Indexing the 'dark side of addiction': substance-induced affective symptoms and alcohol use disorders.
Indexing the 'dark side of addiction': substance-induced affective symptoms and alcohol use disorders.
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DOI：
10.1111/add.14431
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发表时间：
2019-01
期刊：
影响因子：
--
通讯作者：
Wilhelmsen KC
中科院分区：
文献类型：
--
作者：
Ehlers CL;Gilder DA;Gizer IR;Wilhelmsen KC
在酒精使用障碍（AUDs）过程中出现负面情感症状（例如“阴暗面症状”）已经在理论上提出，然而，对其发生的描述是有限的。本研究将两种负性情感症状进行操作，并检验这些表型与以下因素的相关性：1)AUD严重程度临床病程指标；2)共病I轴精神障碍、自杀行为和特质神经质；3)受试者是否报告饮酒以缓解负性情感症状。一项回顾性横断面研究使用逻辑回归来评估两种负面情感症状与AUD严重程度和进展的临床测量之间的关联，以及与其他精神疾病和疾病的合并症，并根据人口统计学特征进行调整。美国社区研究。2568名AUDs患者来自针对欧洲人（n=1663）、墨西哥人和美洲印第安人（n=905）血统的大型人群研究。酒精中毒遗传学半结构化评估用于确定：2种“阴暗面”表型、临床诊断、AUD的临床病程和相关症状。这两种表现型分别是：1)在试图减少或停止饮酒时感到焦虑或抑郁；2)在饮酒期间出现超过24小时的致残性抑郁。这两项在轻度和中度使用障碍中都很少见，而在重度aud中却非常普遍（约60%）。有独立焦虑或情感障碍和特质神经质得分较高也与这两种症状的发生显著相关，酒精“渴望”、寻求治疗次数增加、自杀行为和饮酒缓解症状也显著相关（调整后p <0.01， or范围= 1.5-22）。情感症状在严重的aud中很常见，与独立情感/焦虑障碍、神经质、自杀行为的历史有关，并可能促进进一步的大量饮酒。
The emergence of negative affective symptoms over the course of alcohol use disorders (AUDs) (e.g. “dark side symptoms”) has been suggested theoretically, however, the description of their occurrence is limited. This study operationalized 2 negative affect symptoms and tested the strength of association between these phenotypes and 1) indicators of the clinical course of the severity of AUD, 2) comorbid Axis I psychiatric disorders, suicidal behaviors, and trait neuroticism, 3) whether participants reported drinking to relieve the negative affective symptoms. A retrospective cross-sectional study was used to evaluate associations, using logistic regression, between the two negative affective symptoms and clinical measures of AUD severity and progression as well as comorbidity with other psychiatric disorders and conditions, adjusted for demographic characteristics. U.S. community based studies. 2,568 individuals with AUDs obtained from larger population studies that targeted individuals of European (n=1663), Mexican and American Indian (n=905) ancestry. Semi-Structured Assessment for the Genetics of Alcoholism was used to ascertain: the 2 “dark side” phenotypes, clinical diagnoses, the clinical course of AUD, and associated symptoms. The two phenotypes were: 1) being anxious or depressed when trying to cut down or stop drinking and 2) experiencing disabling depression for more than 24 hours while drinking. Both items were found to be rare in mild and moderate use disorder and highly prevalent (>60%) in severe AUDs. Having an independent anxiety or affective disorder and elevated scores on trait neuroticism were also significantly associated with the occurrence of both symptoms, as was alcohol “craving”, elevated treatment seeking, suicidal behaviors and drinking to relieve the symptoms (all adjusted p’s <0.01, ORs range= 1.5–22). Affective symptoms are common in severe AUDs, are associated with a history of independent affective/anxiety disorders, neuroticism, suicidal behaviors and may promote further heavy drinking.
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影响因子：
5.5
作者：
Ehlers CL;Gilder DA;Criado JR;Caetano R
通讯作者：
Caetano R
影响因子：
7.4
作者：
Magidson, Jessica F.;Wang, Shuai;Blanco, Carlos
通讯作者：
Blanco, Carlos
影响因子：
7.4
作者：
Bulloch, Andrew;Lavorato, Dina;Patten, Scott
通讯作者：
Patten, Scott
影响因子：
25.8
作者：
Andersen, Allan M.;Pietrzak, Robert H.;Han, Shizhong
通讯作者：
Han, Shizhong
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y