Skip to main content

Advertisement

SpringerLink
Log in

The epidemiology of alcohol use in Izmir, Turkey: drinking pattern, impairment and help-seeking

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

There is no report on various patterns of alcohol drinking and related impairment, help-seeking in Turkey. We investigated the 12-month prevalence and correlates of drinking patterns and alcohol use disorders in the general population of Izmir-Turkey, with further analyses on role impairment and help-seeking.

Method

A multi-stage clustered area probability sample of adult household residents in the Izmir Metropolitan Area was assessed using the Composite International Diagnostic Interview 2.1 (n  = 4011). Estimation focused on prevalence and correlates of 12-month drinking pattern and DSM-IV alcohol use disorders. The 12-month drinking pattern included groups of non-regular users, regular non-heavy drinkers, regular heavy drinkers, and alcohol abuse disorder and alcohol dependence. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, and were assessed with Short Form-36 for functional impairments. Multinomial logistic regression was used for underlying associations between the covariates and the drinking patterns.

Results

The rate of lifetime alcohol abstinence was 52.3% while the prevalence of past-year users was 14.8%. The 12-month prevalence estimates of regular heavy drinkers, and alcohol abuse disorder and dependence were 2.5%, 3.2 and 1.6%, respectively. Any of the drinking patterns and alcohol use disorders was associated with male gender, and higher levels of education, monthly income and socioeconomic status. Alcohol dependence was associated with mental health impairment but not with physical impairment. The 12-month rates of help-seeking in alcohol abuse and dependence were 11.6 and 16.5%.

Conclusion

Although alcohol use disorders are lower than estimates of Western countries, alcohol use constitute a major reason of disability with prominent treatment gap.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Health Organization (2010) Global strategy to reduce the harmful use of alcohol. World Health Organization, Geneva

    Google Scholar 

  2. World Health Organization, Regional Office for Europe. (2011) European status report on alcohol and health 2010. World Health Organization, Copenhagen

    Google Scholar 

  3. Rehm J, Allamani A, Elekes Z, Jakubczyk A, Manthey J, Probst C, Struzzo P, Della Vedova R, Gual A, Wojnar M (2015) Alcohol dependence and treatment utilization in Europe—a representative cross-sectional study in primary care. BMC Fam Pract 16:90. doi:10.1186/s12875-015-0308-8

    Article  PubMed  PubMed Central  Google Scholar 

  4. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J (2009) Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. The Lancet 373(9682):2223–2233. doi:10.1016/S0140-6736(09)60746-7

    Article  Google Scholar 

  5. Rehm J, Zatonksi W, Taylor B, Anderson P (2011) Epidemiology and alcohol policy in Europe. Addiction 106(Suppl 1):11–19. doi:10.1111/j.1360-0443.2010.03326.x

    Article  PubMed  Google Scholar 

  6. World Health Organization, Regional Office for Europe (2010) Atlas on substance use (2010): resources for the prevention and treatment of substance use disorders

  7. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N, Burstein R, Murray CJ, Vos T (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The Lancet 382(9904):1575–1586. doi:10.1016/S0140-6736(13)61611-6

    Article  Google Scholar 

  8. Greenfield TK, Kerr WC (2008) Alcohol measurement methodology in epidemiology: recent advances and opportunities. Addiction 103(7):1082–1099. doi:10.1111/j.1360-0443.2008.02197.x

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kalaydjian A, Swendsen J, Chiu WT, Dierker L, Degenhardt L, Glantz M, Merikangas KR, Sampson N, Kessler R (2009) Sociodemographic predictors of transitions across stages of alcohol use, disorders, and remission in the National Comorbidity Survey Replication. Compr Psychiatry 50(4):299–306. doi:10.1016/j.comppsych.2008.09.012

    Article  PubMed  Google Scholar 

  10. World Health Organization (2014) Global status report on alcohol and health. World Health Organization

  11. Celen A (2015) Influence of Holy Month Ramadan on Alcohol Consumption in Turkey. J Relig Health 54(6):2122–2133. doi:10.1007/s10943-014-9875-6

    Article  PubMed  Google Scholar 

  12. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü (2014) Türkiye Nüfus ve Sağlık Araştırması 2013. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı, TÜBİTAK, Ankara

  13. Erhan Deveci S, Acik Y, Ferdane Oguzoncul A, Deveci F (2010) Prevalence and factors affecting the use of tobacco, alcohol and addictive substance among university students in eastern Turkey. Southeast Asian J Trop Med Public Health 41(4):996–1007

    CAS  PubMed  Google Scholar 

  14. Ozgur Ilhan I, Yildirim F, Demirbas H, Dogan YB (2008) Alcohol use prevalence and sociodemographic correlates of alcohol use in a university student sample in Turkey. Soc Psychiatry Psychiatr Epidemiol 43(7):575–583. doi:10.1007/s00127-008-0335-z

    Article  PubMed  Google Scholar 

  15. Ogel K, Corapcioglu A, Sir A, Tamar M, Tot S, Dogan O, Uguz S, Yenilmez C, Bilici M, Tamar D, Liman O (2004) [Tobacco, alcohol and substance use prevalence among elementary and secondary school students in nine cities of Turkey]. Turk Psikiyatri Derg 15(2):112–118

    PubMed  Google Scholar 

  16. Akvardar Y, Turkcan A, Yazman U, Aytaclar S, Ergor G, Cakmak D (2003) Prevalence of alcohol use in Istanbul. Psychol Rep 92(3 Pt 2):1081–1088. doi:10.2466/pr0.2003.92.3c.1081

    Article  PubMed  Google Scholar 

  17. Kılıç C (1998) Türkiye Ruh Sağlığı Profili: Erişkin nüfusta ruhsal hastalıkların yaygınlığı, ilişkili faktörler, yetiyitimi ve ruh sağlığı hizmeti kullanımı sonuçları. Ankara: TC Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü:77–98

  18. Binbay T, Drukker M, Alptekin K, Elbi H, Aksu Tanik F, Ozkinay F, Onay H, Zagli N, van Os J (2012) Evidence that the wider social environment moderates the association between familial liability and psychosis spectrum outcome. Psychol Med 42(12):2499–2510. doi:10.1017/S0033291712000700

    Article  CAS  PubMed  Google Scholar 

  19. Binbay T, Elbi H, Alptekin K, Aksu Tanik F, Drukker M, Onay H, Ozkinay F, Zagli N, Van Os J (2011) Izmir mental health survey for gene-environment interaction in psychoses (TurkSch): objectives and methodology. Turk Psikiyatri Derg 22(2):65–76

    PubMed  Google Scholar 

  20. Binbay T, Drukker M, Elbi H, Tanik FA, Ozkinay F, Onay H, Zagli N, van Os J, Alptekin K (2012) Testing the psychosis continuum: differential impact of genetic and nongenetic risk factors and comorbid psychopathology across the entire spectrum of psychosis. Schizophr Bull 38(5):992–1002. doi:10.1093/schbul/sbr003

    Article  PubMed  Google Scholar 

  21. Topuzoglu A, Binbay T, Ulas H, Elbi H, Tanik FA, Zagli N, Alptekin K (2015) The epidemiology of major depressive disorder and subthreshold depression in Izmir, Turkey: Prevalence, socioeconomic differences, impairment and help-seeking. J Affect Disord 181:78–86. doi:10.1016/j.jad.2015.04.017

    Article  PubMed  Google Scholar 

  22. Kish L (1949) A procedure for objective respondent selection within the household. J Amer Statistical Assoc 44(247):380–387

    Article  Google Scholar 

  23. Andrews G, Peters L (1998) The psychometric properties of the composite international diagnostic interview. Soc Psychiatry Psychiatr Epidemiol 33(2):80–88

    Article  CAS  PubMed  Google Scholar 

  24. Pull CB, Saunders JB, Mavreas V, Cottler LB, Grant BF, Hasin DS, Blaine J, Mager D, Ustun BT (1997) Concordance between ICD-10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study. Drug Alcohol Depend 47(3):207–216

    Article  CAS  PubMed  Google Scholar 

  25. Cottler LB, Grant BF, Blaine J, Mavreas V, Pull C, Hasin D, Compton WM, Rubio-Stipec M, Mager D (1997) Concordance of DSM-IV alcohol and drug use disorder criteria and diagnoses as measured by AUDADIS-ADR, CIDI and SCAN. Drug Alcohol Depend 47(3):195–205

    Article  CAS  PubMed  Google Scholar 

  26. Binbay T, Alptekin K, Elbi H, Zagli N, Drukker M, Aksu Tanik F, Ozkinay F, Onay H, Van Os J (2012) Lifetime prevalence and correlates of schizophrenia and disorders with psychotic symptoms in the general population of Izmir, Turkey. Turk Psikiyatri Derg 23(3):149–160

    PubMed  Google Scholar 

  27. Silveira CM, Viana MC, Siu ER, de Andrade AG, Anthony JC, Andrade LH (2011) Sociodemographic correlates of transitions from alcohol use to disorders and remission in the Sao Paulo megacity mental health survey, Brazil. Alcohol Alcohol 46(3):324–332. doi:10.1093/alcalc/agr007

    Article  PubMed  PubMed Central  Google Scholar 

  28. Silveira CM, Siu ER, Anthony JC, Saito LP, de Andrade AG, Kutschenko A, Viana MC, Wang YP, Martins SS, Andrade LH (2014) Drinking patterns and alcohol use disorders in Sao Paulo, Brazil: the role of neighborhood social deprivation and socioeconomic status. PLoS One 9(10):e108355. doi:10.1371/journal.pone.0108355

    Article  PubMed  PubMed Central  Google Scholar 

  29. Esan O, Makanjuola V, Oladeji B, Gureje O (2013) Determinants of transition across the spectrum of alcohol use and misuse in Nigeria. Alcohol 47(3):249–255. doi:10.1016/j.alcohol.2012.12.011

    Article  PubMed  Google Scholar 

  30. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  31. Kohn R, Saxena S, Levav I, Saraceno B (2004) The treatment gap in mental health care. Bull World Health Organ 82(11):858–866

    PubMed  PubMed Central  Google Scholar 

  32. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü (2004) Türkiye  Nüfus ve Sağlık Araştırması TDHS-2003. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Ankara

  33. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü (2008) Türkiye Nüfus ve Sağlık Araştırması (TDHS) 2007. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Ankara

  34. Kalema D, Vanderplasschen W, Vindevogel S, Derluyn I (2016) The role of religion in alcohol consumption and demand reduction in Muslim majority countries (MMC). Addiction 111(10):1716–1718. doi:10.1111/add.13333

    Article  PubMed  Google Scholar 

  35. Glantz MD, Medina-Mora ME, Petukhova M, Andrade LH, Anthony JC, de Girolamo G, de Graaf R, Degenhardt L, Demyttenaere K, Florescu S, Gureje O, Haro JM, Horiguchi I, Karam EG, Kostyuchenko S, Lee S, Lepine JP, Matschinger H, Neumark Y, Posada-Villa J, Sagar R, Stein DJ, Tomov T, Wells JE, Chatterji S, Kessler RC (2014) Alcohol abuse in developed and developing countries in the World Mental Health Surveys: Socially defined consequences or psychiatric disorder? Am J Addict 23(2):145–155. doi:10.1111/j.1521-0391.2013.12082.x

    Article  PubMed  Google Scholar 

  36. Esser MB, Waters H, Smart M, Jernigan DH (2016) Impact of Maryland’s 2011 alcohol sales tax increase on alcoholic beverage sales. Am J Drug Alcohol Abuse 42(4):404–411. doi:10.3109/00952990.2016.1150485

    Article  PubMed  Google Scholar 

  37. Onat A, Hergenc G, Kucukdurmaz Z, Ugur M, Kaya Z, Can G, Yuksel H (2009) Moderate and heavy alcohol consumption among Turks: long-term impact on mortality and cardiometabolic risk. Turk Kardiyol Dern Ars 37(2):83–90

    PubMed  Google Scholar 

  38. DeWit DJ, Adlaf EM, Offord DR, Ogborne AC (2000) Age at first alcohol use: a risk factor for the development of alcohol disorders. Am J Psychiatry 157(5):745–750. doi:10.1176/appi.ajp.157.5.745

    Article  CAS  PubMed  Google Scholar 

  39. Nair UR, Vidhukumar K, Prabhakaran A (2016) Age at onset of alcohol use and alcohol use disorder: time-trend study in patients seeking de-addiction services in Kerala. Indian J Psychol Med 38(4):315–319. doi:10.4103/0253-7176.185958

    Article  PubMed  PubMed Central  Google Scholar 

  40. Cellucci T, Krogh J, Vik P (2006) Help seeking for alcohol problems in a college population. J Gen Psychol 133(4):421–433. doi:10.3200/GENP.133.4.421-433

    Article  PubMed  Google Scholar 

  41. Buscemi J, Murphy JG, Martens MP, McDevitt-Murphy ME, Dennhardt AA, Demographic T Health Survey (TDHS) (2010) Help-seeking for alcohol-related problems in college students: correlates and preferred resources. Psychol Addict Behav 24(4):571–580. doi:10.1037/a0021122

    Article  PubMed  PubMed Central  Google Scholar 

  42. Carney R, Yung AR, Amminger GP, Bradshaw T, Glozier N, Hermens DF, Hickie IB, Killackey E, McGorry P, Pantelis C, Wood SJ, Purcell R (2016) Substance use in youth at risk for psychosis. Schizophr Res. doi:10.1016/j.schres.2016.08.026

    Google Scholar 

  43. Daeppen JB, Faouzi M, Sanchez N, Rahhali N, Bineau S, Bertholet N (2014) Quality of life depends on the drinking pattern in alcohol-dependent patients. Alcohol Alcohol 49(4):457–465. doi:10.1093/alcalc/agu027

    Article  PubMed  Google Scholar 

  44. Foster JH, Peters TJ, Marshall EJ (2000) Quality of life measures and outcome in alcohol-dependent men and women. Alcohol 22(1):45–52

    Article  CAS  PubMed  Google Scholar 

  45. Levola J, Kaskela T, Holopainen A, Sabariego C, Tourunen J, Cieza A, Pitkanen T (2014) Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions. Disabil Rehabil 36(15):1227–1239. doi:10.3109/09638288.2013.837104

    Article  PubMed  Google Scholar 

  46. Levola J, Aalto M, Holopainen A, Cieza A, Pitkanen T (2014) Health-related quality of life in alcohol dependence: a systematic literature review with a specific focus on the role of depression and other psychopathology. Nord J Psychiatry 68(6):369–384. doi:10.3109/08039488.2013.852242

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey

    Halis Ulaş, Tolga Binbay & Köksal Alptekin

  2. Hakkari State Hospital, Hakkari, Turkey

    Umut Kırlı

  3. Department of Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey

    Hayriye Elbi

Authors
  1. Halis Ulaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tolga Binbay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Umut Kırlı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hayriye Elbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Köksal Alptekin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tolga Binbay.

Ethics declarations

Conflict of interest

None of the authors has a financial or personal relationship with a third party whose interests could be positively or negatively influenced by the article’s content.

Funding

This work is part of the TürkSch project and is funded by the Scientific and Technological Council of Turkey 1001 programme, project no: 107S053 and 112S476.

Ethical standards

The TürkSch study was approved by the Ege University ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All respondents gave informed consent prior to interview.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ulaş, H., Binbay, T., Kırlı, U. et al. The epidemiology of alcohol use in Izmir, Turkey: drinking pattern, impairment and help-seeking. Soc Psychiatry Psychiatr Epidemiol 52, 887–899 (2017). https://doi.org/10.1007/s00127-017-1345-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-017-1345-5

Keywords

Search

Navigation