Longitudinal studies are needed to resolve inconsistencies in previous
findings regarding antecedents of alcoholism.
To investigate genetic and environmental risk factors for alcoholism.
A 4-year longitudinal cohort study.
A population-based cohort was randomly selected from 4 aboriginal groups
in Taiwan. Cohort subjects free from any alcohol use disorder at phase 1 (n
= 499) were reassessed approximately 4 years later (phase 2). The percentage
of participants who completed the study was 98.4%.
Main Outcome Measures
A standardized semistructured clinical interview for alcoholism and
other psychiatric comorbidity was used in both phases of the study. The main
outcome measure was the incidence of alcohol use disorder. Specific risk factors
examined included sociodemographic factors, family history of alcoholism,
extent of acculturation, psychiatric comorbidity, and alcohol-metabolizing
Using Cox proportional hazards regression analysis, the risk for alcoholism
was significantly higher among subjects who were male (odds ratio [OR], 2.78;
95% confidence interval [CI], 1.79-4.32), aged 15 to 24 years (OR, 5.05; 95%
CI, 2.06-6.18), unmarried (OR, 1.60; 95% CI, 1.03-2.49), and employed (OR,
2.25; 95% CI, 1.34-3.77) and had a higher educational level (OR, 1.76; 95%
CI, 1.12-2.75), a family history of alcoholism (OR, 1.73; 95% CI, 1.06-2.83),
and a higher extent of cultural assimilation (OR, 2.07; 95% CI, 1.28-3.35).
Two specific risk pathways emerged on multivariate analysis: the highest risk
was among subjects aged 25 to 34 years with anxiety disorders (OR, 16.86;
95% CI, 3.98-71.41), and the other was among men with the less active ADH2*1 gene (OR, 5.87; 95% CI, 2.73-12.60).
Based on incidence cases of alcoholism among aboriginal Taiwanese, this
study confirms the significant roles of anxiety disorders and of the ADH2*1 allele as antecedents of alcoholism among specific
age and sex groups.