Genetic and Environmental Risk Factors for Alcoholism: A 16-Year Longitudinal Cohort Study
39 Pages Posted: 20 Feb 2019More...
Background: Alcoholism involves genetic, psychological, and sociocultural risk factors. We investigated a wide range of these risk factors in a 16-year follow-up cohort.
Methods: A total of 428 cohort subjects free from any lifetime DSM-III-R alcohol use disorder (AUD) at baseline were followed up. We used a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), together with a life chart containing alcohol drinking history of cohort subjects to assess AUDs and psychiatric comorbid conditions. The extent of acculturation was measured using the Taiwan Aboriginal Acculturation Scale. The main outcome was time to onset of AUDs in months, i.e., the duration between phase 1 and the onset of alcoholism. Both univariate and multiple Cox proportional hazards regression analyses were conducted to investigate the individual and joint effects of sociocultural factors and psychiatric comorbidity assessed 16 years ago, and genetic predisposition to ADH1B (N=387) on the time to onset of alcoholism.
Findings: We found that antecedent anxiety disorder, the extent of acculturation, and ADH1B genotype interact differently in different developmental phases for alcoholism. Among cohort subjects aged 15-20, those who inherited the more active form of ADH1B and had a high extent of acculturation had the lowest risk for alcoholism among all subgroups; among subjects aged 21-34, antecedent anxiety disorder had an independent effect in predicting alcoholism (RR = 3·12; 95% CI = 1·68-5·80); and among subjects aged 35 and older, those with a higher extent of acculturation had a higher risk for alcoholism (RR = 8·92; 95% CI = 1·15- 69·48).
Interpretation: Gene-environment interaction in the development of alcoholism has been demonstrated in this longitudinal cohort. Our results suggest distinct intervention strategies for alcoholism across different developmental stages.
Funding Statement: Taiwan Ministry of Science and Technology
Declaration of Interests: The authors declare that they have no conflict of interest.
Ethics Approval Statement: Ethics approval for the TASP project was initially approved by the National Science Council, Taiwan for phases 1 and 2 surveys, and was further approved by the Institutional Review Board, Academia Sinica for the phase 3 follow-up.
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