From the Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, and National Institute of Nursing Research, National Institutes of Health, Bethesda, MD (KA, PVJ); Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD (JWL, MLS, DG, ND); Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD (BLS, VAR); Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD (DG); Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD (RM); Department of Neurology, Indiana University School of Medicine, Indianapolis, IN (DAK); and Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism, Division of Intramural Clinical and Biological Research and National Institute on Drug Abuse Intramural Research Program, National Institutes of Health (LL).
J Addict Med. 2024;18(5):567-573. doi: 10.1097/ADM.0000000000001332. Epub 2024 May 22.
Alcohol use disorder (AUD) is a global health problem with significant negative consequences, including preventable deaths. Although olfactory dysfunction is associated with chronic alcohol drinking, the relationship among specific types of olfactory deficits, depressive symptoms, and problematic drinking remains to be explored. Here, we examined the prevalence of olfactory distortion (parosmia) and hallucination (phantosmia) and assessed their associations with problematic drinking and depressive symptoms.
In April-June 2022, 250 participants across the spectrum of AUD were recruited for assessment in the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol study. Surveys covered self-reported olfactory function, depressive symptoms, and problematic drinking, with key measures assessed, including the Alcohol Use Disorders Identification Test and the Patient Health Questionnaire. Predictors in the analysis included parosmia and phantosmia, with covariates comprising age, sex, socioeconomic status, race, ethnicity, COVID-19 infection status, and smoking status.
Among 250 individuals, 5.2% experienced parosmia and 4.4% reported phantosmia. Parosmia was associated with higher Alcohol Use Disorders Identification Test scores (β = 7.14; 95% confidence interval = 3.31, 10.96; P < 0.001), whereas phantosmia was linked to higher Patient Health Questionnaire scores (β = 3.32; 95% confidence interval = 0.22, 6.42; P = 0.03). These associations persisted in both the full sample and the subset of participants without COVID-19.
Our study highlights strong existing links among olfactory deficits, problem drinking, and depressive symptoms, underscoring the need to assess smell impairments in clinical settings. Future research should explore these connections further to develop new treatments for individuals with AUD and depression.
酒精使用障碍（AUD）是一个全球性的健康问题，会带来严重的负面影响，包括可预防的死亡。虽然嗅觉功能障碍与慢性饮酒有关，但特定类型的嗅觉缺陷、抑郁症状和问题饮酒之间的关系仍有待探索。在这里，我们研究了嗅觉扭曲（幻嗅）和幻觉（幻听）的患病率，并评估了它们与问题饮酒和抑郁症状的关系。
在 2022 年 4 月至 6 月期间，从酒精滥用和酒精中毒研究所的 COVID-19 大流行对酒精影响研究中招募了 250 名 AUD 患者进行评估。调查涵盖了自我报告的嗅觉功能、抑郁症状和问题饮酒，关键措施包括酒精使用障碍识别测试和患者健康问卷。分析中的预测因素包括幻嗅和幻听，协变量包括年龄、性别、社会经济地位、种族、民族、COVID-19 感染状况和吸烟状况。
在 250 名个体中，5.2%的人经历了幻嗅，4.4%的人报告了幻听。幻嗅与更高的酒精使用障碍识别测试评分相关（β=7.14；95%置信区间=3.31，10.96；P<0.001），而幻听与更高的患者健康问卷评分相关（β=3.32；95%置信区间=0.22，6.42；P=0.03）。这些关联在全样本和没有 COVID-19 的参与者亚组中均存在。
我们的研究强调了嗅觉缺陷、饮酒问题和抑郁症状之间的现有联系，突出了在临床环境中评估嗅觉损伤的必要性。未来的研究应该进一步探索这些联系，为 AUD 和抑郁症患者开发新的治疗方法。
