University of Oulu

Mustonen Antti, Alakokkare Anni-Emilia, Salom Caroline, Hurtig Tuula, Levola Jonna, James G. Scott, Miettunen Jouko, Niemelä Solja, Age of first alcohol intoxication and psychiatric disorders in young adulthood – A prospective birth cohort study, Addictive Behaviors, Volume 118, 2021, 106910, ISSN 0306-4603,

Age of first alcohol intoxication and psychiatric disorders in young adulthood : a prospective birth cohort study

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Author: Mustonen, Antti1,2,3; Alakokkare, Anni-Emilia2,4; Salom, Caroline5,6;
Organizations: 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3Department of Psychiatry, Seinäjoki Central Hospital, Seinäjoki, Finland
4Department of Psychiatry, University of Turku, Turku, Finland
5Institute for Social Science Research, The University of Queensland, Brisbane, Australia
6ARC Centre of Excellence for Children & Families over the Life Course, The University of Queensland, Australia
7Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
8Department of Psychiatry, University of Helsinki, Helsinki, Finland
9Department of Psychiatry, Hyvinkää Area, Helsinki University Hospital, Helsinki, Finland
10QIMR Berghofer Medical Research Institute Herston, Qld, Australia
11Queensland Centre for Mental Health Research, Brisbane, Australia
12School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
13Metro North Mental Health Service, Herston, Qld, Australia
14Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
15Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
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Language: English
Published: Elsevier, 2021
Publish Date: 2021-05-07


Objective: Early onset of alcohol use is associated with an increased risk of substance use disorders (SUD), but few studies have examined associations with other psychiatric disorders. Our aim was to study the association between the age of first alcohol intoxication (AFI) and the risk of psychiatric disorders in a Finnish general population sample.

Methods: We utilized a prospective, general population-based study, the Northern Finland Birth Cohort 1986. In all, 6,290 15–16-year old adolescents answered questions on AFI and were followed up until the age of 33 years for psychiatric disorders (any psychiatric disorder, psychosis, SUD, mood disorders and anxiety disorders) by using nationwide register linkage data. Cox-regression analysis with Hazard Ratios (HR, with 95% confidence intervals (CI)) was used to assess the risk of psychiatric disorders associated with AFI.

Results: Statistically significant associations were observed between AFI and any psychiatric disorder, psychosis, SUDs, and mood disorders. After adjustments for other substance use, family structure, sex and parental psychiatric disorders, AFIs of 13–14 years and ≤12 years were associated with SUD (HR = 5.30; 95%CI 2.38–11.82 and HR = 6.49; 95%CI 2.51–16.80, respectively), while AFI ≤ 12 years was associated with any psychiatric disorder (HR = 1.59; 95%CI 1.26–2.02) and mood disorders (HR = 1.81; 95%CI 1.22–2.68). After further adjustments for Youth Self Report total scores, AFI ≤ 14 was associated with an increased risk of SUD and AFI ≤ 12 with an increased risk of any psychiatric disorder.

Conclusions: We found significant associations between the early age of first alcohol intoxication, later SUD and any psychiatric disorder in a general population sample. This further supports the need for preventive efforts to postpone the first instances of adolescent alcohol intoxication.

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Series: Addictive behaviors
ISSN: 0306-4603
ISSN-E: 1873-6327
ISSN-L: 0306-4603
Volume: 118
Article number: 106910
DOI: 10.1016/j.addbeh.2021.106910
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: The NCBC1986 project is funded by EU QLG1-CT-2000-01643 (EUROBLCS) Grant no. E51560, NorFA Grant no. 731, 20056, 30167, USA / NIH 2000 G DF682 Grant no. 50945. AM has received funding from Emil Aaltonen Foundation, Juho Vainio Foundation, Olvi Foundation, and the Finnish Cultural Foundation. JM has received funding from Juho Vainio Foundation. JL has received funding from Juho Vainio Foundation and speaker fees (Lundbeck, Abbvie, Fioca Ltd.). SN has received funding from Juho Vainio foundation and Sohlberg foundation, speaker fees (Shire-Takeda), and travel fees (Shire-Takeda, Sunovion). JGS is supported by a National Health and Medical Research Council Practitioner Fellowship (APP1105807). CS, TH and AEA report no potential conflicts of interest.
Copyright information: © 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (