Article

The comorbidity of alcoholism with anxiety and depressive disorders in four geographic communities

Abstract

The comorbidity of alcoholism with anxiety and depressive disorders was examined in four epidemiologic investigations from diverse geographic sites. Despite variability in lifetime prevalence rates for these disorders, there was strong cross-site consistency in the magnitude and specific patterns of comorbidity. Individuals with alcohol abuse or dependence generally experienced a twofold to threefold increased risk of anxiety and depressive disorders. Phobic conditions typically preceded the onset of alcoholism, but no systematic pattern was observed for panic or depressive disorders. Considerable heterogeneity was also observed concerning the impact of comorbid conditions on symptoms of the index disorder. While the presence of comorbid anxiety or depressive disorders was consistently associated with moderate increases in the symptoms of alcohol abuse or dependence, alcoholism was associated with large increases in the number of depressive symptoms and little or no increase in phobic symptoms. The findings are discussed in terms of the self-medication hypothesis and the etiologic heterogeneity of these forms of comorbidity in the general population.
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... Harmful alcohol use leads to 2.5 million deaths annually worldwide [2]. Individuals with alcohol abuse and/or dependence are typically at two to three times the risk for both the aggregated categories of anxiety (simple phobia, social phobia, agoraphobia, panic) and depressive disorders (major depression, dysthymia) [3]. Heavy drinking can lead to dependence, which in humans, is generally characterized by over 12-14 drinks per week [4]. ...
... Depression and worry are described as a chain of thoughts and imaginations that negatively influence the individuals' performance and affection and are related to the worry and depression in individuals who have substance abuse and substance abuse is a fundamental factor of different psychological problems that affect the individuals' performance . The results of the research by Glantz and Hartel, 2002;Cohen, 1991;Kessler, 1996;Swendsen, 1998 indicated that, substance abuse gives rise behavioral, mood, emotional and psychological abnormalities and disorders such as behavior and personality disorders, depression, anxiety, alienation etc. one of the main disorders that is seen in individuals who are addicted to the substance, alcohol or mind-altering drugs is the depression. In most studies, depression is regarded as the most prevalent and concurrent disorder of addiction; however, some of the researchers like (Conway and Compton, 2006) regard depression as one of the reasons of tendency to substance abuse and one of the consequences of drug abuse. ...
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social self-efficacy refers to the individual capabilities in dealing with social challenges and the ability to handle interpersonal conflicts. A lot of research has demonstrated that family and the relationships among its members can pave the way to create social self-efficacy beliefs among children especially in dealing with social situations. The aim of this study is to examine the relationship between family communication patterns (Conversation and Conformity) and social self-efficacy in students. The study sample consisted of 496 fourth to sixth grade elementary school students (252 boys and 244 girls), who were administered the revised family communication patterns scale (Fitzpatrick and Ritchie, 1994) and the social selfefficacy questionnaire for students (Wheeler and Led, 1982). The reliability and validity of the instruments have been confirmed. Collected data was analyzed using the simultaneous multiple regression analysis. In addition and in order to compare social efficacy of boys and girls in different educational grades, a two-way ANOVA was used. Results showed that family Conversation orientation is a positive and significant predictor of social self-efficacy. Family Conformity orientation is, on the other hand, a significant negative predictor of social self-efficacy. There was no significant difference among different grades with regard to the total score of social self-efficacy, subscale of conflict situations, and subscale of non-conflict. In addition no significant differences were observed when comparing boys and girls in terms of their mean score of the subscale of non-conflict. However, regarding the conflict subscale, girls had significantly higher scores than the boys. Moreover the mean scores of boys and girls were significantly different with regard to the total social self-efficacy scale score and girls had higher levels of social self-efficacy than boys. As a result, the promotion of Conversation in the family is a predictor of social self-efficacy in children while emphasizing Conformity in the family diminishes the children's social self-efficacy.
... This is supported by the study conducted in Mexico [14]. The possible explanation might be the effect of alcohol consumption on the brain it decreases the serotonin concentration in the blood which is responsible the predisposing them to depressive symptoms [2,40,41]. The other reason might be individuals who consume alcohol might develop depression symptoms like loss of concentration, social isolation, and feels depression. ...
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Background Depression is a common mental disorder and the leading cause of disability globally. Depression has a significant impact on the quality of life, cognition, emotion, and daily functioning and leads individuals to 39% of suicide globally. Previous studies reported that the magnitude of depression is higher among teachers than in the general population. However, little is known in the case of Ethiopia. Therefore this study aimed to assess the magnitude of depressive symptoms and associated factors among public school teachers in Jimma town. Methods A facility-based cross-sectional study using was conducted a multistage random sampling technique. Depressive symptoms were assessed by using the Depression, Anxiety, and Stress 21 items scale. The data were entered into Epi Data version 3.1 and analyzed using STATA V 14.2. Variables with p < 0.25 in the bi-variable logistic regression analysis were entered into a multivariable binary logistic regression to identify predictors. A statistically significant association was declared at a p -value < 0.05. Result The prevalence of depressive symptoms in this study was found to be 44.7% (95% CI: 40–49.3). Moderate and severe level of occupational stress (AOR; 2.63 CI; 1.32, 5.28 and AOR; 4.15 CI; 1.83, 9.45) respectively, having stress, (AOR; 2.40 CI; 1.48, 3.90), having Anxiety symptoms (AOR; 4.43 CI; 2.79, 7.06) and consumption of alcohol (AOR; 2.21 CI; 1.11, 4.37) were identified as a significant predictor for depressive symptoms. Conclusion and recommendation The study revealed that there is a high prevalence of depressive symptoms among participants. Moderate and severe levels of occupational stress, having stress, having anxiety, and consumption of alcohol were factors that are significantly associated with depressive symptoms. Therefore, giving awareness and routine screening of depressive symptoms among teachers is crucial in early detection and management.
... In a study by Swendsen et al, the researchers observed, in different cultural communities, a significant comorbidity between alcoholism and anxiety and depressive disorders. Although there appears to be a lifetime prevalence of these disorders, people with alcoholism are two to three times more likely to develop anxiety or depressive disorders (40). ...
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This review aimed to analyze the latest neurobiological findings regarding Korsakoff syndrome, since alcoholism is the most prevalent addiction worldwide. In addition, we analyzed the optimal treatment that can be administered in order to minimize the symptoms and improve the outcome of these patients. The disruption of memory circuits within the brain of alcoholic patients results in the amnestic syndrome known as Korsakoff syndrome. It is generally characterized by a chronic neuropsychiatric syndrome caused by vitamin B1 (thiamine) deficiency. Other categories of patients can develop Korsakoff syndrome without consuming alcohol such as AIDS patients, terminally ill cancer patients, or patients with chronic infections and malnutrition. Vitamin B1 is required in the Krebs cycle for production of adenosine triphosphate (ATP). It is also a cofactor in the production of acetylcholine and certain neurotransmitters. Alcohol consumption can decrease the intake, gastrointestinal absorption and cellular utilization of vitamin B1. Treatment of alcohol withdrawal along with high doses of vitamin B1 can improve the general outcome of patients. A small percentage of patients can recover from Wernicke's encephalopathy with no permanent brain damage. The onset of Korsakoff syndrome darkens the prognosis. Alcohol abstinence is an absolute recommendation and prevents the extension of neural damage.
... Der Bedarf an wirkungsvollen Therapiemöglichkeiten ist demnach immens.(94) Erkrankte, mit einer Abhängigkeit oder Missbrauch von Alkohol, haben durch ihre Grunderkrankung erschwerend ein 2-bis 3-fach erhöhtes Risiko, an einer Angststörung oder Depression zu erkranken.(137) Sowohl die Pharmakologie als auch die Wirkung von Ethanol auf den menschlichen Organismus werden immer detaillierter verstanden. ...
Thesis
Hintergrund und Ziele In der westlichen Welt wird Alkohol von der Mehrheit der Erwachsenen regelmäßig konsu- miert, trotz eines nicht unerheblichen Risikos für gesundheitliche Folgen, wie psychische und physische Schäden. Neben den medizinischen Schäden durch Alkohol, kommt es auch zu wirt- schaftlichen Folgen und schwerwiegenden sozialen und familiären Problemen. Der volkswirt- schaftliche Schaden durch Alkohol beläuft sich auf rund 40 Millionen Euro pro Jahr. So konsumieren circa 6,7 Millionen Menschen alleine in Deutschland Alkohol in einer ge- sundheitlich riskanten Form und 1,6 Millionen Menschen im Alter von 18-64 Jahren gelten in Deutschland als alkoholabhängig. In diesem Zusammenhang ist der sehr unkritische Um- gang und die gesellschaftliche Akzeptanz des regelmäßigen Konsums von Alkohol als äußerst problematisch anzusehen. Diese Situation birgt eine weitere Erschwerung in der Therapie der Erkrankung. Es gibt keine einfache spezifische Therapie, vielmehr ist die Behandlung der Alko- holsucht sehr komplex, erfordert die volle Bereitschaft des Betroffenen und seiner Angehörigen und dauert im Grunde ein Leben lang. Aufgrund der mangelnden Behandlungsoptionen ist die Suche nach weiteren therapeutischen Möglichkeiten Gegenstand der aktuellen Forschung. In den Fokus der Forschung sind hier die Sphingolipide gerückt, die im Gehirnstoffwechsel ei- ne wichtige, aber zum Teil noch unverstandene Rolle übernehmen. Als Enzym der Familie der Sphingomyelinasen (SMasen) ist auch die neutrale Sphingomyelinase (NSM) in den Hirnstoff- wechsel eingebunden. Das Ziel dieser Arbeit war herauszufinden, welche Auswirkungen der heterozygote Knockout der NSM in Kombination mit dem Konsum von Alkohol einerseits auf die Entwicklung von Sucht und anderseits auf Morphologie von Gehirn und Knochen hat. Material und Methoden Über einen Zeitraum von 43 Tagen wurde das Trinkverhalten von weiblichen fragilitas ossium (fro)-Mäusen mit einem heterozygoten Defekt der NSM sowie wildtyp (wt)-Mäusen als Kon- trollgruppe beobachtet. In der Versuchsgruppe wurde sowohl den fro- als auch den wt-Mäusen der freiwillige Konsum einer 16 vol.%-Ethanollösung angeboten. Der Kontrollgruppe hingegen stand ausschließlich Wasser zur Verfügung. Das Trinkverhalten der Mäuse wurde analysiert, um so eine Aussage zu Konsum und Präferenz zu treffen. Zur Darstellung von Effekten des Alkoholkonsums, der Defizienz der NSM und des Zusammenspiels beider Faktoren auf Hirn- und Knochengewebe, schloss sich an die Phase des Trinkens bei allen 31 Mäusen eine Messung des Gehirns mittels Magnetresonanztomographie (MRT) und eine Computertomographie (CT)- gestützte Messung des kompletten Skeletts an. Im Rahmen der Auswertung der Messungen mit dem Programm „aycan OSiriX mit Segmenta- tion“ wurden die Werte für Hirnvolumina und Knochendichte der fro-Mäuse mit den jeweiligen Kontrollgruppen verglichen. Ergebnisse und Beobachtungen Mäuse mit einem heterozygoten Defekt der NSM zeigten eine erhöhte Präferenz für Alkohol und einen erhöhten Konsum von Alkohol im Vergleich zu wt-Mäusen. Der totale Flüssigkeits- konsum und der Konsum von Leitungswasser lagen unter dem Wert der wt-Mäuse. Bei den Auswertungen der Knochendichte durch eine CT-Untersuchung zeigten sich keine signifikanten Unterschiede in der Knochendichte zwischen wt-Mäusen und fro-Mäusen, unabhängig davon, ob die Mäuse Alkohol oder Leitungswasser tranken. In den Messungen der Hirnvolumina zeig- ten sich jedoch deutliche Unterschiede zwischen fro-Mäusen, die ausschließlich Wasser tranken und derer, die freiwillig Ethanol konsumieren konnten. Bei Ethanol-konsumierenden heterozy- goten fro-Mäusen kam es zu einer Reduktion der Volumina in gemessenen Hirnregionen. Diese Veränderung war vor allem in den Bereichen des dorsalen Hippocampus signifikant und im Be- reich der Inselrinde trendsignifikant. Bei wt-Mäusen konnte diese Reduktion trotz den Konsums von Ethanol nicht aufgezeigt werden. Schlussfolgerung Der alleinige Konsum von Alkohol zeigte keinen Effekt auf die Morphologie von Strukturen im Gehirn. Obwohl Ethanol durch eine erhöhte Produktion von Ceramid eine neurotoxische Zelldegeneration auslöst, war weder die Dauer noch die konsumierte Alkoholmenge ausrei- chend, um in diesem Setting einen Effekt zu bewirken. In Interaktion mit einem heterozygoten Knockout der NSM kam es jedoch bei Konsum von Ethanol zu signifikanten Auswirkungen. Interessanterweise war das Volumen des dorsalen Hippocampus zu Beginn des Experimentes im Vergleich zur wt-Gruppe signifikant erhöht. Somit kann angenommen werden, dass die fro- Mäuse vor Beginn des Alkoholkonsums über eine erhöhte Resilienz gegen Stressoren verfügten. Trotz der eigentlich verminderten Produktion von Ceramid durch die Defizienz der NSM, traten bei gleichzeitigem Konsum von Ethanol neurotoxische Effekte und eine Verminderung defi- nierter Strukturen auf. Als signifikant ist diese Reduktion im dorsalen Hippocampus und als trendsignifikant in der Inselrinde zu werten. Dabei handelt es sich um Strukturen, die immense Wichtigkeit in der Pathogenese psychiatrischer Erkrankungen, wie Sucht und Depression, auf- weisen. Ebenfalls konnte in NSM-Knockout-Mäusen eine erhöhte Präferenz und ein erhöhter Konsum von Ethanol per se festgestellt werden. Ein Einfluss auf die Mineralisierung und Dich- te der Knochen bei fro-Mäusen durch die Mutation selbst, den Konsum von Ethanol oder das Zusammenwirken beider Faktoren war in diesem Experiment nicht festzustellen. Die Ergebnis- se belegen spezifische Auswirkungen durch das Zusammenspiel der heterozygoten Defizienz der NSM mit Ethanol auf die Entwicklung und Morphologie von Hirnstrukturen.
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