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Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United StatesResults From the National Epidemiologic Survey on Alcohol and Related Conditions
Deborah S. Hasin, PhD;
Frederick S. Stinson, PhD;
Elizabeth Ogburn, MS;
Bridget F. Grant, PhD, PhD
Arch Gen Psychiatry. 2007;64(7):830-842.
Context Epidemiologic information is important to inform etiological research and service delivery planning. However, current information on the epidemiology of alcohol use disorders in the United States is lacking.
Objectives To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, and treatment of DSM-IV alcohol abuse and dependence.
Design, Setting, and Participants Face-to-face interviews with a representative US adult sample (N = 43 093).
Main Outcome Measures Lifetime and 12-month DSM-IV alcohol abuse and dependence.
Results Prevalence of lifetime and 12-month alcohol abuse was 17.8% and 4.7%; prevalence of lifetime and 12-month alcohol dependence was 12.5% and 3.8%. Alcohol dependence was significantly more prevalent among men, whites, Native Americans, younger and unmarried adults, and those with lower incomes. Current alcohol abuse was more prevalent among men, whites, and younger and unmarried individuals while lifetime rates were highest among middle-aged Americans. Significant disability was particularly associated with alcohol dependence. Only 24.1% of those with alcohol dependence were ever treated, slightly less than the treatment rate found 10 years earlier. Strong associations between other substance use disorders and alcohol use disorders (odds ratios, 2.0-18.7) were lower but remained strong and significant (odds ratios, 1.8-7.5) when controlling for other comorbidity. Significant associations between mood, anxiety, and personality disorders and alcohol dependence (odds ratios, 2.1-4.8) were reduced in number and magnitude (odds ratios, 1.5-2.0) when controlling for other comorbidity.
Conclusions Alcohol abuse and dependence remain highly prevalent and disabling. Comorbidity of alcohol dependence with other substance disorders appears due in part to unique factors underlying etiology for each pair of disorders studied while comorbidity of alcohol dependence with mood, anxiety, and personality disorders appears more attributable to factors shared among these other disorders. Persistent low treatment rates given the availability of effective treatments indicate the need for vigorous education efforts for the public and professionals.
Author Affiliations: Mailman School of Public Health (Dr Hasin and Ms Ogburn) and College of Physicians and Surgeons (Dr Hasin), Columbia University, New York, New York; New York State Psychiatric Institute, New York (Dr Hasin and Ms Ogburn); and Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland (Drs Stinson and Grant).
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