Health problems in adolescents with alcohol use disorders: Self-report, liver injury, and physical examination findings and correlates

Background: Although adolescent alcohol consumption has been found to be po sitively correlated with self-reported health problems, few studies have ex amined other health indicators. This study compared adolescents with alcoho l use disorders (AUDs) and a community reference group on self-reported hea lth problems, serum liver enzymes, and physical examination findings. The r elevance of negative emotionality to understanding these health problems wa s also investigated. Methods: The subjects were adolescents with AUDs recruited from clinical pr ograms and classified as having DSM-IV alcohol dependence (n = 71) or alcoh ol abuse (n = 57) and reference adolescents without AUDs recruited from com munity sources (n = 131). The assessment of health status included self-rep orted health problems in 15 areas; serum liver enzyme assays, including gam ma -glutamyl transpeptidase, alanine aminotransferase, and aspartate aminot ransferase; and physical examination findings. Negative emotionality was de termined by systematically combining scores from the Hamilton Anxiety Ratin g Scale, the Beck Depression Inventory, the Child Behavior Checklist, and t he Multidimensional Personality Questionnaire. Results: Adolescent AUDs were associated with more self-reported health pro blems, higher gamma -glutamyl transpeptidase and alanine aminotransferase l evels, and more physical examination abnormalities. Negative emotionality w as highly correlated with self-reported health problems, mediated the relat ionship between AUDs and self-reported health problems, and was not correla ted with serum liver enzyme levels or physical examination abnormalities. Conclusions: These results indicated that AUDs during adolescence were asso ciated with health problems, including modest but demonstrable liver injury . Self-reported health problems were probably best understood, in this cont ext, as a negative emotionality manifestation.