title: The burden of alcohol use disorders in US military veterans: results from the National Health and Resilience in Veterans Study.
abstract: To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life-time alcohol use disorder (AUD) and past-year AUD; (2) common psychiatric comorbidities associated with life-time AUD; and (3) correlates of life-time and past-year probable AUD.
  
  
  
  Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans.
  
  
  
  United States.
  
  
  
  Nationally representative sample of 3157 US veterans aged 21 years and older.
  
  
  
  Life-time alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed.
  
  
  
  The prevalence of life-time AUD and past-year probable AUD was 42.2% [95% confidence interval (CI) = 40.5-43.9%)] and 14.8% (95% CI = 13.6-16.0%), respectively. Compared with veterans without AUD, those with life-time AUD had substantially elevated rates of life-time and current mood and anxiety disorders [odds ratios (ORs) = 2.6-4.1], drug use disorder (OR = 10.7), life-time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life-time traumatic events were associated independently with life-time AUD. Younger age, male sex, unpartnered marital status and a life-time diagnosis of major depressive disorder were associated independently with past-year probable AUD.
  
  
  
  More than 40% of US military veterans have a life-time history of alcohol use disorder. Veterans with a life-time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio-demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA. fuehrlein@gmail.com.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. fuehrlein@gmail.com.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Fuehrlein
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Mota
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Arias
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Louis A
authors.initials: LA
authors.lastname: Trevisan
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Lorig K
authors.initials: LK
authors.lastname: Kachadourian
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Clinical Neurosciences Division, US Department of Veterans Affairs National Center for PTSD, West Haven, CT, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Krystal
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Clinical Neurosciences Division, US Department of Veterans Affairs National Center for PTSD, West Haven, CT, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Clinical Neurosciences Division, US Department of Veterans Affairs National Center for PTSD, West Haven, CT, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D055500:Resilience, Psychological; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Alcohol use disorder; anxiety disorder; comorbidity; dual diagnosis; epidemiology; military; mood disorder; veterans