Surprising insights into what makes alcoholics drink

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In people with alcohol dependence, the major factor predicting the amount of drinking seems to be a question of immediate mood, say researchers.

The US scientists found that having long-term mental health problems did not affect alcohol consumption, with one important exception: men with a history of depression had a different drinking pattern than men without a history of depression.

Surprisingly, men with depression were drinking less often than men who were not depressed

"This work once again shows that alcoholism is not a one-size-fits-all condition," lead researcher Dr Victor Karpyak from the Mayo Clinic told delegates at the European College of Neuropsychopharmacology in Paris last week.

"So the answer to the question of why alcoholics drink is probably that there is no single answer; this will probably have implications for how we diagnose and treat alcoholism."

The study of about 450 alcohol-dependent adults showed that men tended to drink more per day than women.

As expected, alcohol consumption in both men and women was associated with feeling either up or down on a particular day, with no significant association with anxiety or substance use disorders.

However, men with a history of major depressive disorder had fewer drinking days and fewer heavy drinking days than men who never a major depressive disorder.

"Research indicates that many people drink to enhance pleasant feelings, while other people drink to suppress negative moods, such as depression or anxiety,” said Dr Karpyak.

“However, previous studies did not differentiate between state-dependent mood changes and the presence of clinically diagnosed anxiety or depressive disorders."

Dr Karpyak said this lack of differentiation was among the reasons for controversial findings about the usefulness of antidepressants in the treatment of alcohol-dependent adults with comorbid depression.