The clinical relevance of this cut-off must be assessed. In absence of prospective study, we may only hypothesize that patients with an early onset of alcohol dependence (earlier than 22 years old) will have a worst prognosis. In the literature, as mentioned, retrospective studies found that an early age at onset of alcohol dependence is associated with greater impulsivity, a more severe dependence (Hingson et al., 2006b), and more severe and frequent alcohol withdrawal complications (Le Strat et al., 2008a). This prognosis is even worsened by more frequent addictive comorbidities. Clinicians usually perform screening tests for other addictions when treating a patient with alcohol dependence. This assessment may be particularly relevant if the patient has an early onset disorder.
