RESUMO
BACKGROUND: Many studies have used disease-specific instruments, such as the Functional Assessment of Cancer Therapy (FACT), when studying health-related quality of life (HRQOL) in patients. Few studies however, have described normative HRQOL values in the general population using FACT - General Population (FACT-GP). The general aim of the present study is thus to describe the normative HRQOL values in the general Swedish population by using the FACT-GP instrument and to investigate to what degree sociodemographic factors and status of self-rated health (SRH) correlate with HRQOL. METHODS: The participants consisted of a pre-stratified (gender, age and education) sample of Swedish citizens that previously had enrolled to be a part of a web panel hosted by a research institute (SOM Institute) at the University of Gothenburg in Sweden. The HRQOL was assessed by using the FACT-GP and SRH. RESULTS: A higher FACT-GP score was mainly associated with males, higher age, higher income and better SRH. The results showed that the Swedish sample scored lower on FACT-GP than previous studies. CONCLUSIONS: Since HRQOL is frequently used as an important endpoint in healthcare research, there is an increasing need for normative data. The results from this study serve as a general population standard against which other studied HRQOL-data could be evaluated.
Assuntos
Nível de Saúde , Qualidade de Vida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Socioeconômicos , Inquéritos e Questionários , Suécia , Adulto JovemRESUMO
AIMS: Community Reinforcement Approach and Family Training (CRAFT) is a support program for concerned significant others (CSOs) to identified persons (IPs) with alcohol use disorders, with the purpose of engaging IPs to treatment and to improve CSO functioning. The purpose of the present study was to investigate the efficacy of an internet-based version of CRAFT (iCRAFT). METHODS: Randomized controlled trial comparing iCRAFT with a wait-list (WL) condition with a nation-wide uptake in Sweden. A total of 94 CSOs to a treatment refusing IP, who described the IP according to DSM-IV criteria for alcohol dependence or abuse, were included in the study. iCRAFT consisted of five weekly administered therapist-guided modules with the following content: (a) improve CSOs' own mental health, (b) improve the CSOs skills in asking the IP to seek treatment, (c) positive communication skills training, (d) contingency management of IP drinking behavior. Main outcome measure was IPs initiative to seek treatment measured at 24 weeks. Secondary outcomes were IP's daily alcohol consumption, CSOs mental health, quality of life and relational satisfaction. RESULTS: Of 94 participants, 15 CSOs reported IP treatment initiative during the study period. Of these, 10 belonged to the iCRAFT condition and five to the WL condition. The difference between conditions was nonsignificant, and the results were inconclusive. Participants in iCRAFT showed short-term improvements regarding depressive symptoms, quality of life and relational happiness. CONCLUSION: This study was unable to demonstrate substantial changes in the iCRAFT program regarding IP treatment seeking or CSO mental health.
Assuntos
Alcoolismo/terapia , Terapia Comportamental/métodos , Terapia Familiar/métodos , Internet , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , CônjugesRESUMO
AIMS: To evaluate the long-term treatment outcome (up to 5 years) with respect to different drinking goals of patients. METHODS: Alcohol-dependent individuals (n = 349) were recruited from three alcohol treatment units. They were interviewed using the Addiction Severity Index (ASI). They were sub-grouped according to their goal at treatment entry: abstinence, low- risk drinking and no decided goal. RESULTS: Patients with abstinence as a goal at treatment entry reported at 2.5 years follow-up a higher abstinence rate, a more pronounced reduction in alcohol consumption, reduction in total number of DSM-IV criteria, higher frequency of low-risk drinking and fewer diagnoses of alcohol dependence compared to the groups who had low risk drinking as a goal or no decided goal. This improvement remained basically unchanged in all three groups at 5 years follow-up, suggesting long-term stability after the treatment interventions. CONCLUSIONS: The findings suggest that: (1) alcohol-dependent patients who have abstinence as their own drinking goal have a more favorable treatment outcome than those who have low-risk drinking as a goal or no decided goal. (2) Abstinence as a drinking goal should be considered for those who have a longer duration (for example more than 10 years) of their alcohol-related problems. (3) Patients who have no decided goal should be recommended abstinence as a drinking goal.
Assuntos
Abstinência de Álcool/psicologia , Abstinência de Álcool/tendências , Alcoolismo/psicologia , Alcoolismo/terapia , Objetivos , Centros de Tratamento de Abuso de Substâncias/tendências , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Alcoolismo/epidemiologia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Autorrelato , Suécia/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
AIMS: To investigate the influence of the A1 allele of the TAQ1A polymorphism in the dopamine D2 receptor (DRD2) gene region on mortality in adult individuals with alcohol dependence. METHODS: The study sample consisted of 359 alcohol-dependent individuals treated for severe alcohol withdrawal symptoms in 1997. Years of survival was studied in an 18-year follow-up. In the analyses, gender and age were controlled for. RESULTS: At the 18-year follow-up, 53% individuals had deceased. The analyses showed that older age (P < 0.001), male gender (P < 0.05) and carrying the A1 allele (P < 0.01) all significantly and independently contributed to shorten years of survival. Among the deceased individuals, the genotype A1+ was the only significant contributor to shorten years of survival. CONCLUSIONS: An important contribution of the present study is that in alcohol dependence the Taq1A1 allele of the DRD2 gene region is a risk factor for premature death of similar importance as the well-known risk factors of age and gender. SHORT SUMMARY: We investigated the influence of A1 allele of the TAQ1A polymorphism in DRD2 receptor gene region on mortality in alcohol-dependent individuals in an 18-year follow-up. Age, gender and the A1 allele contributed to shorten years of survival. Among the deceased, the A1+ was the only contributor to shorten years of survival.
Assuntos
Alcoolismo/genética , Alcoolismo/mortalidade , Alelos , Receptores de Dopamina D2/genética , Adulto , Fatores Etários , Idoso , Causas de Morte/tendências , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Taxa de Sobrevida/tendências , Fatores de TempoRESUMO
It is unclear whether exposure to childhood maltreatment is associated with the age of onset of alcohol use disorder (AUD). A group of socially stable women with AUD seeking treatment (n = 75) were interviewed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview. They also filled out the Childhood Trauma Questionnaire-short form. Emotional abuse, sexual abuse and multiple childhood traumas were found to be associated with earlier onset of AUD. Multivariable linear regression analysis showed that independent predictors for an earlier onset of AUD were exposure to emotional abuse (beta = -7.44, SE = 2.83, adjusted p = 0.010) and mother's alcohol/substance problems (beta = -7.87, SE = 3.45, adjusted p = 0.026). These variables explained 18.9% of the variance of age of onset of AUD. These findings highlight a need for increased clinical attention to AUD subgroups who have experienced childhood maltreatment, especially emotional abuse, as well as a need for including support in the patient's own parental role in the treatment.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Alcoolismo/epidemiologia , Adulto , Idade de Início , Idoso , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Fatores de Risco , Suécia/epidemiologiaRESUMO
BACKGROUND: A large proportion of individuals with alcohol problems do not seek psychological treatment, but access to such treatment could potentially be increased by delivering it over the Internet. Cognitive behavior therapy (CBT) is widely recognized as one of the psychological treatments for alcohol problems for which evidence is most robust. This study evaluated a new, therapist-guided internet-based CBT program (entitled ePlus) for individuals with alcohol use disorders. METHODS: Participants in the study (n = 13) were recruited through an alcohol self-help web site ( www.alkoholhjalpen.se ) and, after initial internet screening, were diagnostically assessed by telephone. Eligible participants were offered access to the therapist-guided 12-week program. The main outcomes were treatment usage data (module completion, treatment satisfaction) as well as glasses of alcohol consumed the preceding week, measured with the self-rated Timeline Followback (TLFB). Participant data were collected at screening (T0), immediately pre-treatment (T1), post-treatment (T2) and 3 months post-treatment (T3). RESULTS: Most participants were active throughout the treatment and found it highly acceptable. Significant reductions in alcohol consumption with a large within-group effect size were found at the three-month follow-up. Secondary outcome measures of craving and self-efficacy, as well as depression and quality of life, also showed significant improvements with moderate to large within-group effect sizes. CONCLUSIONS: Therapist-guided internet-based CBT may be a feasible and effective alternative for people with alcohol use disorders. In view of the high acceptability and the large within-group effect sizes found in this small pilot, a randomized controlled trial investigating treatment efficacy is warranted. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT02384278 , February 26, 2015).
Assuntos
Transtornos Relacionados ao Uso de Álcool/terapia , Terapia Cognitivo-Comportamental/métodos , Depressão/terapia , Qualidade de Vida/psicologia , Adulto , Consumo de Bebidas Alcoólicas/prevenção & controle , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Telefone , Resultado do TratamentoRESUMO
AIMS: The influence of tobacco use in alcohol-dependent individuals is not well understood, especially the role of snuffing, which is common in Northern Europe. The aim was therefore to investigate the influence of smoking and snuffing on the progression, severity and treatment outcome in alcohol-dependent individuals. The hypotheses were that concomitant tobacco use (i.e. smoking or snuffing) would enhance the progression and severity of alcohol dependence and be less beneficial for treatment outcome, relative to tobacco non-users. METHODS: Alcohol-dependent individuals (n = 347) were recruited from three treatment units specialized in alcohol use disorders. Participants were interviewed about their current and past alcohol and tobacco use at treatment entry and at a follow-up interview 2.5 years thereafter. RESULTS: The tobacco users (smokers and snuffers) had an earlier alcohol debut compared to the tobacco never-users. Snuffers reported regular alcohol consumption and inebriation at an earlier age in contrast to smokers and tobacco never-users. There were no difference between the groups regarding treatment outcome. CONCLUSIONS: This study highlights the importance of studying not only the influence of smoking but also of snuffing on the progression, severity and treatment outcome in individuals with alcohol dependence.
Assuntos
Alcoolismo/diagnóstico , Alcoolismo/terapia , Fumar Tabaco/efeitos adversos , Tabaco sem Fumaça/efeitos adversos , Fatores Etários , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Intoxicated eyewitnesses are often discredited by investigators and in court, but few studies have examined how alcohol affects witnesses' memory. The primary aim of the present study was to examine how intoxication (alcohol vs. control), retention interval (immediate vs. one week delay), and number of interviews (one vs. two interviews) affect witnesses' memory. The participants (N = 99) were randomly assigned to consume either orange juice or alcohol mixed with orange juice, and they all witnessed a filmed mock crime afterwards. The recall took place either (a) immediately and after a one week delay or (b) after a one week delay only. No main effect of alcohol was found on the quantity or quality of the witnesses' statements. Both intoxicated and sober witnesses recalled more details, and were more accurate, during immediate compared to delayed recall. For witnesses interviewed twice, an average of 30% new details were provided in the second compared to the first interview, and these were highly accurate. In sum, contrary to what one can expect, intoxicated witnesses with a low to moderate blood alcohol concentration (below 0.10%) were reliable witnesses.
Assuntos
Intoxicação Alcoólica , Etanol/administração & dosagem , Exposição à Violência/psicologia , Entrevistas como Assunto/métodos , Rememoração Mental/efeitos dos fármacos , Adulto , Concentração Alcoólica no Sangue , Feminino , Humanos , Masculino , Fatores de TempoRESUMO
Witnesses to violent crimes are often alcohol intoxicated, but few studies have investigated the impact of alcohol on witness reports. This study investigated how alcohol intoxication and time of interview affected reports of intimate partner violence (IPV). One hundred thirty six healthy men (N = 66) and women (N = 70) were randomized to an alcohol group (0.8g/kg for men, 0.75g/kg for women) (N = 70) or control group (N = 66), given juice. Participants consumed drinks in a laboratory setting before they witnessed an IPV scenario. Fifty percent of the intoxicated and sober participants were interviewed ten minutes after viewing the film and all participants were interviewed one week later. For the analyses, participants in the alcohol group were divided into two groups (moderately/highly intoxicated) based on their BAC-level. Ten minutes after viewing the event, highly (BAC = 0.08-0.15) intoxicated witnesses gave shorter, but as accurate, reports as moderately intoxicated/sober witnesses. All witnesses gave shorter and less accurate reports one week later compared to immediately after. However, an immediate interview increased completeness one week later. In general, time and high intoxication made witnesses give less detailed accounts of actions and verbal information, but not of objects. Highly intoxicated witnesses reported less actions and verbal information in all interviews, while information regarding objects was reported to a similar extent. At the present BAC-level, it is beneficial to conduct an immediate free recall interview with intoxicated witnesses to obtain a maximum amount of correct information and minimize the negative effect of time.
Assuntos
Etanol/administração & dosagem , Exposição à Violência/psicologia , Entrevistas como Assunto/métodos , Rememoração Mental/efeitos dos fármacos , Adulto , Concentração Alcoólica no Sangue , Feminino , Humanos , Masculino , Adulto JovemRESUMO
BACKGROUND: Alcohol-dependent patients have different treatment goals when entering treatment. Furthermore, different treatment settings advocate different treatment goals. Earlier studies have pointed out that treatment goal is important for treatment outcome, both in the treatment setting as well as in the patients themselves. However, to our knowledge, no study has so far investigated the interaction between patient's goal and the goal of the treatment setting. The aim of the study was therefore to study the interaction between these 2 factors on treatment outcome. METHODS: Patients' (n = 201) goals from 2 treatment settings-one that had an abstinence-oriented goal and one with a low-risk drinking goal-were investigated. The patients were followed up 2.5 years after treatment entry and effectiveness of congruent treatment goals on treatment outcome was investigated. RESULTS: There was no significant association between congruent goals and treatment outcomes (p = 0.060). However, when comparing the effectiveness of congruent treatment goal between the 2 treatment settings, the abstinence-oriented treatment setting was significantly more effective (p < 0.01). CONCLUSIONS: The major finding was that there appeared to be no association between congruence itself and treatment outcome. On the other hand, we found that the treatment outcome was more successful if the patient as well as the treatment setting had abstinence as a goal (i.e., congruent goals of abstinence).
Assuntos
Alcoolismo/psicologia , Alcoolismo/terapia , Cuidadores/psicologia , Tomada de Decisão Clínica/métodos , Objetivos , Necessidades e Demandas de Serviços de Saúde , Adulto , Alcoolismo/diagnóstico , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
BACKGROUND: Even in adulthood, the disabilities associated with fetal alcohol spectrum disorders (FASD) may have a major impact on life, but different environmental circumstances during childhood may also be influential. This study aimed to investigate placements in out-of-home care, and number of early separations from caregivers, related to psychosocial outcomes in adults with fetal alcohol syndrome (FAS). Additional analyses were then done on a subgroup's cognitive development and mental health. METHODS: Data on education and living with biological parents or in out-of-home care were obtained from childhood medical records on 51 adults (43% women), mean age 32, all diagnosed with FAS. Adult psychosocial outcomes (e.g. highest completed education, economic status, care due to alcohol or illicit drug abuse, mental health and conviction for crime) were obtained from national registers. RESULTS: No significant within-group differences related to the adult psychosocial outcomes were found. Psychiatric disorders, psychotropic drug prescriptions and crime convictions were equally common, regardless of whether placement in care was early or late, or whether the participants had experienced few or many early separations. CONCLUSIONS: We suggest that the findings illustrate the heterogeneity among individuals with FASD. Welfare authorities' decisions concerning special education and placement in out-of-home care should be tailored to each individual. Interventions from society are still needed for individuals with FAS over 22 years old.
Assuntos
Creches/estatística & dados numéricos , Transtornos do Espectro Alcoólico Fetal/psicologia , Transtornos de Início Tardio/psicologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto JovemRESUMO
BACKGROUND: Primary disabilities in children with fetal alcohol syndrome (FAS) are the results of alcohol's teratogen effect on the fetal brain. Reduced cognitive and executive functions and social cognition are examples of such disabilities. Little is known about primary disabilities in adults with FAS as well as their sense of coherence (SoC). There is thus a need for knowledge about FAS in adulthood. AIMS: To investigate cognitive and executive functions, social cognition and SoC in adults with FAS. METHODS: Twenty adults with FAS (mean age: 30 years) were compared with 20 individuals matched on gender and age. Berg's Card-sorting Test-64, the Tower of Hanoi, Raven's Coloured Progressive Matrices, Digit Span, Faux Pas and the Swedish version of Antonovsky's Sense of Coherence Scale (SoC-29) were used. RESULTS: The FAS group had a weak SoC and displayed deficits in the neuropsychological tests sensitive to cognitive and executive functions and social cognition. The FAS group's median SoC score was 112, lower than the comparison group's median of 133 (P < 0.001). The FAS group had median scores of 29.0 on Raven's Matrices. The median for Digit Span was 5 forwards and 3 backwards, lower than in the comparison group (P < 0.001). CONCLUSIONS: Reduced cognitive and executive functions and impaired social cognition are assumed to have a major impact on life for adults with FAS. We suggest that the findings showing that adults with FAS had a weak SoC, with particularly low scores on the manageability scale, reflect their experiences of living with those primary disabilities. CLINICAL IMPLICATIONS: This study may enhance healthcare for individuals prenatally exposed to alcohol. In general, it contributes with knowledge about this group of individuals who need to be more visible in healthcare, and particularly, it demonstrates some of the neuropsychological disabilities they might have.
Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Função Executiva , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Transtornos do Espectro Alcoólico Fetal/psicologia , Habilidades Sociais , Adulto , Estudos de Casos e Controles , Cognição , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Senso de Coerência , Comportamento SocialRESUMO
BACKGROUND: Reduced central serotonergic neurotransmission has been demonstrated in individuals with excessive alcohol consumption and/or alcohol dependence. Childhood maltreatment has also been found to have a negative impact on central serotonergic neurotransmission. The aim of this study was to evaluate the impact of childhood maltreatment on central serotonergic dysfunction in alcohol-dependent individuals. METHODS: Adult men with a diagnosis of alcohol dependence (n = 18) were recruited from outpatient treatment units for alcoholism. Central serotonergic neurotransmission was assessed by a neuroendocrine method, that is, the prolactin (PRL) response to the selective 5-HT reuptake inhibitor citalopram. Childhood maltreatment was assessed retrospectively by the Childhood Trauma Questionnaire. RESULTS: Alcohol-dependent individuals with childhood experience of emotional abuse had significantly lower PRL response compared with those without such abuse (3 ± 5 and 64 ± 24 mU/l, respectively; t = 6.51, p < 0.001). Among those who reported childhood emotional abuse, 4 of 7 individuals had flat PRL responses in comparison with none in those with no report of such abuse (p < 0.01). CONCLUSIONS: This is the first study to show that self-reported childhood maltreatment, in particular emotional abuse, in male alcohol-dependent individuals is associated with a quite dramatic (more than 90%) reduction in central serotonergic neurotransmission. It should, however, be noted that the number of individuals is relatively small, and the results should therefore be considered as preliminary.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis , Alcoolismo/fisiopatologia , Serotonina , Transmissão Sináptica/fisiologia , Adulto , Citalopram/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Prolactina/sangue , Prolactina/efeitos dos fármacos , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Inquéritos e QuestionáriosRESUMO
This study investigated how different doses of alcohol affected eyewitness recall. Participants (N = 126) were randomly assigned to three groups with different blood alcohol concentration (BAC), either a control group (mean BAC 0.00%, N = 42), a lower alcohol dose group (mean BAC 0.04%, N = 40), or a higher alcohol dose group (mean BAC 0.06%, N = 44). After consumption, participants witnessed a movie of a mock crime and were interviewed one week later. The main results showed that witnesses with the higher intoxication level recalled fewer details compared to witnesses with the lower intoxication level. The amount of alcohol consumed did not have an impact on the accuracy rate. No sex differences were found. The results are discussed in the light of past research. We conclude that more studies are needed before recommendations can be made to an applied setting.
Assuntos
Intoxicação Alcoólica/fisiopatologia , Etanol/farmacologia , Rememoração Mental/efeitos dos fármacos , Rememoração Mental/fisiologia , Adulto , Intoxicação Alcoólica/sangue , Etanol/sangue , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Background: Heritability of alcohol use disorders (AUDs) varies widely, with reported estimates of 30-78% in twin studies. This variation might be due to methodological differences (e.g., using different thresholds for AUDs, age differences between samples). Aim: To investigate the heritability of AUDs in a nation-wide sample of male and female twins in late adolescence (18 years). Participants: The study is based on data from 8,330 18-year-old Swedish monozygotic (MZ) and dizygotic (DZ) twins from the Child and Adolescent Twin Study (Sweden). Method: Univariate sex-limitation twin analyses were performed using (a) total AUDIT score, (b) different AUDIT cut-offs (AUDIT-10: potentially harmful alcohol use and most likely alcohol dependent ; AUDIT-C: potential hazardous alcohol consumption/active alcohol use disorders), and (c) a risk-group classification for alcohol dependence based on AUDIT total score. Results: Prevalence of potential hazardous alcohol consumption/active alcohol use was 57.1%, and for potentially harmful alcohol use prevalence was 26.5%. Prevalence was higher among females (59.0% and 31.1% respectively) than males (54.4% and 20.0% respectively). Overall, the results of the univariate model fitting indicated that there were qualitative sex differences in the genetic and environmental influences on AUDs, with generally moderate heritability estimates ranging between 0.37 and 0.50. Discussion: At odds with previous research, a harmful/hazardous drinking pattern was more common in this age group among females than a low-risk drinking pattern (where males were overrepresented). Heritability estimates were moderate throughout all measures and cut-offs, with equally high contributions from shared and non-shared environment. Sex-limitation models revealed qualitative sex differences for AUDs, suggesting that different genetic and/or environmental factors influence variation in AUDs in males and females.
RESUMO
BACKGROUND: Alcohol dependence has been associated with reduced function of serotonin, dopamine as well as noradrenaline activities in several neuroendocrine studies. To our knowledge, there is, however, no study investigating all these 3 systems with the use of neuroendocrine methods in one and the same alcohol-dependent individual. METHODS: Alcohol-dependent individuals (n = 42) and controls (n = 28) participated in the neuroendocrine test series. Central serotonergic neurotransmission was assessed by the prolactin (PRL) response to citalopram (CIT). The postsynaptic DRD2 function was measured by the growth hormone (GH) response to apomorphine (APO) and the postsynaptic α2-adrenoceptor function by GH response to clonidine (CLON). RESULTS: In the alcohol-dependent individuals, the PRL concentrations were significantly lower at the time points 240 minutes and 300 minutes after CIT administration and mean delta PRL value was significantly reduced by 45% in comparison with controls. There were no significant differences in APO-GH and CLON-GH concentrations at any time points or in mean delta GH values between the groups. An impaired monoaminergic profile, including all 3 systems, was significantly more frequent in alcohol-dependent individuals than controls (43% vs. 6% respectively). CONCLUSIONS: The monoaminergic dysfunction was restricted to an impairment of the serotonergic system, suggesting that this system is especially vulnerable to long-term and excessive alcohol consumption. Moreover, impaired monoaminergic profiles, including low responses in 2 or 3 systems, were more frequently observed in alcohol-dependent individuals than in controls. Such impaired profiles may be of clinical importance, but further studies are needed.
Assuntos
Alcoolismo/sangue , Dopamina/sangue , Norepinefrina/sangue , Serotonina/sangue , Adulto , Alcoolismo/diagnóstico , Biomarcadores/sangue , Estudos de Casos e Controles , Citalopram/farmacologia , Clonidina/farmacologia , Feminino , Hormônio do Crescimento Humano/sangue , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Sistemas Neurossecretores/efeitos dos fármacos , Sistemas Neurossecretores/metabolismo , Prolactina/sangueRESUMO
Components of the brain reward system, i.e. the mesolimbic dopamine, laterodorsal cholinergic and ghrelin signaling systems, have been implicated in alcohol reward in preclinical studies. Genetic variants of these systems have previously been linked to alcohol dependence. Here, we genotyped 31 single nucleotide polymorphisms (SNPs): 1 SNP in the dopamine D2 receptor (DRD2) gene, 20 SNPs in 5 different nicotinic acetylcholine receptor subunit (CHRN*) genes, and 10 SNPs in the genes encoding pro-ghrelin (GHRL) and its receptor (GHSR), in a pilot study of type 1 alcoholics (n = 84) and healthy controls (n = 32). These individuals were characterized using the Temperament and Character Inventory. None of the SNPs were associated with risk of alcohol dependence in this population. The GG genotype of SNP rs13261190 in the CHRNB3 was associated with increased novelty seeking, while SNPs of the ghrelin signaling system were associated with decreased self-directedness (AA of rs495225, GHSR) and alterations in self-transcendence (AA of both rs42451 and rs35680, GHRL). In conclusion, this pilot study suggests that reward-related genes are associated with altered personality scores in type 1 alcohol dependence, which warrants future studies of these associations in larger study samples.
Assuntos
Alcoolismo/psicologia , Grelina/genética , Personalidade/genética , Polimorfismo de Nucleotídeo Único/genética , Receptores de Grelina/genética , Receptores Nicotínicos/genética , Recompensa , Adulto , Alcoolismo/genética , Estudos de Casos e Controles , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Determinação da Personalidade , Projetos Piloto , Receptores de Superfície Celular/genética , Receptores de Dopamina D2/genéticaRESUMO
AIMS: The TaqIA polymorphism of the dopamine D2 receptor (DRD2) gene has been extensively studied in relation to alcoholism, and the TaqI A1 allele appears to be over-represented in alcohol-dependent individuals. In a recent study, this allele has also been associated with a highly increased mortality rate in alcohol-dependent individuals. In the present study, we investigated whether the TaqI A1 allele of the DRD2 gene region was associated with a higher relapse rate in alcohol-dependent individuals. METHODS: Adult women (n = 10) and men (n = 40) with a diagnosis of alcohol-dependence were recruited from two Swedish 12-step treatment units for alcoholism. Subjects were genotyped for the TaqIA polymorphism. On average, 1½ year after the end of the treatment program, subjects were re-interviewed by using the alcohol-related items from the Addiction Severity Index follow-up version. RESULTS: Thirty-three (66%) subjects self-reported relapse and 17 (34%) abstinence during the follow-up period. Thirty-sex percent (18/50) were carriers of the A1 allele of the DRD2 gene region, and 64% (32/50) were non-carriers. Among the carriers of the A1 allele, 89% (16/18) reported relapse in contrast to 53% (17/32) in the non-carriers (P = 0.01; odds ratio = 7.1). CONCLUSION: The present study is, to our knowledge, the first report of an association between the TaqI A1 allele and a substantially increased relapse rate. It should be emphasized that the number of subjects is relatively small, and this investigation should therefore be considered as a pilot study.
Assuntos
Alcoolismo/genética , Receptores de Dopamina D2/genética , Adulto , Alcoólicos , Alcoólicos Anônimos , Alcoolismo/epidemiologia , Alelos , Depressores do Sistema Nervoso Central/farmacologia , Doença Crônica/epidemiologia , Etanol/farmacologia , Feminino , Genótipo , Humanos , Entrevista Psicológica , Masculino , Projetos Piloto , Polimorfismo de Nucleotídeo Único , Escalas de Graduação Psiquiátrica , Recidiva , Fatores de Risco , TemperançaRESUMO
The existence of an "addictive" personality has been extensively debated. The current study investigated personality in male individuals with excessive alcohol consumption (n=100) in comparison to a population-based control group (n=131). The individuals with excessive alcohol consumption were recruited by advertisements in a regional daily newspaper and controls from a population based Swedish Twin Registry. Personality was assessed by the Karolinska Scales of Personality (KSP). Comparisons were made with normative data. Furthermore, by using a multivariate projection-based approach (Principal Component Analysis; PCA), hidden structures of traits and possible relationships among the individuals with excessive consumption and the controls was investigated. The individuals with excessive alcohol consumption as well as the controls had mean values within the normative range in all scales of the KSP. Moreover, the PCA analysis revealed no systematic between-group separation. Taken together, this result demonstrates that male individuals with excessive alcohol consumption do not have a personality different from that of a general population, which supports the notion of no "addictive personality".