Bipolar Disorder in a Population of Adolescents with Alcohol Use Disorders

ABSTRACT

Objectives: The objective of this paper is to present the prevalence of Bipolar Disorder (BPD) in a population of adolescents and young adults with alcohol use disorders (AUD) and to compare salient alcohol use, mood, and diagnostic variables between adolescents with BPD, those with Major Depressive Disorder (MDD), and those with AUD without a mood disorder.

Methods: The subjects were 452 adolescents and young adults, age 12.9 to 28.3 years, who met DSM-IV criteria for a lifetime history of either alcohol abuse or alcohol dependence. DSM-IV psychiatric and AUD diagnoses were obtained by semi-structure interviews (K-SADS and SCID) to discern the possible effect of comorbid BPD on alcohol and other drug variables, we compared adolescents or young adults who met DSM-IV criteria for concurrent BPD and AUD with adolescents with MDD plus AUD and those with AUD and no mood disorder. Following one-way ANOVA comparing across the 3 groups, we proceeded with post hoc analysis comparing the BPD+AUD group with either the MDD + AUD or AUD only group.

Results: 6.4% of the subjects met criteria for BPD. While there were no differences between groups on the alcohol consumption variables, subjects with BPD had a significantly earlier onset of an AUD diagnosis than either the MDD group or the AUD only group. The BPD + AUD group had a significantly greater percentage of subjects meeting criteria for alcohol dependence than the AUD only group.

Conclusions: Comorbid mood disorders, particularly Bipolar Disorder, may have an important effect on alcohol and substance use variables and diagnosis. More research is needed to determine the effect of treatments for mood disorder on both mood and substance use variables.     

Characterizing a Hidden Group of At-Risk Drinkers: Epidemiological Profiles of Alcohol-Use Disorder Diagnostic Orphans

Background: Drinkers who report some symptoms of alcohol-use disorder (AUD) but fail to meet full criteria are “diagnostic orphans.” To improve risk-reduction efforts, we sought to develop better epidemiologic profiles of this underrecognized subgroup. Methods: This study estimated the population prevalence and described AUD symptoms of diagnostic orphans using the 2012–2013 National Epidemiological Survey of Alcohol and Related Conditions-III. Multivariate logistic regression was used to model odds of being a diagnostic orphan or meeting mild, moderate, and severe AUD criteria versus no AUD symptoms. Models were adjusted for the complex survey design using sampling weights and survey procedures (e.g., proc surveylogistic). Results: Among drinkers, 14% of men and 11% of women were classified as diagnostic orphans. The most common symptoms were drinking more or for longer periods than intended, wanting or trying unsuccessfully to quit or cut back, and drinking in ways that increased risk of injury. We noted broad similarities between diagnostic orphans and mild/moderate AUD groups. There were no differences in odds of diagnostic orphans status by race/ethnicity; however, female gender was associated with lower odds of diagnostic orphan status and all levels of AUD. Individual history of AUD, family history of problem drinking, concurrent smoking, and concurrent marijuana use were associated with greater odds of problem drinking, with stronger associations as AUD severity increased. Conclusions: Diagnostic orphans remain a sizeable and overlooked population of problem drinkers. Clarifying the array of symptoms and cooccurring disorders can improve screening and facilitate alcohol risk-reduction intervention efforts.     

Are subthreshold alcohol dependence symptoms a risk factor for developing DSM-IV alcohol use disorders? A three-year prospective study of ‘diagnostic orphans’ in a national sample

Aims

Research suggests that diagnostic orphans (i.e., individuals experiencing only 1–2 criteria for DSM-IV alcohol dependence) may be at increased risk for developing more severe alcohol problems. This study aimed to: (i) investigate the course of diagnostic orphans in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), and (ii) explore whether a specific symptom endorsement pattern(s) could identify diagnostic orphans at Wave 1 who remitted or progressed to alcohol dependence at Wave 2.

Methods

Current drinkers (n = 15,751) were divided into diagnostic groups at Waves 1 and 2: no-alcohol use disorder (AUD); one-criterion orphans, two-criterion orphans, alcohol abuse, or alcohol dependence. Multinomial logistic regression analysis explored the association between diagnostic status at Wave 1 and Wave 2. Chi-square tests investigated differences in the criteria endorsement patterns of diagnostic orphans.

Results

Compared to the no-AUD group, one-criterion orphans at Wave 1 were twice as likely to be in the abuse group and four times more likely to be dependent at Wave 2. Two-criterion orphans were three times more likely to be in the abuse group and eight times more likely to have progressed to dependence. Criterion endorsement patterns of diagnostic orphans at baseline did not significantly differentiate between those who remitted and those who progressed to dependence at follow-up.

Conclusions

Like previous research, diagnostic orphans are at increased for developing to more severe alcohol problems. Relying solely on the DSM-IV AUD diagnostic criteria, however, may not be sufficient to identify those diagnostic orphans who are at risk for progressing to dependence.     

Exposure to paternal alcoholism does not predict development of alcohol-use disorders in offspring: evidence from an offspring-of-twins study

OBJECTIVE: Using an offspring-of-twins design, we tested the hypothesis that exposure to paternal alcoholism during the child's first 12 years will increase offspring risk for subsequent alcohol-use disorders (AUD). Method: Structured psychiatric interviews assessed history of psychiatric and substance-use disorders in Vietnam Era Twin Registry fathers (n = 512), their offspring (n = 877), and mothers of the offspring (n = 507). Exposure was defined as the fathers' endorsement of any Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, AUD symptom, according to the Lifetime Drinking History assessment (administered in 1999), at any time between off- spring ages 0-12 years; all fathers had satisfied DSM, Third Edition, Revised (DSM-III-R), criteria for alcohol dependence in a 1992 diagnostic interview. Cox proportional hazards models were fit to predict time to first symptom of abuse/dependence in offspring. RESULTS: Off- spring exposed to paternal alcoholism were significantly more likely to develop an AUD when compared with offspring of nonalcoholic fathers (hazard ratio [HR] = 1.51; 95% confidence interval [CI]: 1.10-2.07). Although offspring unexposed to paternal alcoholism did not significantly differ from control offspring (HR = 1.50, 95% CI: 0.93-2.41), the magnitude of association was similar to that in the exposed offspring. There were no significant differences in AUD between offspring of alcoholics who were exposed and those who were not exposed to paternal alcoholism, as long as fathers had satisfied DSM-III-R criteria for alcohol dependence at some point in their lives. CONCLUSIONS: There does not appear to be a relationship between exposure to paternal alcoholism during childhood and development of an AUD in offspring. Genetic and high-risk environmental factors that are correlated with lifetime paternal alcoholism may be stronger predictors of offspring AUD than fathers' problem drinking. Future research should be encouraged, using more comprehensive analyses, to examine the role of family genetic influences and other family environmental influences on offspring alcohol outcomes.     

Functioning of Alcohol Use Disorders Criteria Among Middle-Aged and Older Adults: Implications for DSM-5

This study explored dimensionality and rank-order severity of the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) alcohol use disorder (AUD) criteria among adults 50+ years old. Secondary analysis was performed on data from individuals 50+ (N = 3,412) from the 2009 National Survey of Drug Use and Health. Confirmatory factor analyses (CFA) and item response theory (IRT) analyses were performed on the 11 AUD criteria. DSM-IV and DSM fifth edition (DSM-5) classifications were compared. CFA revealed a one-factor model. IRT analyses revealed that AUD criteria identify only severe cases of AUD. Overall, 5.8% met criteria for a DSM-IV AUD; 7.5% met criteria for DSM-5 AUD.     

Gender Differences in Stressful Life Events,Social Support,Perceived Stress,and Alcohol Use Among Older Adults: Results From a National Survey

Stressful life events, perceived stress, and social support relationships with consumption, at-risk drinking, and alcohol use disorder (AUD) were studied in a population-based sample of current drinkers age 60+ in the National Epidemiologic Survey of Alcohol and Related Conditions (Wave 2; 2004–2005; n = 4,360). Stressful life events were associated with AUD among men and women, and crime victimization among men only. However, greater perceived stress was associated with lower consumption among women and greater odds of AUD in men, highlighting differences in the relationship between stress and alcohol use by gender that may be the result of the stress alcohol link.     

Diagnostic concordance of DSM-III, DSM-III-R, DSM-IV and ICD-10 alcohol diagnoses in adolescents

OBJECTIVE: Little is known about the validity of diagnostic criteria for alcohol use disorders (AUDs) when applied to adolescents. This study examined the diagnostic concordance of DSM-III, DSM-III-R, DSM-IV and ICD-10 AUDs in a sample of adolescents with a broad range of alcohol problem severity. METHOD: Participants were 413 adolescents (250 male), ages 13 to 19, drawn from clinical and community sources. AUDs were assessed using the Structured Clinical Interview for the DSM (SCID), modified to make diagnoses in the four nosological systems. Diagnostic agreement for lifetime diagnoses was quantified with the kappa statistic. RESULTS: Agreement was fair to high across the three categories of alcohol dependence, alcohol abuse and no alcohol diagnosis (kappa = 0.51 to 0.76); for alcohol dependence (kappa = 0.51 to 0.83); and for the categories of any AUD versus no AUD (kappa = 0.55 to 0.96). Concordance was very low for alcohol abuse diagnoses (kappa = 0.10 to 0.23), with the exception of DSM-III-R and DSM-IV (kappa = 0.62). Dependence was superior to abuse in the degree of temporal overlap in diagnostic agreements. CONCLUSIONS: Similar to findings with adults, diagnostic concordance among adolescents tended to be fair to high for alcohol dependence and very low for alcohol abuse. The data highlight the inconsistency across nosological systems in the conceptual framework and definition of the alcohol abuse category.     

Alcohol Use and Other Psychiatric Disorders in the Formerly Homeless and Never Homeless: Prevalence,Age of Onset,Comorbidity, Temporal Sequencing,and Service Utilization

Interview survey data were collected on a large (n = 4730) general population sample of adults subsequently classified as “never homeless” (NH) or “formerly homeless” (FH), with the latter group consisting of persons who had past experience of at least a one-month period with no regular place to live. The objective was to analyze differences, as a function of this classification, in the prevalence, age of onset, comorbidity, temporal sequencing, and service utilization pertinent to alcohol-use and other psychiatric disorders. Almost half of the FH group were found to have a one-year DSM diagnosis, nearly twice the rate seen in the NH group. Moreover, at 15.1%, the prevalence of alcohol-use disorder (AUD) comorbid with one or more other psychiatric disorders was five times that reported by NH participants. Subsequent analyses addressed differences between the FH (n = 167) and NH (n = 1031) groups within the subset who met criteria for one or more psychiatric diagnoses. Focusing on drinking behavior, we found that among the FH, dual-diagnosis was associated with elevated rates of alcohol-use problem symptoms and with greater alcohol consumption than were evident in the FH with AUD alone. Also, among the FH with comorbid AUD, as well as among those with two or more psychiatric disorders unrelated to alcohol, there was an earlier onset of psychiatric disorders than in the NH. This earlier onset may have placed these individuals at greater risk for later homelessness and AUD, and may also be indicative of a more severe course of illness. Differences between the FH and the NH suggest the importance of devoting special attention to this unique sample.     

Screening Instruments for Alcohol Problems: A Comparison of Cut Points between Mexican American and Mexican Patients in the Emergency Room

The performance of alcohol use disorder screening instruments (CAGE, BMAST, AUDIT, TWEAK) at various cut points were compared between a Mexican American emergency room (ER) sample (n = 586) and a sample of ER patients in Mexico (n = 1,417) using ICD-10 and DSM-IV criteria for alcohol dependence and harmful drinking/abuse by gender and injury status. Lowering cut points improved instrument performance substantially for females in both samples. Further research is needed to explore instrument performance by gender and level of acculturation.     

Alcoholic men endorse more DSM-IV withdrawal symptoms than alcoholic women matched in drinking history

OBJECTIVE: Given gender differences in alcohol metabolism, drinking patterns and alcohol-related problems, we asked whether men and women recruited for research protocols from treatment programs would meet different subsets of alcohol dependence or withdrawal criteria or differ in current level of functioning. METHOD: The subjects were 66 men and 62 women meeting DSM-III-R or DSM-IV criteria for alcohol dependence. Gender differences were tested infrequency counts of criteria endorsed and Global Assessment of Functioning (GAF) scores. RESULTS: All seven alcohol dependence criteria were endorsed by 50% of the sample. There were no significant gender differences in frequency of individual criteria endorsed. However, more men than women tended to endorse the withdrawal criterion for alcohol dependence and the tremor criterion for alcohol withdrawal, whereas women had higher GAF scores. When subgroups of men and women were matched on alcohol consumption variables, significantly more men than women endorsed the withdrawal criterion for alcohol dependence and the anxiety criterion for alcohol withdrawal, and women still had significantly higher GAF scores than men. CONCLUSIONS: DSM criteria provide a similar characterization of alcohol dependence in male and female research volunteers. Despite this similarity, the DSM criteria were sensitive to gender differences, which can now be challenged with rigorous testing.     

Exposure to dysfunctional parenting and trauma events and posttraumatic stress profiles among a treatment sample with coexisting depression and alcohol use problems

Introduction and Aims. Trauma exposure (including experiencing dysfunctional parenting when a child) and posttraumatic stress disorder (PTSD) frequently coexist with major depressive disorder (MDD) and alcohol use disorders (AUD), with the impact of this comorbidity usually studied as a dual disorder (i.e. PTSD‐MDD or PTSD‐AUD). This study explores trauma exposure (including to dysfunctional parenting), PTSD symptom severity and PTSD in people seeking treatment for coexisting depressive symptoms and alcohol use problems. Design and Methods. Participants (n = 221) with current depression and alcohol use problems were recruited. Trauma exposure, PTSD symptoms and PTSD were assessed using the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style assessed dysfunctional parenting (neglect/over‐control/abuse) experienced as a child. Results. Most participants experienced trauma (71.6%, n = 159), with more than one‐third reaching DSM‐IV criteria for current PTSD (38.0%, n = 84). Unique to this study was that there were no gender differences in rates of trauma exposure, number of traumatic events and PTSD. More severe PTSD symptoms and PTSD were associated with: childhood neglect; earlier depression onset; more severe depression and alcohol problems; and lower general functioning. More severe problems with alcohol were related to Intrusion and Avoidance symptoms, while severe alcohol dependence symptoms were related to hyperarousal. Discussion and Conclusions. PTSD symptoms and PTSD are highly prevalent in those with coexisting depression and alcohol use problems and are associated with a history of childhood neglect and higher levels of comorbidity. Trauma, PTSD symptoms and PTSD should be assessed and addressed among people seeking treatment for coexisting depression and alcohol problems.[Bailey K, Webster R, Baker AL, Kavanagh DJ. Exposure to dysfunctional parenting and trauma events and posttraumatic stress profiles among a treatment sample with coexisting depression and alcohol use problems. Drug Alcohol Rev 2012;31:529–537]     

Modeling the Dimensionality of DSM-IV Alcohol Use Disorder Criteria in a Nationally Representative Sample of College Students

This study examined the dimensionality of DSM-IV alcohol use disorder (AUD) criteria in a nationally representative sample of college students (N = 4,605) using latent variable techniques. We used data from the 2009 National Survey of Drug Use and Health and selected those who were currently enrolled in college and current drinkers. Confirmatory factor analysis provided support for a one-factor solution of the AUD criteria. Item Response Theory analyses indicated that the alcohol abuse and dependence criteria severity parameters were intermixed along the AUD severity continuum with high discrimination parameters. Findings support reformulating the current AUD diagnostic system for the DSM-V. Study's limitations are noted.     

Functioning of Cannabis Abuse and Dependence Criteria Across Two Different Countries: The United States and The Netherlands

Background: Cross-national differences could affect the likelihood of endorsement of DSM cannabis abuse and dependence criteria. The present study examines whether cannabis abuse and dependence criteria function differently across U.S. and Dutch cannabis users. Method: Data on lifetime endorsement of DSM-IV cannabis abuse/dependence criteria were utilized from U.S. cannabis users who participated in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) and from Dutch cannabis users who participated in the Zuid-Holland study. In total, 1,568 cannabis users participated in the NESARC sample, and 359 cannabis users participated in the Zuid-Holland sample. The DSM-IV cannabis abuse/dependence criteria as well as cannabis withdrawal were determined using face-to-face computer-assisted personal interviews. Results: Using Restricted Factor Analysis with Latent Moderated Structures, the cannabis abuse/dependence criteria legal problems (β = ?0.43), failed quit attempts (β = ?1.09), use despite problems (β = ?0.32), and withdrawal (β = ?0.53) showed measurement bias, and were more likely to be endorsed by U.S. than by Dutch cannabis users. Also, men were more likely than women to endorse the criteria hazardous use (β = ?0.27), legal problems (β = ?0.49) and tolerance (β = ?0.20). Findings on failed quit attempts and withdrawal were replicated in matched subsamples, while results on legal problems (country and gender) were partly replicated. Conclusions: Several CUD criteria showed measurement bias across two countries and between males and females. Therefore, differences between countries and gender in prevalence rates of CUD should be regarded with caution.     

Psychometric Properties of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) in Public First Responders

Problematic alcohol consumption is prevalent among first responders because alcohol is commonly used to cope with occupational stress and frequent exposure to traumatic incidents, making them an at-risk population for alcohol use disorders (AUD). This study investigated the psychometric properties of the Korean version of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among public first responders. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (SCID), AUDIT-C, AUDIT, and CAGE were administered to 222 public first responders, who were recruited by convenience sampling. One-week test–retest reliability was evaluated in a subsample (n = 24). Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic accuracy and estimate the optimal cut-off scores for any AUD and alcohol dependence. Three different analytic criteria were utilized to calculate the cut-off scores. The AUDIT-C demonstrated good test–retest reliability (intraclass correlation coefficient for test–retest reliability = 0.91) and satisfactory convergent validity. The areas under the ROC curves for any AUD and alcohol dependence of the AUDIT-C were 0.87 and 0.93, respectively. For any AUD, all three criteria suggested a cut-off score of 7.5 (sensitivity = 81.8%, specificity = 79.8%), whereas for alcohol dependence, a cut-off score of 8.5 (sensitivity = 85.7%, specificity = 86.1%) was derived from two criteria. In conclusion, the AUDIT-C demonstrated good reliability and validity and proved to be a brief and effective screening test for AUD among first responders.     

Dual cannabis and alcohol use disorders in young adults: Problems magnified

ABSTRACT

Background: Alcohol and marijuana are the 2 most commonly used substances among young adults. The present study examines whether having 2 DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) diagnoses (alcohol and cannabis) is associated with greater problems than having 1 (alcohol or cannabis) diagnosis. Methods: Participants were 307 young adults (18–25 years) from the community who met criteria for DSM-5 alcohol use disorder (AUD), cannabis use disorder (CUD), or both (dual use disorder [DUD]). Participants reported alcohol and marijuana use in the past 90 days (Timeline Follow-Back), alcohol problems (Short Inventory of Problems), and marijuana problems (Marijuana Problems Scale). Results: Eighty-four participants (27.4%) met criteria for AUD, 107 (34.9%) met criteria for CUD, and 116 (37.8%) met criteria for DUD. In multivariate analyses, the DUD group reported greater alcohol use frequency and more alcohol problems than the CUD-only group but not the AUD-only group. However, DUD individuals reported greater drinking intensity than singly diagnosed individuals. Those with DUD reported a greater proportion of marijuana consumption days than the AUD-only group but not the CUD-only group. However, DUD individuals reported more marijuana problems than both singly diagnosed groups. Conclusions: Results show that the concurrent presence of both DSM-5 AUD and CUD is associated with heavier drinking patterns and greater marijuana problems than disordered use of either substance alone, thus affirming the magnified severity of alcohol and marijuana use that accompanies dual DSM-5 alcohol and marijuana use disorders.     

Alcohol criteria endorsement and psychiatric and drug use disorders among DUI offenders: Greater severity among women and multiple offenders

Purpose

Data from the Collaborative Study on the Genetics of Alcoholism (COGA), a high-risk family study of alcohol dependence, were used to examine differences in alcohol diagnostic criteria endorsement and psychiatric and drug use disorders by gender and by number of DUI offenses.

Results

Individuals with two or more DUIs exhibited greater severity of alcohol dependence than those with none or one DUI. This severity was characterized in three ways: (1) higher endorsement of alcohol diagnostic criterion items, with evidence of greater severity among women, (2) higher prevalence of co-occurring lifetime psychiatric disorders, and (3) higher rates of drug use and of dependence on cocaine, stimulants, and, for women only, marijuana and opiates.

Conclusions

By examining gradations of disorder within a combination of two high-risk indicators, DUI and family vulnerability, this study provides useful information for clinical research about individuals with chronic and severe alcohol problems. In addition, the observed gender differences in this high-risk sample will contribute to the literature on alcohol dependence among women at the more severe end of the dependence spectrum.     

Interpretation of DSM-5 alcohol use disorder criteria in self-report surveys may change with age. A longitudinal analysis of young Swiss men

Abstract

Background: General population surveys using self-reported measures show alcohol use disorder (AUD) to be most prevalent in young adulthood, but this may be due to misinterpretations of AUD criteria among inexperienced drinkers. The present study investigated changes in prevalence of criteria during emerging adulthood.

Methods: 4924 young Swiss men were followed across three waves (age at wave 1 (w1): 20; w2: 21; w3: 25 years). We measured AUD according to the 11?DSM-5 criteria and estimated Item Response Theory models for each wave and differential item functioning across waves, related to the cohort growing older.

Results: Endorsement of several AUD criteria varied considerably as a function of age in a period of only five years: Five criteria showed differential item functioning between waves 1 and 3 (i.e. between the age of 20 and 25), including the three most frequently endorsed criteria. Prevalence of tolerance (w1, 57.8%; w3, 29.6%) decreased in relation to the AUD score (Mantel–Haenszel OR?=?0.26), whereas the use of alcohol larger/longer than intended (w1, 73.7%; w3, 84.8%; OR?=?1.93) and hazardous use (w1, 62.7%; w3, 68.4%; OR?=?1.31) increased, resulting in an unchanged mean AUD score and prevalence, but changing combinations of criteria to qualify AUD.

Conclusions: Considerable differential item functioning over five years among several of the most endorsed AUD criteria suggests shifts in the interpretation of DSM-5 criteria during emerging adulthood. Self-reported measures of DSM-5 AUD criteria may require reformulation to account for young people’s different perceptions and to yield comparable diagnoses over time and across age groups.     

Betel Quid Chewing,Personality and Mood: Betel Quid Chewing Associated with Low Extraversion and Negative Mood

Background: Betel quid (BQ), chewed by about 600 million people worldwide, is one of the most widely used addictive substances. Little is known about psychological factors in BQ chewers. Objectives: The present study was the first attempt to explore the relationships between BQ chewing, personality, and mood. Methods: A survey was conducted with a purposive sample to assess BQ chewing habits in four subgroups: BQ-only users, BQ users who smoke and/or drink, smokers and/or drinkers only, and substance nonusers. A total of 494 participants were recruited from the civilian, non-institutionalized population in Taiwan. Habitual consumption of BQ, smoking and drinking; socio-demographic variables; extraversion; and mood (tension, depression, anger, vigor, fatigue, confusion, and self-esteem). All BQ chewers were evaluated on BQ dependence domains using DSM IV and ICD-10 criteria. Results: The 6-month BQ dependency rate among BQ chewers, defined by either DSM-IV or ICD-10 criteria, ranged from 42.9 to 45.6%. BQ-only users had significantly lower scores on extraversion than substance nonusers. BQ-only users had statistically significant higher scores on confusion and total mood than substance nonusers. BQ-only users had significantly higher scores on fatigue, anger, tension, and depression, than substance nonusers, BQ users who smoke and/or drink, and smokers and/or drinkers only. The number of BQ dependence domains correlated significantly negatively with total mood scores. Conclusions/Importance: The results supported the two hypotheses: (a) BQ chewing is associated with low extraversion; and (b) BQ chewing is related to negative mood.     

Secular Trends in Prevalence of Alcohol Use Disorder and Its Correlates in Korean Adults: Results from Korea National Health and Nutrition Examination Survey 2005 and 2009

ABSTRACT

The Alcohol Use Disorders Identification Test (AUDIT) has been found to provide an accurate measure for risk of hazardous and harmful alcohol use, as well as possible dependence. Data from 2 representative samples of 7693 adults in the Korea National Health and Nutrition Examination Survey (KNHANES) 2005 and 6276 participants in 2009 were analyzed. The overall age-adjusted prevalence of alcohol use disorder (AUD) in 2009 (38.8%) was higher than that in 2005 (32.7%), with a difference of 6.1% (95% confidence interval [CI], 2.9%–9.3%; P = .0002). Men were about 7 times as likely as women to meet the criteria for AUD (odds ratio [OR] = 7.16; 95% CI, 6.27–8.17). Current smoking was the most important correlate associated with AUD in both genders (women: OR = 6.03; 95% CI, 4.40–8.27; men: OR = 2.83; 95% CI, 2.29–3.48). Among women, unmarried (OR = 1.76; 95% CI, 1.35–2.31), less than high school education (OR = 2.71, 95% CI, 1.86–3.96), and lowest income (OR = 1.45, 95% CI, 1.06–1.97) were associated with AUD. These findings provide the most updated prevalence estimates of AUD in the Korean population and they highlight its strong association with smoking, gender differences, and lower socioeconomic status in the Korean population.