Elizabeth C. Penick

A 30‐year follow‐up study of the sons of alcoholic men

The nature‐nurture question in the etiology of alcoholism is discussed. The research results from twin and adoption studies indicate a considerable genetic (= biological) component in the etiology of alcoholism. A longitudinal high‐risk study of alcoholism is presented. The sons of alcoholic men and matched controls have been followed prospectively since before birth. The main results from previous phases of the study and a recent 30‐year follow‐up assessment are presented.

Psychological distress following a natural disaster: A one-year follow-up of 98 flood victims

Ninety-eight individuals rendered homeless by flooding of the Mississippi were interviewed shortly after the disaster and one year later. Data included demographic information, severity of property damage, personal reactions to the disaster, and the 20-item Mental Status Index, a symptom checklist designed to quantify emotional stress. Just after the flood victims were asked to complete the Mental Status Index twice, using as a frame of reference their mental/emotional state before the disaster and their mental/emotional state since the disaster experience. The results indicated a significant increase in emotional distress immediately after the flood. One year later, the level of emotional distress had declined somewhat relative to that reported shortly after the disaster; however, it still remained significantly above pre-flood levels. Although victims continued to show effects of the disaster after 12 months, none developed a major mental illness for the first time. Findings of this and similar followup studies suggest that the most appropriate and cost/effective role for the mental health worker in times of natural disaster is that of a consultant in crisis management to primary caregivers such as family physicians, clergy, and full-time disaster personnel.

Inpatients with Briquet's syndrome: Presence of additional psychiatric syndromes and MMPI results

Abstract Sixteen Briquets syndrome psychiatric inpatients were compared to 32 age- and sex-matched psychiatric inpatient controls by using a structured diagnostic interview (PDI) and the MMPI. Briquets syndrome patients have significantly more additional psychiatric syndromes on the PDI and significantly more MMPI validity and clinical scale elevations within the pathological range. The MMPI may be of use in screening patients for the presence of Briquets syndrome.

Thirty-Year Follow-Up of Men at High Risk for Alcoholism

Alcoholism runs in families. This has been recognized for centuries. During much of this century it has been generally believed that “familial alcoholism” resulted from children modeling their behavior after their parents. Recent reviews of twin and adoption studies conducted in Europe and the United States indicate that alcoholism, to some extent, is influenced by Whether alcoholism is partly inherited or not, children of alcoholics are at “high risk” for alcoholism. Perhaps 20-30% of sons of alcoholics and 510% of daughters become alcoholic, a rate three to five times greater than that of the general population.’ The term “high risk study” usually refers to a study of children of afflicted families, in this case alcoholics, before they begin heavy drinking. Heavy use of alcohol may produce physical and psychological problems that can be mistaken for causal factors. The present study continues the longitudinal examination of a cohort of Danish men whose biological fathers were identified as alcoholic in a psychiatric registry or community alcohol treatment program and therefore were considered at high risk for alcoholism. The goal is to identify early predictors of future alcoholism. Predictors are not always, but sometimes, related to causation. Exploring causal factors of alcoholism is a goal of the study.

The Contribution of Parental Alcohol Use Disorders and Other Psychiatric Illness to the Risk of Alcohol Use Disorders in the Offspring

BACKGROUND Few population-based studies have investigated associations between parental history of alcoholism and the risk of alcoholism in offspring. The aim was to investigate in a large cohort the risk of alcohol use disorders (AUD) in the offspring of parents with or without AUD and with or without hospitalization for other psychiatric disorder (OPD). METHODS Longitudinal birth cohort study included 7,177 men and women born in Copenhagen between October 1959 and December 1961. Cases of AUD were identified in 3 Danish health registers and cases of OPD in the Danish Psychiatric Central Register. Offspring registration with AUD was analyzed in relation to parental registration with AUD and OPD. Covariates were offspring gender and parental social status. RESULTS Both maternal and paternal registration with AUD significantly predicted offspring risk of AUD (odds ratios 1.96; 95% CI 1.42 to 2.71 and 1.99; 95% CI 1.54 to 2.68, respectively). The association between maternal, but not paternal, OPD and offspring AUD was also significant (odds ratios 1.46; 95% CI 1.15 to 1.86 and 1.26; 95% CI 0.95 to 1.66, respectively). Other predictors were male gender and parental social status. A significant interaction was observed between paternal AUD and offspring gender on offspring AUD, and stratified analyses showed particularly strong associations of both paternal and maternal AUD with offspring AUD in female cohort members. CONCLUSIONS Parental AUD was associated with an increased risk of offspring AUD independent of other significant predictors, such as gender, parental social status, and parental psychiatric hospitalization with other diagnoses. Furthermore, this association appeared to be stronger among female than male offspring. The results suggest that inherited factors related to alcoholism are at least as important in determining the risk of alcoholism among daughters as among sons.

Diagnostic subgroups of antisocial alcoholics: Outcome at 1 year

Of 233 alcoholics initially evaluated and subdivided into groups with an additional diagnosis of antisocial personality disorder (ASP) only (N = 38), ASP plus drug abuse (N = 30), ASP plus major depressive disorder (N = 18), and those with no additional diagnosis (N = 147), 205 were followed up 1 year later. The ASP plus drug group, although younger and having fewer years of alcoholism, did worse in the 1-year follow-up on many indicators of alcoholism severity compared with the other antisocial groups and the alcoholism only group. The ASP plus depressed group demonstrated marked improvement on measures of psychopathology and alcoholism severity over the course of 1 year such that they were comparable on these measures at 1-year follow-up to the other antisocial groups. These findings may indicate that the ASP/drug alcoholic has a poor long-term prognosis compared with the ASP only alcoholic, while the ASP/depressed patient has a disorder comparable in prognosis to the ASP only alcoholic.

Paternal alcoholism predicts the occurrence but not the remission of alcoholic drinking : a 40-year follow-up

Objective:  To test the effects of fathers alcoholism on the development and remission from alcoholic drinking by age 40.

Double-blind, randomized placebo-controlled clinical trial of benfotiamine for severe alcohol dependence

Alcohol dependence is associated with severe nutritional and vitamin deficiency. Vitamin B1 (thiamine) deficiency erodes neurological pathways that may influence the ability to drink in moderation. The present study examines tolerability of supplementation using the high-potency thiamine analog, benfotiamine (BF), and BFs effects on alcohol consumption in severely affected, self-identified, alcohol dependent subjects. A randomized, double-blind, placebo-controlled trial was conducted on 120 non-treatment seeking, actively drinking, alcohol dependent men and women volunteers (mean age=47 years) from the Kansas City area who met DSM-IV-TR criteria for current alcohol dependence. Subjects were randomized to receive 600 mg benfotiamine or placebo (PL) once daily by mouth for 24 weeks with 6 follow-up assessments scheduled at 4 week intervals. Side effects and daily alcohol consumption were recorded. Seventy (58%) subjects completed 24 weeks of study (N=21 women; N=49 men) with overall completion rates of 55% (N=33) for PL and 63% (N=37) for BF groups. No significant adverse events were noted and alcohol consumption decreased significantly for both treatment groups. Alcohol consumption decreased from baseline levels for 9 of 10 BF treated women after 1 month of treatment compared with 2 of 11 on PL. Reductions in total alcohol consumption over 6 months were significantly greater for BF treated women (BF: N=10, -611 ± 380 standard drinks; PL: N=11, -159 ± 562 standard drinks, p-value=0.02). BF supplementation of actively drinking alcohol dependent men and women was well-tolerated and may discourage alcohol consumption among women. The results do support expanded studies of BF treatment in alcoholism.

Sex-Role Affiliation among Male Alcoholics.

Male alcoholic veterans were sex-typed more frequently as feminine than masculine on the PRF ANDRO when compared to college males or older, nonalcoholic veterans (N = 123). Endorsement of passive-feminine characteristics among alcoholics (1) is interpreted to be a consequence, not a cause of the disorder; (2) is considered reversible with the achievement of sustained sobriety; and (3) is a feature that possibly needs to be addressed directly in order to facilitate successful therapeutic interventions.

Lithium compliance in alcoholic males: A six month followup study☆

One hundred alcoholic patients were followed at monthly outpatient clinics for 6 months. Half were assigned low to moderate doses of lithium carbonate and half to chlordiazepoxide (10 mg tid) (active placebo). Drinking behavior and medication compliance were monitored at monthly clinics. After 6 months 52% of the lithium and 44% of the chlordiazepoxide patients were medication compliant. Of the 48% remaining in the lithium group, 14% did not return for a single visit while 14% came only once. Twenty percent came to clinic regularly; however they had never taken the medication as assigned. Of the 56% non-compliant chlordiazepoxide patients, 16% did not attend a single clinic; 24% came only once or twice and the remaining 16% attended clinics regularly although they were never medication-compliant. Drinking days and the percentage of patients reporting abstinence for one or more months were determined for medication compliant patients and for patients who attended clinic regularly but who did not take medication. Data were analyzed by Kruskal-Wallis one way analysis of variance tests. While lithium and chlordiazepoxide compliant patients tended to report fewer mean drinking days per month (4.6 and 4.8 respectively) than the non-medication group (6.9) these differences were not significant; however, compared to 44% in the non-medication group, 60% of the lithium patients and 58% of the chlordiazepoxide patients reported having significantly more months of abstinence (p less than .05). These results do not show that lithium is differentially efficacious in reducing alcohol consumption.