The 14-year course of alcoholism in a community sample: do men and women differ?

Drug Alcohol Depend. 2008 Jan 11;93(1-2):1-11. doi: 10.1016/j.drugalcdep.2007.08.013. Epub 2007 Nov 1.

Abstract

Objective: To investigate the course of alcoholism in males and females in a 14-year follow-up of persons with DSM-III alcoholism compared to very heavy drinkers and unaffected controls in a community sample.

Methods: Case-control study based on data from the 1997 Health Services Use and Cost study, a 14-year follow-up survey of 442 individuals who participated in two waves of the 1981-1983 St. Louis Epidemiologic Catchment Area study. Cases met criteria for DSM-III alcohol abuse (AA) or dependence (AD) at both waves of the ECA: "Two-times Alcohol Use Disorder Positives (ECA 2t-AUDPs)." Two comparison groups were frequency matched to 2t-AUDPs: (1) ECA Very Heavy Drinkers/One-time Alcohol Use Disorder Positives (ECA VHD/1t-AUDPs) and (2) ECA alcohol-unaffecteds. Lifetime and past year alcohol use disorders, patterns of drinking and recovery among males and females are reported.

Results: 84.6% of 2t-AUDPs again met lifetime DSM-III criteria at 14-year follow-up. At follow-up, only 9.3% male 2t-AUDPs and 20.7% female 2t-AUDPs met past year DSM-IV AUD criteria. Past year drinking patterns, however, revealed higher rates of DSM-IV AA or AD, problem or risk drinking among 2t-AUDPs (61.7%) compared to both ECA VHD/1t-AUDPs (41.2%) and ECA alcohol-unaffecteds (22.1%).

Conclusions: In a community sample, the rate of past year DSM-IV alcohol dependence was lower among male 2t-AUDPs than females, though both groups showed past year rates substantially lower than lifetime rates. However, less than half of ECA 2t-AUDPs exhibited low-risk or abstinent alcohol use behaviors, indicating that while remission from diagnosis is common, clinical relevance persists.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Alcoholism / diagnosis
  • Alcoholism / epidemiology*
  • Case-Control Studies
  • Catchment Area, Health
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Remission Induction
  • Retrospective Studies
  • Risk Factors
  • Risk-Taking
  • Severity of Illness Index
  • Sex Distribution
  • United States / epidemiology