The clinical course of DSM-5 alcohol use disorders in young adult native and Mexican Americans

• Published in: The American journal on addictions Vol. 24; no. 8; pp. 713 - 721
• Main Authors: Ehlers, Cindy L., Stouffer, Gina M., Corey, Linda, Gilder, David A.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-12-2015
• Subjects: Adolescent; Adult; Age Factors; Alcohol-Related Disorders - diagnosis; Alcohol-Related Disorders - epidemiology; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Indians, North American - psychology; Indians, North American - statistics & numerical data; Male; Mexican Americans - psychology; Mexican Americans - statistics & numerical data; Middle Aged; Prognosis; Sex Characteristics; United States - epidemiology; White People - psychology; White People - statistics & numerical data; Young Adult; United States
• ISSN: 1055-0496; 1521-0391
• DOI: 10.1111/ajad.12290

Background and Objectives
To determine if the clinical course of DSM‐5 alcohol use disorders (AUD) in select populations of young adults (18–30 years) differed based on gender, diagnostic severity (mild, moderate, severe), and ethnicity.
Methods
Native Americans (NA) and Mexican Americans (MA) (n = 1,129) were recruited from the community and completed a structured diagnostic interview. Participants with DSM‐5 AUDs were compared based on gender, severity of the disorder (mild, moderate, severe), and ethnicity for differences in drinking levels, as well as the clinical course of AUD as defined by the occurrence and sequence of 36 alcohol‐related life events.
Results
Seventy percent of the NA men, 64% of the NA women, 56% of the MA men, and 42% of the MA women met lifetime diagnostic criteria for a DSM‐5 AUD. NA reported more alcohol‐related life events and at an earlier age than MA. A high degree of similarity in the clinical course was found between men and women and between those with severe or moderate disorder, but not with those with mild disorder.
Conclusions
NA had higher drinking levels and more alcohol problems at an earlier age than MA. A similar clinical course was seen based on gender and ethnicity in these young adults, but not based on diagnostic severity.
Scientific Significance
The DSM‐5 mild AUD category differs from the moderate and severe categories on drinking history, clinical course, gender, and ethnic distribution. Mild AUD may not be in the same clinical continuum as moderate and severe AUD in these populations. (Am J Addict 2015;XX:1–9)