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Onset of Alcohol Use Disorders and Comorbid Psychiatric Disorders in a Military Cohort: Are there Critical Periods for Prevention of Alcohol Use Disorders?

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Abstract

Alcohol use disorders (AUD) are commonly comorbid with anxiety and mood disorders; however, a strategy for AUD prevention remains unclear in the presence of three competing etiological models that each recommends different high-risk groups. Therefore, the investigation of the three hypotheses in a characteristically unique cohort is critical to identifying pervasive characteristics of AUD that can inform a universal prevention strategy. The current study evaluated the temporality and onset of comorbid AUD and psychiatric disorders in a representative sample of 528 Ohio Army National Guard soldiers using structured clinical interviews from 2009 to 2012. We examined temporality both statistically and graphically to identify patterns that could inform prevention. General estimating equations with dichotomous predictor variables were used to estimate odds ratios between comorbid psychiatric disorders and AUDs. An annualized rate of 13.5 % persons per year was diagnosed with any AUD between 2010 and 2012. About an equal proportion of participants with comorbid psychiatric disorders and AUD initiated the psychiatric disorder prior to the AUD and half initiated the psychiatric disorder after the AUD. Regardless of onset, however, the majority (80 %) AUD initiated during a short interval between the ages of 16 and 23. Focused primary prevention during this narrow age range (16–23 years) may have the greatest potential to reduce population mental health burden of AUD, irrespective of the sequencing of comorbid psychiatric disorder.

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health, 722 W. 168th Street, Room 1513, New York, NY, 10032-3727, USA

    David S. Fink & Gregory H. Cohen

  2. U.S. Army Substance Abuse Program, U.S. Army Garrison Ansbach, Ansbach, Germany

    M. Shayne Gallaway

  3. Department of Psychiatry, University of Toledo, Toledo, OH, USA

    Marijo B. Tamburrino & Thomas Fine

  4. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

    Israel Liberzon

  5. Department of Psychiatry, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Philip Chan, Edwin Shirley, Toyomi Goto, Nicole D’Arcangelo & Joseph R. Calabrese

  6. School of Public Health, Boston University, Boston, MA, USA

    Laura Sampson & Sandro Galea

  7. Biomedical Research and Informatics Center, Michigan State University, Ann Arbor, MI, USA

    Philip L. Reed

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  1. David S. Fink
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  2. M. Shayne Gallaway
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  3. Marijo B. Tamburrino
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  4. Israel Liberzon
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  6. Gregory H. Cohen
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  7. Laura Sampson
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  8. Edwin Shirley
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  9. Toyomi Goto
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  12. Philip L. Reed
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  13. Joseph R. Calabrese
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  14. Sandro Galea
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Corresponding author

Correspondence to David S. Fink.

Ethics declarations

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.”

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Funding

This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Joint Warfighter Medical Research Program under Award No. W81XWH-15-1-0080, W81XWH-07-1-0409, and W81XWH-10-1-0579 [DSF, MTB, IL, PC, GHC, LS, ES, TG, ND, TF, PLR, JRC, SG]. The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense. This report was supported by National Institute on Drug Abuse grant T32DA031099 [DSF]. The informatics support for this research was provided by the Michigan State University Clinical and Translational Sciences Institute, through its Biomedical Research Informatics Core.

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Fink, D.S., Gallaway, M.S., Tamburrino, M.B. et al. Onset of Alcohol Use Disorders and Comorbid Psychiatric Disorders in a Military Cohort: Are there Critical Periods for Prevention of Alcohol Use Disorders?. Prev Sci 17, 347–356 (2016). https://doi.org/10.1007/s11121-015-0624-1

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