Course Of Alcohol Dependence Research Articles

The affective temperaments as a prognostic factor in the course of alcohol addiction – a key to enhance diagnoses and therapy?

The paper outlines the role of affective temperaments, as defined by Akiskal, in the development and maintenance of alcohol use disorders with a particular focus on the clinical course of addiction. Among affective temperaments, a cyclothymic temperament seems to play a key role in the development and maintenance of alcohol use disorders, and have the greatest influence on the clinical course of addiction. A high cyclothymic score is associated with inter alia an earlier onset of drinking and alcohol dependence, a negative course of alcohol dependence, relapse and alcohol craving. The structure of affective temperaments is also a predictor of suicidal behavior and drug addiction in the alcohol addict population. Interest has been growing regarding the role of affective temperament in the development and course of alcohol dependence; however, further research in this area is needed. An understanding of the temperamental determinants of alcohol dependence in the affective dimension may significantly support diagnostic and therapeutic procedures. Affective temperament profile may be suggestive of alcohol use disorders and may be a primary prognostic factor of craving and relapse, potential suicide, treatment motivation and the co-occurrence of drug dependence among patients with alcohol use disorder.

СРАВНИТЕЛЬНЫЙ АСПЕКТ ФОРМИРОВАНИЯ АЛКОГОЛЬНОЙ ЗАВИСИМОСТИ, АССОЦИИРОВАННОЙ С КОГНИТИВНЫМИ РАССТРОЙСТВАМИ, У ЖЕНЩИН В РАЗЛИЧНЫХ ЭТНИЧЕСКИХ ПОПУЛЯЦИЯХ

Background. The development of alcohol dependence in women associated with cognitive impairment has different degrees of severity in different ethnic populations in the Siberian region: Tuvan and Russian ethnic groups. The comparative aspect of the study is important in assessing the typology and course of alcohol dependence in women of different ethnic backgrounds. Objective. To study the features of the development of alcohol dependence and cognitive impairment in women of Tuvan and Russian ethnic backgrounds. Materials and methods. The study included two groups of women with alcohol dependence. The first group consisted of 78 women of Tuvan nationality (mean age 41.6±9.9 years), who were treated in the Republican Narcological Dispensary of the Republic of Tyva. The second group consisted of 66 women of Russian nationality (mean age 41.6±9.0 years), who were treated in the Department of Addictive States of the Research Institute of Mental Health of the Tuvan National Research Medical Center. Clinical-psychopathological, psychological, mathematical-statistical methods were used. Results. In women of Tuvan nationality, the development and formation of alcohol dependence (from the appearance of the first signs to the development of withdrawal syndrome) occurs progressively. They are characterized by a high degree of psychotic forms of alcoholism, which develop after 5-6 years of alcohol abuse, compared to Russian women, in whom the first alcoholic psychosis develops only after 14-15 years of alcohol abuse. In 16.7% of Tuvan women, psychosis acquired a tendency to frequent recurrence. Typical stereotypy in pictograms is associated with alcoholic psychosis. Excessive typical stereotypy was found on pictograms in 50% of Tuvan patients and 30.4% of Russian patients without a history of alcoholic psychosis; In the subgroups of female patients who suffered from alcoholic psychoses, this feature was found in 72.41% of Tuvan and 66% of Russian women. Conclusion. The identified clinical and psychopathological symptoms confirm the progressive development of alcohol dependence in women of Tuvan ethnicity. Cognitive impairments are characterized by the monotony of associative connections, a decrease in the level of generalization, and the volume of working memory.

Some factors affecting on the severity of Acute Psychoses in Alcohol Withdrawal

IntroductionAlcohol withdrawal delirium is severe complication of alcohol withdrawal leading to high mortality. Early identification of severe course of psychosis and complications threatening the patient’s life is the most important problem in the treatment of these patients.ObjectivesUnder supervision were 690 men, dependent on alcohol, in the state of withdrawal with acute psychotic disorder (primary hospitalization in the framework of this study); the average age - (39,9 ± 3,4 years), the average age of alcohol abuse - (9,7 ± 1, 1 years). The patients were examined in a dynamics after a re-hospitalization after 5-7 years. This allowed us to verify the differential diagnostic approach to acute psychotic disorders in a state of abandonment, to investigate the impact of chronic acute psychotic disorders on the course of alcohol dependence, including the formation of deficits.Methodsclinical, clinical and psychopathological, methods of quantified scales and mathematical statistics.ResultsThere were estimated factors influencing the severity of alcohol withdrawal with delirium: total amount of alcohol consumed per week, drunken alcoholics, persistent alcohol abuse, social disadaptation, cognitive impairment, psychological disorders, reducing the quality of alcohol consumed, food pattern characterized total calorie mostly due to alcohol, life trajectory, severe or chronic somatic diseases, rate of progression of alcohol dependence.ConclusionsThe severity of acute psychotic disorder in the state of alcohol withdrawal mostly depended situational factors such as the number of days of severe drinking before a psychotic disorder, the pattern of nutrition, the quality and quantity of alcohol consumed, the presence of acute somatic diseases.DisclosureNo significant relationships.

Severity of depressive symptomatology and socio-demographic characteristics of patients with alcoholism in the Republic of Dagestan depending on territorial patterns of residence

Introduction. Living in urban and rural areas can affect the risk of developing and the course of alcohol dependence and comorbid conditions. The aim of the work was to evaluate the degree of depressive symptoms and socio-demographic characteristics of patients with alcoholism in the Republic of Dagestan, depending on the territorial features of residence. Materials and methods. The study involved 104 patients aged 51.2±9.9 years (27 to 74 years), registered in the State Budgetary Institution «Republican narcological dispensary» of the Republic of Dagestan with a diagnosis of alcohol dependence. The patients were divided into 2 groups depending on the territorial features of their residence: 62 (59.6%) patients residing in urban areas and 42 (40.4%) residing in rural areas. In order to evaluate socio-demographic characteristics all patients were questioned. The degree of severity of depressive symptoms was assessed with the Beck scale. Results. Analysis of alcohol dependence characteristics revealed no differences between the groups (p>0.05). The degree of depression was found to be more pronounced in patients living in rural areas than in those living in urban areas: mild depression was 7.3% and 29.0% (p<0.05), moderate depression was 9.8% and 1.6% (p<0.05), and severe depression was 39.0% and 25.8% (p<0.05), respectively. The severity of depression correlated with the presence of work in patients (r=0.324; p<0.001). Discussion. Alcohol consumption leads to a more severe manifestation of depression, contributing to physiological changes in the body. Conversely, depressed people are more prone to uncontrolled alcohol consumption, which in their subjective opinion alleviates psychosocial suffering. The connection between alcohol abuse and depressive symptoms is bidirectional, meaning that both of these disorders influence the development and course of the other and simultaneously exacerbate the risk of developing the other disorder. Conclusions. Alcohol-dependent individuals living in rural areas of the Republic of Dagestan are characterized by unemployment that correlates with anxiety-depressive symptoms, as well as a more severe degree of depression severity.

Neuroendocrine factors - predictors of the formation of alcohol dependence and human ecology in various ethnic populations, new approaches to therapy

IntroductionIntegrated clinical and biological approaches in the study of disorders caused by alcohol consumption in people of different ethnic groups, are important for determining effective treatment strategies.ObjectivesTo study the clinical and dynamic features and the role of neuroendocrine factors of the formation and course of alcohol dependence in individuals of Tuvan ethnicity.Methods68 Russian alcoholics and 67 Tuvans alcoholics only men and 20 healthy male were monitored. Clinical assessment of the condition of patients was carried out with the traditional clinical description. Enzyme-linked immunosorbent assay kits were used to determine serum hormone levels in patients and volunteers.ResultsThe systematic consumption of alcoholic beverages develops among Tuvans in adulthood, in contrast to Russian men who begin to drink systematically young. Alcohol dependence in people of Tuvan nationality are formed several years later than in Russians: a symptom of loss of quantitative control over use was detected in Tuvans at 36.9±9.9 years, in Russian patients at 29,8±7.5 years; the formation of withdrawal syndrome in Tuvans occurs at the age of 37.7±8.4 years, unlike Russians, in whom the withdrawal syndrome develops on average at the age of 29.6±6.0 years. The index of the ratio cortisol/progesterone in the blood of examined Russian alcoholics is almost twice as high as the index of examined healthy donors; in patients of Tuvan ethnicity, index is almost five times higher.ConclusionsAlcohol dependence among representatives of the Tuvan ethnic group indicates a greater vulnerability to the effects of alcohol.DisclosureNo significant relationships.

Characteristics Of The Clinic And The Course Of Sonata Addiction Preceding The Formation Of Complicated Alcoholism

The clinical characteristics and the course of alcohol dependence, preceding the formation of a complicated sonata were studied in 60 patients. A study of the clinical characteristics and the course of alcohol dependence preceding the formation of a complicated sonata was carried out in 60 patients. It has been established that in most cases, the introduction to sonatas occurs against the background of an expanded stage of previous alcoholism, characterized by a rapid rate of development and high progression.

A Prospective Comparison of Bipolar I and II Subjects With and Without Comorbid Alcohol Dependence From the COGA Dataset.

Objective: Comorbidity of alcohol use disorders in bipolar subjects is high as indicated by epidemiological and clinical studies. Though a more severe course of bipolar disorder in subjects with comorbid alcohol dependence has been reported, fewer studies considered the longitudinal course of alcohol dependence in bipolar subjects and the prospective course of comorbid bipolar II subjects. Beside baseline analysis, longitudinal data of the COGA (Collaborative Study on Genetics in Alcoholism) were used to evaluate the course of bipolar I and II disordered subjects with and without comorbid alcohol dependence over more than 5 years of follow-up.Methods: Characteristics of bipolar disorder, alcohol dependence and comorbid psychiatric disorders were assessed using semi-structured interviews (SSAGA) at baseline and at a 5-year follow-up. Two hundred twenty-eight bipolar I and II patients were subdivided into groups with and without comorbid alcohol dependence.Results: Of the 152 bipolar I and 76 bipolar II patients, 172 (75, 4%) had a comorbid diagnosis of alcohol dependence. Bipolar I patients with alcohol dependence, in particular women, had a more severe course of bipolar disorder, worse social functioning and more suicidal behavior than all other groups of subjects during the 5-year follow-up. In contrast, alcohol dependence improved significantly in both comorbid bipolar I and II individuals during this time.Conclusions: A 5-year prospective evaluation of bipolar patients with and without alcohol dependence confirmed previous investigations suggesting a more severe course of bipolar disorder in comorbid bipolar I individuals, whereas bipolar II individuals were less severely impaired by comorbid alcohol use disorder. While severity of alcohol dependence improved during this time in comorbid alcohol-dependent bipolar I patients, the unfavorable outcome for these individuals might be due to the higher comorbidity with personality and other substance use disorders which, together with alcohol dependence, eventually lead to poorer symptomatic and functional clinical outcomes.

M.P. Mussorgsky: interrelation of creativity and alcoholism

The article is devoted to the study of the circumstances of life, illness and creativity of the famous composer Modest Mussorgsky in aspects of possible influence of alcohol intake. For the purpose of retrospective diagnosis of alcohol dependence, and also for assessing the possibility of its impact on the composer's creativity, a pathographic analysis of publications about Modest Mussorgsky health throughout his life was carried out. A study of the letters of M.P. Mussorgsky, the memoirs of his contemporaries, the works of the composer's biographers, as well as the analytical studies of specialists in retrospective diagnostics showed that alcohol dependence negatively affected his creative activity. However, despite the progressive, clearly malignant course of alcohol dependence, the composer's professional skills evolved until the last days of his life. It is no less significant that in the most unfavorable periods of life, the composer wrote his most significant works. Often, Mussorgsky's music in its positive emotional content contrasts sharply with the grim realities of his life. There is no doubt that the composer's work was his only effective means of combating both alcohol addiction and life's hardships.

Study of the polymorphic variants of the PIP5K2A gene association with the comorbidity of alcoholism and affective disorders

One of the common pathogenetic mechanisms of the formation of alcohol dependence and depressive disorders can be a violation of the neurotransmitter systems, in particular — dopamine. Phosphatidylinositol-4-phosphate-5-kinase type 2 alpha (PIP5K2A) plays an important role in the regulation of neuronal excitability and synaptic dopamine neurotransmission. The aim of this study was to assess the presence of associations of the PIP5K2A gene polymorphic variants with the comorbid course of alcohol dependence and depressive disorders. This study showed differences in the frequency of the genotype distribution of 3 PIP5K2A gene polymorphisms (rs946961, rs1132816, and rs1417374) both between patient groups compared with the control group, and between the patient group and the group with the comorbid course of disorders.

Basic Human Body Dimensions Relate to Alcohol Dependence and Predict Hospital Readmission.

Alcohol dependence is a severe mental illness and there is a need for more effective preventive and therapeutic strategies. Translational research suggests that intrauterine sex hormone exposure modulates the risk and course of alcohol dependence during adulthood. During development, sex hormones permanently shape sexually dimorphic body dimensions. Thus, these dimensions may provide insight into sex hormone organization. Here, we compared body measurements (absolute, relative to, and residualized on height) between 200 alcohol-dependent in-patients and 240 age-matched healthy control subjects and investigated how these measurements associate with the patients’ prospective 12- and 24-month outcome. The results show that alcohol dependence is related to lower absolute, relative, and residualized body measurements for height and weight, head circumference, bitragion head arc, lip-chin distance, hip, thigh, and calf circumference, and foot length and breadth. In male alcohol-dependent in-patients, higher risk, shorter latency, and more alcohol-related readmissions were predicted by higher absolute, relative, and residualized thigh and calf circumferences. The second-to-fourth finger length ratio, a putative proxy for prenatal sex hormone organization, was not convincingly correlated with the body dimensions, suggesting that the results represent pubertal (or later) effects. The study’s findings have implications for further research. The body measurements’ high accessibility may facilitate the future transition into clinical settings.

Биопсихосоциальные предикторы клинического течения алкогольной зависимости у женщин

Биопсихосоциальные предикторы клинического течения алкогольной зависимости у женщин

Нарушения проспективной способности как возможный патогенетический механизм алкогольной зависимости

The article presents a taxonomy of prospective capacity (PC) relying on the up-to-date understanding of its neurobiological and psychological mechanisms. The rationale for the existence of a dissociation between adaptive and maladaptive manifestations of explicit and implicit forms of PC rests on a study of clinical cases of alcohol-dependent patients (N=5) and adult children of alcoholics (N=1), who ap plied for outpatient psychotherapy of alcohol dependence or related issues. The patients underwent specific semi-structured interviews (Shustov et al., 2000; Johnsson, 2011); completed the Life Line method (Nurkova, 2000) and compiled genograms (McGoldrick et al, 2008). Based on the findings of clinical case studies, the authors have proposed that alcohol-dependent patients’ PC deficits that aggravate the course of alcohol dependence may relate to the existence of socially and culturally bound automatic prospective schemata, i.e. scripts that relate to specific states of self and actualize under uncertainty, stress and/or alcohol intoxication.

OPRM1 A118G and serum β-endorphin interact with sex and digit ratio (2D:4D) to influence risk and course of alcohol dependence

Activation of mesolimbic mu-opioid receptors by their endogenous ligand, β-endorphin, can mediate the rewarding effects of alcohol. However, there is conflicting evidence on the relationship between the mu-opioid receptor (OPRM1) A118G single nucleotide polymorphism (SNP) and alcohol dependence risk. Preclinical evidence suggests that sex and sex hormone-dependent prenatal brain organization may interact with the opioid system to influence alcohol drinking behavior. We genotyped 200 alcohol-dependent patients and 240 healthy individuals for the OPRM1 A118G SNP and measured serum β-endorphin level at recruitment and after acute withdrawal. We then determined the association between these factors and alcohol dependence risk and 24-month outcome in the context of both sex and second-to-fourth digit lengths ratio (2D:4D) – a biomarker of prenatal sex hormone levels. The OPRM1 A118G AA genotype associated with elevated risk of alcohol-related hospital readmission, more readmissions, and fewer days until first readmission in male patients only. After normalizing patient 2D:4D against control 2D:4D, we found that normalized 2D:4D ratios were lower in male 118G patients than male AA patients, suggesting prenatal androgens interact with OPRM1 to influence alcohol dependence risk. In addition, β-endorphin levels after acute withdrawal correlated negatively with withdrawal severity in females but not in males, which may indicate β-endorphin protects against withdrawal-induced stress in a sex-specific manner.

An overlooked issue: sexual dysfunctions in men addicted to alcohol

Abstract Introduction According to the data obtained in the EZOP Poland study (2015), the prevalence of alcohol dependence in lifetime in Poland amounts to about 2.2% of the population, entailing enormous social, family and personal harm, including health damage. It is estimated that about 72% of alcohol-dependent patients complain about one or more problems related to the sexual sphere, which may result from both the development of somatic complications in the course of alcohol dependence, and from psychiatric complications that themselves can lead to sexual dysfunction. There are reports and clinical observations indicating that the occurrence of sexual dysfunction (SD) can affect the shortening or interruption of the period of abstinence. Aim The aim of this work is to show sexual dysfunctions in alcohol-dependent men and to discuss the factors that may affect the occurrence of the above-mentioned dysfunctions. Material and methods The available literature was reviewed using Medline, Google Scholar and ScienceDirect browsers by entering the keywords: alcohol dependence, sexual dysfunction, comorbidity, alcohol-caused diseases and time descriptors: 1979-2016. Results • Alcohol dependence is associated with the occurrence of various types of sexual dysfunctions (SD). • The diagnosis of SD should take into account all possible causes that may lead to the development of SD in this group of patients, including the comorbidity of somatic diseases or the negative impact of drugs on sexual function. • Occurrence of SD is connected with a higher risk of abstinence interruption. • There is a need to carry out more research in order to better understand the relationship between alcohol dependence and the prevalence of sexual dysfunctions.

The association between impulsivity, emotion regulation, and symptoms of alcohol use disorder

Emotion dysregulation and impulsivity are important factors influencing the development and course of alcohol dependence. However, few empirical studies investigate the association between different aspects of impulsivity (cognitive, attentional, behavioral), emotion regulation, and alcohol use disorder symptoms in the same model. The goal of this study was to assess the association between emotion regulation and different facets of impulsivity among patients with an alcohol use disorder and healthy controls. The sample was comprised of 273 individuals: 180 participants with an alcohol use disorder undergoing inpatient alcohol treatment and 93 healthy controls. Emotion regulation was assessed using the Schutte Self-Report Emotional Intelligence Test subscale. Impulsivity was assessed with Barratt's Impulsiveness Scale (BIS-11). Statistical models tested both the BIS-11 total score, as well as three secondary factors (non-planning, attentional, and motor impulsivity). Findings indicate that individuals with alcohol use disorder symptoms were characterized by poor emotion regulation and high levels of impulsivity in all analyzed domains. Moreover, path analytic models indicated that after accounting for demographic factors (i.e., biological sex, age, education) there was evidence for a significant indirect effect of alcohol use disorder symptomatology on non-planning and attentional impulsivity via emotion regulation. There was no association between emotion regulation and motor impulsivity. These findings indicate the importance of targeting emotion regulation skills as well as behavioral control when treating patients with alcohol use disorder.

SPECIFICITIES OF CLINICAL ARRANGING ALCOHOLIC REMEDY IN PERSONS WITH VARYING LEVELS OF PSYCHOSOCIAL STRESS

The article noted that in recent times Ukraine has been characterized by the presence of a significant number of stress factors, as a result of which an increase in the long-term stress load occurs. It is indicated that this forms a number of adverse factors affecting the increase in the use of psychoactive substances in the community, first of all, of alcohol. To the fore among these factors, above all, is the action of superstrong stressors, such as political and economic instability and fighting in the east of Ukraine. It was stated that taking into account the systemic interaction of these stress loads (political and economic instability and combat actions), approaches to the treatment of alcohol dependence with comorbid post-stress states should be based on biopsychosocial bases, and the existing therapeutic and rehabilitative strategies should be significantly modified according to the formation and course of this dependence.To understand the ways of modifying existing therapeutic and rehabilitation strategies, taking into account the aggravating effect of stress on the formation and course of alcohol dependence, we analyzed the characteristics of the clinical arrangement of alcohol dependence in individuals with various psycho-traumatic experiences and levels of psychosocial stress. It was established that the clinical symptoms of alcohol dependence in general were more variable in the group of combatants, slightly less - among immigrants; and the differences between the two groups in the overwhelming majority of symptoms are not significant. Local residents showed a significantly smaller variety of clinical symptoms of alcohol dependence, although in general the prevalence rates of its manifestations in all three groups are comparable. Significantly more pronounced differences in clinical symptoms were found when analyzing it, taking into account the level of psychosocial stress, which suggests this factor determining the clinical variability of alcohol dependence. The findings suggest that the degree of vulnerability to psychosocial stress and response to it are the leading factors in determining the clinical arrangement of alcohol dependence. Indicators of participation in hostilities or forced displacement also have a certain value, but their effect on the variability of the clinical symptoms of alcohol dependence is less.

Efficiency of Cocarnit preparation in clinical course of alcohol dependence at withdrawal syndrome stage

IntroductionRecently scientific attention of Ukrainian narcology was focused on the group of new complex pharmacological preparations with polymodal pathogenic effect option (Cocarnit, World Medicine, Great Britain).Aims and objectivesTo ground feasibility of Cocarnit application in complex treatment of alcohol withdrawal syndrome (AWS).MethodEleven patients with alcohol addiction were examined. An integrated research of relieving and adjuvant effects of pharmacological preparation Cocarnit in complex with traditional detoxication therapy in clinical course of alcohol dependence at AWS stage was carried out. One to 2 ampoules of Cocarnit were injected intramuscularly once per 24 hrs, № 6.MethodsClinical-psychopathological, clinical-laboratory, consulting of specialists, methods of psychological investigation (CIWA; САН; SF-36) at day 1, 7 and 14 of treatment.ResultsAWS quantification score on admission was 41. Further therapeutic regress of all AWS components was registered. At day 1 the patient's condition started improving, clinical score was 32; at day 3 – 17; day 5 – the score was 13, insignificant tremor remained. At day 7 of treatment, practically complete relieving effect of the therapy was ascertained. With САН method at day 7 of the treatment, an increase of figures in all scales was registered: state of health 2.7, activity 2.4, mood 2.5. SF-36 method: at day 1 – the score was 24, day 7 – 32, day 14 – 49.ConclusionsThus, the developed by us method of integrated treatment with inclusion of Cocarnit for withdrawal state in alcohol addicts allows to stop acute signs of pathology within 3–5 days.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Impact of Zonisamide on the Development and Course of Alcohol Dependence in Rabbits. A pharmaco-EEG study.

Zonisamide is a new anti-epileptic drug whose mechanism of action is associated with neurotransmission systems also involved in the pathogenesis of addiction. Recently, the role of memory processes and the hippocampus (Hp) is underlined in dependence. In our previous study, we determined that zonisamide decreases changes in hippocampal bioelectric activity induced by a single dose of ethanol. This study uses a pharmaco-EEG method to examine the impact of zonisamide on the development and course of alcohol dependence in rabbits. Quantitative changes in EEG were observed in the midbrain reticular formation, Hp and frontal cortex. Zonisamide was administered p.o. once a day at dose of 30 mg/kg/day during the entire experiment. Solutions with increasing concentrations of ethanol were administered for 6 weeks, followed by a 2-week period of abstinence. The long-term administration of ethanol caused characteristic changes in rabbit EEG recordings, which were associated with a shift toward lower frequencies resulting in a depressive effect on the bioelectric activity of selected brain structures. Co-administration of zonisamide and ethanol caused a reduction of ethanol-induced alterations. Changes in EEG recordings were different during period of abstinence and were associated with potent shift toward the high frequencies. Zonisamide significantly decreased encephalographic features of neuronal hyperactivity when administered during the abstinence. Zonisamide decreases ethanol- and abstinence-induced changes in the EEG recordings. These effects may be a significant part of drug's mechanism of action in alcohol addiction therapy. A pharmaco-EEG method was used to determine the influence of a new anti-epileptic drug zonisamide on the development and course of alcohol dependence in rabbits. The drug co-administered with ethanol decreased alcohol-induced changes in selected brain structures. Zonisamide also decreases abstinence-induced changes in the EEG recordings.

Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors

ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD) and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 53 adults who were in treatment for alcohol dependence at a Brazilian public university outpatient service. Assessment instruments Social Phobia Inventory (SPIN), Short Alcohol Dependence Data and Beck Depression Inventory. Bivariate analyses between the categorical outcome (Probable SAD: SPIN ≥ 19) and explanatory variables were conducted. Correlates of SPIN total and subscales scores (dimensional outcomes) were also investigated. Results The diagnosis and treatment of alcohol dependence occurred, on average, 30 years after the onset of alcohol use and 39.6% of the 53 patients (37 men and 16 women) reported alleviation of social anxiety symptoms with alcohol use. Twenty-four (45.3%) patients presented probable SAD. These patients differed from non-SAD alcohol-dependent individuals by having lower income and higher frequency of depression, suicidal ideation, suicide plans and attempts. The SPIN subscales mostly associated with suicidal behaviors were social inadequacy and social inferiority. Conclusions SAD symptoms are common among help-seeking alcohol-dependent individuals and should be directly investigated and treated, since depression and suicidality are associated with this comorbidity. Prospective studies are needed to assess the impact of SAD treatment on the clinical course of alcohol dependence.

Physical pain and impulsivity in alcohol-dependent patients

Background: Physical pain and impulsivity are considered to be prevalent and significant factors that influence the course of alcohol dependence. The aim of the study was to investigate relationships between different dimensions of impulsivity and the current experience of physical pain in individuals entering alcohol treatment.Method: A sample of 366 (73.5% men and 26.5% women) DSM-IV alcohol-dependent subjects was recruited in alcohol treatment centers in Poland. The study sample was divided into a ‘mild or no pain’ group (65.6%) and a ‘moderate or greater pain’ group (34.4%). Levels of impulsivity were measured by the stop-signal task as well as the total and subscale scores of the Barratt Impulsiveness Scale (BIS-11).Results: The experience of physical pain was significantly associated with higher levels of impulsivity as measured by both total BIS-11 scores and longer stop reaction times. Physical pain remained as independent correlate of behavioral impulsivity (stop reaction time) and the BIS-11 subscale of attentional impulsivity while controlling for other variables. An additional analysis revealed that BIS-11 scores were not associated with stop reaction times.Conclusions: Physical pain is an independent correlate of both subjectively reported and objectively measured levels of impulsivity. Therapeutic interventions aimed at reducing pain in alcohol-dependent individuals should be studied to evaluate their impact on improving attention and behavioral control.