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The aim of this study was to identify predictive risk factors for psychological distress in adolescents who live or do not live with alcoholic family members. An epidemiological study was conducted with a selection of 211 adolescents under psychological distress from a sample of 715 students from the state education network of João Pessoa, state of Paraíba, Brazil. Data were collected using three instruments: the Family CAGE; the Self-reporting Questionnaire and a structured questionnaire. The logistic regression model was used for analysis. The results evidenced that adolescents who lived with alcoholic family members whose mothers had higher education levels had lower chances of manifesting psychological illnesses (OR = 0.63). Among adolescents who did not live with alcoholic family members, the highest chances for manifesting illnesses were associated with the education level of their fathers (OR = 1.2), being female (OR = 1.8), and belonging to a non-nuclear family. The planning of actions/interventions that favor the effective construction of care for these individuals must take into consideration the socio-cultural singularities of the family context.