• 생물정신의학
• /
• 제11권1호
• /
• pp.33-39
• /
• 2004

Objective:Nitric oxide(NO) has been known to be associated with tolerance and preference to alcohol. It has also been known to affect various alcohol drinking behavior, alcohol withdrawal symptoms and alcohol- induced brain damage. The purpose of this study was to determine the difference, among alcohol dependence group, alcohol drinking group and abstinence group, in serum concentration of nitrite, a stable metabolite of NO, and it's relationship to clinical and biochemical markers of alcoholism. Methods:Forty subjects diagnosed as alcohol dependence according to DSM-IV diagnostic criteria were evaluated for the clinical characteristics and biochemical markers of alcohol dependence including nitrite with their CIWA-Ar scores checked just after admission. Thirty-nine healthy controls were also evaluated, divided into twenty-three alcohol drinking group and sixteen abstinence group. Clinical characteristics were evaluated by CIWA-Ar, CAGE and AUDIT questionnaires. Aspartate aminotransferase(AST), alanine aminotransferase (ALT), gamma glutamyltransferase(GGT) and mean corpuscular volume(MCV) were used as the biochemical markers of alcohol dependence. Serum nitrite concentrations were measured by Griess reaction. Results:1) The concentrations of nitrite in alcohol dependence patients were not different from those in the control subjects. 2) There were no significant association between the nitrite concentrations and the CIWA-Ar scores in alcohol dependence patients. 3) Nitrites are significantly increased in alcohol dependence group and alcohol drinking group compared with abstinence group. Conclusions:These findings suggest that serum nitrite concentration has no relation with alcohol withdrawal symptoms, but alcohol drinking increases serum nitrite concentration influenced by general condition of the body.

• 생물정신의학
• /
• 제10권2호
• /
• pp.159-167
• /
• 2003

Objective:Under the hypothesis that 5-HTTLPR polymorphism plays some role in the susceptibility or vulnerability of some subgroup of alcohol dependence, associations of 5-HTTLPR polymorphism with alcohol dependence were examined. Method:This association analysis included 109 Korean alcohol dependent and 113 Korean control subjects. DNA of all subjects were genotyped for the biallelic functional polymorphism in the 5-HTTLPR. Considering the likelihood of heterogeneity in the alcohol dependence phenotype, alcohol dependent subjects were subgrouped by onset age, family history of alcohol dependence and severity of withdrawal symptoms. Results:There were no significant differences in the frequencies of either the 5-HTTLPR genotype or the short vs. long allele in alcohol dependent and control subjects. The frequency of the S allele and S-carrier (LS or SS genotype) was significantly increased in the early onset alcohol dependent subjects and the familial alcohol dependent subjects compared with that in the control subjects. Conclusion:The results suggest that the 5-HTT 'S' promoter polymorphism is associated with an increased susceptibility or vulnerability to develop early onset alcohol dependence and familial alcohol dependence, which characterize Cloninger's type 2 alcohol dependence.

• 생물정신의학
• /
• 제14권3호
• /
• pp.161-166
• /
• 2007

Objectives:Recent studies have raised the possibility that nerve growth factor(NGF) is abnormally regulated in the central nervous system(CNS) of animal models with alcohol dependence. The possible alteration of NGF by prolonged alcohol intake may play an important role in alcohol-induced neurotoxicity. Carbohydrate-deficient transferrin(CDT) is regarded as a reliable biological marker of alcohol dependence. The goal of this study was to estimate the changes of %CDT and serum NGF level according to the duration of alcohol abstinence, and to identify whether %CDT level is associated with the serum NGF level in the patients with alcohol dependence. Methods:The subjects were 24 patients with alcohol dependence. We used the Axis-Shield ASA to measure the %CDT level and the enzyme-linked immunosorbent assay(ELISA) to measure the serum NGF level. %CDT and NGF levels were measured immediately after the admission and at 2 weeks after the admission. Results:Decreased %CDT were observed during the period of 2 weeks after the admission. NGF level was not significantly different after 2 weeks. The NGF levels were not correlated with %CDT. The possibility of %CDT as a predictor of alcohol-induced neurotoxicity was not confirmed. Conclusion:Serum NGF levels is not a reliable indicator of abstinence state in the patients with alcohol dependence. Further studies are needed to evaluate the relation between two indicators in regard to hematological and neurological changes in alcohol dependence.

• 생물정신의학
• /
• 제13권4호
• /
• pp.273-278
• /
• 2006

Objectives : Biochemical markers can provide an objective evidence of heavy alcohol drinking. The purpose of this study was to compare and evaluate the usefulness of biological markers detecting alcohol dependence, such as mean corpuscular volume(MCV), gamma-glutamyl transferase(GGT), and carbohydrate-deficient transferrin(CDT) in the patients of an alcohol counseling center. Methods : This study was done with 64 patients with alcohol dependence and 36 healthy subjects. Relative values(%) of CDT were determined in their sera with turbidimetric immunoassay(Bio-Rad %CDT assay, Axis-Shield ASA, Oslo, Norway), and were compared with conventional markers of alcohol consumption, GGT and MCV. Results : Among the patients with alcohol dependence, 78.1% showed abnormal %CDT levels compared with GGT(61.9%) and MCV(20.7%). The areas under the receiver operating characteristic(ROC) curves(95% confidence interval) for %CDT, GGT, and MCV were 0.934(0.866-0.973), 0.871(0.789-0.930), and 0.575 (0.472-0.673), respectively. Conclusion : %CDT seems to be the most reliable biological marker for the detection and monitoring of alcohol consumption in the patients with alcohol dependence of the alcohol counseling center.

• 정신신체의학
• /
• 제4권1호
• /
• pp.13-20
• /
• 1996

This study was performed to explore the frequency of panic attack induced by sodium lactate in alcohol dependence patients and to compare the extent of blunted growth hormone reponses after clonidine infusion with that of normal controls. The authors investigated 10 alcohol dependence patients receiving inpatient care in Hangang Sacred Heart Hospital from March 2, 1993 to August 31, 1993 and 10 normal controls. The disagnosis of alcohol dependence was based on DSM-III-R. Thirty minutes after the sodium lactate infusions clonidins were administrated. Venous bloods were sampled before the sodium lactate infusions, and 30, 45, 60, 90 minutes after the administrations of clonidine. Plasma growth hormone levels were measured by RIA method. The results were as follows : 1) In the questionaires of Hamilton Anxiety Rating Scale, Hamilton Depression Raing Scale, CAGE, Korean MAST, the scores of alcohol dependent patients were higher than those of normal controls. 2) Sixty percent of alcohol dependence patients and twenty percent of normal controls had panic attacks induced by sodium lactate. 3) All panic attacks induced by sodium lactate were relieved after clonidine infusions. 4) There were blunted growth hormone responses after clonidine infusions in alcohol dependence patients who had sodium lactate induced panic attacks like panic disorder patients. These results suggest that alcohol dependence patients may have noradrenergic abnormality same as panic disorder patients and two disorder may have high biological correlations each other.

• 생물정신의학
• /
• 제8권2호
• /
• pp.239-245
• /
• 2001

Objective : Dopamine transporter is member of family of Na/Cl dependent neurotransmitter transporter, 12 transmembrane domain, that has high substrate specificity, affinity. It is related with dopamine reuptake in presynaptic vesicle. DAT has a VNTR in its 3'-untranslated region(UTR). 3'-UTR VNTR polymorphism is related with modification of dopamine transmission. The association between with VNTR polymorphism and neuropsychiatric disorders such as alcohol dependence, and low activity ALDH has been studied, but their relationship is unclear. We study about association of 3'-UTR VNTR of DAT gene and G2319A and alcohol dependence. Method : Group of Korean subjects were studied with alcohol dependence(n=49 male) compared to mentally healthy controls(n=53 male). The peripheral blood sample was acquired, and Polymerase Chain Reaction(PCR) amplification, MspI procedure was done. Result : There was a significant difference between alcohol dependence group and normal control(genotype frequency p<0.05, allele frequency p<0.05) Allele A frequency and genotype(GG, GA) frequency was a significant difference between alcohol dependence group and normal control(p<0.05). Conclusion : Our study showed that genetic polymorphism of DAT1 G2319A had relation with alcohol dependence.

• 생물정신의학
• /
• 제12권2호
• /
• pp.196-206
• /
• 2005

Objectives:The purpose of this study is to evaluate the pathophysiology of alcoholics by investigating the differences in frequency of Aldehyde Dehydrogenase 2(ALDH2) genotypes and ALDH2 alleles between patients with alcohol dependence and controls, and the differences of drinking and personality traits in Korean male alcoholics with ALDH2 genotype variances. Methods:The authors selected 98 patients with alcohol dependence and 53 controls. Self-report questionnaires for acute reponses after alcohol ingestion, the AUI(Alcohol Use Inventory), and the NEO-PI-R(NEO Personality Inventory Revised) were given to all patients with alcohol dependence. ALDH2 genotypes were typed with MboII RFLP(Restriction Fragment Length Polymorphism) method in 53 controls and 98 patients with alcohol dependence. The authors divided alcoholic patients into two groups according to the presence of variant $ALDH2^2$ allele;normal ALDH2 alcoholics(N=87) and variant ALDH2 alcoholics(N=11). Results:1) The genotypic frequencies of subjects with $ALDH2^{1/1}$ were higher and those with $ALDH2^{1/2}$ and $ALDH2^{2/2}$ were lower in patients than in controls. 2) Alcohol dependence could be found in $ALDH2^{2/2}$ homozygote individuals. 3) Variant ALDH2 alcoholics had more family problems in the AUI than normal ALDH2 alcoholics. 4) Variant ALDH2 alcoholics experienced more flushing and cardiovascular responses after alcohol ingestion than normal ALDH2 alcoholics. 5) Variant ALDH2 alcoholics had less altruistic personality traits in the NEO-PI-R than normal ALDH2 alcoholics. 6) Variant ALDH2 alcoholics tended to have more tolerance to alcohol than normal ALDH2 alcoholics. Conclusion:Variant $ALDH2^2$ allele might play a protective role in the pathogenesis of alcohol dependence and there were several significant differences of drinking and personality traits in Korean male alcoholics with ALDH2 genotype variances.

• 생물정신의학
• /
• 제18권3호
• /
• pp.109-118
• /
• 2011

Objectives Many studies have suggested different neurobiological findings and clinical courses in alcoholism. Recently, subtyping in alcohol dependence has become essential to overcome the heterogeneity of patients. Among several criteria of subtypes, Lesch's typology is proposed to integrate biological, social, and psychological factors. This review provides neurobiological findings and treatment-responses of alcohol dependence according to Lesch's typology. Method We searched the international published medical literature using the search terms 'Lesch's typology' and 'alcohol dependence' and using the limits 'human'. Results We identified 17 studies with subjects of alcohol dependence according to Lesch's typology. Conclusion They indicated that each subtype of Lesch's typology can have specific neurobiological factors and different clinical responses as follows. Lesch's subtype 1 is characterized by severe withdrawal symptoms and associated with elevated glutamate and homocysteine. Lesch's subtype 2 is defined by individuals who drink alcohol as self-medication for anxiety. Their craving has significant positive correlations with prolactin, leptin level, or intake-volume (vasopressin). Lesch's subtype 4 is related to cerebral dysfunction and associated with increased glutamate and left-handedness. Clinical trials showed that naltrexone was effective in Lesch's subtype 3 and 4 patients, while acamprosate was effective in the subtypes 1 and 2.

• 사회복지연구
• /
• 제44권3호
• /
• pp.113-145
• /
• 2013

본 연구는 여성의 생애맥락적 관점을 유지한 채 이들이 알코올 의존에 이르게 되는 과정에 대하여 알아보고자 한 현상학적 사례연구이다. 참여자들의 생애맥락에서 가장 먼저 드러나는 현상은 '불완전한 관계'라는 현상이었고 이는 알코올 의존 현상을 추동하고 있었다. 특히 본 연구자들은 참여자들의 생애 첫 음주를 주목하였는데, 이들에게 생애 첫 음주는 '고유한 상징체계'로서 독특한 의미가 부여되고 있었다. 참여자들이 술을 선택하는 과정에서 드러난 현상은 일상 사건의 연장이라는 '일상성'의 현상이었다. 참여자들의 일상성의 맥락에서 본 알코올 의존 현상은 '침습' 혹은 '침투'라는 과정을 거치게 된다. 이러한 과정을 거쳐 여성들의 알코올 의존 체험은 '현실의 무성화'와 '현실의 신기루화'로 나타났다. 이러한 연구결과를 바탕으로 여성 알코올 의존자들에 대한 개입을 위한 실천적 함의를 도출하였다.

• 정신신체의학
• /
• 제12권1호
• /
• pp.47-55
• /
• 2004

연구목적: 알콜 의존 환자의 우울 증상과 스트레스에 대한 반응과 감정표현불능증에 대하여 알아본 후, 상관관계에 대하여 조사하여 향후 환자의 삶의 질을 높일 수 있는 치료적 중재를 위한 기초 자료로 사용하고자 본 연구를 시행하였다. 방 법: 알콜 의존으로 진단을 받은 환자 94명과 정신과 치료 경험이 없는 사람 34명을 대상으로 하여 한국우울증척도와 스트레스 반응 척도와 감정표현불능증 척도를 시행하였다. 결 과: 우울 증상과 스트레스 반응 요인과 알콜 의존 지수가 알콜 의존 환자의 감정표현불능증 전체 변이 중에 약 55%를 설명하였으며, 이 중 스트레스에 대한 반응이 가장 큰 설명력을 보였다. 결 론: 우울 증상, 스트레스에 대한 반응, 학력, 음주 회수 등이 알콜 의존 환자의 감정표현불능증과 가장 밀접한 관련이 있는 요인으로 밝혀졌으며, 환자가 경험하는 신체화 증상을 포함한 우울 증상과 스트레스에 대한 정신과 의사의 관심이 필요함을 시사하는 것으로, 알콜 의존 환자의 우울 증상과 감정표현불능증에 대한 적극적 치료를 통하여 궁극적으로 환자의 삶의 질을 높일 수 있도록 하는 정신과 의사의 노력이 필요하리라 본다.