Multidimensional Quality of Life Across the Spectrum of Alcohol Use Behavior

Jeremy W Luk; Vijay A Ramchandani; Nancy Diazgranados; Melanie L Schwandt; Tommy Gunawan; David T George; David Goldman

doi:10.1176/appi.prcp.20220023

Multidimensional Quality of Life Across the Spectrum of Alcohol Use Behavior

Psychiatr Res Clin Pract. 2022 Nov 28;4(4):92-101. doi: 10.1176/appi.prcp.20220023. eCollection 2022 Winter.

Authors

Jeremy W Luk¹, Vijay A Ramchandani², Nancy Diazgranados¹, Melanie L Schwandt¹, Tommy Gunawan^{1

2}, David T George¹, David Goldman^{1

3}

Affiliations

¹ Office of the Clinical Director National Institute on Alcohol Abuse and Alcoholism Bethesda MD USA.
² Human Psychopharmacology Laboratory National Institute on Alcohol Abuse and Alcoholism Bethesda MD USA.
³ Laboratory of Neurogenetics National Institute on Alcohol Abuse and Alcoholism Rockville MD USA.

Abstract

Objective: Quality of life (QoL) is inversely associated with alcohol misuse and is a key measure by which recovery from alcohol use disorder (AUD) might be assessed. Yet, the determinants of QoL are scarcely known. The authors examined three ways through which demographic characteristics, familial and early life factors, and psychopathology conferred risks for QoL, including unique direct effects, developmental pathways, and clinical risk Profiles.

Methods: Cross-sectional data from 1095 adults (50.4% without AUD; 49.6% with AUD) who participated in the NIAAA Natural History Protocol from January 2015 to March 2022 were analyzed. Multivariable regressions, path analysis, and latent Profile analysis were conducted.

Results: AUD was uniquely associated with lower QoL, and adverse effects of child maltreatment history and psychopathology symptoms on QoL were of similar or larger magnitudes. Mediation analysis indicated family history of AUD and child maltreatment history were indirectly associated with lower QoL through higher attention-deficit/hyperactivity disorder symptoms, higher depressive symptoms, and positive AUD diagnosis. Latent Profile analysis of an enriched set of clinical characteristics identified four latent Profiles capturing the full range of alcohol use behavior. Latent Profiles with greater severity of familial and early life factors, psychopathology, and problematic drinking showed dose-response associations with lower levels of physical, psychological, social, and environment QoL.

Conclusions: A constellation of developmental and clinical characteristics disproportionately affects individuals with AUD and is negatively associated with QoL domains. To improve QoL, prevention and intervention need to target multiple factors, including history of child maltreatment, comorbid psychopathology, and problematic drinking itself.

© 2022. This article is a U.S. Government work and is in the public domain in the USA. Psychiatric Research and Clinical Practice published by Wiley Periodicals LLC on behalf of American Psychiatric Association.