Severity of alcohol-related problems and mortality: results from a 20-year prospective epidemiological community study

Abstract

There is evidence that high alcohol use is associated with an increase in mortality. Little is known about long-term effects of problematic alcohol consumption in non-clinical (community) populations. The aim of our study was to obtain data on this and related issues in a representative rural community sample assessed longitudinally over a period of 20 years. Assessments focused on a baseline survey from 1980 to 1984 and 20-year follow-up from 2001 to 2004. Based on expert interviews and standardized self-rating scales (e.g. MALT; Munich Alcoholism Test), the following three groups were defined (a) severe alcohol problems, (b) moderate alcohol problems, and (c) no alcohol problems. Mortality and hazard rates were analyzed with logistic and Cox regression adjusted for several health risk factors. From an original community sample of 1,465 individuals, 448 were deceased at 20-year follow-up. Participation rates were high. Baseline prevalence according to the MALT was 1.6% for severe alcohol problems and 4.0% for moderate alcohol problems. Over the 20-year time span, individuals with severe alcohol problems had a significantly elevated risk for dying earlier than the group with no alcohol problems (2.4 times higher). Mortality for those with moderate alcohol problems at baseline had a non-significantly elevated 20-year mortality risk (1.5 times higher) compared to those with no alcohol problems. Cox survival analyses corroborate these findings from multiple sequential logistic regression analyses. In discussing the mortality risk of persons with alcohol problems, the severity of the alcohol problems must be taken into account.

Taxometric analysis of DSM-IV and DSM-5 alcohol use disorders

“…However, the results are in line with results of other epidemiological research, where the majority of people with alcohol use disorders in the general population were shown to have similar outcome characteristics in terms of mortality as the heavy drinking general population (Dawson, 2000; Fichter et al, 2011; Perälä et al, 2010), while only a subgroup of those with alcohol use disorders (who actually sought treatment) had much higher mortality rates (Campos et al, 2011; Gerdner and Berglund, 1997; Hayes et al, 2011; Rossow and Amundsen, 1997). …”

Alcohol use disorders and mortality: a systematic review and meta‐analysis

“…The analysis was based on 221 683 observed deaths among the AUD group (169 030 men, 48 024 women, and 4629 not stratified by sex), with 853 722 AUD at risk. Among the 81 studies, six used identification of alcohol problems by TB registration or occurrence of drunk driving , and nine by use of questionnaire and/or physician interview in population surveys . Follow‐up time ranged from 1.5 to 40 years, with a weighted average of 8.99 years.…”

Pain, affect and psychotic illness

“…Steinlechner et al [7] examines this issue from the other side by asking the question whether ''Restless legs syndrome'' is a possible predictor of psychiatric disorders in parents of children with ADHD. Predicting outcome of severe alcohol-related problems is the basis of a 20-year prospective epidemiological community study by Fichter et al [8]. These are important data as the majority of our patients will suffer from psychiatric comorbidities for a substantial proportion of their life time.…”