2012 ISBRA POSTER ABSTRACTS
P169
GENDER EFFECT OF COMORBID ANXIETY AND DEPRESSION ON NEGATIVE CRAVING
IN TREATMENT SEEKING ALCOHOLICS
V.M. Karpyak; J.M. Biernacka; J.R. Geske; O.A. Abulseoud; M.D. Brunner; M. Chauhan; D.K.
Hall-Flavin; L.L. Loukianova; G.J. Melnyk; D.A. Onsrud; B.D. Proctor; J.E. Wittkopp; T.D.
Schneekloth; M.S. Drews; T.L. Pietrzak; M.K. Skime; M.A. Frye; D.A. Mrazek
Mayo Clinic, Rochester, MN, USA
Background: A tendency to drink in the context of negative emotional situations is
interpreted as negative or relief craving. Our previous research demonstrated that
intensity of depressive symptoms correlates with the intensity of cravings and these
relationships are stronger in females. To further investigate the effects of comorbid
anxiety and depressive disorders on intensity of negative cravings, we evaluated the
presence of these phenotypes in alcohol dependent males and females participating in
the prospective study A Probe Study of Acamprosate: Genes Associated with Response
supported by NIAAA P20 Grant Mayo Clinic Center for Individualized Treatment of
Alcohol Dependence.
Methods: 223 male (age=42.611.5) and 120 female (age=41.012.2) subjects were
assessed with Psychiatric Research Interview of Substance and Mood Disorders (PRISM).
Intensity of negative craving was assessed by Inventory of Drug Taking Situations
(IDTS). T-tests were used to compare mean scores of negative craving subscale of
IDTS separately in male and female groups of alcohol dependent subjects with and
without comorbid depressive or anxiety disorders. Chi-square tests were used to assess
association of depressive and anxiety disorders with gender.
Results: Major Depressive Disorder (MDD) and Substance Induced Depression (SID) were
more common in females then in males (55.7% vs. 40.2%, p=0.008 and 46.1% vs. 24.4%,
p<0.0001, respectively). Any Anxiety Disorder (AD) and Substance Induced Anxiety (SIA)
were also more frequent in females but difference was not statistically significant (52.6%
vs. 42.6%, p=0.083 and 7.0% vs. 4.8%, p=0.414). In males, presence of MDD, SID, and
AD was associated with significantly higher negative IDTS scores (p<0.05 for each). The
negative IDTS scores in females without MDD or SID was higher then in males without
MDD or SID (63.224.5 vs 52.320.3, p=0.002). However, the difference between
negative IDTS score in females with and without MDD, SID and AD was not significant.
Conclusions: We have demonstrated that comorbid depressive and anxiety disorders
in treatment-seeking alcoholic males are associated with significant increase in negative
cravings. We confirmed our previous findings that intensity of negative cravings is higher
in female compared to male alcoholics. However, further increase of the negative IDTS
score related to presence of comorbid MDD, SID or AD was not statistically significant
in female alcoholics. These findings indicate that individualized treatment selection for
alcohol dependent subjects should consider gender-specific effects of comorbid mood
and anxiety disorders.
P170
CLASSIFICATION OF ALCOHOLISM ACCODING TO THE VALUE OF AUTISTIC AND
NON-AUTISTIC DIFFERENTIATION
Y. Komoto
Okayama Psychiatric Medical Center, 3-16 Shikatahonnmachi, Kitaku, Okayama, 7000915,
Japan
Alcoholism is a heterogeneous disease. I attempted to make classifications from the
recovery process perspective. In detail, I classified alcoholism types according to
strength/weakness of autism features and investigated how these features were associated
with continuation of abstinence. The subjects were 102 man outpatients diagnosed with
alcoholism. The investigations were made on 3 areas: 1. Basic background including
sex, age etc. 2. Medical variables including psychiatric complications, self-help group
participation, the longest abstinence period etc. 3. Autism-spectrum Quotient (AQ) scores,
which is a self-administered test of autism features on a maximum scale of 50 points.
The mean (standard deviation) of AQ scores of 102 subjects was 22.6 (7.18) with normal
distribution. 78 subjects who had been followed-up for more than 2 years were classified
into the low and average score (0-29) group of 62 subjects (non-autistic type), and the
high score (30-50) group of 16 subjects (autistic type), according to their AQ scores.
No significant difference was observed in terms of patients background and medical
variables, but the number of subjects with stable abstinence (more than 2 years) was
higher in the autistic type compared to the non-autistic type (p=0.0208). It was presumed
that continuation of abstinence was more difficult in the non-autistic type compared to the
autistic type.By psychopathological analysis of these 2 types, there was a clear distinction
between the non-autistic type in which the craving is overcome through deepening of self-
insight and the autistic type in which the craving declines, and the subjects are easily able
to return to their lives prior to the drinking. As the mechanism of disorder formation, with
the former type, psychological rewards such as temporary relief of conflict or increase
in the delusion of self-grandeur were the driving force for the drinking habit. In contrast,
with the latter group, one characteristic of autism, that is the tendency toward a repetitive
ritualistic behavior, contributed to repetition in the act of drinking. With this characteristic,
though, once the habit of abstinence is started, that habit tended to be continued (recovery
promotion). In addition, as a characteristic of an autistic personality, there is a reduced
active sense of identity between the self that is drinking and the self that has overcome
drinking, which contributed to the recovery facilitation. Treatment approaches should be
managed appropriately for these 2 types.
134A
P171
COMORBID ALCOHOLISM IN BIPOLAR DISORDER AFFECTING PHYSICAL HEALTH
RATHER THAN SOCIAL FUNCTION
S.Y. Tsai; P.H. Chen; S.H. Huang; K.H. Chung; Y.F. Wang
Department of Psychiatry, Taipei Medical University Hospital; College of Medicine, Taipei
Medical University, Taipei, Taiwan
Background: Over 30% comorbidity of alcohol use disorders in bipolar disorder from
the Western societies has been well known and may confound their outcome studies.
However, several lines of evidence from small sample-size studies suggest that the
genetically-determined deficiency in ALDH activity may protect some Asian populations
with bipolar disorder (e.g., Taiwan) from alcohol use disorder. Therefore, the outcome of
bipolar disorder may vary due to the cross-cultural difference in alcohol use problems
between Western and Eastern populations. We attempted to investigate the comorbidity
of alcohol use disorders in a large Taiwanese clinical population with bipolar disorder
and to find out the impacts of alcoholism on the social functioning, physical, and mental
health conditions Methods: The clinical data of patients with bipolar I disorder (DSM-
IV) were obtained by a combination of reviewing charts, self-reporting questionnaires,
and board-certificated psychiatrist directly interviewing with patients. Data of alcoholic-
and non-alcoholic were compared. Results: Totally, 393 bipolar patients were recruited
in the study and 34 of them (8.4 %) fulfilled the criteria of alcohol use disorders (DSM-IV)
in their life time. The alcoholic group had significantly (p< 0.05) higher mean body mass
index (29.1+ 6.1 kg/m2) than non-alcoholic group (25.3+ 4.1 kg/m2). Alcoholic group
tended to male (87.9%), have positive history of rapid cycling (21.2%) and concurrent
gastro-intestinal morbidity (31.0%) with statistical significance (p< 0.05). There was no
significant difference in socioeconomic classes, unemployed, and divorced/separated
statuses between two groups. Multiple logistic regression showed that alcoholic patients
were more likely to be male and have gastro-intestinal morbidity. Conclusions: Unlike the
Western reports, we suggest that comorbid alcohol use disorders among Chinese bipolar
patients in Taiwan does not increase and be comparable to that of general population.
This fact reflects that alcohol use problems may play a critical role in the racial difference
of outcome of major psychiatric disorders. The main impact of alcohol use disorders
on the outcome of patients with bipolar disorder is physical health condition rather than
psychosocial function.
18 Sociology
P172
WINES AND SPIRITS OF FOREIGN DENOMINATIONS MANUFACTURED IN THE
FORMER SOVIET UNION
S.V. Jargin
Peoples Friendship University of Russia, Moscow, Russia
Manufacturing of wines and liquors of foreign denominations in the former Soviet Union
has a long history. Some sorts of Champaign, Port, Madeira, Jeres (Sherry) and other
wines were of good quality; and our people consumed them, when importation from the
West was very scarce. Thanks to this practice, many our citizens are acquainted with
foreign sorts of wine and spirits and recognize today the originals. Our wine-makers did
great work developing new sorts of wine and spirits, including the imitations, which was
fuelled by genuine interest of many people. Quality wine and Cognac were available to
the broad public: during the 1970s, a 0.75 l bottle of marochnoe (quality wine), such
as Crimean Madera, Port or Jeres, cost about 3.30 rubles, their cheaper but still good
varieties - around 2.50 rubles, while a 0.5l bottle of vodka cost about 4 and of the cheapest
Cognac - 8 rubles. During the anti-alcohol campaign of 1985-88 we have lost a part of this
heritage. On the other hand, as far as we know, in the West are sold only original products
of the above-named denominations, in accordance with the Protected Geographical
Status framework. The problem awaits its solution: under which names and etiquettes the
above-mentioned sorts of wines and spirits can be produced and sold. The optimal way,
on our opinion, would be international agreements regulating the use of denominations
such as "Soviet Champaign" (which is still in production), "Crimean Madera", and so forth.
Some popular Portwein sorts in the former Soviet Union were numbered (e.g. Portwein
no. 33 or 72); it might be a good idea to continue using these denominations, under the
condition of strict adherence to the original formula, because these beverages have great
nostalgic value. Unfortunately, surrogates are sometimes sold in Russia under the label
"Portwein". Otherwise, "-type-names" can be used, e.g. "Jeres-type wine". In a sense, well
known sorts of wines and spirits can be compared with classical paintings or architectural
monuments: using modern technologies, they can be imitated or "improved". This is
the reason why manufacturing standards of renowned beverages should be protected
together with their names. However, imitations have their right to exist, provided that
consumers can recognize from the label, where the original is and where is an imitation. It
should be stressed in this connection that back labels of wines and spirits must be clearly
readable, which is not always the case in the former Soviet Union.