Adolescent Repeated Alcohol Intoxication as a Predictor of Young Adulthood Alcohol Abuse: The Role of Socioeconomic Context

Abstract

Aims. Trajectories of alcohol abuse from adolescence onwards are not well known. We examined the relationship between repeated alcohol intoxication in adolescence and later alcohol abuse, testing whether this association varies depending on individuals’ socioeconomic context. Methods. Study participants (n = 674, age 22–35 years in 2009) belong to the French TEMPO cohort study; their parents also participate in an epidemiological study—the GAZEL cohort. Repeated alcohol intoxication was assessed by questionnaire in adolescence (1999) (defined by ≥3 episodes of alcohol intoxication in the preceding 12 months). In young adulthood (2009), alcohol abuse was assessed by the WHO AUDIT questionnaire. Socioeconomic characteristic studied was childhood family income. Data were analyzed using logistic regression models controlling for age, sex, childhood temperament, parental history of alcohol use, and the quality of family relations. Results. Among adolescents who reported repeated alcohol intoxication, 30.8% reported alcohol abuse in young adulthood (adjusted OR=4.27, 95%CI 2.21–8.27). This association appeared stronger in participants who grew up in families with low income (adjusted OR=11.86, 95%CI 3.35–41.94 vs. 2.49, 95%CI 1.09–5.68 for youths from families with intermediate or high income). Conclusions. In most adolescents (69.2%), alcohol abuse is a time-limited behavior. Nonetheless, in participants from low income families, the likelihood of persistent alcohol abuse beyond adolescence may be increased. Although some limitations are noted, a preliminary conclusion is that alcohol abuse trajectories over time need to be monitored, particularly in certain subgroups.

Keywords :

• Socioeconomic position
• alcohol abuse persistence
• epidemiology
• longitudinal cohort
• community sample

THE AUTHORS

Ahmed Yaogo is a Medical Doctor with a PhD in Epidemiology and Public Health (University of Paris Sud), a Master degree in Health Economics, a Master degree in Health Management and trained in Statistics and Data Science. He practices Psychiatry at Ville Evrard Hospital.

Dr. Eric Fombonne trained in child psychiatry in France. He held appointments as clinical scientist at the National Institute of Health and Medical Research (INSERM, France),as Senior Lecturer and Reader at the Institute of Psychiatry and Maudsley Hospital, King's College London, UK (1993-2001), as tenured Professor of Psychiatry at McGill University, Head of the Division of Child Psychiatry and Canada Research Chair in Child Psychiatry (2001-2012). In September 2012, he joined the Department of Psychiatry at Oregon Health & Science University in Portland, Oregon, and is now Director of Autism Research at the Institute for Developmental Disabilities and CDRC. He has a long experience of clinical work with children with autism and their families, over the lifespan, and has been also directing clinical services for teenagers with depression. His research activities on developmental disorders and child and adolescent psychiatric disorders encompass genetic, longitudinal, epidemiological studies and clinical trials. He has published over 290 articles in peer-reviewed journals, 40 chapters in books, and is on the editorial board of several journals in the field of autism and child psychiatry.

France Lert holds a PhD degree in Health Economics in France. In 1976, she joined the National Institute of Health and Medical Research (INSERM) as a researcher. She has a long experience of research in the field of HIV AIDS, drug use and drug addiction. From 2005 to 2014, she was the head of the INSERM research group (Epidemiology of the occupational and social determinants of health, Center for Research in Epidemiology and Population Health). She retired in 2014.

Maria Melchior holds a PhD degree in Epidemiology and Public Health (Harvard University). She was appointed senior research fellow at the French National Institute of Health and Medical Research (INSERM) in 2007. Her research focuses on social inequalities in mental health.

GLOSSARY

• TEMPO cohort: a large community sample of youths followed prospectively from childhood to young adulthood.

• GAZEL cohort: a large sample of national company workers followed prospectively since 1989. GAZEL participants hold a variety of occupations –from manual workers to managers–and live throughout France. Prior studies reported large socioeconomic inequalities in mortality and morbidity in this sample (Bowes et al., 2012; Redonnet et al., 2012).

• Alcohol abuse: defined based on the AUDIT questionnaire [score >=7 (women) or >=8 (men)], a 10-items screening test developed by the World Health Organization to match DSM IV criteria of alcohol abuse or dependence, which has been validated against clinical diagnosis (Bohn, Babor, & Kranzler, 1995).

• Repeated alcohol intoxication: ≥3 episodes of alcohol intoxication in the preceding 12 months.

• Regular alcohol intoxication: ≥10 episodes of alcohol intoxication in the preceding 12 months.

• Family income during childhood: participants. parents report about the range in which was their family income in Euros (€) per month (in 1989).