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Monday, July 29, 2013

Predicting persistency of DSM-5 alcohol use disorder and examining drinking patterns of recently remitted persons: a prospective general population study

To establish the 3-year persistency rate of alcohol use disorder (AUD) and its predictors, and to examine drinking patterns of recently remitted persons.

The Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) surveyed a nationally representative sample of adults (aged 18-64) at baseline (response=65.1%) and 3-year follow-up (response=80.4%).
People with AUD at baseline, as defined by DSM-5 (n=198).
AUD, drinking patterns and mental disorders were assessed using the Composite International Diagnostic Interview 3.0. Other predictors were assessed with an additional questionnaire. Predictors of persistency were examined with univariable and multivariable logistic regression analyses.
The AUD persistency rate was 29.5% (95% CI=20.0-39.0). In the multivariable model, the older (25-34 and 35-44) age groups had lower AUD persistency (odds ratio (OR)=0.05; p=.014 and OR=0.14; p=.028, respectively) than the youngest age group (18-24). A higher number of weekly drinks and a comorbid anxiety disorder predicted AUD persistency (OR=1.03; p=.043 and OR=4.56; p=.046, respectively). Furthermore, remission was associated with a reduction of 6 drinks per week between T0 and T1. It should be noted however that 35.8% (95% CI=22.4-49.2) of persons in diagnostic remission still drank more than the recommended maximum (>7/14 drinks weekly for women/men).
Only a minority of people in the Netherlands with alcohol use disorder (AUD) as defined by DSM-5 still have the disorder 3 years later. Factors that help identify people at risk of AUD persistence are: younger age, a higher number of weekly drinks and a comorbid anxiety disorder. A substantial number of people recently in diagnostic remission still drink above the maximum recommended level.

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