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

Abstract

Background. Among adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are interindividual 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.

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

“…For example, using data from a longitudinal study of adult male twins, cannabis initiation has been shown to be predicted by high genetic risk for problem cannabis use, high genetic risk of externalizing disorder, high sensation seeking personalities, low parental monitoring, high peer group deviance, and cannabis availability (Gillespie, Lubke, Gardner, Neale, & Kendler, 2012). In another community-based longitudinal study, early initiation of alcohol and nicotine use were associated with early initiation of cannabis use; however, only the association with nicotine use remained after controlling for externalizing disorders and parental substance dependence (Behrendt et al, 2012). This study also demonstrated that early initiation of alcohol and cannabis, paternal alcohol dependence, and externalizing disorders were associated with cannabis use and a higher risk of developing cannabis use disorders.…”

Early Adolescent Symptoms of Social Phobia Prospectively Predict Alcohol Use

“…Consistent with previous prospective studies examining if diagnostic-level SP during middle adolescence predicts later alcohol use (Behrendt et al, 2011;Buckner et al, 2008;Crum and Pratt, 2001;Zimmermann et al, 2003), we hypothesized that (a) baseline SP symptoms would predict increased odds of alcohol use throughout middle adolescence and (b) SP symptoms measured annually would prospectively predict increased odds of alcohol use over time from late childhood through middle adolescence.…”

“…For example, one study demonstrated that SP at age 16 was associated with a 4.5 times greater likelihood of meeting criteria for alcohol dependence at age 30 (Buckner et al, 2008), whereas another study indicated that among adolescents and young adults, SP at baseline (age 14-24) predicted the persistence of alcohol dependence between baseline and follow-up (4 years later) as well as the onset of regular and hazardous alcohol use at follow-up (Zimmerman et al, 2003). Importantly, only SP and externalizing disorders at baseline were associated with more rapid transition from alcohol use to alcohol dependence; bipolar disorder, panic attacks, nicotine dependence, and problematic cannabis use were not associated with this transition (Behrendt et al, 2011). Thus, there is compelling evidence to suggest that an SP diagnosis places individuals at increased risk for alcohol use, alcohol dependence, and persistence of AUDs over time.…”

Sex differences in the cumulative incidence of substance use by birth cohort

“…An early onset of use of a specific substance is a risk factor for disorders related to that substance (Behrendt, Wittchen, Hofler, Lieb, & Beesdo, 2009;Dawson, Goldstein, Chou, Ruan, & Grant, 2008;Grucza, Norberg, Bucholz, & Bierut, 2008;Pitkanen, Lyyra, & Pulkkinen, 2005), although this effect has not been proved across substance classes. In contrast, a younger age at first alcohol use has been associated with increased risk of cannabis use (Behrendt et al, 2012).…”