title: Health problems in adolescents with alcohol use disorders: self-report, liver injury, and physical examination findings and correlates.
abstract: BACKGROUND
  Although adolescent alcohol consumption has been found to be positively correlated with self-reported health problems, few studies have examined other health indicators. This study compared adolescents with alcohol use disorders (AUDs) and a community reference group on self-reported health problems, serum liver enzymes, and physical examination findings. The relevance of negative emotionality to understanding these health problems was also investigated.
  
  
  METHODS
  The subjects were adolescents with AUDs recruited from clinical programs and classified as having DSM-IV alcohol dependence (n = 71) or alcohol abuse (n = 57) and reference adolescents without AUDs recruited from community sources (n = 131). The assessment of health status included self-reported health problems in 15 areas; serum liver enzyme assays, including gamma-glutamyl transpeptidase, alanine aminotransferase, and aspartate aminotransferase; and physical examination findings. Negative emotionality was determined by systematically combining scores from the Hamilton Anxiety Rating Scale, the Beck Depression Inventory, the Child Behavior Checklist, and the Multidimensional Personality Questionnaire.
  
  
  RESULTS
  Adolescent AUDs were associated with more self-reported health problems, higher gamma-glutamyl transpeptidase and alanine aminotransferase levels, and more physical examination abnormalities. Negative emotionality was highly correlated with self-reported health problems, mediated the relationship between AUDs and self-reported health problems, and was not correlated with serum liver enzyme levels or physical examination abnormalities.
  
  
  CONCLUSIONS
  These results indicated that AUDs during adolescence were associated with health problems, including modest but demonstrable liver injury. Self-reported health problems were probably best understood, in this context, as a negative emotionality manifestation.
authors.affiliation: Pittsburgh Adolescent Alcohol Research Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA. clarkdb@msx.upmc.edu
authors.forename: D B
authors.initials: DB
authors.lastname: Clark
authors.forename: K G
authors.initials: KG
authors.lastname: Lynch
authors.forename: J E
authors.initials: JE
authors.lastname: Donovan
authors.forename: G D
authors.initials: GD
authors.lastname: Block
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000150:complications; D000410:Alanine Transaminase / Q000097:blood; D019973:Alcohol-Related Disorders / Q000150:complications*; D000437:Alcoholism / Q000150:complications*; D005260:Female; D006304:Health Status; D006801:Humans; D008099:Liver / Q000201:enzymology; D008108:Liver Diseases, Alcoholic / Q000150:complications / Q000175:diagnosis*; D008297:Male; D010808:Physical Examination; D010947:Plants, Toxic; D014026:Nicotiana; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase