Gender Differences among Sardinians with Alcohol Use Disorder

Roberta Agabio,Luigi Minerba,Flavia Franconi,Claudia Pisanu,Gian Luigi Gessa

doi:10.3390/jcm10204688

Roberta Agabio, Luigi Minerba + Show 3 more

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https://doi.org/10.3390/jcm10204688

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Abstract

Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol use disorder (AUD). Knowledge of these characteristics in AUD patients is useful to improve access to treatments. This paper investigated the drinking characteristics of 66 female and 282 male outpatients with AUD, born from 1937 to 1991, living in Sardinia, and compared their characteristics with those of AUD patients living in other countries. Most Sardinian patients were men, approximately 3 years younger than women; women consumed lower amounts of alcohol than men but did not differ from men in the severity of AUD. Men were more often single than women, while a higher proportion of women reported that their mother or spouse was affected by AUD. Anxiety and depression were more prevalent among women while a higher proportion of men were affected by substance use disorders. Women were older than men at the age of first drink, regular drinking, and onset of AUD, and progressed faster than men from regular use to AUD onset. Women did not differ from men in age at first request for care, and in the lapse from AUD onset to first request for care. Women and men waited for more than 8 and 9 years, respectively, before receiving medical treatment. Gender differences progressively decreased among younger patients. Although the scarce number of women in some cohorts limits the strength of these findings, drinking characteristics of Sardinian patients did not vary significantly from those of AUD patients living in other countries. These results suggest that the number of Sardinian women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD.

Highlights

The study was conducted in a large area in Sardinia, Italy with approximately 550,000 adult inhabitants and four public healthcare facilities that provide outpatient treatment for alcohol use disorder (AUD)
Genetic factors have a major role in the development of AUD
Twin and adoption studies have shown that half the risk of developing AUD is heritable [70] and several genome-wide association studies (GWASs) have found significant associations between AUD and genes encoding alcohol-metabolizing enzymes, with significant differences between populations [71]

Summary

Introduction

The majority of studies on drinking characteristics of patients with AUD have been performed largely in Northern countries [5,6]. Sardinia has a low socioeconomic status, with a gross domestic product equal to 70% of the European average, and a low level of education, attested to by a low number of university graduates [10]. The latter aspects are important due to the fact that in low- and middle-income countries, the impact of gender diverges between countries and regions [11–13], with intraregional variations being smaller [11]. A higher convergency between men and women in drinking characteristics has been documented in countries with a lower gender gap [14–18], such as the United States [5,6,19–33], Canada [34], Germany [35,36], UK [37], and Australia [38]

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