Patterns of alcohol-dependence symptoms using a latent empirical approach: associations with treatment usage and...

The aim of this study was to understand the variation in response to alcohol use by identifying classes of alcohol users based on alcohol-dependence symptoms and to compare these classes across demographic characteristics, abuse symptoms, and treatment usage.

Data from combined 2002-2005 National Survey on Drug Use and Health identified 110,742 past-year alcohol users, age 18 years or older. Latent class analysis defined classes based on observed clustering of alcohol-dependence symptoms based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Chi-square statistics were used to test differences in sociodemographic and alcohol-abuse characteristics across classes. Multivariable latent class regressions were used to compare treatment usage across classes.

The four-class model had the best overall fit and identified classes that differed quantitatively and qualitatively, with 2.3% of the users in the most-severe class and 83.8% in the least-severe/ not-affected class. These classes differed in a number of demographic characteristics and alcohol-abuse symptoms. All individuals in the most severe class met DSM-IV criteria for alcohol dependence; 80% of this class had alcohol-abuse symptoms. Twenty-six percent of the moderate and 50% of the moderate-high class met dependence criteria. Approximately 19% of the most-severe class and less than 5% of the moderate and moderate-high class received treatment for alcohol in the past year.

This study demonstrates that meeting dependence criteria only partially captures variations in responses to severity of alcohol problems. Although individuals in the most-severe class were more likely to perceive need and receive treatment, the percentage of individuals receiving treatment was low.