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Lifetime Co-occurrence of DSM-III-R Alcohol Abuse and Dependence With Other Psychiatric Disorders in the National Comorbidity Survey

Kessler, Ronald C.·1997·Archives of General Psychiatry

DOI 10.1001/archpsyc.1997.01830160031005

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Abstract

OBJECTIVE: To study patterns of co-occurrence of lifetime DSM-III-R alcohol disorders in a household sample. METHODS: Data came from the National Comorbidity Survey (NCS), a nationally representative household survey. Diagnoses were based on a modified version of the Composite International Diagnostic Interview. RESULTS: Respondents with lifetime NCS/DSM-III-R alcohol abuse or dependence had a high probability of carrying at least 1 other lifetime NCS/DSM-III-R diagnosis. Retrospective reports have suggested that most lifetime co-occurring alcohol disorders begin at a later age than at least 1 other NCS/DSM-III-R disorder. Earlier disorders are generally stronger predictors of alcohol dependence than alcohol abuse and stronger among women than men. Lifetime co-occurrence is positively, but weakly, associated with the persistence of alcohol abuse among men and of alcohol dependence among both men and women. CONCLUSIONS: Caution is needed in interpreting the results due to the fact that diagnoses were made by nonclinicians and results are based on retrospective reports of the age at onset. Within the context of these limitations, though, these results show that alcohol abuse and dependence are often associated with other lifetime DSM-III-R disorders and suggest that, at least in recent cohorts, the alcohol use disorders are usually temporally secondary. Prospective data and data based on clinically confirmed diagnoses are needed to verify these findings.

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Authors: Kessler, R. C.
Affiliations: Harvard University (US)
Corresponding author: Kessler, Ronald C.
ORCID: Kessler, Ronald C.
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 1997-04-01
Volume: 54
Issue: 4
Pages: 313
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archpsyc.1997.01830160031005
OpenAlex: W2124876944
Cited by: 2,085
References: 33
Citations by year: 2026: 12 · 2025: 35 · 2024: 35 · 2023: 31 · 2022: 38 · 2021: 50 · 2020: 75 · 2019: 93 · 2018: 45 · 2017: 55 · 2016: 69 · 2015: 86 · 2014: 85 · 2013: 106 · 2012: 96
FWCI: 39.97
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (K20AA000168, K20-AA00168)
National Institute of Mental Health (R01MH046376, R01 MH46376, K01 MH00507)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords: alcohol abuse, alcoholism, psychiatric comorbidity, age of onset, sex differences, National Comorbidity Survey, household surveys
MeSH terms: Alcoholism, Mental Disorders, Female, Health Surveys, Humans, Male, Probability, Retrospective Studies, Sex Factors, United States, Comorbidity, Prevalence, Age of Onset

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Lifetime Co-occurrence of DSM-III-R Alcohol Abuse and Dependence With Other Psychiatric Disorders in the National Comorbidity Survey

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