The purpose of this study was first to compare 18-19-year-old male abstainers with alcohol consumers, and especially light consumers, regarding degree of sociability as indicated by their (in)security in the company of others, their number of close friends, intimate conversations with friends and their popularity in school. Secondly, we analysed the importance of antecedents to and covariates of abstinence. In addition, the significant antecedents and covariates gave us information as to abstinence patterns. The study was based on a survey of all Swedish males, 18-19 years old, conscripted for military service in 1969-70. Data had been collected by means of questionnaires and psychological interviews, giving measures of each respondent's social background, psychiatric/psychological and psychosomatic health status, substance use, deviant behaviour and degree of sociability. Poor sociability was more common among the abstainers than among all the other categories of drinkers, including the light consumers. The conscripts' social background, and especially their fathers' drinking habits, had the strongest effects in explaining abstinence. Sixty-two per cent of all abstainers had non-drinking fathers, compared to 28% of the light consumers. As to the majority of abstainers, this indicates a link between the social background of temperance and their own reported abstinence. Their poor sociability could be a consequence of abstaining at a young age when abstinence is uncommon. Those who abstained despite a drinking father showed a worsening psychological status, suggesting a link between psychologically impaired health, poor sociability and abstinence. Though the abstainers were the least sociable, the difference between the abstainers, the light consumers and the moderate consumers in other categories were generally small.(ABSTRACT TRUNCATED AT 250 WORDS)
The present study, which is part of a multipurpose study on alcohol use among women, focuses on the association between education, occupation, family structure and development of alcohol dependence or abuse in women. A total of 316 women were selected by stratified random sampling from all women in a defined part of Gothenburg, Sweden. In a face to face interview, questions were asked about occupation, education, family structure and other variables reflecting socioeconomic conditions and relations within the family. As outcome measures we used alcohol dependence and abuse (ADA), diagnosed in a clinical interview according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R). We found that never having been married, or having poor communication with the spouse, as well as having no children at home to take care of, were strongly associated with ADA in women. The role of social class depended on whether education or occupation was used as a measure. Our findings are compatible with the hypothesis that development of alcohol-related problems among women to a large extent is influenced by matters that relate to home and private life.
The association between alcohol consumption and 15 year mortality was studied in a cohort of 49,464 Swedish conscripts, mostly aged 18-19. A strong association was found. The relative risk of death among conscripts with a high consumption of alcohol (greater than 250 g/week) was 3.0 (95% confidence interval (2.3 to 4.1) compared with those with moderate consumption (1-100 g/week). After adjustment for social background variables the relative risk was reduced to 2.1 (95% confidence interval 1.4 to 3.2). Among causes of death a strong predominance was found for violent death, suicide or probable suicide being the leading single cause and accounting for 236 (36%) of all deaths. The reported U shaped curve for total mortality was not confirmed, though when violent deaths were excluded a U shaped curve was suggested for other causes of death. These findings provide important epidemiological data on the drinking habits of young people and the consequences for mortality.
The association between level of alcohol consumption and admission for psychiatric care during a 15-year follow-up was studied in a cohort of 49,464 Swedish conscripts. The relative risk for psychiatric admission among high consumers of alcohol (more than 250 g alcohol per week) was 5.3 (95% confidence interval 4.7-6.0) compared with moderate consumers (1-100 g alcohol per week). After control for social background variables in a multivariate model, the odds ratio was 1.8 (1.5-2.1). Abstainers had the same rate of admission as moderate consumers. The association with alcohol was positive in all diagnostic categories studied. Neurotic depression was found to be a risk factor for admission for alcoholism, indicating that a causal association between alcohol and neurotic depression may go in both directions.
AIMS: This is the first of a set of three papers evaluating drinking status and mortality risk. Analyses of multiple studies describe associations of drinking patterns with characteristics hypothesized to confound the relationships between drinking status and mortality. Characteristics which both significantly differentiate drinking groups and are consistent across studies would suggest that mortality studies not controlling for them may be compromised. DESIGN AND PARTICIPANTS: Associations are evaluated from the raw data of 10 general population studies which contained mortality data. Long-term abstainers are compared to former drinkers, long-term abstainers and former drinkers are compared to light drinkers (by quantity, frequency and volume in separate analyses) and moderate to heavy drinkers are compared to light drinkers. Tetrachoric correlation coefficients assess statistical significance; meta-analysis determines if associations are homogeneous across studies. MEASUREMENTS: Measures of alcohol consumption are quantity, frequency and volume; long-term abstainers are differentiated from former drinkers. Multiple measures of health, social position, social integration and mental health characteristics are evaluated. FINDINGS: Across studies, adult male former drinkers are consistently more likely to be heavier smokers, depressed, unemployed, lower SES and to have used marijuana than long-term abstainers. Adult female former drinkers are consistently more likely to be heavier smokers, in poorer health, not religious, and unmarried than long-term abstainers. Both types of abstainers tend to be of lower SES than light drinkers and report poorer health (not consistent). Female abstainers are more likely to be of normal or overweight than light drinkers. CONCLUSIONS: Characteristics of two groups of abstainers, other than their non-use of alcohol, may confound the associations found between drinking and mortality risk.
AIMS: This is the second of a set of three papers evaluating drinking status and mortality risk. Analysis of eight general population surveys of men evaluated all-cause mortality rates by drinking pattern. DESIGN AND PARTICIPANTS: Raw data from three studies of youth and five studies of adults were evaluated. Logistic regression models controlled for confounding characteristics. Meta-analysis combined study results. MEASUREMENTS: Drinking pattern was alternatively defined by quantity, frequency and volume of drinking. Final models included drinking pattern (as well as abstinence in the youth models and long-term abstainers and former drinkers in adult models), age and other confounding variables. Models also evaluated interactions of age and, respectively, long-term abstinence and former drinking. FINDINGS: No evidence was found for the hypothesis that abstinence is associated with greater mortality risk than light drinking. In the youth samples, abstainers had a lower risk of dying than those drinking less than 15 times per month. One study of the adult samples showed a significant age by former drinker interaction; this did not alter the lack of association of former drinking with mortality risk or the homogeneity of results across studies for this finding. The most consistent finding was the association of heavy drinking with mortality among youth. Among adults, drinking 43 or more drinks per month and drinking 21 or more times per month were associated with increased mortality risk. Quantity per occasion was not significantly associated with mortality risk among adults. CONCLUSIONS: That frequent drinking was related to mortality risk, whereas heavier quantity was unrelated, is inconsistent with the belief that daily consumption of a few glasses of wine has salutary effects. Empirically, however, this pattern tends to be unusual. Findings were homogeneous across studies lending generalizability to results.
In a prospective population study of women in Gothenburg, Sweden, three examinations were conducted with 12-year intervals between 1968-1969 and 1992-1993. There were 1462 participants aged 38-60 years in the baseline study in 1968-1969, with a participation rate of 90.1%. This paper describes longitudinal changes and secular trends with respect to women's alcohol habits. An alcohol frequency questionnaire was validated at baseline and was re-administered at all examinations. Between 1968-1969 and 1980-1981, the proportion of alcohol abstainers decreased significantly both in 38-year-old and 50-year-old women. Women reporting alcohol intake at least once per week had higher socio-economic status and higher education than other women. Serum gamma-glutamyl transpepsidase concentration was higher in women with the heavier alcohol intake, while a number of potential cardiovascular risk indicators were higher in women with the lower intake. Daily intake of wine and spirits was about as common at all three examinations, whereas moderate intake of wine and spirits was more common in 1980-1981 and 1992-1993 than in 1968-1969. There seemed to be an increase in overall consumption of alcohol, mainly due to the increase in moderate drinking, but there was no indication of a large increase in heavy consumption of alcohol.
OBJECTIVE: Our aims were to study associations between depressive disorders and alcohol dependence/abuse (ADA) in a female population-based sample, and to identify risk indicators common to both depressive disorders and ADA. METHOD: Three hundred and sixteen women in a stratified randomized sample were interviewed face to face. They were asked about their childhood/adolescence and alcohol habits. Clinical lifetime diagnoses according to DSM-III-R were made. Depressive disorders includes different mood disorders. RESULTS: Half the women with ADA also had a depressive disorder, and 25% of the women with depressive disorders also had ADA. Alcohol intoxication before the age of 15 and psychological and/or psychiatric problems before the age of 18 years increased the risk for ADA and depressive disorders in our study. CONCLUSION: Our results support previous findings of an association between depressive disorders and ADA, beginning early in life.