The time course of development of alcohol-related problems in men and women.

Abstract

A predictable sequence of alcohol-related problems has been hypothesized to be applicable to the clinical course of alcoholism. However, few recent data are available on this question. The age of first occurrence of 44 alcohol-related life experiences was determined for 478 DSM-III-R defined alcohol-dependent (alcoholic) individuals (317 men and 161 women), and for 444 drinking but not alcohol-dependent subjects (183 men and 261 women). Data were gathered through personal interviews with alcohol-dependent subjects and their relatives using a structured psychiatric interview (SSAGA). A high level of similarity (Spearman's rho = .81, p = .0004) was found for the retrospective reports of the order of appearance of alcohol-related problems between the present sample and an analysis of 636 alcoholic male inpatients who participated in a prior study. Within the present group of 478 alcoholics, the order of appearance of alcohol-related problems was similar for men and women (rho = .84, p < .0001), and the time course of development of problems was similar for treated and untreated alcoholic subgroups (rho = .86, p < .001). Analyses of 19 alcohol-related life experiences in 444 drinking but not alcohol-dependent individuals indicated an overall rank order for occurrence of problems similar to those observed for alcohol-dependent individuals (rho = .76, p < .001). These data corroborate the high level of predictability regarding the order of occurrence of major alcohol-related life problems among alcohol-dependent men and women, extending the previous findings to women with alcohol dependence and to alcoholics who have never received inpatient treatment.