Frequent alcohol intoxication and high alcohol tolerance during adolescence as predictors of mortality:a birth cohort study

Abstract Purpose: Long-term prospective studies evaluating the health burden that is consequent to adolescent drinking are needed. The aim of this study was to examine the predictive associations between self-reported alcohol tolerance and frequent intoxication at age 15–16 years and the risk of death by age 33 years. Methods: A sample (n = 6,615; 49.3% males) of the Northern Finland Birth Cohort Study 1986 was studied. Self-reported alcohol tolerance (drinks needed to feel intoxicated) and frequency of alcohol intoxication at age 15–16 years were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Categories were formed for both predictive variables from self-reported tolerance and frequency of intoxication in mid-adolescence. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30 years. Results: By the age of 33 years, of all 6,615 participants, 53 (.8%) were deceased. The HR for death by age 33 years was 3.08 (95% CI 1.17–8.07) among adolescents with high alcohol tolerance compared with adolescents without alcohol use or intoxication. The frequency of alcohol intoxication was also associated with mortality; HR 2.05 (95% CI 1.01–4.16) for those who had been intoxicated one to two times and HR 3.02 (95% CI 1.21–7.54) for those who had been intoxicated three or more times in the past 30 days compared with adolescents without intoxication. Conclusions: High self-reported alcohol tolerance and frequent alcohol intoxication during mid-adolescence significantly predicted death by age 33 years. These behaviors carry long-term repercussions with respect to premature loss of life. Substantial efforts should be made to diminish this mortality risk

Association of age at first drink and first alcohol intoxication as predictors of mortality:a birth cohort study

Abstract Background: More information on the health-related repercussions of age at onset of adolescent drinking is needed. The aim of this study was to examine the associations between self-reported age at first drink and age at first alcohol intoxication with the risk of death by age 30. Methods: The sample (n = 6564; 49.1% males) included all participants of the Northern Finland Birth Cohort Study 1986 (NFBC1986) for whom the two measures of adolescent drinking were available. Self-reported age at onset of first drink and first alcohol intoxication were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Adolescents were dichotomized into those reporting age at first drink and age at first intoxication before or after age 14. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30. Results: By the age of 30, 0.7% (n = 47) of all 6564 participants were deceased. In the multivariable models, male gender and a history of illicit substance use in adolescence were associated with both all-cause mortality and mortality due to accidents or suicide. After controlling for confounding variables, age at first alcohol intoxication was associated with all-cause mortality (HR 2.33; 95% CI 1.04–5.20) as well as death due to accidents or suicide (HR 2.99; 95% CI 1.11–8.05). Conclusions: Earlier age at first intoxication carries long-term repercussions with respect to premature loss of life. Efforts should be made targeting the prolongation of initiating binge drinking in adolescence to diminish this mortality risk

Age of first alcohol intoxication and psychiatric disorders in young adulthood:a prospective birth cohort study

Abstract Objective: Early onset of alcohol use is associated with an increased risk of substance use disorders (SUD), but few studies have examined associations with other psychiatric disorders. Our aim was to study the association between the age of first alcohol intoxication (AFI) and the risk of psychiatric disorders in a Finnish general population sample. Methods: We utilized a prospective, general population-based study, the Northern Finland Birth Cohort 1986. In all, 6,290 15–16-year old adolescents answered questions on AFI and were followed up until the age of 33 years for psychiatric disorders (any psychiatric disorder, psychosis, SUD, mood disorders and anxiety disorders) by using nationwide register linkage data. Cox-regression analysis with Hazard Ratios (HR, with 95% confidence intervals (CI)) was used to assess the risk of psychiatric disorders associated with AFI. Results: Statistically significant associations were observed between AFI and any psychiatric disorder, psychosis, SUDs, and mood disorders. After adjustments for other substance use, family structure, sex and parental psychiatric disorders, AFIs of 13–14 years and ≤12 years were associated with SUD (HR = 5.30; 95%CI 2.38–11.82 and HR = 6.49; 95%CI 2.51–16.80, respectively), while AFI ≤ 12 years was associated with any psychiatric disorder (HR = 1.59; 95%CI 1.26–2.02) and mood disorders (HR = 1.81; 95%CI 1.22–2.68). After further adjustments for Youth Self Report total scores, AFI ≤ 14 was associated with an increased risk of SUD and AFI ≤ 12 with an increased risk of any psychiatric disorder. Conclusions: We found significant associations between the early age of first alcohol intoxication, later SUD and any psychiatric disorder in a general population sample. This further supports the need for preventive efforts to postpone the first instances of adolescent alcohol intoxication

The relationships between use of alcohol, tobacco and coffee in adolescence and mood disorders in adulthood

Abstract Introduction: Alcohol, tobacco and coffee are commonly used substances and use in adolescence has previously been linked to mood disorders. However, few large prospective studies have investigated adolescent use in relation to mental health outcomes in adulthood. The main aim of this study was to examine the prospective associations between alcohol use, cigarette smoking and coffee consumption at age 16 and subsequent mood disorders up to 33 years of age. Methods: Data from The Northern Finland Birth Cohort 1986 Study were used and a total of 7660 participants (49.9% male) were included. Associations between alcohol use, cigarette smoking and coffee consumption at age 16 and later diagnoses of major depression and bipolar disorder were examined using multinomial logistic regression analyses. Results: Mean number of cigarettes/day (OR, 1.23 [95% CI 1.01–1.50]) and mean volume of alcohol consumption (OR, 1.22 [95% CI 1.01–1.47]), but not frequency of excessive drinking, in adolescence were associated with increased risk for subsequent bipolar disorder after adjustment for sex, parental psychiatric disorders, family structure, illicit substance use, and emotional and behavioral problems at age 16. An association between cigarette smoking and major depression attenuated to statistically non-significant when adjusted for emotional and behavioral problems. No associations were observed between adolescent coffee consumption and subsequent mood disorders. Conclusions: This is the first study to report an association of adolescent cigarette smoking and subsequent bipolar disorder diagnosis providing grounds for further research and pointing to a place for preventive measures among adolescents

Alcohol use in adolescence as a risk factor for overdose in the 1986 Northern Finland Birth Cohort Study

Abstract Background: Overdoses and poisonings are among the most common causes of death in young adults. Adolescent problem drinking has been associated with psychiatric morbidity in young adulthood as well as with elevated risk for suicide attempts. There is limited knowledge on adolescent alcohol use as a risk factor for alcohol and/or drug overdoses in later life. Methods: Here, data from The Northern Finland Birth Cohort 1986 study with a follow-up from adolescence to early adulthood were used to assess the associations between adolescent alcohol use and subsequent alcohol or drug overdose. Three predictors were used: age of first intoxication, self-reported alcohol tolerance and frequency of alcohol intoxication in adolescence. ICD-10-coded overdose diagnoses were obtained from nationwide registers. Use of illicit drugs or misuse of medication, Youth Self Report total score, family structure and mother’s education in adolescence were used as covariates. Results: In multivariate analyses, early age of first alcohol intoxication [hazard ratios (HR) 4.5, 95% confidence intervals (CI) 2.2–9.2, P < 0.001], high alcohol tolerance (HR 3.1, 95% CI 1.6–6.0, P = 0.001) and frequent alcohol intoxication (HR 1.9, 95% CI 1.0–3.4, P = 0.035) all associated with the risk of overdoses. Early age of first intoxication (HR 5.2, 95% CI 1.9–14.7, P = 0.002) and high alcohol tolerance (HR 4.4, 95% CI 1.7–11.5, P = 0.002) also associated with intentional overdoses. Conclusions: Alcohol use in adolescence associated prospectively with increased risk of overdose in later life. Early age of first intoxication, high alcohol tolerance and frequent alcohol intoxication are all predictors of overdoses