Skip to main content
Erschienen in: European Archives of Psychiatry and Clinical Neuroscience 6/2007

01.09.2007 | ORIGINAL PAPER

Alcoholism in women: is it different in onset and outcome compared to men?

verfasst von: Alexander Diehl, Bernhard Croissant, Anil Batra, Götz Mundle, Helmut Nakovics, Karl Mann

Erschienen in: European Archives of Psychiatry and Clinical Neuroscience | Ausgabe 6/2007

Einloggen, um Zugang zu erhalten

Abstract

Onset and course of alcohol dependence show gender related differences (telescoping effect) suggesting that women are more vulnerable to chronic alcohol consumption. This raises the question whether the differences are associated with a different treatment outcome as well. We hypothesized, that alcohol dependent women with a telescoping course show a less favourable treatment outcome compared to men. We investigated 212 alcohol dependent patients; matching 106 consecutively admitted women with 106 men drawn from a total sample of 343 male patients. The treatment program consisted of a 6 week inpatient treatment and 12 months of outpatient aftercare. We assessed milestone variables in development and course of alcoholism and carried out standardized diagnostic tests, physical and blood examinations to evaluate the course of the disease and treatment outcome. Overall, we confirm the telescoping effect, a faster progression in the course of alcoholism (developmental events and adverse consequences) in women compared to men (“telescoping effect”). However, despite the telescoping effect treatment outcome was similar in women and men. During the inpatient treatment program no alcohol relapse occurred. Throughout the 12 months outpatient treatment we found no significant differences in the survival analysis between women (283.29 ± 11.26 days) and men (284.72 ± 12.16 days). At the end of the 12 months both groups had an abstinence rate of approximately 50% and a drop-out rate of 33%.
Literatur
Zurück zum Zitat Acker C (1986) Neuropsychological deficits in alcoholics: the relative contributions of gender and drinking history. Br J Addict 81:395–403PubMedCrossRef Acker C (1986) Neuropsychological deficits in alcoholics: the relative contributions of gender and drinking history. Br J Addict 81:395–403PubMedCrossRef
Zurück zum Zitat Ammon E, Schafer C, Hofmann U, Klotz U (1996) Disposition and first-pass metabolism of ethanol in humans: is it gastric or hepatic and does it depend on gender? Clin Pharmacol Ther 59:503–513PubMedCrossRef Ammon E, Schafer C, Hofmann U, Klotz U (1996) Disposition and first-pass metabolism of ethanol in humans: is it gastric or hepatic and does it depend on gender? Clin Pharmacol Ther 59:503–513PubMedCrossRef
Zurück zum Zitat Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, Gastfriend DR, Hosking JD, Johnson BA, LoCastro JS, Longabaugh R, Mason BJ, Mattson ME, Miller WR, Pettinati HM, Randall CL, Swift R, Weiss RD, Williams LD, Zweben A (2006) Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 295:2003–2017PubMedCrossRef Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, Gastfriend DR, Hosking JD, Johnson BA, LoCastro JS, Longabaugh R, Mason BJ, Mattson ME, Miller WR, Pettinati HM, Randall CL, Swift R, Weiss RD, Williams LD, Zweben A (2006) Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 295:2003–2017PubMedCrossRef
Zurück zum Zitat Ashley MJ, Olin JS, le Riche WH, Kornaczewski A, Schmidt W, Rankin JG (1977) Morbidity in alcoholics. Evidence for accelerated development of physical disease in women Arch Intern Med 137:883–887PubMedCrossRef Ashley MJ, Olin JS, le Riche WH, Kornaczewski A, Schmidt W, Rankin JG (1977) Morbidity in alcoholics. Evidence for accelerated development of physical disease in women Arch Intern Med 137:883–887PubMedCrossRef
Zurück zum Zitat Ballesteros J, Gonzalez-Pinto A, Querejeta I, Arino J (2004) Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women. Addiction 99:103–108PubMedCrossRef Ballesteros J, Gonzalez-Pinto A, Querejeta I, Arino J (2004) Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women. Addiction 99:103–108PubMedCrossRef
Zurück zum Zitat Beck AT, Beamesderfer A (1974) Assessment of depression: the depression inventory. Mod Probl Pharmacopsychiatry 7:151–169PubMed Beck AT, Beamesderfer A (1974) Assessment of depression: the depression inventory. Mod Probl Pharmacopsychiatry 7:151–169PubMed
Zurück zum Zitat Bottlender M, Soyka M (2005) Outpatient alcoholism treatment: predictors of outcome after 3 years. Drug Alcohol Depend 80:83–89PubMedCrossRef Bottlender M, Soyka M (2005) Outpatient alcoholism treatment: predictors of outcome after 3 years. Drug Alcohol Depend 80:83–89PubMedCrossRef
Zurück zum Zitat Bucholz KK, Homan SM, Helzer JE (1992) When do alcoholics first discuss drinking problems? J Stud Alcohol 53:582–589PubMed Bucholz KK, Homan SM, Helzer JE (1992) When do alcoholics first discuss drinking problems? J Stud Alcohol 53:582–589PubMed
Zurück zum Zitat Chou SP, Dawson DA (1994) A study of the gender differences in morbidity among individuals diagnosed with alcohol abuse and/or dependence. J Subst Abuse 6:381–392PubMedCrossRef Chou SP, Dawson DA (1994) A study of the gender differences in morbidity among individuals diagnosed with alcohol abuse and/or dependence. J Subst Abuse 6:381–392PubMedCrossRef
Zurück zum Zitat DSM-IV (1996) Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV). American Psychiatric Association, Washington, DC DSM-IV (1996) Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV). American Psychiatric Association, Washington, DC
Zurück zum Zitat Fernandez-Sola J, Estruch R, Nicolas JM, Pare JC, Sacanella E, Antunez E, Urbano-Marquez A (1997) Comparison of alcoholic cardiomyopathy in women versus men. Am J Cardiol 80:481–485PubMedCrossRef Fernandez-Sola J, Estruch R, Nicolas JM, Pare JC, Sacanella E, Antunez E, Urbano-Marquez A (1997) Comparison of alcoholic cardiomyopathy in women versus men. Am J Cardiol 80:481–485PubMedCrossRef
Zurück zum Zitat Feuerlein W, Kufner H (1989) A prospective multicentre study of in-patient treatment for alcoholics: 18- and 48-month follow-up (Munich Evaluation for Alcoholism Treatment, MEAT). Eur Arch Psychiatry Neurol Sci 239:144–157PubMedCrossRef Feuerlein W, Kufner H (1989) A prospective multicentre study of in-patient treatment for alcoholics: 18- and 48-month follow-up (Munich Evaluation for Alcoholism Treatment, MEAT). Eur Arch Psychiatry Neurol Sci 239:144–157PubMedCrossRef
Zurück zum Zitat Foster JH, Peters TJ, Marshall EJ (2000) Quality of life measures and outcome in alcohol-dependent men and women. Alcohol 22:45–52PubMedCrossRef Foster JH, Peters TJ, Marshall EJ (2000) Quality of life measures and outcome in alcohol-dependent men and women. Alcohol 22:45–52PubMedCrossRef
Zurück zum Zitat Frezza M, di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS (1990) High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism N Engl J Med 322:95–99PubMedCrossRef Frezza M, di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS (1990) High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism N Engl J Med 322:95–99PubMedCrossRef
Zurück zum Zitat Hanna E, Dufour MC, Elliott S, Stinson F, Harford TC (1992) Dying to be equal: women, alcohol, and cardiovascular disease. Br J Addict 87:1593–1597PubMedCrossRef Hanna E, Dufour MC, Elliott S, Stinson F, Harford TC (1992) Dying to be equal: women, alcohol, and cardiovascular disease. Br J Addict 87:1593–1597PubMedCrossRef
Zurück zum Zitat Hesselbrock MN (1991) Gender comparison of antisocial personality disorder and depression in alcoholism. J Subst Abuse 3:205–219PubMedCrossRef Hesselbrock MN (1991) Gender comparison of antisocial personality disorder and depression in alcoholism. J Subst Abuse 3:205–219PubMedCrossRef
Zurück zum Zitat Hesselbrock MN, Meyer RE, Keener JJ (1985) Psychopathology in hospitalized alcoholics. Arch Gen Psychiatry 42:1050–1055PubMed Hesselbrock MN, Meyer RE, Keener JJ (1985) Psychopathology in hospitalized alcoholics. Arch Gen Psychiatry 42:1050–1055PubMed
Zurück zum Zitat Hommer D, Momenan R, Kaiser E, Rawlings R (2001) Evidence for a gender-related effect of alcoholism on brain volumes. Am J Psychiatry 158:198–204PubMedCrossRef Hommer D, Momenan R, Kaiser E, Rawlings R (2001) Evidence for a gender-related effect of alcoholism on brain volumes. Am J Psychiatry 158:198–204PubMedCrossRef
Zurück zum Zitat Hommer D, Momenan R, Rawlings R, Ragan P, Williams W, Rio D, Eckardt M (1996) Decreased corpus callosum size among alcoholic women. Arch Neurol 53:359–363PubMed Hommer D, Momenan R, Rawlings R, Ragan P, Williams W, Rio D, Eckardt M (1996) Decreased corpus callosum size among alcoholic women. Arch Neurol 53:359–363PubMed
Zurück zum Zitat Jarvis TJ (1992) Implications of gender for alcohol treatment research: a quantitative and qualitative review. Br J Addict 87:1249–1261PubMedCrossRef Jarvis TJ (1992) Implications of gender for alcohol treatment research: a quantitative and qualitative review. Br J Addict 87:1249–1261PubMedCrossRef
Zurück zum Zitat Johnson PB, Richter L, Kleber HD, McLellan AT, Carise D (2005) Telescoping of drinking-related behaviors: gender, racial/ethnic, and age comparisons. Subst Use Misuse 40:1139–1151PubMedCrossRef Johnson PB, Richter L, Kleber HD, McLellan AT, Carise D (2005) Telescoping of drinking-related behaviors: gender, racial/ethnic, and age comparisons. Subst Use Misuse 40:1139–1151PubMedCrossRef
Zurück zum Zitat Jones BM, Jones MK (1976) Alcohol effects in women during the menstrual cycle. Ann N Y Acad Sci 273:576–587PubMedCrossRef Jones BM, Jones MK (1976) Alcohol effects in women during the menstrual cycle. Ann N Y Acad Sci 273:576–587PubMedCrossRef
Zurück zum Zitat Lehrl S, Triebig G, Fischer B (1995) Multiple choice vocabulary test MWT as a valid and short test to estimate premorbid intelligence. Acta Neurol Scand 91:335–345PubMed Lehrl S, Triebig G, Fischer B (1995) Multiple choice vocabulary test MWT as a valid and short test to estimate premorbid intelligence. Acta Neurol Scand 91:335–345PubMed
Zurück zum Zitat Loft S, Olesen KL, Dossing M (1987) Increased susceptibility to liver disease in relation to alcohol consumption in women. Scand J Gastroenterol 22:1251–1256PubMed Loft S, Olesen KL, Dossing M (1987) Increased susceptibility to liver disease in relation to alcohol consumption in women. Scand J Gastroenterol 22:1251–1256PubMed
Zurück zum Zitat Mann K, Ackermann K, Croissant B, Mundle G, Nakovics H, Diehl A (2005) Neuroimaging of gender differences in alcohol dependence: are women more vulnerable? Alcohol Clin Exp Res 29:896–901PubMedCrossRef Mann K, Ackermann K, Croissant B, Mundle G, Nakovics H, Diehl A (2005) Neuroimaging of gender differences in alcohol dependence: are women more vulnerable? Alcohol Clin Exp Res 29:896–901PubMedCrossRef
Zurück zum Zitat Mann K, Batra A (1993) [Community based management of alcohol dependent patients. Evaluation of a combined inpatient and ambulatory treatment concept] Psychiatr Prax 20:102–105PubMed Mann K, Batra A (1993) [Community based management of alcohol dependent patients. Evaluation of a combined inpatient and ambulatory treatment concept] Psychiatr Prax 20:102–105PubMed
Zurück zum Zitat Mann K, Batra A, Gunthner A, Schroth G (1992) Do women develop alcoholic brain damage more readily than men? Alcohol Clin Exp Res 16:1052–1056PubMedCrossRef Mann K, Batra A, Gunthner A, Schroth G (1992) Do women develop alcoholic brain damage more readily than men? Alcohol Clin Exp Res 16:1052–1056PubMedCrossRef
Zurück zum Zitat Mann K, Kapp B, Kühnel P, Federle E (1995) Good estimates for reliability and validity in alcoholics’ self reports. Alcohol and Alcoholism 30:545–545 Mann K, Kapp B, Kühnel P, Federle E (1995) Good estimates for reliability and validity in alcoholics’ self reports. Alcohol and Alcoholism 30:545–545
Zurück zum Zitat McKay JR, Weiss RV (2001) A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups. Preliminary results and methodological issues Eval Rev 25:113–161PubMedCrossRef McKay JR, Weiss RV (2001) A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups. Preliminary results and methodological issues Eval Rev 25:113–161PubMedCrossRef
Zurück zum Zitat O’Connor PG, Horwitz RI, Gottlieb LD, Kraus ML, Segal SR (1993) The impact of gender on clinical characteristics and outcome in alcohol withdrawal. J Subst Abuse Treat 10:59–61PubMedCrossRef O’Connor PG, Horwitz RI, Gottlieb LD, Kraus ML, Segal SR (1993) The impact of gender on clinical characteristics and outcome in alcohol withdrawal. J Subst Abuse Treat 10:59–61PubMedCrossRef
Zurück zum Zitat Olenick NL, Chalmers DK (1991) Gender-specific drinking styles in alcoholics and nonalcoholics. J Stud Alcohol 52:325–330PubMed Olenick NL, Chalmers DK (1991) Gender-specific drinking styles in alcoholics and nonalcoholics. J Stud Alcohol 52:325–330PubMed
Zurück zum Zitat Pequignot G, Chabert C, Eydoux H, Courcol MA (1974) Augmentation du risque de cirrhose en fonction de la ration d’alcool. Rev l’ Alcoolisme 20:191–202 Pequignot G, Chabert C, Eydoux H, Courcol MA (1974) Augmentation du risque de cirrhose en fonction de la ration d’alcool. Rev l’ Alcoolisme 20:191–202
Zurück zum Zitat Pfefferbaum A, Rosenbloom M, Deshmukh A, Sullivan E (2001) Sex differences in the effects of alcohol on brain structure. Am J Psychiatry 158:188–197PubMedCrossRef Pfefferbaum A, Rosenbloom M, Deshmukh A, Sullivan E (2001) Sex differences in the effects of alcohol on brain structure. Am J Psychiatry 158:188–197PubMedCrossRef
Zurück zum Zitat Piazza NJ, Vrbka JL, Yeager RD (1989) Telescoping of alcoholism in women alcoholics. Int J Addict 24:19–28PubMed Piazza NJ, Vrbka JL, Yeager RD (1989) Telescoping of alcoholism in women alcoholics. Int J Addict 24:19–28PubMed
Zurück zum Zitat Project MATCH Research Group (1997) Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes. J Stud Alcohol 58:7–29 Project MATCH Research Group (1997) Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes. J Stud Alcohol 58:7–29
Zurück zum Zitat Project MATCH Research Group (1998) Matching alcoholism treatments to client heterogeneity: Project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 22:1300–1311CrossRef Project MATCH Research Group (1998) Matching alcoholism treatments to client heterogeneity: Project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 22:1300–1311CrossRef
Zurück zum Zitat Rabinovitz M, Van Thiel DH, Dindzans V, Gavaler JS (1989) Endoscopic findings in alcoholic liver disease: does gender make a difference? Alcohol 6:465–468PubMedCrossRef Rabinovitz M, Van Thiel DH, Dindzans V, Gavaler JS (1989) Endoscopic findings in alcoholic liver disease: does gender make a difference? Alcohol 6:465–468PubMedCrossRef
Zurück zum Zitat Randall CL, Roberts JS, Del Boca FK, Carroll KM, Connors GJ, Mattson ME (1999) Telescoping of landmark events associated with drinking: a gender comparison. J Stud Alcohol 60:252–260PubMed Randall CL, Roberts JS, Del Boca FK, Carroll KM, Connors GJ, Mattson ME (1999) Telescoping of landmark events associated with drinking: a gender comparison. J Stud Alcohol 60:252–260PubMed
Zurück zum Zitat Ross HE (1989) Alcohol and drug abuse in treated alcoholics: a comparison of men and women. Alcohol Clin Exp Res 13:810–816PubMedCrossRef Ross HE (1989) Alcohol and drug abuse in treated alcoholics: a comparison of men and women. Alcohol Clin Exp Res 13:810–816PubMedCrossRef
Zurück zum Zitat Ross HE, Glaser FB, Germanson T (1988) The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry 45:1023–1031PubMed Ross HE, Glaser FB, Germanson T (1988) The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry 45:1023–1031PubMed
Zurück zum Zitat Sanchez-Craig M, Spivak K, Davila R (1991) Superior outcome of females over males after brief treatment for the reduction of heavy drinking: replication and report of therapist effects. Br J Addict 86:867–876PubMedCrossRef Sanchez-Craig M, Spivak K, Davila R (1991) Superior outcome of females over males after brief treatment for the reduction of heavy drinking: replication and report of therapist effects. Br J Addict 86:867–876PubMedCrossRef
Zurück zum Zitat Schuckit MA, Anthenelli RM, Bucholz KK, Hesselbrock VM, Tipp J (1995) The time course of development of alcohol-related problems in men and women. J Stud Alcohol 56:218–225PubMed Schuckit MA, Anthenelli RM, Bucholz KK, Hesselbrock VM, Tipp J (1995) The time course of development of alcohol-related problems in men and women. J Stud Alcohol 56:218–225PubMed
Zurück zum Zitat Schuckit MA, Daeppen JB, Tipp JE, Hesselbrock M, Bucholz KK (1998) The clinical course of alcohol-related problems in alcohol dependent and nonalcohol dependent drinking women and men. J Stud Alcohol 59:581–590PubMed Schuckit MA, Daeppen JB, Tipp JE, Hesselbrock M, Bucholz KK (1998) The clinical course of alcohol-related problems in alcohol dependent and nonalcohol dependent drinking women and men. J Stud Alcohol 59:581–590PubMed
Zurück zum Zitat Seppa K, Sillanaukee P (1994) Women, alcohol, and red cells. Alcohol Clin Exp Res 18:1168–1171PubMedCrossRef Seppa K, Sillanaukee P (1994) Women, alcohol, and red cells. Alcohol Clin Exp Res 18:1168–1171PubMedCrossRef
Zurück zum Zitat Staines G, Magura S, Rosenblum A, Fong C, Kosanke N, Foote J, Deluca A (2003) Predictors of drinking outcomes among alcoholics. Am J Drug Alcohol Abuse 29:203–218PubMedCrossRef Staines G, Magura S, Rosenblum A, Fong C, Kosanke N, Foote J, Deluca A (2003) Predictors of drinking outcomes among alcoholics. Am J Drug Alcohol Abuse 29:203–218PubMedCrossRef
Zurück zum Zitat Stockwell T, Hodgson R, Edwards G, Taylor C, Rankin H (1979) The development of a questionnaire to measure severity of alcohol dependence. Br J Addict Alcohol Other Drugs 74:79–87PubMed Stockwell T, Hodgson R, Edwards G, Taylor C, Rankin H (1979) The development of a questionnaire to measure severity of alcohol dependence. Br J Addict Alcohol Other Drugs 74:79–87PubMed
Zurück zum Zitat Timko C, Moos RH, Finney JW, Connell EG (2002) Gender differences in help-utilization and the 8-year course of alcohol abuse. Addiction 97:877–889PubMedCrossRef Timko C, Moos RH, Finney JW, Connell EG (2002) Gender differences in help-utilization and the 8-year course of alcohol abuse. Addiction 97:877–889PubMedCrossRef
Zurück zum Zitat Urbano-Marquez A, Estruch R, Fernandez-Sola J, Nicolas JM, Pare JC, Rubin E (1995) The greater risk of alcoholic cardiomyopathy and myopathy in women compared with men. JAMA 274:149–154PubMedCrossRef Urbano-Marquez A, Estruch R, Fernandez-Sola J, Nicolas JM, Pare JC, Rubin E (1995) The greater risk of alcoholic cardiomyopathy and myopathy in women compared with men. JAMA 274:149–154PubMedCrossRef
Zurück zum Zitat York JL, Welte JW (1994) Gender comparisons of alcohol consumption in alcoholic and nonalcoholic populations. J Stud Alcohol 55:743–750PubMed York JL, Welte JW (1994) Gender comparisons of alcohol consumption in alcoholic and nonalcoholic populations. J Stud Alcohol 55:743–750PubMed
Metadaten
Titel
Alcoholism in women: is it different in onset and outcome compared to men?
verfasst von
Alexander Diehl
Bernhard Croissant
Anil Batra
Götz Mundle
Helmut Nakovics
Karl Mann
Publikationsdatum
01.09.2007
Verlag
D. Steinkopff-Verlag
Erschienen in
European Archives of Psychiatry and Clinical Neuroscience / Ausgabe 6/2007
Print ISSN: 0940-1334
Elektronische ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-007-0737-z

Weitere Artikel der Ausgabe 6/2007

European Archives of Psychiatry and Clinical Neuroscience 6/2007 Zur Ausgabe

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

So wirken verschiedene Alkoholika auf den Blutdruck

23.05.2024 Störungen durch Alkohol Nachrichten

Je mehr Alkohol Menschen pro Woche trinken, desto mehr steigt ihr Blutdruck, legen Daten aus Dänemark nahe. Ob es dabei auch auf die Art des Alkohols ankommt, wurde ebenfalls untersucht.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.