Women and alcohol. Early background factors and aspects of comorbidity

Abstract

Aims. The aims were to: 1) study associations between early background factors, and alcohol dependence/abuse (ADA), 2) explore the associations between childhood sexual abuse (CSA) and ADA, and 3) assess if predictors of ADA also predict depression, and study comorbidity between depression and ADA. Method. We used two population-based samples of women within the "Women and Alcohol in Göteborg" (WAG) project, and data were collected in two phases: a questionnaire phase, followed by an interview phase. A stratified randomised sample of women was invited for interview. At interviews questions about childhood and adolescence were asked and clinical life time diagnoses were made according to DSM-III-R. CIDI-SAM was also used for diagnosing ADA. Results. Psychological or psychiatric problems or deviant behaviour before the age of 18 years, early alcohol debut age or early alcohol intoxication are some factors found to increase the odds for ADA. Also CSA was associated with ADA and concurrent violence or threat strengthened this association. ADA and depression were associated, and two identified predictors of ADA were also associated with depression: psychological or psychiatric problems before the age of 18 years and alcohol intoxication under 15. Conclusion. Factors from childhood/adolescence predict ADA in women. CSA is associated with the development of ADA, and this association is strengthened by concurrent violence or threat. Thus, CSA per se may not increase the risk for ADA. Depression and ADA are co-occurring, and there are predictors common to both. In prevention and treatment it is important to take into account that the development of ADA starts early in life and that attention should thus be paid to signs of early deviant behaviour, psychological or psychiatric problems, or a suboptimal social circumstances during childhood and adolescence. More research is needed with focus on CSA and the role of violence or threat in the development of ADA.