Alcohol dependence and conduct disorder among Navajo Indians

Objective: The purpose of this study is to examine the association between conduct disorder before age 15 and subsequent alcohol dependence, and to de scribe the lifetime prevalence of alcohol dependence among Navajo Indian wo men and men. Method: This was a case-control design which included both men (n = 735) and women (n = 351) and in which the Diagnostic Interview Schedu le was used for the diagnosis of the lifetime history of alcohol dependence and conduct disorder. Alcohol dependent cases were selected from inpatient and out-patient treatment programs (204 men, 148 women). Whenever possible , controls were matched for age, sex and community of residence and were ra ndomly selected and interviewed until a nonalcohol dependent individual was found. Among the men, there were 374 alcohol dependent controls and 157 no nalcohol dependent controls. Among the women, the figures were 60 and 143, respectively. When combined, the controls comprise samples of the adult mal e and female populations from which estimates of lifetime prevalence of alc ohol dependence, and of the amount of alcohol dependence in the population attributable to conduct disorder, may be inferred. Results: Conduct disorde r is a risk factor for alcohol dependence among both men and women. Lifetim e prevalence of alcohol dependence in this population is high (70.4% for me n and 29.6% for women), but the amount of alcohol dependence in the populat ion attributable to conduct disorder is low. On the other hand, among the a lcohol dependent, those with conduct disorder had the most severe alcohol- and nonalcohol-related problems. Conclusions: The potential limitations of the study are those common to case-control designs, especially biased recal l by cases. There are also potential sampling biases among the controls. It is shown that none of the potential biases invalidate the findings, which support the hypothesis that in this population conduct disorder is a risk f or alcohol dependence. The implications for primary prevention of alcohol d ependence are discussed.