[Dimensions of personality, attachment style and early maladaptive schemas in alcohol-dependent patients: Are there gender-specific differences?] / Dimensions de personnalité, style d'attachement et schémas précoces d'inadaptation chez des patients alcoolo-dépendants : quelles sont les spécificités liées au sexe ?

AIM: Literature reports particularities in certain psychological dimensions, such as personality traits, early maladaptive schemas and attachment styles among patients dependent on alcohol. Several international studies have also emphasized significant gender differences in psychological profiles. However, in France, only a few studies have dealt with this subject. Our aim was on the one hand to study the characteristics of alcohol-dependent patients in these variables, and on the other hand to search for gender differences. METHOD: The personality dimensions were assessed with the French Big Five Inventory (Fr-BFI), the attachment style with Bartholomew's Relationship Scales Questionnaire (RSQ), and early maladaptive schemas with the short version of Young's questionnaire (YSQ-S1). Seventy-three subjects were included: 39 alcohol-dependent patients (19 men and 20 women) and 34 healthy control subjects (17 men and 17 women). The scores of alcohol-dependent patients were compared with those of a healthy control group (n=34, 17 men, 17 women) and available standards. We also compared the scores of men and women with alcohol dependence between them, and we compared the scores of men and women to those of the control group and those of the reference sample of the same sex. RESULTS: This is an ongoing study and we publish here the first results. Compared with control subjects, and the reference sample, alcohol-dependent patients showed significantly higher levels of neuroticism and lower levels of extraversion. Furthermore, differences in attachment styles were observed compared to the control group: alcohol-dependent patients presented a less secure attachment, seemed more fearful and detached, but the results remained within the normal standards. Compared to the control subjects, alcohol-dependent patients showed a significant increase in scores regarding many schemas: emotional deprivation, abandonment, abuse/mistrust, isolation, imperfection, dependence, symbiotic relationship, subjugation, and emotional inhibition. Men and women with alcohol dependence did not show a significant difference between them concerning the dimensions of personality, the schemas, and attachment styles. In addition, the comparison of each sub-group (male/female) with the control group of the same sex and standards available showed specific features: for dimensions of personality, alcohol-dependent men presented a high level of neuroticism and a low level of extraversion, while the women showed no specific features. Concerning attachment, both men and women differed from the control group. Their attachment was more fearful and men showed a less secure and more detached attachment. As for patterns, three are higher among men and women with alcohol dependence compared to controls of the same sex: emotional deprivation, abuse/mistrust, and imperfection. In addition, these schemas seem to be more specific according to gender: alcoholic women differed from controls of the same sex at the subjugation schema, which was not the case for men, while only men differed from men of the control group by higher scores in insufficient self-control, dependency and symbiotic relationship. DISCUSSION: This study shows not only particularities in patients with alcohol dependence concerning personality dimensions, styles of attachment and early maladaptive schemas, but also gender differences when comparing each subgroup (men and women) with controls of the same sex. Even if these results need to be confirmed by using a larger sample, the particularities deserve consideration, especially gender differences in view of appropriate psychotherapeutic strategies.

Mental health and substance use among self-employed lawyers and pharmacists.

BACKGROUND: Self-employed workers experience occupational stress and may suffer from various mental health disorders. AIMS: To assess the mental health, substance use and risk factors for psychological distress in a sample of self-employed lawyers and pharmacists. METHODS: A cross-sectional study, using self-completion postal questionnaires, of lawyers and pharmacists. The General Health Questionnaire-28 (GHQ-28) was used as a measure of current mental health, and some additional questions evaluated alcohol, tobacco and psychotropic drug use and somatic morbidity. A multiple regression model was used to analyse the respective impact of the different risk factors on psychological suffering. RESULTS: A total of 1282 lawyers and 1153 pharmacists participated representing response rates of 36 and 35%, respectively. According to the GHQ-28 score, the rate of psychological distress was high in the sample overall, especially in lawyers (52 versus 47% in pharmacists, P < 0.05). According to the mean number of drinks per day, 16% of the lawyers and 13% of the pharmacists reported alcohol misuse, and lawyers were twice as likely as pharmacists to smoke (26 versus 13%, P < 0.001). Higher GHQ-28 scores were associated in lawyers with female gender, being widowed or divorced, smoking and using anxiolytic medication and in pharmacists with being younger, smoking, alcohol abuse and anxiolytic and hypnotic use. CONCLUSIONS: In our sample of these self-employed groups, both pharmacists and lawyers reported a high rate of psychological distress.