女性的喝酒慾望更可能和憂鬱有關


  May 6, 2008(華盛頓特區) — 根據梅約診所自我參與酒癮治療之300多名病患所進行的初步回溯研究顯示,女性的憂鬱症狀與喝酒慾望有關;這項研究發表於美國精精神醫學會第161次年會中的壁報。
  
  比較參加治療計畫的男性和女性,女性有比較高的憂鬱症狀和飲酒渴望分數;經臨床診斷為酒癮者發現有這兩種診斷,定義為酒癮加上憂鬱、雙極異常或焦慮異常。
  
  主要作者、加州大學舊金山分校的Nelli Boykoff向Medscape Psychiatry表示,結果顯示婦女飲酒以緩解焦慮和憂鬱,男性則比較可能是為了飲酒作樂。
  
  共同作者、梅約診所的Mark A. Frye醫師表示,我們真正震驚的是,當婦女參加28天的計畫時,她們的憂鬱症狀和飲酒渴望顯著高於男性,憂鬱和飲酒渴望之間的關聯強烈。
  
  他指出,就我們所知,這是第一篇指出婦女和男性的酒癮有不同的臨床關聯研究,根據這些相關資料,或許可以有不同的治療目標。
  
  【憂鬱女性飲酒者】
  研究者對364名參加密集戒癮計畫的病患進行臨床資料回溯分析 (135名女性、229名男性) ,這是一個在梅約診所的28天住宿治療計畫,使用貝克憂鬱量表(Beck Depression Inventory,BDI)測量憂鬱症狀,使用賓州酒癮量表(Pennsylvania Alcohol Craving Scale,PACS)測量飲酒渴望。
  
  病患平均年紀為47.9歲,平均在19.7歲時開始飲酒,女性飲酒量幾乎和男性一樣多— 女性平均多到每天10.8 杯,男性是平均每天13.8杯;約半數病患(53%) 每天飲酒,75%符合國立酒精濫用與中毒研究所(National Institute on Alcohol Abuse and Alcoholism,NIAAA)定義的危險使用者(男性每天超過5杯、女性每天超過4杯);92人只有酒癮,139人有酒癮和憂鬱、雙極異常、或焦慮異常。
  
  相較於男性,女性加入治療計畫時明顯有較高的憂鬱(P= <.001)和飲酒渴望(P=.001)分數。
  
  女性的憂鬱和飲酒渴望分數有明顯的關聯,此關聯可見於只有酒癮的女性(r =.78; P<0.0001) 以及同時有酒癮和另一種主要的非藥物診斷者(r=.36;P=0.01)。
  
  【可能的解釋:緩解渴望與獲得渴望】
  研究者寫道,渴望飲酒是酒精依賴的重要元素,且有復發關聯,為酒癮治療策略成功控制飲酒渴望的主要關鍵。
  
  他們指出,飲酒渴望可以分成幾個不同機轉—緩解渴望 (與穀氨酸鹽[glutamate]有關)、獲得渴望(與多巴胺、鴉片有關)、以及妄想渴望(與血清素有關);有些初步研究認為,naltrexone 和 acamprosate 分別可以處理獲得渴望和緩解渴望。
  
  Boykoff小姐結論表示,憂鬱看似與女性的飲酒渴望有強烈關聯,我們認為需要後續研究確認憂鬱和緩解渴望的關聯,以期能影響治療結果。
  
  Frye醫師為Janssen-Cilag、AstraZeneca Pharmaceuticals、Abbott Laboratories、Bristol-Myers Squibb、GlaxoSmithKline與 Otsuka Pharmaceuticals之諮詢顧問;Boycoff小姐未提供任何財經宣告。
  
  美國精精神醫學會第161次年會:年輕研究者的新研究壁報組第1組。壁報NR1-013。2008年5月3-8日。

Alcohol Craving in Women, Not<

By Marlene Busko
Medscape Medical News

May 6, 2008 (Washington, DC) — Depressive symptoms in women, but not men, correlated with alcohol craving in an early retrospective study of over 300 patients who were self-referred for an alcohol addiction treatment program at the Mayo Clinic.

The study was presented in a poster at the American Psychiatric Association 161st Annual Meeting.

On admission to the treatment program, compared with the men, women also had higher depressive-symptom and alcohol-craving scores. This was true for subjects with a clinical diagnosis of alcohol dependence alone as well as those with a dual diagnosis, which was defined as alcohol dependence plus depression, bipolar disorder, or anxiety disorder.

"It appears that the women are drinking to relieve anxiety and to relieve depression, whereas the men might be drinking just to feel good, for a positive feeling," lead study author Nelli Boykoff, from the University of California, San Francisco, California, told Medscape Psychiatry.

"What we were really struck by was that when women came into the 28-day program, their depressive symptoms and cravings for alcohol were significantly higher than those of the men, and that correlation [between depression and alcohol craving] was robust," said study coauthor Mark A. Frye, MD, from the Mayo Clinic in Rochester, Minnesota.

"To our knowledge, this is one of the first studies to show that indeed women and men differ in their clinical correlates of alcoholism, and there may be some very relevant ways to target treatment based on some of these correlational data," he added.

Depressed Women Drinkers

The investigators performed a retrospective analysis of clinical data from 364 patients (135 women and 229 men) who participated in the Intensive Addiction Program, a 28-day residential treatment program, in the Mayo Clinic. Depressive symptoms were measured by the Beck Depression Inventory (BDI), and alcohol cravings were measured by the Pennsylvania Alcohol Craving Scale (PACS).

On average, the patients were aged 47.9 years and had started drinking when they were 19.7 years old. Women were drinking almost as heavily as the men — on average, as many as 10.8 drinks/day vs the men's 13.8 drinks/day. About half of the patients (53%) were daily drinkers, and 75% met the National Institute on Alcohol Abuse and Alcoholism (NIAAA) definition of hazardous user (more than 5 drinks/day for a man or more than 4 drinks/day for a woman). There were 92 subjects with alcohol-only addiction and 139 subjects with alcoholism along with depression, bipolar disorder, or anxiety disorder.

On admission to the treatment program, compared with the men, the women had significantly higher depression (= < .001) and alcohol craving (P = .001) scores.

Women, but not men, had a marked correlation between their depression and craving scores. This correlation was found in women who had only alcohol dependence (r = .78; < 0.0001) and as well as in those who had both alcohol dependence and an additional Axis 1 nondrug diagnosis (r = .36; P = 0.01).

Possible Explanation: Relief Craving vs Reward Craving

Craving for alcohol is a central component of alcohol dependence and has been shown to be linked with relapse, which makes successful control of craving a key element of alcoholism treatment strategies, the group writes.

They note that craving can be divided into subtypes with different possible mechanisms — relief craving (involving glutamate), reward craving (involving dopamine, opiate), and obsessive craving (involving serotonin). Some preliminary work has suggested that naltrexone and acamprosate may be more effective for reward craving and relief craving, respectively, they observe.

"Depression seems so strongly correlated with alcohol craving in women that we definitely need to take a look at it [and at relief craving] in further studies and see whether it will affect outcome and treatment," Ms. Boykoff concluded.

Dr. Frye is a consultant for Janssen-Cilag, AstraZeneca Pharmaceuticals, Abbott Laboratories, Bristol-Myers Squibb, GlaxoSmithKline, and Otsuka Pharmaceuticals. Ms. Boycoff did not provide any financial disclosure.

American Psychiatric Association 161st Annual Meeting: New Research Young Investigators' Poster Session 1. Poster NR1-013. May 3-8, 2008.

    
相關報導
憂鬱和焦慮會縮短IBD突發時間
2016/2/26 上午 10:55:00
童年時的憂鬱會影響灰質發展
2016/1/15 上午 10:03:32
母親的憂鬱會使兒童「老化」
2015/7/8 下午 04:47:12

上一頁
   1   2   3   4   5   6   7   8   9   10  




回上一頁