ABSTRACT
OBJECTIVE: Alcohol dependence is more prevalent in men than in women. The evidence for how prenatal and adult androgens influence alcohol dependence is limited. We investigated the effects of prenatal and adult androgen activity on alcohol dependence. Moreover, we studied how the behaviours of pregnant women affect their children's prenatal androgen load. METHOD: We quantified prenatal androgen markers (e.g., second-to-fourth finger length ratio [2D : 4D]) and blood androgens in 200 early-abstinent alcohol-dependent in-patients and 240 controls (2013-2015, including a 12-month follow-up). We also surveyed 134 women during pregnancy (2005-2007) and measured the 2D : 4D of their children (2013-2016). RESULTS: The prenatal androgen loads were higher in the male alcohol-dependent patients compared to the controls (lower 2D : 4D, P = 0.004) and correlated positively with the patients' liver transaminase activities (P < 0.001) and alcohol withdrawal severity (P = 0.019). Higher prenatal androgen loads and increasing androgen levels during withdrawal predicted earlier and more frequent 12-month hospital readmission in alcohol-dependent patients (P < 0.005). Moreover, stress levels (P = 0.002), alcohol (P = 0.010) and tobacco consumption (P = 0.017), and lifetime stressors (P = 0.019) of women during pregnancy related positively to their children's prenatal androgen loads (lower 2D : 4D). CONCLUSION: Androgen activities in alcohol-dependent patients and behaviours of pregnant women represent novel preventive and therapeutic targets of alcohol dependence.
Subject(s)
Alcoholism/blood , Alcoholism/physiopathology , Androgens/metabolism , Prenatal Exposure Delayed Effects/metabolism , Prenatal Exposure Delayed Effects/physiopathology , Substance Withdrawal Syndrome/blood , Substance Withdrawal Syndrome/physiopathology , Adult , Alcohol Drinking/epidemiology , Alcoholism/epidemiology , Alcoholism/metabolism , Cross-Sectional Studies , Denmark/epidemiology , Dihydrotestosterone/blood , Female , Fingers/anatomy & histology , Humans , Longitudinal Studies , Male , Pregnancy , Prenatal Exposure Delayed Effects/epidemiology , Sex Factors , Smoking/epidemiology , Stress, Psychological/epidemiology , Testosterone/bloodABSTRACT
INTRODUCTION: Numerous investigations have shown that premature discharge against medical advice from alcohol detoxification treatment is associated with poor outcome. The aim of the present study was to assess the risk of different possible influencing factors. PATIENTS AND METHOD: 168 in-patients admitted for detoxification treatment were included in the study. All patients were detoxified using clome-thiazole and/or carbamazepine in individual, symptom-triggered dosages. Possible influencing factors were recorded using a standardised interview. RESULTS: Cox regression revealed a lower risk of premature discharge being significantly asso-ciated with few preceding withdrawals, intoxication at admission and treatment with clomethiazole. Kaplan-Meier survival statistics showed a significantly lower risk only for being treated with clomethiazole (premature discharge until day 7: chi2=25.07; p<0.001; premature discharge until day 14: chi2=5.19; p=0.023). Other included demographic factors like daily intake of ethanol before admission, duration of alcohol dependence, age or smoking status were not associated with the risk of premature discharge. DISCUSSION: The present findings show that pharmacotherapy with clomethiazole may positively influence the risk of premature discharge. This might be a consequence of the psychoactive properties of the drug which leads to positive reinforcement.