title: Heavy episodic drinking in Europe: a cross section study in primary care in six European countries.
abstract: OBJECTIVE
  We examined the prevalence of heavy episodic drinking in general practice attenders who were non-hazardous drinkers, the associated risk factors and the outcome over 6 months.
  
  
  METHODS
  Consecutive attenders aged 18-75 were recruited from the UK, Spain, Slovenia, Estonia, the Netherlands and Portugal and followed up after 6 months. Data were collected on alcohol use using the Alcohol Use Disorder Identification test (at recruitment and 6 months) and risk factors for heavy episodic alcohol use at recruitment.
  
  
  RESULTS
  The prevalence of heavy episodic drinking in non-hazardous drinkers was 4.5% across Europe [lowest in Portugal (1.5%); highest Netherlands (8.4%)]. It was less frequent in Spain, Slovenia, Estonia and Portugal compared with the UK and Netherlands. It was higher in men [odd ratio (OR) 4.4, 95% confidence interval (CI) 3.3, 5.9], people between 18 and 29 years of age, those employed (OR 1.8, 95% CI 1.3, 2.6) and those using recreational drugs (OR 2.1, 95% CI 1.4, 3.3). It was lower in people with existing DSMIV major depression (OR 0.54, 95% CI 0.31, 0.96). Heavy episodic drinkers were more likely to become hazardous drinkers at 6 months (male: OR 7.2, 95% CI 4.1, 12.7; female: OR 9.4, 95% CI 4.3, 20.6).
  
  
  CONCLUSIONS
  Women and men in the UK, men in the Netherlands and younger people in all countries are at the greatest risk of exhibiting heavy episodic drinking behaviours even in the absence of hazardous alcohol use. There is hence an urgent need for general practitioners to consider early detection and management of heavy episodic drinking behaviour in this population.
authors: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, UCL, Rowland Hill Street, London NW3 2PF, UK. i.nazareth@pcps.ucl.ac.uk
authors: Irwin
authors: I
authors: Nazareth
authors: Carl
authors: C
authors: Walker
authors: Antonia
authors: A
authors: Ridolfi
authors: Anu
authors: A
authors: Aluoja
authors: Juan
authors: J
authors: Bellon
authors: Mirijam
authors: M
authors: Geerlings
authors: Igor
authors: I
authors: Svab
authors: Miguel
authors: M
authors: Xavier
authors: Michael
authors: M
authors: King
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D002492:Central Nervous System Depressants / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D000431:Ethanol / Q000009:adverse effects*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol