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Predictors of Initial and Sustained Remission from Alcohol Use Disorders: Findings from the 30‐Year Follow‐Up of the S an D iego Prospective Study
Author(s) -
Trim Ryan S.,
Schuckit Marc A.,
Smith Tom L.
Publication year - 2013
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.12107
Subject(s) - alcohol use disorder , alcohol , alcohol dependence , alcohol abuse , medicine , family history , proband , complete remission , psychiatry , pediatrics , psychology , chemotherapy , biochemistry , chemistry , mutation , gene
Background Individuals who report problematic drinking early in life often recover from alcohol‐related disorders, with or without formal treatment. While risk factors associated with developing alcohol use disorders ( AUD s), such as a family history of alcoholism and the genetically influenced low level of response ( LR ) to alcohol, have been identified, less is known about characteristics that relate to remission from AUD s. Methods The male subjects (98% C aucasian) for this study were 129 probands from the S an D iego P rospective S tudy who were first evaluated at age 20 as drinking but not alcohol‐dependent young men, most of whom were college graduates by follow‐up. The individuals evaluated here met criteria for an AUD at their first follow‐up at ages 28 to 33 and were followed every 5 years for the next 2 decades. Discrete‐time survival analysis was used to examine rates of initial and sustained AUD remission and to evaluate the relationships of premorbid characteristics and other risk factors to these outcomes. Results Sixty percent of the sample met criteria for an initial AUD remission of 5 or more years, including 45% with sustained remission (i.e., no subsequent AUD diagnosis). Higher education, lower drinking frequency, and having a diagnosis of alcohol abuse (rather than dependence) were associated with higher rates of initial AUD remission. A lower LR to alcohol at age 20, as well as lower drinking frequency, having received formal alcohol treatment, and older age at the first follow‐up all predicted a greater likelihood of sustained AUD remission. Conclusions This study identified key factors associated with initial and sustained AUD remission in subjects diagnosed with AUD in young adulthood. Characteristics associated with better outcomes early in the life span, such as lower drinking frequency and early treatment, appear to have a lasting impact on remission from AUD across adulthood.