Do men with excessive alcohol consumption and social stability have an addictive personality?

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".

Tobacco use is associated with more severe alcohol dependence, as assessed by the number of DSM-IV criteria, in Swedish male type 1 alcoholics.

BACKGROUND: A high smoking prevalence has been reported in treatment-seeking alcohol-dependent individuals. It has also been suggested that alcohol-dependent individuals who smoke may have a more severe course and greater severity of their alcoholism. METHODS: This study evaluated the impact of tobacco use in 108 Swedish male type 1 alcohol-dependent individuals, recruited by advertisement in a local daily newspaper. They were sub-grouped into smokers (N = 50), snuffers (N = 12) and tobacco nonusers (N = 46). The number of criteria for the diagnosis of alcohol dependence was used to assess the severity of alcohol dependence. RESULTS: The smokers were significantly younger compared to the tobacco non-using group, and also younger at their onset of excessive alcohol consumption. Both smokers and snuffers fulfilled significantly more DSM-IV criteria for alcohol dependence than tobacco nonusers. Furthermore, significantly higher proportions of smokers and snuffers fulfilled the criteria no 2 (experiencing withdrawal syndrome) and no 7 (continuing to use alcohol despite problems). CONCLUSIONS: These findings indicate that not only smoking, but also snuffing, is associated with greater severity of alcohol dependence, as reflected by the greater number of DSM-IV criteria.

Different effects of smoking or use of smokeless tobacco on platelet MAO-B activity in type 1 alcohol-dependent subjects.

BACKGROUND: Low platelet monoamine oxidase (MAO)-B activity has been proposed as a marker for alcohol-dependence. Findings are, however, contradictory and the influence of confounding factors have been thoroughly investigated. Thus, it is now well established that cigarette smoking reduces platelet MAO-activity. However, not much is known about the influence of smokeless tobacco, i.e. snuff or chewing tobacco, on platelet MAO-B activity. The aim of the present study was to compare platelet MAO-B activity in type 1 alcohol-dependent subjects with concomitant use of smokeless tobacco (i.e. snuff users), use of smoking tobacco (i.e. cigarette smokers), and in those without any tobacco use. METHODS: Platelet MAO-B activity was examined in three groups of alcohol-dependent subjects: snuff users (n = 14), cigarette smokers (n = 33), and non-tobacco users (N = 46). RESULTS: In the alcohol-dependent subjects concomitant cigarette smokers, but not snuff users, were found to have significantly lower platelet MAO-B activity as compared to non-tobacco users (platelet MAO-B activity 4.0 +/- 1.5, 5.1 +/- 1.5 and 5.0 +/- 1.9 microkat/kg protein, respectively). CONCLUSIONS: The findings in the present study suggests that in the alcohol-dependent subjects the concomitant use of smokeless tobacco, i.e. snuffing, does not have an inhibitory effect on platelet MAO-B activity. This may have implications for future research. Thus, alcohol-dependent subjects with concomitant tobacco use should be grouped separately according to the form of the tobacco used, i.e. smoking or smokeless tobacco.

The taqI DRD2 A1 allele is associated with alcohol-dependence although its effect size is small.

BACKGROUND: Numerous studies of the relationship between the TaqIA DRD2 A1 allele and alcohol-dependence have been performed and many of these have shown an association whereas others have not (Noble, 2003). This has consequently generated some controversy as to whether such an association actually exists (Noble, 2003). In the two recent meta-analyses by Noble (2003) and Young et al. (2004) some very important methodological issues have been discussed, which need to be addressed in forthcoming studies. Thus, the sample size is of great importance. In case-control studies it has been estimated that to detect the role of genes with small effect size of approximately 2, which is in the range of the DRD2 A1 allele-alcoholism relationship, case-control sets of 300-400 subjects are necessary (Noble, 2003). METHODS: In the present study, we have consequently recruited a large number of subjects, 375 alcohol-dependent individuals, who were treated as inpatients for alcohol withdrawal symptoms and out of these 357 could be evaluated. As controls, 578 individuals screened and 254 individuals unscreened for alcohol consumption were used. Thus, the total number of subjects was 1217. RESULTS: In the present study, in which the TaqI A1/A2 DRD2 polymorphism was in Hardy-Weinberg equilibrium in the patient group and the two control groups, we found that the TaqI DRD2 A1/A2 genotype frequency differed significantly between the alcohol-dependent group and both the total and screened control groups. Furthermore, the TaqI DRD2 A1 allele frequency was significantly overrepresented in the alcohol-dependent subjects as compared with both the total and screened control groups. The odds ratio for alcohol-dependency being associated with the A1 allele was 1.34. CONCLUSIONS: Consequently, the findings in this study lend further support to the notion of an association between the DRD2 A1 allele and alcohol-dependence, although the effect size of the DRD2 A1 allele is small.

Individuals with excessive alcohol intake recruited by advertisement: demographic and clinical characteristics.

AIMS: Studies have shown that most individuals with alcohol problems have never received any treatment for their alcoholism. The purpose of the present study was to describe demographic and clinical characteristics in male individuals with excessive alcohol intake who were recruited by advertisements. These characteristics were compared between individuals with or without prior treatment histories. METHODS: Subjects (n = 367) responded to the advertisements in a regional daily newspaper and called the investigators. A structured interview was performed and a complete dataset of demographic and clinical information was collected in 342 individuals. RESULTS: Individuals with no prior treatment history (n = 238) were found to be more often cohabitant, employed, and they reported fewer on-going psychiatric symptoms than individuals with treatment histories (n = 104). CONCLUSION: Since individuals with no prior treatment history seldom experience psychiatric symptoms, they are less likely to seek treatment in the health care system. It is therefore of importance to find ways to reach this 'hidden' group early with excessive alcohol consumption. One way to do so might be via alcohol treatment programs at working places since the majority of them are employed.

Changes in mental well-being during Minnesota treatment.

The present study assessed mental well-being daily in 28 alcohol-dependent patients who underwent 28 days of Minnesota inpatient treatment. The Swedish Mood Adjective Check List (sMACL) with six bipolar dimensions was used for daily self-reports. At start of treatment, patients had lower levels in four dimensions of mental well-being compared to those of a norm group. Moreover, patients showed significant improvements in all levels of mental well-being during treatment, and at the end of treatment patients had values within the normal range, except for one dimension (activation/deactivation), in which the levels were significantly higher. The findings may suggest a beneficial effect of this type of treatment on mental well-being, although findings may also reflect a mere effect of adjustment to treatment or the social situation.

Tobacco use is associated with reduced central serotonergic neurotransmission in type 1 alcohol-dependent individuals.

BACKGROUND: Reduced central serotonergic neurotransmission in alcohol dependence may be attributed to the effects of cigarette smoking (and possibly more specifically to nicotine) rather than to alcoholism or its subtypes. The aim of the present study was therefore to compare central serotonergic neurotransmission in tobacco-using (cigarette smokers and users of smokeless tobacco, i.e., snuffers) alcohol-dependent individuals to that of tobacco-nonusing alcohol-dependent individuals. METHODS: The central serotonergic neurotransmission was assessed by the prolactin (PRL) response to the serotonin-releasing agent D-fenfluramine (30 mg orally). Male subjects (n = 37) aged 20-65 years were recruited for this purpose. They were all type 1 alcohol-dependent individuals and had ended their alcohol intake the day before the D-fenfluramine challenge test. RESULTS: There was no difference in baseline PRL concentrations between tobacco-using (n = 18) and tobacco-nonusing (n = 19) alcohol-dependent individuals. On the other hand, the maximum PRL response after D-fenfluramine was significantly lower in the tobacco-using group as compared to the tobacco-nonusing individuals. CONCLUSION: Whether the reduction in central serotonergic neurotransmission in tobacco-using alcohol-dependent individuals is pre-existing or a result of tobacco use remains to be elucidated.

Subnormal alpha-2-adrenoceptor-mediated sedation during 6 months of sobriety in male type 1 alcohol-dependent subjects.

AIMS: In the present study, alpha(2)-adrenoceptor function was investigated over 6 months of sobriety in eight male alcohol-dependent subjects. METHODS: Subjects were investigated with repeated clonidine (CLON, 2 micro g/kg body weight intravenously) challenge tests at days 1 and 7, and months 2 and 6 after the end of a period of heavy alcohol intake. CLON-induced sedation was rated at challenge tests. Mental well-being was self-reported before all challenge tests. Three challenge tests were performed at 1-week intervals in six male healthy controls. RESULTS: Sedation was significantly lower after CLON at all time-points for the challenge tests in alcohol-dependent subjects compared with mean values for three challenge tests in controls. Three dimensions of mental well-being were negatively correlated with scores of CLON-induced sedation at month 6. CONCLUSIONS: alpha(2)-Adrenoceptor function is subnormal, as assessed by CLON-induced sedation, for at least 6 months after termination of alcohol intake. Whether this subnormal receptor function is pre-existing and possibly genetically determined or is a consequence of long-term alcohol intake must be further investigated, as should this receptor status in alcohol-dependent subjects with longer time-periods of sobriety.

Platelet monoamine oxidase B in family history positive and family history negative type 1 alcohol-dependent subjects.

AIMS AND METHODS: In the present study platelet monoamine oxidase B (MAO-B) activity was investigated in 76 male type 1 alcohol-dependent subjects with and without a family history of alcoholism. RESULTS: Platelet MAO-B activity did not differ between family history positive (FHP) and family history negative alcohol-dependent subjects. The smoking status of the subjects was registered and there was still no difference between the groups when possible effects of smoking were taken into account. It should, however, be noted that platelet MAO-B activity was lower in alcohol-dependent subjects with three or four alcohol-dependent first-degree relatives. CONCLUSIONS: Although this latter finding should be interpreted with caution due to the small number of subjects, it cannot be excluded that FHP alcohol-dependent subjects with a large number of alcohol-dependent first-degree relatives may have lower platelet MAO-B activity.

Mental well-being in subjects with long-term excessive alcohol consumption: an experimental study.

Daily self-reports on six dimensions of mental well-being, with the use of the Swedish Mood Adjective Check List (sMACL), were investigated in 61 socially stable and physically and mentally healthy subjects with long-term excessive alcohol consumption (113 +/- 42 g of pure alcohol daily) during a 7-week study. At the start of the study, all subjects had low levels of mental well-being compared with those for a norm group, most markedly among those who did not complete the study period (n = 20). At the end of the investigation, subjects who completed the study (n = 41) had levels of mental well-being similar to those of a norm group. Subjects who reduced their alcohol consumption by 60% did not differ in levels of mental well-being compared with subjects without reduction in intake. No differences in levels of mental well-being were observed in subjects treated with citalopram compared with those given placebo.

Platelet monoamine oxidase-B activity in type 1 alcohol-dependent subjects in sustained full remission.

AIMS: The present study investigated platelet monoamine oxidase-B (MAO-B) activity in male alcohol-dependent subjects in sustained full remission (minimum 1 year), to exclude possible transient changes in platelet MAO-B activity, which occur up to several months after the end of alcohol intake. METHODS: MAO-B activity was examined in 16 alcohol-dependent subjects, characterized as type 1 alcoholics, with an abstinence period of 6 +/- 7 years (mean +/- SD) and in 12 healthy controls. RESULTS: The long-term abstinent alcohol-dependent subjects did not differ from controls in platelet MAO-B activity. CONCLUSIONS: Type 1 male alcohol-dependent subjects appear to have normal platelet MAO-B activity. The possibility, however, cannot be excluded that type 2 long-term abstinent alcoholics may have lower platelet MAO-B activity.

Is long-term heavy alcohol consumption toxic for brain serotonergic neurons? Relationship between years of excessive alcohol consumption and serotonergic neurotransmission.

The relationship between years of excessive alcohol consumption and central serotonergic neurotransmission, as assessed by the prolactin (PRL) response to D-fenfluramine, was investigated in 22 male alcohol-dependent subjects. A negative correlation was obtained, that is, the longer duration of excessive alcohol consumption the lower PRL response to D-fenfluramine. It is therefore suggested that long duration of excessive alcohol consumption in alcohol-dependent subjects causes a reduction in central serotonergic neurotransmission, possibly by a toxic effect of alcohol on serotonin neurons. The relationship between depressive and anxiety symptoms during on-going drinking and the PRL response to D-fenfluramine was also investigated. No such correlations were obtained, suggesting that reduction in central serotonergic neurotransmission does not pre-dispose to the development of depressive and anxiety symptoms, at least in relation to on-going drinking in alcohol-dependent subjects.

Extremely long recovery time for the sedative effect of clonidine in male type 1 alcohol-dependent subjects in full sustained remission.

The possible relation between alpha-2-adrenoceptor function-as assessed by changes in systolic and diastolic blood pressure and heart rate, as well as level of sedation, after administration of clonidine (2.0 microg/kg, i.v.)-and length of time of alcohol dependence or duration of remission was investigated in 17 male subjects with alcohol dependence in full sustained remission. Six healthy males were used as control subjects. The clonidine-induced scores for level of sedation were found to correlate with duration of time in remission (r = 0.60; P <.02). Median split of duration of remission revealed that subjects with short-term (2 +/- 1 years) duration of remission had significantly lower scores for clonidine-induced level of sedation than the scores for both subjects with long-term (12 +/- 5 years) duration of remission (P <.004) and control subjects (P <.02). There was also a significant correlation between duration of remission and values for clonidine-induced reduction of systolic blood pressure (r = 0.51; P <.05). Results indicate an extremely long recovery period in some aspects of alpha-2-adrenoceptor function, especially for clonidine-induced increase in level of sedation, with a normalization time of 4 to 5 years.