These results should be interpreted in the context of 6 potential methodological limitations. First, we detected individuals with AUD from official registry records obviating the need for cooperation or accurate recall. The validity of our method is supported by high concordance for registration across our modes of ascertainment.29 However, prevalence of AUD in this sample was substantially lower than estimated from interview surveys in the United States30,31 and Norway.30,32 Therefore, our AUD cases are likely to be more severely affected than those ascertained from population-based interview studies. The stronger association with mortality for AUD observed in this vs prior samples2,3 might result from the high average severity of our ascertained cases and, in particular, our use of medical registry, as among individuals with AUD in the general population, treatment is associated with increased mortality.2
