title: Risk and speed of transitions to first alcohol dependence symptoms in adolescents: a 10-year longitudinal community study in Germany.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  Among first AD symptoms, tolerance (13.1%) and much time spent (5.0%) were most prevalent. Five to 30% of all first AD symptoms occurred during the first year 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% and 15.4%), as was early onset of tolerance, much time spent and loss of control.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany. silke.behrendt@psychologie.tu-dresden.de
authors.forename: Silke
authors.initials: S
authors.lastname: Behrendt
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.forename: Michael
authors.initials: M
authors.lastname: Höfler
authors.forename: Roselind
authors.initials: R
authors.lastname: Lieb
authors.forename: Nancy Chooi Ping
authors.initials: NC
authors.lastname: Low
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology*; D019973:Alcohol-Related Disorders; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult