THE CLINICAL COURSE OF ALCOHOL-RELATED PROBLEMS IN ALCOHOL-DEPENDENT AND NONALCOHOL DEPENDENT DRINKING WOMEN AND MEN

Objective: This article examines the differences in the clinical cours e of alcohol dependence in men and women, interpreting results in ligh t of the gender differences in nonalcoholics and potential findings fr om the general population. Method: As part of the Collaborative Study on the Genetics of Alcoholism (COGA) protocol, a detailed semistructur ed interview was administered to 1,085 alcohol dependent women and 2,1 20 alcohol dependent men, along with 1,936 women and 1,233 men who a e re drinkers but not alcoholic. Subjects were alcohol dependent proband s, controls, and relatives of each. Results: The men's and women's ran k orders of alcohol-related life events were similar for alcohol depen dent subjects, with a rho (rho) of .95, a figure that remained constan t even when only primary alcoholics were considered. In general, those items for which the two genders evidenced differences in either the m ean age of occurrence or the proportion of people who experienced an e vent were similar to gender differences in drinking among nonalcoholic s or the literature on the general population. These included for wome n a lower maximum number of drinks per day, a 1- to 2-year later onset of several early alcohol-related problems and fewer years between the onset of problems and seeking help. Female alcoholics also showed a l ower proportion with legal, job or personal problems related to alcoho l. There were also high levels of similarity (rho = .76, p > .001) for 28 life events related to alcohol for 1,936 women and 1,233 men who w ere drinkers but not alcohol dependent. Conclusions: Overall, the time course of alcohol-related problems for men and women were more simila r than different. While there was evidence of a ''telescoping'' of the time between the onset of problems and treatment for women, the gende r differences in ages of onset of events were relatively small. These data support the conclusion that, after considering gender differences in drinking in society, there is little evidence that the natural his tory of alcohol dependence in women is substantially different than in men.