Risk and speed of transitions to first alcohol dependence symptoms in adolescents : a 10-year longitudinal community study in Germany

Background Although in many western countries alcohol use (AU) and symptoms of alcohol dependence (AD) are frequent in adolescence, temporal patterns and trajectories remain understudied. It is unclear whether early onset of AU is associated with the speed of transition to first AD symptoms and whether specific first AD symptoms and their timing are associated with AD. Aims To examine (i) the incidence patterns of self-reported first AD symptoms; (ii) whether early AU is associated with the risk and speed of transition to first AD symptoms; and (iii) whether first AD symptoms and their timing are associated with AD. Design A total of 3021 community subjects from Germany aged 14-24 years at baseline followed prospectively over 10 years. AU, AD symptoms and AD were assessed using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI). Findings Among first AD symptoms, tolerance (13.1 Five to 30 after first AU. Early AU was not related to the risk of first AD symptoms. The speed of transition to first AD symptoms was greater among those with AU onset in later adolescence. Tolerance and loss of control were associated with AD development (risk difference 3.9 15.4 control. Conclusion Early AU and early AD symptoms are frequent among adolescents. Early self-reported tolerance, much time spent and loss of control are particularly predictive for AD and important targets for early preventive interventions.