Do premorbid personality disorders predict adult alcoholism? Results from a Danish Longitudinal High Risk Study

Abstract

Aims

The Danish Longitudinal Study on Alcoholism was designed to identify predictors of adult male alcoholism. The present study examines the predictability of premorbid personality disorders.

Methods

Subjects were selected from a Danish birth cohort (n = 9125, born 1959 – 61) that included 223 sons of alcoholic fathers (high risk = HR) and 106 matched sons of non-alcoholics (low risk = LR). These subjects have been studied systematically over the past 40 years. Most recently, they were evaluated at age 40 (n = 202) by a psychiatrist using structured interviews and DSM-III-R criteria to diagnose an Alcohol Use Disorder.

Results

HR subjects were more likely than LR subjects to develop alcohol dependence over the past 40 years (31% vs. 16%, p < .03). However, HR subjects were not more likely to develop alcohol abuse (17% vs. 15%). Both ADHD (as measured by school teachers) and ASPD (onset before age 15) predicted alcoholism independently at age 40. ADHD and ASPD were much stronger independent predictors of adult alcoholism than parental risk status. Other personality and anxiety disorders did not predict an alcoholic outcome.

Conclusions

Paternal alcoholism predicted alcohol dependence in sons at age 40. But the most predictive premorbid variables were ASPD and ADHD, both with onset in childhood and adolescence.