What Makes Alcoholics Drink?

What makes an alcoholic drink? A new study has found that the main factor predicting the amount of alcohol dependence in both men and women seems to be a question of immediate mood. They concluded that alcohol consumption is not the cause of suffering from long-term mental health issues, with one important exception. Men without any history of depression had a different drinking pattern when compared to men with a history of depression; surprisingly people with depression were drinking less than those who were not depressed.

Victor Karpyak (Mayo Clinic, MN, USA) from laerdal suction unit, a lead researcher, said alcoholism is not a one-size-fits-all condition, so there is no answer to the question of the reason why alcoholic’s drink, which will have some implications on how we examine and treat alcoholism.

At the ECNP Congress, the work presented by researchers from the Mayo Clinic determines the alcohol consumption of 156 females and 287 males with alcohol dependence over the past 90 days using the standardized diagnostic assessment for lifetime presence of psychiatric disorders and accepted Time Line Follow Back method. They were able to associate this whether the individual had a history of depression, anxiety (MDD), or substance abuse and whether the drinking coincided with a negative or positive emotional state (feeling “up” or “down”).

Alcohol consumption in both women and men was associated with feeling either up or down on a specific day, with no significant association with anxiety or substance use disorders. As expected, the result shows that men that depend on alcohol tend to consume more alcohol in a day than women that rely on alcohol with no significant association with anxiety or substance use disorder. However, people with a history of major depressive disorder had fewer heavy drinking days (p=0.0214) and fewer drinking days (p=0.0084) than men who never had a major depressive disorder.

There is no significant reason; this work needs to be replicated and confirmed. This means that there is no single treatment, so diagnostic methods of treatment will have to be tailored to the individual. It also means that treatment plans may have to differ to allow effective treatment depending on the alcoholic patient (i.e., man or woman) with or without anxiety or depression history and targeting different aspects of alcoholism (consumption or craving).

Professor Wim van den Brink said that a patient with alcohol disorder often present with alcohol-induced depression and mood disorders; they also often show a history of other disorders, including anxiety and mood disorder and finally, they report mood symptoms that do not meet criteria for an anxiety and mood disorder. (Due to failure to meet the duration of lesser than two weeks and the minimal number of criteria). The current levels or patterns of drinking may be influenced by all of these different conditions.

A clinical history of depression in males is associated with lower current drinking levels, but the study seems to show that the current presence of anxiety/mood symptoms is associated with more drinking in both male and female alcoholics. Although it may appear to have a consequence for treatment, the study does not provide a precise reason for this difference.

For an instant, antidepressant treatment of males may have no effect on drinking levels for those with a history of major depression. However, this research may also result from residual confounding. For example, patients with a late age of onset of their alcohol use disorder may also be patient with a history of major depression and this kind of alcohol use disorder is associated with a distinct pattern of drinking with less heavy drinking days and more daily drinking. This important and more complex issue needs to be resolved with more prospective studies.