Sex-specific association of depressive disorder and transient emotional states with alcohol consumption in male and female alcoholics (original) (raw)
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Frontiers in Psychiatry
Background: Alcohol dependence is highly prevalent in the general population; some differences in alcohol use and dependence between women and men have been described, including outcomes and ranging from biological to social variables. This study aims to compare the severity of alcohol dependence with clinical and psychopathological characteristics between sexes. Methods: A cross-sectional descriptive study was conducted in alcohol-dependent outpatients; the recruitment period was 7 years. The assessment of these patients was carried out by obtaining sociodemographic characteristics and using the Semi-structured Clinical Interview for Axis I and II (SCID-I and SCID-II), European version of the Addiction Severity Index (EuropASI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) scales. Variables were compared and analyzed. Results: The sample was composed of 178 patients (74.2% males and 25.8% females) with a mean age of 46.52 ± 9.86. No sociodemographic differences were found between men and women. Females had a higher rate of suicide attempts and depression symptoms at the treatment onset. When results of EuropASI were compared, females had worse psychological and employment results than males. According to consumption variables, males had an earlier onset of alcohol use, had more regular alcohol use, and develop alcohol dependence earlier than females. Conclusions: According to results, there are sex-dependent differences (severity and other variables such as mood or suicide) in alcohol dependence. Thus, this may implicate the need of future specific research and treatment programs based on the specific necessities of each sex.
Drug and Alcohol Review, 2001
This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants˜ use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed. [Sannibale C, Hall W. Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders. Drug Alcohol Rev 2001;20:369 383]
Addiction (Abingdon, England), 2016
Depression and anxiety are often comorbid with alcoholism and contribute to craving and relapse. We aimed to estimate the prevalence of lifetime diagnoses of major depressive disorder (MDD), substance-induced depression (SID), anxiety disorder (AnxD) and substance induced anxiety (SIA), the effects of these comorbidities on the propensity to drink in negative emotional states (negative craving), and test whether these effects differ by sex. Secondary analyses of baseline data collected in a single-arm study of pharmacogenetic predictors of acamprosate response. Academic medical center and affiliated community-based treatment programs in American upper mid-west. 287 males and 156 females aged 18-80, meeting DSM-IV criteria for alcohol dependence. The primary outcome measure was "propensity to drink in negative emotional situations" (determined by the Inventory of Drug Taking Situations) and the key predictors/covariates were sex and psychiatric comorbidities including, MDD,...
The American Journal on Addictions, 2013
Background and Objectives: The aim of this study was to investigate potential gender differences in situations associated with heavy alcohol drinking. Methods: Data from 395 alcohol dependent patients participating in the Mayo Clinic Intensive Addiction Program were evaluated. Each participant completed the inventory of drug taking situations (IDTS), Penn alcohol craving scale (PACS), patient health questionnaire (PHQ-9), and/or Beck depression inventory (BDI). Gender differences in IDTS scores representing three domains (negative, positive, and temptation) of situations associated with heavy alcohol use were examined. Results: Women with alcohol dependence report a higher frequency of heavy drinking in unpleasant emotional (IDTS negative scores mean AE SD women vs. men: 52.3 AE 22.1 vs. 43.8 AE 21.8; p ¼ .0006), and as a result of temptation (IDTS temptation scores mean AE SD women vs. men: 40.4 AE 23.0 vs. 35.3 AE 20.8; p ¼ .035). Upon admission, women also scored significantly higher on depressive symptoms as measured by the BDI (23.4 AE 11.4 vs. 18.2 AE 9.8, p < .001). After controlling for depressive symptom severity as a covariate, the IDTS gender differences were no longer significant. Conclusion and Scientific Significance: Our results suggest that unpleasant or temptation based emotional situations are a vulnerability risk factor for heavy drinking particularly in females. This risk appears to be at least partially driven by depressive symptom burden. Future research is needed to further investigate this finding. (Am J Addict
Gender Differences in Comorbidly Depressed Alcohol-Dependent Outpatients
Alcoholism: Clinical and Experimental Research, 1997
Clinical profiles of alcohol-dependent male and female outpatients were evaluated at treatment entry to compare the level of clinical severity in alcoholics with a coexistent comorbid depressive disorder to alcoholics who have never been depressed. Due to a higher proportion of females than males in the depressed alcoholic population, selected patient groups were oversampled to create a study group with equivalent number of males and females with and without comorbid depression. Clinical severity was assessed by examining both the extent of alcohol problems, and depressive symptomatology at treatment entry with respect to gender differences (unrelated to depression), effects of comorbid depression (unrelated to gender), and effects from the interaction of gender and depression. There were 93 DSM-III-R alcohol-dependent outpatients (50 males, 43 females), half of whom had a current or lifetime DSM-III-R depressive disorder. The amount of drinking in the 90 days before treatment entry, the degree of alcohol severity, and the number of lifetime drinking-related consequences were collected in the first week after detoxification. Diagnoses of lifetime and current depression were determined via the Structured Clinical Interview for DSM-III-R, and depressive symptoms were evaluated with rating scales 1 week after detoxification. In most cases, a depressive disorder was diagnosed only if sometime in the patient's history depressive symptoms had either predated problem drinking or been present during a 6-month abstinent period. depressed males had a more severe clinical profile with respect to their alcoholism (i.e., more drinking, drinking-related problems, and alcohol severity than depressed females and never-depressed males). Surprisingly, females who had never been depressed (also no family history of depression) reported drinking the same quantities of alcohol in the 90 days before treatment and had comparable alcohol severity and number of consequences as males who had never been depressed. Depressed females, however, were more severely depressed (i.e., reported more intensive depressive symptoms than depressed male alcoholics). Thus, determining the type and extent of clinical severity at treatment entry in comorbidly depressed alcoholics depends on the gender of the patient The significant interaction between gender and the presence of comorbid depression that was found in this study may have important implications for predicting success in treatment.
American Journal of Epidemiology, 1997
Longitudinal relations between depressive symptoms and alcohol problems have been examined infrequently in community-based studies, and gender-specific findings to date appear to be inconclusive. Study hypotheses were that depressive symptoms predicted subsequent alcohol problems for females, whereas alcohol problems predicted subsequent depressive symptoms for males. The authors examined these relations in a random sample of household adults (aged 19 years or more) from Erie County, New York, assessed in 1986York, assessed in , 1989York, assessed in , and 1993. Measures of alcohol problems (in the previous year) incorporated an alcohol abuse/dependence diagnosis and a heavy alcohol use index. The Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms over a 1-month time frame. Comprehensive logistic regression models incorporated prior depressive symptoms, prior alcohol problems, and sociodemographic variables (age, race, education, marital status, employment, total family income, and number of children living at home). For females, depressive symptoms predicted subsequent alcohol problems over 3 years (odds ratio = 3.04, 95% confidence interval 1.35-6.80, p < 0.01) and 4 years (odds ratio = 2.42, 95% confidence interval 1.14-5.12, p < 0.05), but not for 7 years. There was no evidence to support the hypothesis for males. This study clarifies and extends prior investigations of relations between these two prevalent mental health problems in a community-based sample. Am J Epidemiol 1997;146:966-74. alcoholism; depression; logistic models; longitudinal studies; women Depression and alcoholism, the two most prevalent mental disorders in the United States, are associated with increased morbidity and mortality (1). Findings from a national comorbidity survey indicate that 17 percent of respondents had a lifetime history of major depression and 10 percent had an episode in the previous 12 months. For alcohol dependency, the corresponding rates were 14 and 7 percent (1). These prevalence rates suggest that these conditions contribute to the national mental health expenditures of $18.15 billion (2). Recent findings from a 9-year follow-up of
Drug and Alcohol Dependence, 2011
Background-Co-occurring alcohol use disorder and major depression (C-ALDP) is a major public health problem. Yet, the available evidence is mixed regarding the implications of C-ALDP for alcohol involvement. The purpose of this research was to examine the associations between past 12-month co-occurring AUDs (abuse and dependence) and major depressive episode (MDE) and alcohol involvement in a representative community sample. Design-The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is a national household survey of 43,083 adults ages 18 and older. For the NESARC, the target population is the civilian noninstitutionalized population, 18 years of age and older, living in the United States and the District of Columbia. Methods-All NESARC interviews were conducted with the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM IV Version (AUDADIS-IV; Grant et al., 2003). Results-Prevalence of past 12-month co-occurring AUD (abuse or dependence) and MDE was 1.2%, corresponding to about 2.4 million adults ages 18 and older. Among males with alcohol dependence, comorbid MDE was associated with a greater number of days drinking at home alone. Among females and males with alcohol abuse and dependence, comorbid MDE was associated with higher prevalence of drinking to enhance depressed mood. Comorbid MDE was also associated with lower levels of some drinking behaviors among those with alcohol abuse. Conclusions-Co-occurring AUDs and MDE are associated with specific dimensions of alcohol involvement, and this association is more consistent for alcohol dependence than abuse.