Associations of phenylthiocarbamide tasting to alcohol problems and family history of alcoholism differ by gender

Past research associating phenylthiocarbamide/propylthiouracil (PTC/PROP) taste status with alcoholism has produced equivocal results. Some have found higher proportions of nontasters among those with a family history of alcoholism than controls, whereas others have not. The purpose of this study was to investigate the relationship between PTC taste status, alcohol problems, and family history of alcoholism. A total of 244 undergraduate students participated in this study, with a gender distribution of 75% female and 25% male. We found support for our hypothesis that male supertasters would report fewer problems with alcohol and a less significant family history of alcoholism. Interestingly, we also found that female supertasters had a greater family history of alcoholism and more current problems associated with alcohol use. Implications for the genetic link between PTC taste status and alcoholism are discussed.     

Female alcoholics. V: The relationship between family history of alcoholism and outcome 3-10 years after treatment

In a long-term follow-up study of 44 female alcoholics, a family history of alcoholism was related to younger age of onset of problem drinking, but did not necessarily imply a poorer outcome within this highly selected group of individuals. Alcoholism in father and his family was not related to either antisocial or borderline personality disorder nor outcome. However, alcoholism in mother and her family correlated with both borderline personality disorder and a significantly poorer outcome. The findings are discussed within different frames of reference, considering genetic mechanisms, psychodynamic factors and family systems theory.     

The clinical significance of the thyrotropin-releasing hormone test in alcoholic men.

Sixty-six alcoholic men who had been abstinent from alcohol for at least four weeks were assessed clinically and then investigated in terms of Thyroid-Stimulating Hormone (TSH) and prolactin responses to a Thyrotropin-Releasing Hormone (TRH) challenge. Consistent with other studies, a third of the subjects had a blunted TSH response to TRH. This blunted response was not associated with a family history of alcoholism, or current depressive symptoms, past history of depression or family history of depression. However, subjects with a blunted TSH response were more likely to have had an earlier onset of alcoholism and to have had shorter alcoholic remissions in the past.     

The effect of parental alcohol and drug disorders on adolescent personality

OBJECTIVE: The relationship of parental alcohol or drug diagnosis to offspring personality was examined in a population-based sample of 17-year-old twins (568 girls and 479 boys) participating in the Minnesota Twin Family Study. Whether offspring personality characteristics 1) are specific to the type of substance use disorder in parents (alcohol versus drug) and 2) are found in high-risk offspring without substance use disorders as well as in offspring with substance use disorders was investigated. METHOD: Personality was assessed with the Multidimensional Personality Questionnaire; substance use disorders were assessed in person through diagnostic interviews. RESULTS: In both male and female offspring, parental history of alcohol dependence was associated with greater negative emotionality, aggression, stress reaction, and alienation but lower well-being; parental history of drug disorders was associated with lower constraint, control, harm avoidance, and traditionalism but higher social potency. Excluding offspring with a substance use disorder had virtually no effect on the statistical significance of these findings. CONCLUSIONS: In contrast to findings in some adult samples, personality characteristics associated with a family history of substance use disorders are found even in adolescent offspring who have not yet developed these disorders themselves, suggesting that personality might be one indicator of familial risk for substance use disorders during this developmental stage. Personality profiles of offspring of parents with substance use disorders also show some diagnostic specificity, with constraint associated with parental drug abuse and negative emotionality with parental alcoholism.     

The A1 allele of the DRD2 gene (TaqI A polymorphisms) is associated with antisocial personality in a sample of alcohol-dependent patients.

BACKGROUND: Presence of A1 allele of the DRD2 gene has been associated with a predisposition for alcoholism although there are limited data about its phenotypic expression in alcoholism. OBJECTIVES: To determine the importance of the A1 allele in clinical variables of alcohol dependence. METHODOLOGY: A sample of 103 alcohol-dependent males was studied. All patients were recruited consecutively from the general hospital and community settings. The diagnostics were made with the structured clinical interview for DSM-III-R (SCID); and the International Personality Disorder Examination (IPDE). Diagnosis of family alcoholism was made by direct interview or with the Research Diagnostic Criteria-Family History (RDC-FH). The Addiction Severity Index (ASI) and the Severity of Alcohol Dependence Scale (SADS) were used to assess alcohol dependence severity. Genotyping was done by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. RESULTS: Approximately 39% of the sample carried the A1 allele (A1+ group). This group had higher prevalences of antisocial personality disorder (60% vs. 15.9%); and alcoholism family history (72.5% vs. 52.4%). Also A1+ had early onset alcohol abuse and more drinking problems. The presence of A1+ was the main factor to explain the diagnosis of antisocial personality disorder, but the weight of this factor was not sufficient to explain the complications assessed by the ASI. CONCLUSIONS: Our results support the existence of an association between the A1 allele and factors resulting from dopaminergic deficiency, otherwise denominated reward deficiency syndrome.     

Female alcoholics. II. The expression of alcoholism in relation to gender and age

A sample of 233 consecutive alcohol-dependent female admissions were cross-matched for date of birth and admission with male subjects of similar ethnic background. Primary drug abusers were not included. A quarter of subjects of both sexes were married. There were no gender or age differences in the level of family history of alcoholism. Highly significant gender and age differences were found in alcohol-related behaviours, which were more prominent in the younger age groups and in male subjects. These crucial differences were highlighted by stratification of the results into age groups at decade intervals. Individual personality traits or a family history of alcoholism were found to determine the age of onset and pattern of alcoholism, whereas gender and maturational stage influenced the expression of alcohol-related behaviours that occur in treatment populations.     

The validity of neurotic-reactive depression. New data and reappraisal

A family history of alcoholism can be used as a validating factor in the diagnosis of reactive-neurotic depression. Not only is this true but there are clear data that indicate the presence of positive symptoms that can be used to make the diagnosis. A set of criteria based on previous research is presented for the diagnosis of neurotic-reactive depression. These criteria are based on a clustering of certain symptoms, events, and traits in patients with neurotic-reactive depression. The patients showed stormy life-styles, some specific symptoms, personality abnormalities, presence of life events before the onset of depression, and a family history of alcoholism. They had relatively few hospitalizations for depression and responded poorly to specific antidepressant treatment.     

Patterns of familial alcoholism, alcoholism severity, and psychopathology

The interrelationships among the severity of alcoholism, psychopathology/personality, and the degree of familial alcoholism were examined using the following four familial alcoholism classification schemes, which each differentiated three degrees of familial alcoholism: 1) conventional, compared alcoholics with no, nonparental, and parental alcoholic relatives; 2) lineality, distinguished between subgroups with alcoholism in neither, one, or both sides of their family; 3) generational, compared alcoholics having no, one, or two generations of familial alcoholism; 4) quantitative, credited one point for each first-degree and 1/2 point for each second-degree alcoholic relative. The subjects were 83 male alcoholic Veterans Administration inpatients 50 years of age or under. The Alcohol Use Inventory, various alcohol-related symptoms and behaviors, and laboratory values were used to evaluate the severity/pattern of alcoholism. Psychopathology/personality were measured by the MMPI, the Psychopathic State Inventory, the MacAndrew Alcoholism Scale, the Childhood Problem Behaviors Questionnaire, and the percentage of patients with an antisocial personality disorder (ASP) diagnosis. Surprisingly few subgroup differences were revealed in the severity/pattern of alcoholism. Only age at time of treatment and use of nonalcoholic drugs were associated with increasing familial alcoholism. On the other hand, childhood behavior problems, particularly antisocial behavior, and an ASP diagnosis were found to be associated with an increasing degree of familial alcoholism. The diagnosis of ASP was most apparent in the two-generational and bilineal alcoholics, while an increased degree of familial alcoholism was not associated with ASP for the conventional classification. Bilineal familial alcoholics also exhibited an MMPI profile reflective of a characterological disorder.(ABSTRACT TRUNCATED AT 250 WORDS)     

Psychiatric comorbidity and suicidality among intravenous drug users.

BACKGROUND: Prevalence of lifetime psychiatric comorbidity and history of attempted suicide among intravenous drug users was investigated. METHOD: One thousand sixty-two relatives of hospitalized alcoholics, felons, and control subjects were administered a structured interview that gathered data on lifetime psychiatric symptoms and psychoactive drug use. Psychiatric diagnoses were based on interview information, medical records, and family history data. Comparisons were made between 411 subjects who used no illicit drugs, 329 cannabis users, 230 subjects who had used psychoactive drugs other than cannabis more than five times but had never injected drugs, and 92 intravenous drug users. RESULTS: Any history of injecting drugs increased the odds of being diagnosed with antisocial personality disorder by a factor of 21.01, alcoholism by 4.42, and unipolar depression by 3.02. A diagnosis of antisocial personality disorder increased the odds of having injected drugs by a factor of 27.19, while diagnoses of alcoholism or unipolar depression conveyed odds for injecting drugs of 4.62 and 3.70, respectively. Intravenous drug use was associated with an 8.27-fold increase in odds for a suicide attempt compared with no drug use. CONCLUSION: Rates of alcoholism, depression, and antisocial personality disorder, but not other psychiatric disorders (other than drug dependence), are significantly elevated in intravenous drug users. Moreover, among drug users, the decision to inject is differentially made by those with antisocial personality disorder. A history of suicide attempt is common among intravenous drug users, but injecting appears to convey little additional risk above substantial but non-intravenous drug use.     

Clinical characteristics of familial versus sporadic alcoholism in a sample of male and female patients.

Presence of a family history of alcoholism may predict clinical characteristics in affected subjects, such as an earlier age at onset. More frequent and severe social maladjustment and somatic complications are also regularly cited for familial alcoholism, although subject to many other confusing factors. We analysed the clinical specificities of 79 alcohol-dependent inpatients according to the absence versus presence of family history of alcoholism. Patients were evaluated for lifetime psychiatric morbidity with the Diagnostic Interview for Genetic Studies (DIGS), for somatic complications with a systematic screening list, and first-degree relatives (N = 428) were assessed with the Family Inventory Schedule and Criteria (FISC). Age at onset and social complications were predicting familial versus sporadic alcoholism, even when considering censored data and/or interaction between variables. But differences became non-significant when excluding patients with antisocial personality. If age at onset effectively appears to be the most informative characteristic for predicting familial versus sporadic alcoholism, it seems that it may be necessary in future studies to systematically take into account antisocial personality diagnosis, because of a probable contamination.     

精神分裂症的性别差异

目的:探讨精神分裂症患者的性别差异。方法:收集240例不同性别精神分裂症患者的首次发病年龄、病程、阳性家族史、临床症状、病前人格和诊断分型等资料,并进行分析比较。结果:首次发病年龄、病程和阳性家族史无性别差异,读心症、钟情妄想、其他妄想、思维逻辑性障碍和怪异行为等阳性症状在男性患者组和女性患者组中的分布差异有显著性,其他阳性症状及阴性症状在两组中的分布差异无显著性。结论:精神分裂症患者的阳性症状存在性别差异,女性精神分裂症患者的临床症状多表现为阳性症状。     

酒精所致精神障碍患者个性特征与应对方式

目的：探讨酒精所致精神障碍患者个性特征与应对方式的相关性。方法：运用艾森克人格问卷（EPQ）及应对方式问卷（CSQ）对55例酒精所致精神障碍患者（研究组）和43名无酗酒史的健康人（对照组）进行问卷调查,并对其相关因素进行分析。结果：与对照组相比,研究组的个性以精神质为显著特征;EPQ评分除内外向因子外其他维度如精神质（t=4.75,P〈0.001）、神经质（t=4.95,P〈0.001）以及掩饰程度（t=-2.47,P〈0.015）差异均有统计学意义。两组CSQ评分比较,研究组的应对方式不成熟,以退避（t=9.08,P=0.000）、幻想（t=10.33,P=0.000）和自责（t=8.74,P=0.000）评分较对照组显著增高。相关分析发现,研究组神经质与合理化（r=0.263,P〈0.05）、自责（r=0.298,P〈0.05）呈正相关;内外向与解决问题（r=0.532,P〈0.01）、求助（r=0.582,P〈0.01）呈显著正相关,精神质与解决问题（r=-0.270,P〈0.05）呈负相关。结论：酒精所致精神障碍患者的应对方式受其个性特征影响。     

Clinical and temperamental differences between early- and late-onset alcoholism in Korean men

OBJECTIVES: The aims of this study were to elucidate the clinical and temperamental differences between early- and late-onset alcoholism among Korean men and to ascertain the validity of Cloninger's typology model of alcoholism for Koreans. METHODS: All of the subjects were screened after a detoxification period of at least 2 weeks using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders for diagnosing alcohol dependence and identifying psychiatric comorbidities. The Korean version of the tridimensional personality questionnaire was then administered to 173 male alcoholic inpatients; and information regarding their criminality, family history of alcoholism, and age at the onset of alcohol-related problems was gathered. We divided the patients into 2 groups based on the age at the onset of alcoholism: (1) early onset (n = 80), when they were up to 25 years old at the onset, and (2) late onset (n = 93), when they were older than 25 years at the onset. RESULTS: Early-onset patients exhibited more criminality (chi2 = 15.45, df = 1, P < .001, odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.93-7.65), suicide attempts (chi2 = 7.92, df = 1, P = .005, OR [95% CI] = 3.14 [1.38-7.15]), and family history of alcoholism (chi2 = 24.75, df = 1, P < .001, OR [95% CI] = 5.27 [2.67-10.37]). With regard to the tridimensional personality questionnaire profile, the early-onset patients exhibited a higher score of novelty seeking (t = 3.42, P = .001), with the difference still being significant after adjusting for age by analysis of covariance (using age as a covariate) (F = 5.928, P = .016). However, harm avoidance (t = -0.13, P = .89), reward dependence (t = -0.19, P = .85), and persistence (t = -0.62, P = .54) did not differ between the 2 groups. CONCLUSIONS: There were several distinct clinical and temperamental differences between early- and late-onset alcoholism among Korean male alcoholic patients. It is suggested that the age at the onset of alcoholism can be used to discriminate alcoholic subtypes. Our data also partly support Cloninger's typology of 2 types of alcoholic individuals.     

心理健康状况对慢性酒中毒患者生活质量的影响

目的：探讨慢性酒中毒患者心理健康状况与生活质量的关系。方法：运用症状自评量表（SCL-90）和生活质量综合评定问卷（GQOLI-74）对55名慢性酒中毒患者（患者组）和43名无酗酒史的当地市民（对照组）进行问卷调查,对相关因素进行分析。结果：患者组SCL-90各因子分均显著高于对照组（P〈0.05或P〈0.01）。患者组GQOLI-74各维度和客观状态总分除物质生活外均显著低于对照组（P〈0.001）。患者组心理健康状况与生活质量存在相关性。结论：慢性酒中毒患者的心理健康状况有不同程度损害,生活质量下降。慢性酒中毒患者的治疗,不仅要控制患者的精神病性症状和改善负性情绪,更要重视躯体化症状和纠正强迫性觅酒行为。     

Types of alcoholics, II. Application of an empirically derived typology to treatment matching.

Data from 79 male alcoholics who were randomly assigned to either coping skills training or interactional group psychotherapy were used to replicate a multidimensional, empirically derived typology and to evaluate the typology's usefulness in matching patients to treatment. Consistent with previous cluster analysis research, indicators of risk for alcoholism, alcohol dependence, drinking history, and psychopathological impairment distinguished alcoholics along two broad dimensions of vulnerability and severity, with one subtype (type B alcoholics) manifesting an earlier onset of problem drinking, more familial alcoholism, greater dependence on alcohol, and more symptoms of antisocial personality than the other subtype (type A alcoholics). Analyses of outcome indicated that type A alcoholics fared better in interactional treatment and more poorly with coping skills training. Conversely, type B alcoholics had better outcomes with the coping skills treatment and worse outcomes with interactional therapy. Differences in treatment response were maintained for 2 years from the beginning of aftercare treatment.     

Gender differences in the specificity of alcoholism transmission among the relatives of opioid addicts

Gender differences in the specificity of drug versus alcohol transmission were examined among 201 opioid addicts and their 877 first-degree relatives using direct interviews and a structured family history method based on the Schedule for Affective Disorders and Schizophrenia Research Diagnostic Criteria. A strong association of parental alcoholism with alcoholism among the proband addicts was found, suggesting some specificity for drug versus alcohol abuse. We also found that among the 477 siblings, those with alcoholism alone did not have parents with drug abuse and those parents with drug abuse did not have children with alcoholism alone. Rates of parental alcoholism were higher in alcoholic female than in alcoholic male probands, suggesting greater female "loading" was needed in order to become alcoholic. This increased loading in women was also found among the siblings, but alcoholic parents appeared to transmit a nonspecific tendency for either drug or alcohol abuse to their female children. Thus, it may take a greater "dose" of parental transmission for a woman to become a substance abuser, and transmission of alcoholism may be specific in men, but not in women.     

Caffeine dependence in combination with a family history of alcoholism as a predictor of continued use of caffeine during pregnancy

OBJECTIVE: The purpose of the study was to examine whether caffeine dependence and a family history of alcoholism are associated with continued use of caffeine during pregnancy. METHOD: Forty-four women seeking obstetrical care in an office-based practice completed questionnaires and provided saliva samples at three prenatal visits occurring 2-3, 3-4, and 7 months postconception. On visit 1, the patients received the physician's instructions to stop using caffeine. Structured interviews were used to assign a diagnosis of caffeine dependence (lifetime) and to identify family history of alcoholism. Outcome measures included self-reported levels of caffeine use and saliva caffeine levels at the three prenatal visits. RESULTS: Although most women eliminated or substantially reduced their caffeine consumption between pregnancy awareness and prenatal visit 1, those with a lifetime diagnosis of caffeine dependence and a family history of alcoholism had higher levels of caffeine use and lower rates of abstinence throughout pregnancy. Saliva caffeine levels confirmed these effects. Withdrawal symptoms, functional impairment, and craving were cited as reasons they failed to eliminate or cut back on caffeine use. Fifty percent of the women with both a lifetime diagnosis of caffeine dependence and a family history of alcoholism continued to use caffeine in amounts (>300 mg/day) greater than those considered safe during pregnancy, compared to none of the women without caffeine dependence and a family history of alcoholism. Women with a lifetime diagnosis of caffeine dependence and a family history of alcoholism also reported higher rates of past cigarette smoking and problematic alcohol use. CONCLUSIONS: Caffeine-dependent women with a family history of alcoholism were not able to follow their physician's advice to reduce or eliminate caffeine consumption during pregnancy, despite their wanting to do so. This subgroup may require more intensive intervention to ensure caffeine abstinence and may be at greater risk for abuse of or dependence on other drugs.     

Morel's laminar sclerosis showing apraxia of speech: Distribution of cortical lesions in an autopsy case

A 57‐year old man with chronic alcoholism presented with apraxia of speech and disturbance of consciousness. He had a history of gastrectomy and had been drinking alcohol. The symptoms improved with administration of thiamine, but he later developed diarrhea and delirium, and died approximately 40 days after the onset. Autopsy findings were consistent with Wernicke's encephalopathy and pellagra encephalopathy. Furthermore, laminar cortical necrosis with vacuoles and astrocytosis was found in the second and third layers of the bilateral frontal cortices, suggesting Morel's laminar sclerosis. The lesions were mainly located in the bilateral primary motor cortices. Involvement of the lower part of the left primary motor cortex may be associated with apraxia of speech in our case.     

Suicide attempts in antisocial alcoholics

The dual diagnoses of alcoholism and antisocial personality are frequently associated with suicide attempts. A group of 94 alcoholics with antisocial personality were divided on the basis of a previous suicide attempt. A variety of symptoms, including depression, alcohol and drug abuse, conduct disorder, and violence were found more frequently in the suicide attempter group as reported on the structured interview. These emotional problems were additionally found to have an earlier onset. The results were consistent with the concept of secondary sociopathy and indicated that higher psychopathology may be associated with suicide behavior.     

Comparative dexamethasone suppression test measurements in bulimia, depression and normal controls

Twenty bulimics, 20 depressives and 20 normal controls were studied using the Dexamethasone Suppression Test (DST) as defined by Carroll et al. Their past psychiatric and family histories were compared. We found that actively bulimic subjects had a rate of DST non-suppression of 20%, and that 20% of them had a past history of a major depressive disorder. Forty per cent had a history of alcoholism and/or antisocial personality in a first degree relative, but only 5% had a positive family history of affective disorder. These rates were significantly lower than those found in the depressed group except for the family history of alcoholism and/or antisocial personality for which there was no significant difference. We identified a subgroup of bulimic DST non-suppressors who, like patients with melancholia, were characterized by past history of major depressive illness and high rates of family history of affective disorder, alcoholism and/or antisocial personality in first degree relatives. This group responded to antidepressant medications in a manner similar to depressed patients.