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Telescoping and Gender Differences in Alcohol Dependence: New Evidence From Two National Surveys

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Keyes, Katherine M., Martins, Silvia S., Blanco, Carlos, Hasin, Deborah S.·2010·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2009.09081161PMC PMC3767417
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Abstract

OBJECTIVE: The course of alcohol disorders in women is often described as "telescoped" compared to that in men, with a later age at initiation of alcohol use but shorter times from use to dependence and treatment. This study examined evidence for such a telescoping effect in the general population and tested birth cohort effects for gender differences. METHOD: Data from two U.S. national surveys conducted 10 years apart (1991-1992 and 2001-2002) using the same diagnostic instrument (the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV) were used to analyze five birth cohorts. Age at initiation of alcohol use, time from first use to dependence, and time from dependence to first treatment were analyzed. Interaction terms (cohort by gender; cohort by gender by time) were tested in Cox proportional hazards models. RESULTS: Little evidence was found for a telescoping effect in women. For alcohol use and dependence, cohort and gender interacted, which suggests that gender differences are diminished in more recent cohorts. A three-way interaction of cohort, gender, and time was significant for time from first use to dependence, suggesting that men have a shorter time to dependence, especially in younger cohorts. CONCLUSIONS: A telescoping effect is not evident in the general population. Gender differences in the overall hazard of alcohol use and dependence are decreasing in more recent cohorts, while gender differences in time from first use to dependence are increasing. These findings challenge the commonly held notion of a gender-specific course of alcohol disorders and suggest the need for a greater clinical focus on problem drinking in women and further research on accelerated time to dependence in men.

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  • For many, although not all, substances, women progress more rapidly from use to SUD.

    “This is particularly concerning because, for many (although not all) substances, women progress more rapidly from use to SUD 332,333 .”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [332]

    The paper’s introductory discussion reports that women in clinical samples progressed faster from drinking initiation to alcohol dependence. But it does not establish this pattern for many substances, and its Discussion (page unavailable) finds that, in the general population studied, men had a shorter time from first alcohol use to dependence. (LLM, conf=0.83)

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Authors
Keyes, K. M., Martins, S. S., Blanco, C., & Hasin, D. S.
Affiliations
  • New York State Psychiatric Institute (US)
  • Johns Hopkins University (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2010-08-01
Volume
167
Issue
8
Pages
969-976
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2009.09081161
PMC
PMC3767417
OpenAlex
W2124189011
Cited by
271
References
32
Citations by year
2026: 11 · 2025: 11 · 2024: 9 · 2023: 24 · 2022: 12 · 2021: 18 · 2020: 55 · 2019: 12 · 2018: 19 · 2017: 16 · 2016: 22 · 2015: 16 · 2014: 13 · 2013: 14 · 2012: 8
FWCI
7.68
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (1f31da026689-01)
  • National Institute on Alcohol Abuse and Alcoholism (K05AA014223)
  • National Institute on Drug Abuse (R21DA020667, R03DA023434, R01DA019606, R01 DA018606, F31-DA026689, R01DA018652, K02DA023200)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
alcoholism, gender differences, birth cohort effects, time to treatment, women's alcohol use
MeSH terms
Adolescent, Adult, Alcohol Drinking, Alcoholism, Female, Health Surveys, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Sex Factors, Time Factors, United States, Cohort Studies, Cohort Effect, Proportional Hazards Models, Age of Onset, Age Distribution, Disease Progression

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