Predictors of the 2-year recurrence and persistence of alcohol dependence

Lynn Boschloo, Nicole Vogelzangs, Wim van den Brink, Johannes H Smit, Aartjan T F Beekman, Brenda W J H Penninx

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1639-40
Number of pages2
JournalAddiction
Volume107
Issue number9
Early online date28 Feb 2012
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Alcoholism
Recurrence
Anxiety
Odds Ratio
Alcohols
Depression
Confidence Intervals
Interviews
Mental Health Services
Diagnostic and Statistical Manual of Mental Disorders
Primary Health Care
Cohort Studies
Outpatients
Logistic Models
Regression Analysis
Demography
Prospective Studies
Delivery of Health Care
Education

Keywords

  • Adolescent
  • Adult
  • Aged
  • Alcoholism/epidemiology
  • Anxiety Disorders/epidemiology
  • Chronic Disease
  • Depressive Disorder/epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands/epidemiology
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Young Adult

Cite this

Boschloo, L., Vogelzangs, N., van den Brink, W., Smit, J. H., Beekman, A. T. F., & Penninx, B. W. J. H. (2012). Predictors of the 2-year recurrence and persistence of alcohol dependence. Addiction, 107(9), 1639-40. https://doi.org/10.1111/j.1360-0443.2012.03860.x
Boschloo, Lynn ; Vogelzangs, Nicole ; van den Brink, Wim ; Smit, Johannes H ; Beekman, Aartjan T F ; Penninx, Brenda W J H. / Predictors of the 2-year recurrence and persistence of alcohol dependence. In: Addiction. 2012 ; Vol. 107, No. 9. pp. 1639-40.
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abstract = "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.",
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Boschloo, L, Vogelzangs, N, van den Brink, W, Smit, JH, Beekman, ATF & Penninx, BWJH 2012, 'Predictors of the 2-year recurrence and persistence of alcohol dependence' Addiction, vol. 107, no. 9, pp. 1639-40. https://doi.org/10.1111/j.1360-0443.2012.03860.x

Predictors of the 2-year recurrence and persistence of alcohol dependence. / Boschloo, Lynn; Vogelzangs, Nicole; van den Brink, Wim; Smit, Johannes H; Beekman, Aartjan T F; Penninx, Brenda W J H.

In: Addiction, Vol. 107, No. 9, 09.2012, p. 1639-40.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Predictors of the 2-year recurrence and persistence of alcohol dependence

AU - Boschloo, Lynn

AU - Vogelzangs, Nicole

AU - van den Brink, Wim

AU - Smit, Johannes H

AU - Beekman, Aartjan T F

AU - Penninx, Brenda W J H

N1 - © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

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N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Alcoholism/epidemiology

KW - Anxiety Disorders/epidemiology

KW - Chronic Disease

KW - Depressive Disorder/epidemiology

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Prospective Studies

KW - Recurrence

KW - Risk Assessment

KW - Risk Factors

KW - Young Adult

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DO - 10.1111/j.1360-0443.2012.03860.x

M3 - Article

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JO - Addiction

JF - Addiction

SN - 0965-2140

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Boschloo L, Vogelzangs N, van den Brink W, Smit JH, Beekman ATF, Penninx BWJH. Predictors of the 2-year recurrence and persistence of alcohol dependence. Addiction. 2012 Sep;107(9):1639-40. https://doi.org/10.1111/j.1360-0443.2012.03860.x