Early-onset Alcohol Dependence Research Articles

Adult Attention Deficit Hyperactivity Disorder and Its Correlates with the Presence and Severity of Early-onset Alcohol Dependence: An Estimate from a Tertiary Care Center

Adult Attention Deficit Hyperactivity Disorder and Its Correlates with the Presence and Severity of Early-onset Alcohol Dependence: An Estimate from a Tertiary Care Center

Externalizing psychopathology and cognitive functions in patients with early- and late-onset alcohol dependence.

Background:Alcohol use disorder is attributing to a significant health-care burden worldwide. Early-onset alcohol dependence is associated with more adverse outcomes than those with late-onset alcohol dependence. Comorbid externalizing disorders and cognitive deficits may be associated with the negative outcomes in early-onset alcohol dependence. This study aims at exploring the externalizing psychopathology and cognitive performance in early-onset alcohol dependence versus late-onset alcohol dependence.Materials and Methods:This is a cross-sectional study carried out on patients attending the psychiatry unit of a tertiary care center of north India after obtaining approval from the institutional ethics committee. A total of 57 patients with alcohol dependence enrolled in the study, after screening a total of 112 patients. Patients were evaluated for the externalizing psychopathology (using SSAGA intravenous [IV]) and cognitive performance (using Wisconsin Card Sorting Test [WCST] and continuous performance test [CPT]). Comparison of sociodemographic, clinical variables as well as externalizing psychopathology and cognitive performance was done between early-onset and late-onset alcohol dependence.Results:Comparison between early-onset and late-onset alcohol dependence revealed that the score of individual externalizing psychopathologies and the total externalizing psychopathology score on SSAGA IV in the early-onset group are significantly higher than late-onset alcohol dependence. Similarly, there is a significant difference in the executive functions (on WCST) between the two groups (early onset < late onset). On CPT, there are significantly more errors of omission in the early-onset group in comparison to their late-onset counterparts.Conclusion:Early-onset alcohol dependence is associated with more externalizing psychopathology and more cognitive dysfunction than late-onset alcohol dependence.

A Cross-sectional Study of Psychiatric Comorbidity and Severity of Addiction in Patients with Early- and Late-Onset Alcohol Dependence.

Background:Alcohol use disorder is a serious health problem with high comorbidities. Early-onset alcohol use has been associated with greater impulsivity, increased severity of dependence, frequent alcohol withdrawal complications, externalizing symptoms, and antisocial behaviors. We aimed to evaluate the psychiatric comorbidities and severity of addiction in early- and late-onset alcohol dependence.Methods:This was a cross-sectional study. All patients fulfilling the diagnostic criteria of alcohol dependence as per International Classification of Diseases (10th edition) were included in it. Semi-Structured Assessment for Genetics of Alcoholism IV was applied to find the age of onset of dependence as per the lifetime frame and also to find comorbidities. Composite International Diagnostic Interview 3.0. was used to find other comorbidities. The severity of addiction was evaluated with Addiction Severity Index, 5th edition. All the sociodemographic and clinical parameters were compared between patients with the early- and late-onset alcohol dependence. Results:Out of the 112 patients screened, 57 met the selection criteria, 26 were with early-onset and 31 with late-onset alcohol dependence. The patients were all males. The patients with early-onset alcohol dependence had a higher family history (P = 0.006) and were nonearning (P = 0.002) in comparison to the group with late-onset dependence. The comorbidity among all patients was 59.6% and 84.2% in current and lifetime frames, respectively. It was significantly higher in the early-onset group, both for current (P = 0.015) and lifetime (P = 0.031) frames. On the domains of Addiction Severity Index 5th edition, the early-onset group had a more severe profile of addiction in all domains except the medical domain. Conclusion:Comorbidity is high among patients with alcohol dependence and is even higher for the early-onset group. The family history was higher in the early-onset group and they have more severe profile of substance use.

The SLC6A3 gene possibly affects susceptibility to late-onset alcohol dependence but not specific personality traits in a Han Chinese population.

Dopaminergic dysfunction has an important role in the pathoetiology of alcohol dependence (AD). The purpose of this study was to determine whether the solute carrier family 6 member 3 (SLC6A3) gene (also known as the dopamine transporter DAT gene) was associated with AD, and whether variants in the SLC6A3 locus were associated with specific personality traits in patients with AD. Sixteen polymorphisms in SLC6A3 were analyzed using 637 patients with AD and 523 healthy controls. To reduce clinical heterogeneity, patients were classified into two subgroups: early-onset AD (EOAD) and late-onset AD (LOAD). The Tridimensional Personality Questionnaire was used to assess the personality traits novelty seeking (NS) and harm avoidance (HA) in the patients with AD. Using allele frequency and genotype distribution comparisons and logistic regression analysis, we found evidence of association between rs6350 and AD (P < 0.05). Following subgroup analysis, we confirmed evidence of an association in patients with LOAD (P = 0.003), but not in patients with EOAD. Heterozygous carriers of the A allele have a nearly 3 times greater risk to develop LOAD compared to individuals who do not have an A allele. Although we found that patients with AD had higher NS and HA scores compared to controls (P < 0.001), we did not find evidence of association between SLC6A3 polymorphisms and either NS or HA in patients with AD using linear regression analysis. The findings from our study indicate that the SLC6A3 gene may have a role in susceptibility to late-onset AD in the Han Chinese population.

Late-onset alcohol dependence: patient-reported problems

Introduction: Elderly alcohol dependent patients can be discriminated based on the age of onset of alcohol use. This is relevant for their clinical problem presentation and for the course of treatment.Materials and methods: In this paper, problems of elderly patients are presented at intake in an addiction treatment center, based on the most recent, almost nationwide applied intake instrument in The Netherlands: the MATE. Prevalences are analyzed for substance use, psychiatric and somatic co-morbidity, level and severity of dependence, limitations in daily functioning, craving, and perceived levels of depression, anxiety and stress. Among a total of 1942 alcohol dependent patients, four subpopulations were compared in the analyses: adults (24–55 years), elderly patients (≥ 55 years) with early (early-onset alcohol dependence (EOAD), < 25 years), middle (medium-onset alcohol dependence (MOAD), 25–45 years) and late (late-onset alcohol dependence (LOAD), > 45 years) onset alcohol dependence.Results: Results show that LOAD has less problem severity in almost all assessment areas than adults. They do however use 3.5 times more often medication for physical illnesses, and suffer more often from confusion and somatic diseases. LOAD is not different from EOAD and MOAD.Conclusion: The results show that LOAD in a relatively short time period developed an alcohol dependence and alcohol related problems that are similar to that of their peers who used alcohol for a much longer time.

Are childhood externalizing disorders the harbinger of early-onset alcohol dependence?

Background & objectives:The subtyping of alcohol dependence (AD) into early-onset (EO) and late-onset (LO) subgroups has been shown to have clinical and biological validity. As externalizing disorders (EDs) predate AD, the link of ED with age of onset of alcohol dependence needs to be investigated. The aim of this study was to examine the relationship of EDs such as disruptive behaviour disorder (DBD) and attention deficit hyperactivity disorder (ADHD) with age at onset of AD in a sample of male subjects.Methods:One hundred consecutive male subjects with AD presenting to the De-Addiction Services and an equal number of biologically unrelated non-substance-dependent control subjects were included in the study. The AD subjects were divided into EO (age of onset of AD ≤25 yr; n = 21) and LO (age of onset of AD >25 yr; n = 79). Subjects were examined for evidence of DBD and ADHD in childhood, and current ADHD using structured instruments such as Semi-Structured Assessment for the Genetic of Alcoholism-IV (SSAGA-IV) and Kiddie – SADS – Present and Lifetime Version (K-SADS-PL). The odds ratio of association of EDs with EO and LO AD was calculated by comparing these subgroups with the biologically unrelated control group. Later, both the subgroups of alcohol dependence were compared for the presence of EDs.Results:All EDs (DBDs/childhood or adult ADHD) were more common in AD individuals as compared to the controls. However, when AD subgroups were compared with controls, the association of DBDs and ADHD reached a significant level only in the EO subgroup. A comparison of EO and LO AD showed that more EO individuals had history of both childhood disruptive disorder and ADHD compared to LO subgroup. Adult ADHD was also over-represented in EO subgroup.Interpretation & conclusions:Our study showed more EDs in alcohol dependent individuals compared to controls. Further, the association observed between EDs and EO alcohol dependence points towards a developmental continuum between these two conditions.

Physical and Mental Health and Social Functioning in Older Alcohol-Dependent Inpatients: The Role of Age of Onset

Aims: Age of onset is an important criterion to distinguish subgroups of alcohol-dependent patients. This study investigated physical and mental health and social functioning of older inpatients with early (age <25), late (25-44), and very late (≥45) onset of alcohol dependence. Methods: In a specialized detoxification ward for older patients in The Hague, the Netherlands, 157 older alcohol-dependent inpatients (38% women, mean age 62.7 ± 6.5) were interviewed with the European version of the Addiction Severity Index. Results: As a group, older alcohol-dependent patients had substantial physical, mental and social problems, which were largely independent of the age of onset of alcohol dependence. Patients with early-onset alcohol dependence had more chronic medical problems and more suicidal thoughts than patients with late-onset alcohol dependence. The very-late-onset group did not significantly differ from the other two groups in any of the variables under study. Conclusions: Despite previous studies showing more favourable outcomes for the (very) late-onset compared to the early-onset alcohol-dependent group, their comorbid (mental) health and social problems are in many respects similar, and require careful assessment and treatment. This may be crucial for successful treatment and improving quality of life in these patients.

EPA-1133 – Relationship of temperament, character and severity of psychopathology with aggression in alcohol dependent inpatient men

Aggression is suggested to be a predictive factor for alcohol use but the casual relationship between aggression and alcohol dependence is complex. Early aggressive acts are a risk factor for early onset alcohol dependence and aggression is suggested to be a long term individual characteristic which is probably in association with personality traits preexisting before the alcohol use. The aim of this study was to evaluate the relationship of personality dimensions with aggression among alcohol dependent inpatients and to control the effect of psychiatric symptom severity on this relationship. Participants were consecutively admitted male alcohol (n=94) dependent inpatients. Patients were investigated with the Buss–Perry Aggression Questionnaire (BPAQ), the Temperament and Character Inventory (TCI) and the Symptom Checklist-Revised (SCL-90-R). Character dimensions self-directedness (SD) and cooperativeness (C) were negatively and severity of psychiatric symptoms was positively correlated with severity of aggression and its dimensions. Low SD and C, which are indicative of a personality disorder, were predictors of aggression. When severity of psychiatric symptoms was included in analyses as an independent variable, it became the main predictor. Consistent with the hypothesis that aggression is an expression of poor character development, aggression was found to be more closely related with character compared to temperament dimensions. Nevertheless, our findings also suggest that the relationship between the aggression and character dimensions may be indirect through psychopathology. Therefore, when the aggression is the main problem, it is important to evaluate alcohol dependents for the personality dimensions and severity of psychiatric symptoms.

O6 * FREE ORAL COMMUNICATIONS 6: PSYCHOSOCIAL FACTORS AND ALCOHOL USE DISORDERS

O6 * FREE ORAL COMMUNICATIONS 6: PSYCHOSOCIAL FACTORS AND ALCOHOL USE DISORDERS

Factors associated with delirium tremens: A retrospective chart study

Objectives: Delirium tremens is the most severe on the spectrum of alcohol withdrawal syndromes. The mortality rate in this condition has been reported as high as 20%; however, with appropriate diagnosis and prompt treatment, mortality has been reduced to 1%. We studied the sociodemographic, clinical and laboratory data in alcohol dependant patients who developed delirium during the period of abstinence and compared them with patients who had uncomplicated withdrawal states. Materials and Methods: This investigation was done in the deaddiction centre, department of psychiatry, Father Muller Medical College Mangalore. A retrospective chart review spanning a period of 8 months (Jan-Aug 2011) was done to select 60 consecutive patients with alcohol dependence syndrome without medical or other psychiatric co-morbidity (excluding nicotine dependence). Socio demographic, clinical and laboratory data comprising haematological and biochemical parameters at the time of admission were compared between 30 alcohol dependents who developed delirium and 30 alcohol dependents who had uncomplicated withdrawal state. Results: No statistical significance is observed on sociodemographic data between the groups. Early onset dependence were noted to be developing delirium in withdrawal period. Elevated bilirubin levels and SGOT levels are significantly more in delirious patients. Statistically significant higher blood glucose levels were seen in patients with uncomplicated withdrawal. Conclusion: Patients with elevated bilirubin and transaminases, and early onset alcohol dependence are prone to develop delirium during alcohol withdrawal states.

Predictors of Alcohol Dependence Relapse During Recurrence of Major Depression

This study sought to determine clinical predictors of alcohol relapse during recurrence of major depression. The total sample included 2,820 adults with a history of alcohol dependence who had a comorbid current episode of major depression. Twenty-six percent had a relapse of alcohol dependence. Relapsers were more likely to be male, single, less educated, and younger than non-relapsers. Early onset alcohol dependence and past year drug use disorder significantly increased the likelihood of relapse. Early onset substance use dependence is a more powerful predictor of alcohol relapse than early onset major depression.

Age of Onset and Neuropsychological Functioning in Alcohol Dependent Inpatients

Differences in clinical characteristics between early and late onset alcohol dependent patients have been examined intensively, but little is known about the differences in neuropsychological functioning between these patient groups. Clinical characteristics and neuropsychological functions of inpatients with early onset and late onset alcohol dependence are therefore investigated in this study. Ninety-three abstinent alcohol dependent inpatients meeting a current diagnosis of DSM-IV alcohol dependence were divided into early onset alcohol dependent patients (EOA; ≤25 years; n = 36) and late onset alcohol dependent patients (LOA; >25 years; n = 57). Patients using psychoactive medication and patients dependent on other substances than alcohol (and nicotine) were excluded. A comprehensive neuropsychological test battery was administered. EOA reported higher trait impulsivity, antisocial traits, and attention deficit hyperactivity disorder-related traits and exhibited an impulsive reflection style, especially in a high-risk context, compared with LOA. Against expectations, EOA performed significantly better on measures of planning, cognitive control, visual memory, and delayed recognition memory than LOA, whereas no significant group differences occurred on measures of delay discounting, digit span, and attention. Better Stroop interference, better visual memory, and a more impulsive reflection style was predictive of an early age of onset, and explained a significant and additional amount of variance (18.8%) on top of the clinical characteristics, together explaining 53.4% of the variance. Both clinical characteristics and neuropsychological variables contributed independently to the age of onset of problematic alcohol use. Results indicate that especially an impulsive reflection style, besides higher trait impulsivity, may be the core feature of early onset alcohol dependence. However, the contribution of the neuropsychological variables is complex and more research is needed to clarify the role of psychiatric comorbidity and poly-substance abuse in an unselected sample of alcohol dependent patients.

Early‐Onset Alcohol Dependence Increases the Acoustic Startle Reflex

Hyperreactivity and impaired sensory gating of the acoustic startle response in alcohol dependence has been suggested to reflect a residual effect of previous detoxifications, increasing the severity of subsequent withdrawal episodes. Previous studies on the acoustic startle only included early-onset alcohol-dependent patients. The observed abnormalities may therefore also be specific for this subtype of alcohol dependence. We investigated the acoustic startle response in alcohol-dependent patients and healthy controls and hypothesized that (i) early-onset alcohol-dependent patients show increased acoustic startle responses compared with late-onset alcohol-dependent patients and healthy controls, and (ii) the duration of alcohol dependence or the number of prior detoxifications would not explain the differences in the acoustic startle between early- and late-onset alcohol dependence. The acoustic startle reflex was assessed in detoxified, male alcohol-dependent patients (N = 83) and age-matched healthy male controls (N = 86). Reflex eye blink responses to an auditory startle stimulus were measured by means of electromyographic recordings over the right orbicularis oculi muscle. Reflex amplitudes and levels of prepulse inhibition (PPI) were analyzed. There was no association between number of previous withdrawals and the startle response or PPI. Early-onset alcohol-dependent patients showed higher acoustic startle amplitudes compared with late-onset alcohol-dependent patients and healthy controls [75/105 dB: F(2, 166) = 9.2, p < 0.001; 85/105 dB: F(2, 166) = 12.1, p < 0.001; 95 dB: F(2, 166) = 8.2, p < 0.001; 105 dB: F(2, 166) = 9.7, p < 0.001], and there were no differences in PPI. Increased acoustic startle response in detoxified early-onset alcohol-dependent patients may reflect a trait marker specifically involved in early-onset alcohol dependence. The findings of the current study do not support the hypothesis that the increased startle response is a residual state marker.

Alcoholic Marriage: Later Start, Sooner End

Although associations between drinking behavior and marital status are well documented, timing of marital transitions as a function of alcohol use or disorder has received limited empirical attention. We examine the relationship between lifetime history of alcohol dependence (AD) and timing and survival of first marriages in a sample of 3,575 female and 1,845 male adult Australian twins born mostly between 1940 and 1964. Survival analyses were conducted using Cox proportional hazards regression models. Results indicate moderate delays in marriage associated with AD for both women and men. Among ever-married respondents, AD was strongly predictive of early separation, with similar effects observed for women and men. Heritable sources of covariation were also documented. For women, genetic influences shared between early-onset AD and marital timing were found. Genetic influences shared between AD and marital survival were observed for women without regard to onset and for men with later-onset AD. Results confirm the importance of AD as a predictor of both timing and survival of first marriages, with genetic influences contributing to observed associations.

Early onset alcohol dependence with high density of family history is not “male limited”

Objective Based on classical adoption studies, early onset type II alcoholism was originally described as “male limited.” We examined the possible expression of this subtype in present day alcohol-dependent women. Detailed systematic assessment was obtained from 200 treatment-seeking alcohol-dependent women and 189 healthy population controls. Women fulfilling type II alcoholism criteria had higher alcoholism severity as measured by The Alcohol Use Disorders Identification Test and markedly higher use of illicit drugs. Both alcoholism subtypes scored higher than normal on anxiety and impulsivity traits, but type II women scored markedly higher on aggression subscales than either of the other groups. Importantly, density of family history was markedly higher in type II women, suggesting a higher heritability. Despite its original description as male limited, early onset alcoholism with high density of family history is likely to be a valid construct in women. Its recognition has important implications for diagnosis, treatment, and research.

Gene Study Helps Unravel Biology of Alcoholism

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessGene Study Helps Unravel Biology of AlcoholismJun YanJun YanSearch for more papers by this authorPublished Online:21 Aug 2009https://doi.org/10.1176/pn.44.16.0025A new genomewide association study (GWAS) has found several mutations linked to increased susceptibility for developing alcohol dependence, bringing scientists a step closer to understanding the complex biological mechanisms of alcohol use disorders.Two single nucleotide polymorphisms (SNPs), both located on the chromosomal region 2p35, had the highest degree of association with alcohol dependence in a relatively homogenous patient population. These SNPs are located near the PECR gene, which encodes an enzyme (peroxisomal trans-2-enoyl-coA reductase) involved in fatty-acid metabolism, particularly when the body's energy supply is switched from glucose to fat.A third SNP with a slightly lower association with alcohol dependence is located within the PECR gene. These three variants are “in strong linkage disequilibrium, or LD, meaning that the same variants at different loci almost always appear together,” Marcella Rietschel, M.D., the senior author of the study, told Psychiatric News. “So it is very likely—but still not certain—that the PECR gene is involved [in alcohol dependence].”Rietschel is a professor of genetic epidemiology in psychiatry at the Central Institute of Mental Health Mannheim at the University of Heidelberg, Germany.This chromosomal region has been implicated in alcohol dependence in previous research. The PECR gene is expressed most heavily in the liver, but very little in the brain. “As alcohol does not act only on the brain, alcohol dependence can be modulated by many factors whose primary target is not the brain,” Rietschel said. “The best known genetic variants modulating alcohol addiction are variants in the genes metabolizing alcohol, like variants in the alcohol dehydrogenase gene clusters.”Indeed, this study confirmed several other SNPs associated with alcohol dependence, including those located in the ADH1C gene coding for one of the alcohol-metabolizing alcohol dehydrogenases, as well as the CDH13 gene coding for a cell-adhesion protein known as T-cadherin. Both genes have been implicated in alcohol dependence in previous studies.Despite the strong evidence, these variants and their impact on alcohol dependence need to be replicated by additional studies. “The uncertainty is a problem encountered in many GWA studies: A SNP is found to be associated but is not functional itself, so one cannot be sure if this SNP is itself involved in the regulation of genes or if it is only in LD with other causal SNPs, which can be quite far away or even in other genes,” said Rietschel. Since the three top SNPs discovered in this study are close to and in the PECR gene, “this gene definitely merits further investigation.”The researchers first performed a genomic scan for more than 500,000 SNPs, using a sample of 487 alcohol-dependent patients and 1,358 controls. The GWAS identified 121 SNPs that were likely candidates for genetic association.The patients selected for the GWAS were German men with a DSM-IV diagnosis of alcohol dependence, whose condition was severe enough to require hospitalization for treatment or prevention of alcohol withdrawal. In addition, the subjects all had an onset of alcohol dependence before age 28; early-onset alcohol dependence has been shown to have a stronger hereditary component. Because alcohol dependence is a multifactorial disorder with multiple phenotypes and genotypes, the researchers narrowed their sampling to clinically similar patients to reduce the heterogeneity.Because of the vast number of mutations existing in every person and the large number scanned in a GWAS, scientists face the challenge of weeding out too many potential false-positive “hits,” or variants that appear to be significantly associated with a disease when they are, in fact, random coincidences. To minimize false hits and maximize true disease-associated mutations, strategies such as stringent statistical criteria and replication studies are often used in genetic association studies.Here, the researchers used a method called convergent functional genomics. This approach combines gene-expression data from animal models, evidence from human genetic association studies, and findings from human tissues such as brain tissue in autopsies to help prioritize investigation on the most promising candidate genes or the most likely biological pathways. In this study, 19 SNPs were identified after the human GWAS findings were compared with homologous, over-expressed genes in rats that were“ alcoholic” strains.Armed with 121 candidate SNPs from the GWAS and 19 SNPs derived from convergent functional genomics analysis, the researchers performed a replication study of 1,024 male patients with alcohol dependence and 996 age-matched controls. The replication study confirmed that 15 SNPs have a significant association with alcohol dependence.This study was funded by grants from the German government and the European Commission.An abstract of “Genome-Wide Association Study of Alcohol Dependence” is posted at<archpsyc.ama-assn.org/cgi/content/abstract/66/7/773>.▪ ISSUES NewArchived

CLINICAL STUDY: Abnormalities in cortical and transcallosal inhibitory mechanisms in subjects at high risk for alcohol dependence: a TMS study

Central nervous system (CNS) hyperexcitability and a resulting state of behavioral undercontrol are thought to underlie the vulnerability to early-onset alcohol dependence (AD). The aim of this study was to explore the differences in the functioning of cortical inhibitory systems, utilizing transcranial magnetic stimulation (TMS), in subjects at high risk (HR) and low risk (LR) for AD and to examine the relationship between CNS inhibition and behavioral undercontrol. Right-handed HR (n = 15) and LR (n = 15) subjects, matched for age, gender, height, weight and education, were assessed for psychopathology and family history of alcoholism using the Semi-Structured Assessment for the Genetics of Alcoholism and the Family Interview for Genetic Studies. Following single-pulse TMS, an electromyogram recorded from the right opponens pollicis muscle was used to measure the silent periods at different stimulus intensities. HR subjects had significantly shorter contralateral and ipsilateral (iSP) silent periods and a relatively higher prevalence of 'absent' iSP. They had significantly higher mean externalizing symptoms scores (ESS) than LR subjects, and there was a significant negative correlation between iSP duration and ESS. These preliminary findings suggest that HR subjects have relative impairments in corticocortical and transcallosal inhibitory mechanisms. The consequent state of CNS hyperexcitability may be etiologically linked to the excess of externalizing behaviors observed in this population, which is thought to be a predisposition to a higher risk of developing early-onset alcoholism.

The association between attention-deficit/hyperactivity disorder and early-onset alcohol dependence: A retrospective study

Background:Early onset (EO) alcohol dependence (AD) has been found to represent a subtype of alcoholism with a distinct profile and prognosis compared to late onset (LO) alcohol dependence. Externalizing disorders, especially attention deficit hyperactivity disorder (ADHD) that may continue as attention deficit hyperactivity disorder, residual type (ADD, RT) in adulthood, may increase susceptibility to early-onset AD.Aims:To examine the relationship between ADHD and ADD, RT symptoms and age at onset of AD in a sample of Indian male patients. 70 male subjects with AD presenting to the De-Addiction Services of the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, were studied. The study had a retrospective design.Materials and Methods:Patients were examined for evidence of past ADHD in childhood and current ADD, RT using structured instruments. Chi-square tests and odds ratios were used to express the relative risk of association of ADHD with early- and late-onset AD.Results:Significantly more EO alcoholics (19/30, 63.3%) had a history of ADHD in childhood compared to LO alcoholics (7/28, 25%, P < 0.05) ADD, RT was also over-represented in EO probands.Conclusions:The results of this study are consistent with previous research that shows a high incidence of ADHD in early-onset alcoholics. This may have important management implications.

Lack of Association of Alcohol Dependence and Habitual Smoking With Catechol‐O‐methyltransferase

To test whether variation in the gene encoding the enzyme catechol-O-methyltransferase (COMT), which catalyzes the breakdown of dopamine and other catecholamine neurotransmitters, is associated with the risk for alcohol dependence and habitual smoking. Single nucleotide polymophisms (SNPs) were genotyped in a sample of 219 multiplex alcohol-dependent families of European American descent from the Collaborative Study on the Genetics of Alcoholism (COGA). Family-based tests of association were performed to evaluate the evidence of association between the 18 SNPs distributed throughout COMT, including the functional Val158Met polymorphism, and the phenotypes of alcohol dependence, early onset alcohol dependence, habitual smoking, and comorbid alcohol dependence and habitual smoking. No significant, consistent evidence of association was found with alcohol dependence, early onset alcohol dependence, habitual smoking or the comorbid phenotype. There was no evidence that the functional Val158Met polymorphism, previously reported to be associated with these phenotypes, was associated with any of them. Despite the substantial size of this study, we did not find evidence to support an association between alcohol dependence or habitual smoking and variation in COMT.

Family-based and case–control association studies of glutamate receptor GRIK3 Ser310Ala polymorphism in Polish patients and families with alcohol dependence

The aim of this study was to evaluate the role of the GRIK3 functional polymorphism (Ser310Ala) in the pathogenesis of alcoholism. This polymorphism was investigated in two types of studies: (1) the association study in a whole group of alcoholics (116 patients fulfilling ICD-10 alcohol dependence (AD) criteria and 255 controls, Polish descent) and homogenous overlapping subgroups of patients with: a history of delirium tremens and/or alcohol seizures, early age of onset of alcoholism (AOO < 26 years), a co-occurrence of dissocial personality disorder, a history of familial alcoholism; (2) the family-based study (using Transmission Disequilibrium Test (TDT) in 100 Polish families with alcohol dependence). The history of alcoholism was obtained using SSAGA (Polish version). GRIK3 functional polymorphism was determined using PCR. TDT revealed an adequate transmission of both alleles to the affected offspring in the whole group of alcohol families (29 × Ser, 24 × Ala; χ 2 = 0.472; d.f. = 1; p = 0.492) and in the homogenous subgroups of families. No significant associations between any of the above mentioned alcohol phenotypes and Ser310 allele were observed (the whole AD group: p = 0.66 AD with delirium and/or seizures: p = 0.521; early onset AD: p = 0.868; AD with familial history of alcoholism: p = 0.798 and AD with dissocial personality disorder: p = 0.618). These findings do not seem to support the hypothesis of the role of this polymorphism in the pathogenesis of alcoholism.