Academic journal article Indian Journal of Psychiatry

Severity of Alcoholism in Indian Males: Correlation with Age of Onset and Family History of Alcoholism

Academic journal article Indian Journal of Psychiatry

Severity of Alcoholism in Indian Males: Correlation with Age of Onset and Family History of Alcoholism

Article excerpt

Byline: R. Pradeep, Saira. Banu, M. Ashok

Background: Family History of Alcoholism and earlier Age of Onset are found to predict Severity of alcoholism. Previous Indian studies in this regard have methodological issues related to the definition of alcoholism and reliability of information obtained. Aims: To study the relationship between the Age of onset/Family History and Severity of alcoholism. Settings and Design: Consecutively admitted, 20 to 50 year old men, with alcohol-related problems at an urban teaching hospital, were recruited. Materials and Methods: After detoxification, alcohol use detection inventory test, severity of alcohol dependence questionnaire, schedule for clinical assessment in neuropsychiatry, and family interview for genetic studies were administered. Family history density was computed. Statistics: Pearson's correlations, linear regression, and ANOVA tests were used. Results: Family history density and severity of alcoholism were positively correlated. Age of onset of initiation had a significant negative correlation with severity. The effect of family history on the rapidity of development of Problem-drinking did not reach statistical significance among those with early age of onset. The variance explained by the 'family history status' and 'age of onset' for the severity of alcoholism was similar to that reported in earlier western studies. Conclusion: This study, with enhanced methodology, using a general hospital sample of problem drinkers concludes that the age of onset of initiation is a better predictor of severity of alcoholism, than family history of alcoholism alone. Postponing the use of alcohol till the age of 25 years could be explored as a primary prevention strategy in genetically vulnerable adolescents.

Introduction

There is a three-to-five-fold increased risk of alcoholism in the relatives of alcoholics. [sup][1] In various international studies, individuals with a positive family history have shown to have an increased severity of alcohol dependence. [sup][2],[3] Family history method varies across studies. Some authors have attempted to study family history by using parental alcoholism alone. [sup][4] Others have tried multigenerational models to classify alcoholism. [sup][4],[5] Turner et al. proposed a Family Pattern of Analysis (FPA), which explained more variance than other methods. [sup][6] This has led to the suggestion by Zucker et al. , that a standard measure be used to enable across studies. [sup][7] He proposed Family History Density (FHD), which is a modification of FPA and has a weighting scheme. It is based on familial relatedness.

A lowered age of onset has also been associated with increased severity of alcoholism and later development of alcohol dependence. Evidence suggests that the early age of onset is associated with aggression, problems with law; [sup][8] social role maladaptation, loss of behavioral control when drinking, [sup][9] and childhood criminality. [sup][10] Some of the reasons stated for initiation of alcohol use early in life were pressure from peer groups, experimentation, and curiosity. Varma et al. found that early-onset alcoholics (age at onset of alcohol dependence 25 years or less) were younger, had a larger proportion of first-degree relatives with both lifetime use and abuse/dependence of alcohol, but not of other psychoactive substances, and they had experienced a greater number of alcohol-related problems in the previous one year. They were also higher sensation seekers and tended to display aggression, violence, and general disinhibition when drinking. [sup][11] A recent Indian study reported that the age of onset of alcohol use in a hospital based population was 18 years and the age of onset of dependence was 27 years. They also found that these subjects developed the first criteria of dependence after six years of alcohol use and then required only four years to develop the dependence syndrome according to ICD-10. …

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