Major life events and risk of alcohol use disorders: a prospective cohort study.

AIMS: To estimate associations of individual major life events as well as accumulated major life events in childhood, adult private life and adult work life with risk of alcohol use disorders (AUD).

DESIGN: Prospective cohort study with baseline examination in 1991-93 and linkage to national registers to identify AUD at follow-up.

SETTING: Copenhagen, Denmark.

PARTICIPANTS: Individuals (aged 21-93 years) who participated in the Copenhagen City Heart Study in 1991-93 (n = 8758).

MEASUREMENTS: The primary outcome was first registration with AUD during follow-up (n = 249). AUD was identified in the Danish National Patient Register, in the Danish Psychiatric Central Register and in an outpatient treatment register. Major life events were assessed by a questionnaire in the Copenhagen City Heart study. Data were analysed by Cox proportional hazards models adjusted for age, sex, educational level, household income, cohabitation status and psychiatric comorbidity.

FINDINGS: Serious family conflicts in childhood [hazard ratio (HR) = 1.35; 95% confidence interval (CI) = 1.00, 1.83] and serious economic problems in adult life (HR = 2.22; 95% CI = 1.64, 3.01) were associated significantly with increased risk of AUD. Prospective analyses did not show consistent effects of accumulation of major life events in childhood or adult life, but an additional analysis based on all AUD registrations suggested an association between accumulated childhood events and risk of AUD.

CONCLUSIONS: Serious economic problems in adult life are associated strongly with risk of alcohol use disorders, and there may be an influence of accumulated childhood events on risk of alcohol use disorders.