Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Drug Alcohol Depend. 2019 Mar 1;196:31-39. doi: 10.1016/j.drugalcdep.2018.12.010. Epub 2019 Jan 11.
We assessed the impact of comorbid depression and anxiety disorders as well as positive and negative emotional states on alcohol consumption in alcohol dependent men and women.
Per day alcohol consumption during 90 days before enrolment was assessed by the Time Line Follow Back (TLFB) in 287 men and 156 women meeting DSM-IV-TR criteria for alcohol dependence. Propensity to drink in negative/positive emotional states was assessed using the Inventory of Drug Taking Situations (IDTS). Psychiatric comorbidities, including major depressive disorder (MDD), substance-induced depression (SID), anxiety disorders (AnxD), or substance-induced anxiety (SIA) were identified by Psychiatric Research Interview of Substance and Mood Disorders (PRISM).
In the combined group, increased number of drinks per day and number of heavy drinking days correlated with increased IDTS scores (all p < 0.0001), while the lifetime history of MDD was associated with fewer drinking days (p = 0.045) but not average number of drinks per day. Male sex was associated with higher alcohol consumption per day (p < 0.0001), but not with the number of drinking days (p > 0.05). Lifetime MDD history was associated with less drinking days (p = 0.0084) and less heavy drinking days (p = 0.021) in alcohol dependent men, while current MDD was associated with higher alcohol use per day in alcohol dependent women (p = 0.044).
Our findings suggest that emotional states and lifetime MDD history have sex-specific impact on alcohol use in alcohol dependent men and women. The mechanisms underlying these findings and their relevance to treatment outcomes need to be examined in future studies.
我们评估了共病抑郁和焦虑障碍以及正性和负性情绪状态对酒精依赖男性和女性饮酒量的影响。
在符合 DSM-IV-TR 酒精依赖标准的 287 名男性和 156 名女性中，通过时间线回溯（TLFB）评估入组前 90 天的每日饮酒量。使用药物使用情况清单（IDTS）评估在负性/正性情绪状态下的饮酒倾向。通过物质和心境障碍精神病学研究访谈（PRISM）确定共病性，包括重性抑郁障碍（MDD）、物质诱发的抑郁障碍（SID）、焦虑障碍（AnxD）或物质诱发的焦虑障碍（SIA）。
在合并组中，每日饮酒量和重度饮酒天数的增加与 IDTS 评分的增加相关（均 p<0.0001），而 MDD 的终生病史与饮酒天数减少相关（p=0.045），但与每日平均饮酒量无关。男性与每日饮酒量较高相关（p<0.0001），但与饮酒天数无关（p>0.05）。MDD 终生病史与酒精依赖男性的饮酒天数减少（p=0.0084）和重度饮酒天数减少（p=0.021）相关，而当前 MDD 与酒精依赖女性的每日饮酒量增加相关（p=0.044）。
我们的发现表明，情绪状态和 MDD 终生病史对酒精依赖男性和女性的饮酒量有性别特异性影响。需要在未来的研究中检查这些发现的机制及其与治疗结果的相关性。
