Early-Age alcohol initiation increases the risk of mental disorders in children and adolescents: a longitudinal cohort study

Although alcohol use is proved to relate with poor psychiatric outcomes, the longitudinal impact of early-age alcohol initiation on youth mental health is poorly characterized. The current study analyzed semi-structured interview data on substance use collected at baseline and over two years of follow-up (6, 12, 18, and 24 months) as part of the Adolescent Brain Cognitive Development (ABCD) study. Participants that reported having at least one sip were defined as alcohol experimenters. Latent class trajectory model (LCTM) was used to characterize sipping patterns over follow-up period. In this study, 1659 alcohol experimenters were identified (mean age at baseline, 9.55 ± 0.50 years; 944 males [56.9%]) and matched with 1659 controls without any alcohol use. Early-age alcohol initiation was associated with higher risk of developing mental disorders (MDs, OR 1.25, [95% CI, 1.03–1.52]). Subgroup analyses suggested that pre-baseline alcohol exposure could increase the risk of sleep-wake disorder (OR 1.39, [95%CI, 1.06–1.82]), bipolar disorder (OR 1.70, [95%CI, 1.10–2.67]), non-suicidal self-injury behavior (OR 1.91, [95% CI, 1.20–3.08]) and suicidal ideation (OR 1.51, [95% CI, 1.22–2.15]). Two sipping patterns were identified among follow-up alcohol experimenters: increased sipping (Class 1, 56.7%) and decreased sipping (Class 2, 43.3%) over the two-year follow-up period. Compared with controls, only Class 1 was significantly associated with increased risk of MDs (OR 1.48, [95% CI, 1.02–2.14]). Both Class 1 and Class 2 showed elevated risk of suicidal ideation (Class1: OR 2.38, [95%CI, 1.22–4.71]; Class2: OR 2.64, [95%CI, 1.29–5.44]). These findings suggest an association between early alcohol exposure and negative mental health conditions in children aged under 12 years, highlighting children as a potential priority population for alcohol prevention efforts.