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根据梅约诊所自我参与酒瘾治疗之300多名病患所进行的初步回溯研究显示，女性的忧郁症状与喝酒欲望有关；这项研究发表于美国精精神医学会第161次年会中的壁报。
比较参加治疗计划的男性和女性，女性有比较高的忧郁症状和饮酒渴望分数；经临床诊断为酒瘾者发现有这两种诊断，定义为酒瘾加上忧郁、双极异常或焦虑异常。
主要作者、加州大学旧金山分校的Nelli Boykoff向Medscape Psychiatry表示，结果显示妇女饮酒以缓解焦虑和忧郁，男性则比较可能是为了饮酒作乐。
共同作者、梅约诊所的Mark A. Frye医师表示，我们真正震惊的是，当妇女参加28天的计划时，她们的忧郁症状和饮酒渴望显著高于男性，忧郁和饮酒渴望之间的关联强烈。
他指出，就我们所知，这是第一篇指出妇女和男性的酒瘾有不同的临床关联研究，根据这些相关资料，或许可以有不同的治疗目标。
【忧郁女性饮酒者】
研究者对364名参加密集戒瘾计划的病患进行临床资料回溯分析 (135名女性、229名男性) ，这是一个在梅约诊所的28天住宿治疗计划，使用贝克忧郁量表(Beck Depression Inventory，BDI)测量忧郁症状，使用宾州酒瘾量表(Pennsylvania Alcohol Craving Scale，PACS)测量饮酒渴望。
病患平均年纪为47.9岁，平均在19.7岁时开始饮酒，女性饮酒量几乎和男性一样多— 女性平均多到每天10.8 杯，男性是平均每天13.8杯；约半数病患(53%) 每天饮酒，75%符合国立酒精滥用与中毒研究所(National Institute on Alcohol Abuse and Alcoholism，NIAAA)定义的危险使用者(男性每天超过5杯、女性每天超过4杯)；92人只有酒瘾，139人有酒瘾和忧郁、双极异常、或焦虑异常。
相较于男性，女性加入治疗计划时明显有较高的忧郁(P= <.001)和饮酒渴望(P=.001)分数。
女性的忧郁和饮酒渴望分数有明显的关联，此关联可见于只有酒瘾的女性(r =.78; P<0.0001) 以及同时有酒瘾和另一种主要的非药物诊断者(r=.36;P=0.01)。
【可能的解释：缓解渴望与获得渴望】
研究者写道，渴望饮酒是酒精依赖的重要元素，且有复发关联，为酒瘾治疗策略成功控制饮酒渴望的主要关键。
他们指出，饮酒渴望可以分成几个不同机转—缓解渴望 (与谷氨酸盐有关)、获得渴望(与多巴胺、鸦片有关)、以及妄想渴望(与血清素有关)；有些初步研究认为，naltrexone 和 acamprosate 分别可以处理获得渴望和缓解渴望。
Boykoff小姐结论表示，忧郁看似与女性的饮酒渴望有强烈关联，我们认为需要后续研究确认忧郁和缓解渴望的关联，以期能影响治疗结果。
Frye医师为Janssen-Cilag、AstraZeneca Pharmaceuticals、Abbott Laboratories、Bristol-Myers Squibb、GlaxoSmithKline与 Otsuka Pharmaceuticals之谘询顾问；Boycoff小姐未提供任何财经宣告。
美国精精神医学会第161次年会：年轻研究者的新研究壁报组第1组。壁报NR1-013。2008年5月3-8日。
Alcohol Craving in Women, Not<
By Marlene Busko
Medscape Medical News
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 (P = < .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; P < 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.