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Background: Heavy episodic drinking is common in the United States (US) and causes substantial burden to individuals and the society. The transition from first drinking to first heavy drinking episode is a major milestone in the escalation of drinking. There is limited evidence about whether major depressive symptoms predict the progression from drinking to heavy drinking and potential variations across age, sex, and depressive symptoms. In this study, we aim to estimate the association between history of major depressive symptoms and the risk of first heavy drinking episode among new drinkers in the US., Methods: Study population was US non-institutionalized civilian new drinkers 12 years of age and older who had their first drink during the past 12 months drawn from the National Survey on Drug Use and Health. History of major depressive symptoms and alcohol drinking behaviors were assessed via audio-computer-assisted self-interviews. Logistic regressions and structural equation modeling were used for analysis., Results: Depressed mood and/or anhedonia predicted the transition from the first drink to a heavy drinking episode among underage female new drinkers, whereas null associations were found among males and female new drinkers who had their first drink at 21 and later. Among new drinkers with depressed mood and/or anhedonia, low mood or energy positively predicted the progression to a heavy drinking episode among late-adolescent boys, but negatively among late-adolescent girls; neurovegetative symptoms positively predicted the progression to a heavy drinking episode among young adult new drinkers., Conclusions: The relationships linking major depressive symptoms and the transition from drinking to first heavy drinking episode vary across age, sex, and depressive symptoms., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China., Methods: Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng., Results: The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were "failure to quit/cutdown" and "drinking more or for longer than intended." Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11)., Conclusion: AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms., (© 2021. The Author(s).)

Objective: In this study of newly incident drinkers (NIDs), we (a) investigate and calibrate measurement equivalence of 7 clinical features of an alcohol dependence syndrome (ADS) across sex and age-of-onset subgroups and (b) estimate female-male differences in ADS levels soon after taking the first full drink, with focus on those with first full drink before the 24th birthday., Methods: The study population is 12- to 23-year-old NIDs living in the United States (n = 33,561). Calibrated for measurement equivalence, male-female differences in levels of newly incident ADS are estimated for 6 age-of-onset subgroups., Results: Measurement equivalence is achieved by dropping the "difficulty cutting down" item. Then, among early-adolescent-onset NID, females have higher ADS levels (for 12- to 13-year-old NID: β = .25; 95% CI [0.05, 0.45]). In contrast, when drinking onset is delayed to adulthood, males have higher ADS levels (e.g., for 18- to 19-year-old NID: β = -.27; 95% CI [-0.52, -0.02]; for 20- to 21-year-old NID: β = -.38; 95% CI [-0.65, -0.12])., Conclusions: In the United States, there is female excess in ADS levels measured soon after drinking onset in early adolescence. The traditional male excess is seen when drinking onset occurs after mid-adolescence. Evidence from other countries will be useful., (Copyright © 2018 John Wiley & Sons, Ltd.)

Age-specific incidence estimates are important and useful facts in psychiatric epidemiology, but incidence estimation can be challenging. Methods artifacts are possible. In the United States, where the minimum legal drinking age is 21 years, recent cross-sectional field research on 12- to 25-year-olds applied conventional "age-at-assessment" approaches (AAA) for incidence estimation based on 12-month recall. Estimates disclosed unexpected nonlinear patterns in age-specific incidence estimates for both drinking onset and for transitioning from first drink to heavy drinking. Here, our aim is to draw attention to an "age of onset" (AOO) alternative to AAA approaches and to verify whether the AOO approach also discloses nonlinearity. Yearly data are from U.S. nationally representative samples drawn and assessed for National Surveys on Drug Use and Health, 2002-2014, with standardized audio computer-assisted self-interview assessments for drinking outcomes. Both AAA and AOO approaches show nonlinearities, with an unexpected dip in drinking incidence rates after age 18 and before the age 21 minimum legal drinking age. The AOO and the AAA approaches disclosed similar age-specific patterns. We discuss advantages of the AOO approach when nonlinear incidence patterns can be anticipated, but we conclude that the AAA approach has not created an artifactual nonlinear pattern., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Drinking motives have been linked to alcohol consumption and drinking-related problems in western countries, but evidence about this relationship is largely lacking for Asian countries. We aim to assess the relationship between drinking motives and drinking-related outcomes in China, where alcohol use disorders are an increasingly important contributor to the overall burden of illness., Methods: Validated Chinese versions of the Drinking Motives Questionnaire-Revised (DMQ-R) and the Alcohol Use Disorder Identification Test (AUDIT) were used to assess drinking motives and drinking-related outcomes among 612 current drinkers identified from a cross-sectional survey of a representative sample of 2425 adults living in Ningxia Province in 2013. Structural equation modeling was used to estimate the relationships linking specific drinking motives ('enhancement', 'conformity', 'social' and 'coping') to drinking-related outcomes ('level of alcohol consumption', 'alcohol dependence' and 'adverse consequences')., Findings: The enhancement motive is significantly associated with the level of alcohol consumption (β=0.52, 95% CI=0.27, 0.78). The conformity motive is associated with higher levels of alcohol dependence (β=0.74, 95% CI=0.50, 0.98) and adverse consequences of drinking (β=0.43, 95% CI=0.04, 0.81). The social motive and drinking to cope motive are not significantly associated with any of the three drinking outcomes., Interpretation: The relationships between drinking motives and drinking-related outcomes in China are quite different from those reported in western countries. This study highlights the need to consider local context when adapting prevention or intervention strategies developed in western countries to address the problem of the harmful use of alcohol in China., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: This study integrates data from high-quality mental health surveys in five provinces in China to examine the prevalence, demographic correlates, age of onset, and comorbidity of alcohol use disorder (AUD)., Methods: The five cross-sectional surveys initially screened a representative sample of 74,752 community-living adults (94% response rate) from a sampling population including over 12% of China's adult population. Psychiatrists then administered a detailed diagnostic exam to an enriched sample of 21,015 respondents (95% response rate). The prevalence of AUD in females in China is below 0.5%, so we limited our analysis to 9619 males who completed the diagnostic interview., Results: Using meta-analyses to summarize estimates across the five locations, the current (30-day) prevalence of AUD among adult Chinese males was 9.8% (95% CI=5.7-16.9%), but there was wide cross-province variation. After adjusting for age and other demographic variables, the prevalence of AUD was significantly lower in single men than in married men (OR=0.4, CI=0.2-0.7), lower in men who were not currently working than in men who were currently working (OR=0.7, CI=0.5-0.96), and lower in men with comorbid mental disorders than in men without comorbid mental disorders (OR=0.4, CI=0.2-0.8). The risk of developing AUD peaked at 30 years of age., Conclusions: Substantial differences in the demographic correlates and age of onset of AUD in men in China compared to those reported in other countries highlight the importance of understanding the country-specific and region-specific profile of AUD before developing intervention and prevention strategies., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: To study male-female and age differences in estimates of rapid transition from first full drink to alcohol dependence among youthful newly incident drinkers in the United States (US)., Method: The study population included 12-to-25-year-old non-institutionalized US civilian residents, sampled for US National Surveys on Drug Use and Health 2002-2013, with assessments via confidential computer assisted self-interviews. Newly incident drinkers are those who had their first full drink soon before the assessment (n=32,562 12-to-25-year- olds). Alcohol dependence (AD) criteria are from DSM-IV., Results: For 12-to-25-year-old females, the peak risk for making a rapid transition from first full drink to alcohol dependence is seen during adolescence, followed by declining estimates (meta-analysis summary=3% at 12-17 years of age, 95% CI=2%, 3%). Among males, corresponding estimates fluctuate around 2%, with no appreciable differences across age strata. Among 12-to-17-year-old newly incident drinkers, there is a female excess in the rapid transition to alcohol dependence; a male excess is observed among young adult newly incident drinkers. Evaluated cohort-wise, using an epidemiological mutoscope view, individual cohorts show a congruent pattern, with age at first drink held constant., Conclusions: Studying multiple replication samples of young newly incident drinkers, we discovered a clear female excess in the risk of a rapid transition from first full drink to alcohol dependence among adolescents, with age patterns differing across males and females., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

This study examined adult drinking patterns in the first year after onset and whether these patterns changed after 3 years. We also investigated whether specific demographic characteristics or DSM-IV alcohol use disorder symptoms were related to drinking transitions. Data from National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. "Newly onset alcohol users" (NOAUs; n = 854) were adults who initiated drinking in the year prior to Wave 1 (2001-2002) and who were followed-up at Wave 2 (2004-2005). Latent class models were estimated for 10 frequency-type drinking patterns at both waves. Latent transition analysis explored changes in drinking patterns from baseline to follow-up. Three drinker classes emerged at Wave 1: (a) low risk (41%); (b) sporadic hazardous (35%); and (c) regular hazardous (24%). One in 5 (18%) NOAUs stopped drinking by Wave 2 and were assigned to an "abstainer" class. The transition probability into the "abstainer" class was highest for the Wave 1 low risk drinkers (86%). The remaining NOAUs (82%) continued to drink at Wave 2. Of these, 70% of regular hazardous drinkers at Wave 1 maintained this drinking pattern at Wave 2, with approximately 30% reducing their pattern of drinking. One third of sporadic hazardous drinkers at Wave 1 remained at this level of drinking at Wave 2; the remainder escalated the drinking. Tolerance, larger/longer, cut down/quit and withdrawal were common among regular hazardous drinkers. Adult drinkers who engage in a low frequency and quantity drinking pattern are most likely to stop drinking soon after onset. Drinking patterns adopted in the first year after onset were indicative of drinking involvement 3 years later.

Aims: This study aims to estimate, using a unique quantile regression approach, the relationship linking alcohol use disorder (AUD) and disability (physical and mental) using data from a prospective study of household dwelling adults in the United States., Methods: Data from the two-wave National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) are used to assess AUD-associated disability. A total of 24,716 non-institutionalized adults are grouped into "never AUD" and "newly incident AUD" groups. The main outcome variables of interest are the changes in physical and mental disability levels between the two waves, as measured by summary scores of the Short Form Health Survey Version 2. Alcohol use disorder and other mental disorders are assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version. Linear regression and quantile regression approaches are used for analysis., Results: The occurrence of AUD is associated with poorer mental disability outcomes, mainly due to the occurrence of alcohol dependence. The association for physical disability is dependent on the history of other mental disorders. Among those with antecedent mental disorders, alcohol dependence is associated with better physical health; among those without antecedent mental disorders, alcohol dependence is associated with poorer outcomes in physical health., Conclusions: Evidence tentatively supports a causal link between AUD and mental disability., (Copyright © American Academy of Addiction Psychiatry.)

Background: Alcohol problems are widespread throughout the United States. While treatment can be successful, many individuals continue to drink. One method to assess treatment results over time is by investigating abstinence as a measure of success., Objectives: The main aim of this study is to investigate factors that may be associated with past-year (PY) abstinence among individuals who received prior-to-past-year (PPY) treatment for alcohol problems, while also assessing abstinence by treatment subtype., Method: This study uses data from 1742 individuals who received PPY treatment for alcohol problems in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Logistic regression models were used to assess the strength of association between alcohol abstinence and key demographic and clinical factors., Results: The level of PY abstinence was 36.5% among those who previously sought treatment for alcohol problems. Younger age groups and those who were nicotine dependent or had a cannabis use disorder were less likely to be abstinent. There were no differences based on sex or PY major depression or generalized anxiety disorder., Conclusion: While causal inferences cannot be made, these results suggest that the majority of people continue to drink, even after being treated for alcohol problems. Nonetheless, variation may exist depending on the form of treatment a person receives. More research is needed regarding long-term levels of abstinence after individuals receive treatment.

Background: Evidence in support of a suspected causal association linking childhood physical punishment (CPP) and later alcoholic beverage-related disturbances has been found in metropolitan China. Here, the focus shifts to the CPP association with the estimated risk of starting to drink, having the first drinking problem, and transitioning from first drink to the first drinking problem., Methods: Data are from the World Mental Health Surveys-metropolitan China study, with representative samples of adult household residents living in two metropolitan cities, Beijing and Shanghai. Recalled information was available for early life experiences (including CPP, other childhood adversities, and parental alcohol and drug problems), as well as the onset age of drinking and drinking problems. Survival analyses were used to estimate the Hazard Ratio. A structural equation modeling approach was used to control for other inter-correlated childhood adversities., Results: Cox proportional hazards modeling discloses statistically robust associations linking CPP with drinking and drinking problems, as well as more rapid transitions from first drink to first drinking problem, even after accounting for other childhood adversities and parental drinking problems. These associations cannot be attributed to a more general noxious family environment., Conclusions: These results lay a foundation for future experimental studies on the possible causal relationship linking CPP with the onset of drinking problems and the transition from drinking to drinking problems., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of the current study is to estimate a link between early physical punishment in childhood and later alcohol outcomes, taking family history of drinking problems into account, with epidemiological data from China. The yield from previous studies on this relationship is mixed evidence, largely traceable to research design variations, including model specifications that concern parental alcohol or other drug problems (AODPs) that might account for both earlier discipline practices and later drinking problems in the offspring., Method: Data are from the World Mental Health Surveys-metropolitan China study, with cross-sectional representative sample surveys of adult household residents living in two metropolitan cities, Beijing and Shanghai. Participants in this general mental health survey were asked about early life experiences (e.g., parental AODP, childhood misbehavior), as well as their own drinking outcomes. Stratification was used to control for parental AODP., Results: Logistic regressions found robust associations linking childhood physical punishment with drinking outcomes, even with stratification for parental AODP and childhood misbehavior., Conclusions: These results from a cross-sectional survey lay a foundation for future prospective and longitudinal research on possible causal relationships that link childhood physical punishment with later drinking outcomes in China.

Aims: The aim of the current study is to estimate the association between childhood physical punishment (CPP) and level of alcohol use disorder (AUD), using two different approaches to take other childhood adversities into account., Design and Setting: Population survey using face-to-face interviews to a representative sample of non-institutionalized adult residents of Beijing and Shanghai, China., Participants: A total of 5201 participants aged 18-70 years., Measurements: A version of the World Mental Health Composite International Diagnostic Interview was used. Standardized assessments covered early life experiences of childhood physical punishment, other childhood adversities, parental drinking problems, childhood conduct problems and clinical features of AUD., Findings: A robust association linking CPP and level of AUD was found, holding other childhood adversities constant (probit coefficient = 0.70, 95% CI = 0.40, 1.00) via covariate terms in structural equations modeling. Furthermore, there was evidence that CPP might exert an additional influence on level of AUD over and above a generally noxious family environment (probit coefficient = 0.20, 95% CI = 0.02, 0.38)., Conclusions: There appears to be a robust association between reports of harsh punishment in childhood and alcohol dependence in adulthood adjusting for a range of possible confounding factors. Whether the association is causal or whether both are related to a common underlying factor or recall bias needs to be investigated further., (© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.)

Background: Globally, there is a male excess in the occurrence of heavy drinking once alcoholic beverages are consumed and some new evidence that this 'gender gap' might be null among underage drinkers. Here, we estimate age-specific male-female differences in heavy drinking episode (HDE) incidence across the first eight calendar-quarters after first full drink.Methods: Study population is non-institutionalized civilians in the United States (2006-2014). Standardized audio computer-assisted self-interviews were used to assess the date of first full drink and the date of first HDE (i.e., 5+ drinks on one occasion) among ∼33,000 12-to-21-year-old newly incident drinkers (all with 1st full drink and HDE evaluated within 24 months of drinking onset). Time-to-HDE survival analyses are used to estimate age-specific male-female ratios in the hazard of HDE onset.Results: We found that among early adolescent new drinkers (drinking onset at age 11-14), the newly incident drinking females progress to HDE more quickly than males (HR = 1.3, 95% CI = 1.1, 1.6). In contrast, male excess risk is observed when drinking starts at or after age 15 years. For underage drinkers, age-specific hazard ratios (HR) depend upon age at first full drink.Conclusions: Based on recent survey data from the US, this study's survival analyses support early adolescent female excess in the onset of HDE. When drinking starts at or after age 15 years, a male excess becomes apparent within two years since first full drink. Future studies may probe any sex-specific mechanisms toward the rapid onset of HDE at different age groups. [ABSTRACT FROM AUTHOR]

Objective: This study sought to discover recent age-specific and cohort-specific patterns of newly incident drinking of alcoholic beverages among young people in the United States, with identification of age at peak risk, cohort by cohort, and age by age.Method: Data are from the U.S. National Surveys on Drug Use and Health 2002-2013, with 12 independent successive replications of nationally representative surveys (n ≈ 420,000 12- to 25-year-olds). Drinking was assessed via confidential computer-assisted self-interviews.Results: Looking across age strata, we found rising age-specific drinking incidence rates across adolescence to a plateau at age 16-18 years and made a new discovery of a statistically robust and highly reproducible dip in incidence at age 19-20 years, followed by the major peak at age 21 years, with sharply reduced incidence thereafter. Evaluated using an epidemiological mutoscope view, individual cohorts showed a congruent pattern, with starting age held constant. A completely different pattern was seen in age-specific prevalence estimates that showed monotonic linear increases.Conclusions: The novelty seen here, with multiple replications, is a set of clearly nonlinear, age-specific drinking incidence patterns not documented in prior studies. Evidence of noncongruent prevalence patterns is provided. We hope these simple examples will be useful in teaching the epidemiology of alcohol drinking. [ABSTRACT FROM AUTHOR]

Background This research extends prior epidemiological estimates for the United States and re-examines a previously described male excess in alcohol drinking. Its aim was to estimate fine-grained age-specific incidence of becoming a drinker among 12- to 24-year-old U.S. males and females, and to compare incidence estimates with prevalence proportions. Methods The study population is 12- to 24-year-old noninstitutionalized U.S. civilian residents. Estimates are from 12 successive U.S. National Surveys on Drug Use and Health ( NSDUH), with nationally representative samples drawn each year from 2002 to 2013 and assessed via computer-assisted self-interviews ( n ~ 390,000). Analysis-weighted incidence and prevalence estimates are generated using the NSDUH Restricted Data Analysis System for 6 year-pairs. Meta-analysis-derived summary estimates are provided, treating each year-pair as a replication. Results In this 21st century evidence, there no longer is male excess of incidence with respect to underage drinking. Indeed, in mid-adolescence, there is a clear female excess for the risk of becoming an underage drinker. Meta-analytic summaries disclosed no other male-female differences in incidence. Nevertheless, a male excess in the prevalence of recently active drinking can be seen after the age of 19 years. Conclusions This new evidence from the United States shows that the so-called 'gender gap' in risk of becoming a drinker has narrowed to the point of there being no gap at all. Indeed, in mid-adolescence, risk of starting to drink is greater for females than for males. [ABSTRACT FROM AUTHOR]

Aims To identify studies about the prevalence of alcohol use disorder (AUD) in mainland China, evaluate the quality of these studies and conduct a meta-analysis of the prevalence of AUD in China's adult population and in population subgroups defined by sex, age and urban versus rural residency. Methods Relevant studies published prior to January 2014 were identified from the following databases: China Knowledge Resource Integrated (CNKI), Wanfang, Pubmed, EmBase and Web of Science. A 16-item quality assessment inventory for epidemiological studies in mainland China was constructed to evaluate the methodological rigor of the studies. A total of 38 studies including 1 304 354 individuals were identified. Outcomes included current and life-time prevalence of AUD, alcohol dependence and alcohol abuse. Results The pooled life-time and current prevalence of alcohol dependence were 1.4% [95% confidence interval (CI) = 1.3, 1.5] and 1.5% (95% CI = 1.2, 1.9). For males, pooled estimates of the current prevalence of alcohol dependence, alcohol abuse and AUD were 4.4 (95% CI = 3.1, 5.7), 4.0 (95% CI = 2.2, 5.7) and 10.1% (95% CI = 4.7, 15.4), respectively; the corresponding values for females were all below 0.2, 0.1, and 0.1%. There was large between-study heterogeneity in the prevalence measures that was associated with sample size, the use of key informants and the use of substitute respondents. The quality of included studies was generally low. Higher-quality studies reported higher prevalence. Conclusions Alcohol use disorder is an urgent public health problem in China, especially among males. When using high-quality studies, current and life-time prevalence estimates of alcohol dependence in China measure 2.2% and 3.7%, respectively, approaching those of the Netherlands, United States and other western countries. [ABSTRACT FROM AUTHOR]

This study investigates the occurrence of clinical features of alcohol dependence and socially maladaptive drinking during the first 24 months after the onset of alcohol use. Data for this study are from the nationally representative 2004-07 National Surveys on Drug Use and Health (NSDUH). General population of the United States, aged 12 years and older. New-onset alcohol users (NOAUs) were drinkers who started to drink alcohol within 24 months of the NSDUH assessment and consumed alcohol during the last 12 months. The NSDUH assessed for clinical features of alcohol dependence and socially maladaptive drinking, consistent with the DSM-IV. NOAUs frequently experienced problems relating to self-reported tolerance, spending a great deal of time recovering from the effects of alcohol and unsuccessful attempts at cutting down on drinking. The likelihood of experiencing the clinical features increased steadily in the first 9 months after use, but appeared to plateau or only gradually increase thereafter. Strong evidence emerged that the clinical features measured a single latent dimensional of 'alcohol use disorder' (AUD) in this sample. The majority of the clinical features were good indicators of the underlying AUD continuum in the 2 years after first drinking onset. There may be a period of time during the second year of alcohol use, when level of alcohol use disorder fluctuates rather than increases. Public health and safety efforts designed to target problematic alcohol use in the earliest stages of alcohol involvement could be useful in preventing the escalation of alcohol problems in this group of drinkers. [ABSTRACT FROM AUTHOR]