title: Delay to first treatment contact for alcohol use disorder.
abstract: BACKGROUND
  This study explored the patterns and correlates of time to first treatment contact among people with alcohol use disorder (AUD) in Australia. Specifically it examined the relationship between sex, birth cohort, onset of AUD symptoms, severity, comorbidity, symptom type and time to first treatment contact (treatment delay) among those with alcohol abuse and dependence in a large population sample.
  
  
  METHODS
  Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N=8841). A modified version of the World Health Organization's Composite International Diagnostic Interview was used to determine the presence and age of onset of DSM-IV AUD and other mental disorders and the age at which respondents first sought treatment for alcohol or other drug-related problems.
  
  
  RESULTS
  Median time to first treatment contact for an AUD was 18 years (14 years dependence, 23 years abuse). Projected lifetime treatment rates were 78.1% for alcohol dependence and 27.5% for abuse. Those with earlier onset and from older cohorts reported longer delay and were less likely to ever seek treatment compared to those with later onset or from more recent cohorts. Those with comorbid anxiety but not mood disorder, or who reported alcohol-related role disruption or recurrent interpersonal problems were more likely to ever seek treatment and reported shorter delay compared to those who did not report these symptoms.
  
  
  CONCLUSIONS
  Treatment delay for alcohol use disorder in Australia is substantial. Those with earlier onset and those with comorbid mood disorder should be a target for earlier treatment.
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: c.chapman@unsw.edu.au.
authors.forename: Cath
authors.initials: C
authors.lastname: Chapman
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Slade
authors.affiliation: School of Psychology, University of Sydney, NSW 2006, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Hunt
authors.affiliation: NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Teesson
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006296:Health Services / Q000639:trends; D006306:Health Surveys / Q000379:methods / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D061665:Time-to-Treatment / Q000639:trends*; D055815:Young Adult
keywords: Alcohol abuse; Alcohol dependence; Service utilization; Treatment delay