Addiction Research Group, Department of Psychiatry, University of Szeged, Szeged, Hungary.
Department of Psychiatry, University of Szeged, Szeged, Hungary.
Eur Addict Res. 2023;29(2):83-91. doi: 10.1159/000527973. Epub 2023 Jan 23.
Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS).
A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ2 tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality.
The highest incidence of DT was in spring (36.8%; χ2 (3) = 27.666; p < 0.001), especially in March (13.9%; χ2 (11) = 33.168; p < 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables.
The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.
由于死亡率高，识别与酒精相关震颤谵妄（DT）相关的因素在临床环境中至关重要，震颤谵妄是酒精戒断状态（AWS）最严重的形式。先前的研究表明季节性与其他类型的谵妄之间存在关系；然而，据我们所知，这是第一项检验季节性在酒精依赖综合征（ADS）中对 DT 影响的实证研究。
本研究采用回顾性研究，时间范围为 2008 年至 2015 年；共纳入 1591 例患者的病历，共计 2900 次住院就诊。根据 ICD-10 诊断将患者分为三组：ADS、AWS 和 DT。使用单因素方差分析和卡方检验分析组间特征。使用多项逻辑回归模型探索 DT 的潜在预测因素，包括季节性。
DT 的最高发病率出现在春季（36.8%；χ2（3）=27.666；p<0.001），尤其是在 3 月（13.9%；χ2（11）=33.168；p<0.001）。春季、较高的平均年龄、较高的合并躯体疾病发生率和较低的合并精神疾病发生率是 DT 的显著预测变量，这些因素在控制了社会人口学和临床变量后仍然成立。
本研究表明，在温带气候区，春季，尤其是 3 月是 DT 的关键时期。这可以解释为冬季后期效应，因为与其他春季月份相比，该月的温度较低。此外，较高的年龄和合并躯体疾病的发生可以被视为 DT 的危险因素。这些结果支持进一步开展临床研究以更好地了解季节性对 DT 的影响。
