. Perkonigg ,
G. Bühringer ,
R. Lieb  and
H.-U. Wittchen
S. Behrendt*
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany
K. Beesdo-Baum
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany
P. Zimmermann
Affiliation:
Max Planck Institute of Psychiatry, Munich, Germany
M. Höfler
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany
A. Perkonigg
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany
G. Bühringer
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany IFT Institut fuer Therapieforschung, Munich, Germany
R. Lieb
Affiliation:
Max Planck Institute of Psychiatry, Munich, Germany Department of Psychology, Unit of Epidemiology and Health Psychology, University of Basel, Switzerland
H.-U. Wittchen
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany Max Planck Institute of Psychiatry, Munich, Germany
*
*Address for correspondence: S. Behrendt, Ph.D., Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany. (Email: silke.behrendt@psychologie.tu-dresden.de)
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Abstract

Background

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.

Method

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.

Results

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.

Conclusions

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.

Keywords

Aetiologyalcohol abuseDSM-IV alcohol dependenceepidemiologytransition
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 5 , May 2011 , pp. 1073 - 1085
Copyright
Copyright © Cambridge University Press 2010

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