AIMS: To identify independent risk factors of the recurrence of alcohol dependence (AD) in people with a remitted disorder at baseline and persistence of AD in people with a current disorder at baseline. DESIGN: Prospective cohort study with assessments at baseline and 2-year follow-up. SETTING: Recruitment from the general population, primary care and out-patient mental health-care services. PARTICIPANTS: People with remitted AD (n = 253) and current AD (n = 135). MEASUREMENTS: Recurrence and persistence of AD during 2-year follow-up were established using the Composite International Diagnostic Interview (CIDI) interview based on DSM-IV. Logistic regression analyses were performed to explore the role of potential risk factors (i.e. baseline severity of alcohol problems, measures for depression and anxiety, socio-demographics, vulnerability factors and addiction-related factors) as independent predictors of a negative course. FINDINGS: Overall recurrence and persistence rates of AD were 14.6 and 40.7%, respectively, and were highly conditional on the severity of alcohol problems [adjusted odds ratio (OR) per standard deviation (SD) increase: OR = 3.64, 95% confidence interval (CI): 2.21-6.01 and OR = 2.12, 95% CI: 1.32-3.40, respectively). Severity of depressive/anxiety symptoms was an additional independent predictor of the recurrence of AD, whereas male gender and high education were significant independent risk factors of the persistence of AD. CONCLUSIONS: Alcohol dependence has a dynamic course, with only moderate levels of diagnostic stability. Both recurrence and persistence of alcohol dependence are highly dependent on severity of baseline alcohol problems, whereas severity of depressive/anxiety symptoms predicts only the recurrence of alcohol dependence. Both measures may be useful in identifying people at an increased risk of a negative course and who could be targeted by prevention strategies.
AIMS: To identify independent risk factors of the recurrence of alcohol dependence (AD) in people with a remitted disorder at baseline and persistence of AD in people with a current disorder at baseline. DESIGN: Prospective cohort study with assessments at baseline and 2-year follow-up. SETTING: Recruitment from the general population, primary care and out-patient mental health-care services. PARTICIPANTS: People with remitted AD (n = 253) and current AD (n = 135). MEASUREMENTS: Recurrence and persistence of AD during 2-year follow-up were established using the Composite International Diagnostic Interview (CIDI) interview based on DSM-IV. Logistic regression analyses were performed to explore the role of potential risk factors (i.e. baseline severity of alcohol problems, measures for depression and anxiety, socio-demographics, vulnerability factors and addiction-related factors) as independent predictors of a negative course. FINDINGS: Overall recurrence and persistence rates of AD were 14.6 and 40.7%, respectively, and were highly conditional on the severity of alcohol problems [adjusted odds ratio (OR) per standard deviation (SD) increase: OR = 3.64, 95% confidence interval (CI): 2.21-6.01 and OR = 2.12, 95% CI: 1.32-3.40, respectively). Severity of depressive/anxiety symptoms was an additional independent predictor of the recurrence of AD, whereas male gender and high education were significant independent risk factors of the persistence of AD. CONCLUSIONS:Alcohol dependence has a dynamic course, with only moderate levels of diagnostic stability. Both recurrence and persistence of alcohol dependence are highly dependent on severity of baseline alcohol problems, whereas severity of depressive/anxiety symptoms predicts only the recurrence of alcohol dependence. Both measures may be useful in identifying people at an increased risk of a negative course and who could be targeted by prevention strategies.
Authors: Domenic A Ciraulo; David H Barlow; Suzy Bird Gulliver; Todd Farchione; Sandra B Morissette; Barbara W Kamholz; Katherine Eisenmenger; Bonnie Brown; Eric Devine; Timothy A Brown; Clifford M Knapp Journal: Behav Res Ther Date: 2013-08-30
Authors: Vivia V McCutcheon; Marc A Schuckit; John R Kramer; Grace Chan; Howard J Edenberg; Tom L Smith; Annah K Bender; Victor Hesselbrock; Michie Hesselbrock; Kathleen K Bucholz Journal: Addiction Date: 2017-07-06 Impact factor: 6.526
Authors: Andrzej Jakubczyk; Anna Klimkiewicz; Maciej Kopera; Aleksandra Krasowska; Małgorzata Wrzosek; Halina Matsumoto; Margit Burmeister; Kirk J Brower; Marcin Wojnar Journal: J Psychiatr Res Date: 2013-01-12 Impact factor: 4.791
Authors: A Jakubczyk; M A Ilgen; M Kopera; A Krasowska; A Klimkiewicz; A Bohnert; F C Blow; K J Brower; M Wojnar Journal: Drug Alcohol Depend Date: 2015-11-23 Impact factor: 4.492