Alcoholism and seasonal affective disorder

doi:10.1016/j.comppsych.2003.09.007

Comprehensive Psychiatry

Volume 45, Issue 1, January–February 2004, Pages 51-56

https://doi.org/10.1016/j.comppsych.2003.09.007 Get rights and content

Abstract

Seasonal changes in mood and behavior (seasonality) may be closely related to alcoholism. Some patients with alcoholism have a seasonal pattern to their alcohol misuse. They may be self-medicating an underlying seasonal affective disorder (SAD) with alcohol or manifesting a seasonal pattern to alcohol-induced depression. Both genetic and environmental factors play a role in the etiology and pathogenesis of alcoholism and SAD, operating, at least in part, through the brain serotonergic system. Family and molecular genetic studies suggest that there may be a genetic link between seasonality and alcoholism. Certain environmental and social factors may contribute to the development of seasonality in patients with alcoholism. The fact that SAD and alcoholism may be comorbid shows the importance of a thorough diagnostic interview. Both mental health and drug and alcohol professionals should be provided with education to assist with appropriate identification, management, and referral of patients presenting with comorbid alcoholism and SAD.

Section snippets

Seasonality and seasonal affective disorder

Seasonal affective disorder (SAD), a condition where depressions in fall and winter alternate with nondepressed periods in the spring and summer, can be considered a distinct subtype of major depression.7, 8, 9, 10 In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)11 SAD is listed as a specifier of either bipolar or recurrent major depressive disorder, with a seasonal pattern of major depressive episodes. The tendency to experience seasonal changes in mood and behavior,

Seasonality and alcoholism

Recent data suggest that seasonality may be closely related to alcoholism. Some patients with alcoholism have a seasonal pattern to their alcohol abuse.17 Avery et al.18 reported that during their research on SAD, they have had to exclude many potential subjects from their studies because those subjects were abusing alcohol or had a history of alcohol abuse. Anderson et al.19 reported that, in an alcohol/substance abuse program, 23% of the patients had SAD. Patients with alcoholism may be

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Emergency Department Visits for Alcohol-Associated Falls Among Older Adults in the United States, 2011 to 2020
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The aim of this study was to examine the epidemiology of alcohol-associated fall injuries among older adults aged ≥65 years in the United States.
We included emergency department (ED) visits for unintentional fall injuries by adults from the National Electronic Injury Surveillance System-All Injury Program during 2011 to 2020. We estimated the annual national rate of ED visits for alcohol-associated falls and the proportion of these falls among older adults’ fall-related ED visits using demographic and clinical characteristics. Joinpoint regression was performed to examine trends in alcohol-associated ED fall visits between 2011 and 2019 among older adult age subgroups and to compare these trends with those of younger adults.
There were 9,657 (weighted national estimate: 618,099) ED visits for alcohol-associated falls, representing 2.2% of ED fall visits during 2011 to 2020 among older adults. The proportion of fall-related ED visits that were alcohol-associated was higher among men than among women (adjusted prevalence ratio [aPR]=3.6, 95% confidence interval [CI] 2.9 to 4.5). The head and face were the most commonly injured body parts, and internal injury was the most common diagnosis for alcohol-associated falls. From 2011 to 2019, the annual rate of ED visits for alcohol-associated falls increased (annual percent change 7.5, 95% CI 6.1 to 8.9) among older adults. Adults aged 55 to 64 years had a similar increase; a sustained increase was not detected in younger age groups.
Our findings highlight the rising rates of ED visits for alcohol-associated falls among older adults during the study period. Health care providers in the ED can screen older adults for fall risk and assess for modifiable risk factors such as alcohol use to help identify those who could benefit from interventions to reduce their risk.
Seasonality contributes to depressive, anxiety and alcohol use disorders in the Finnish general adult population
2022, Journal of Affective Disorders
Citation Excerpt :
In addition, season-bound exaggeration of illness has been observed in some other mental disorders as well, for example, in eating disorders (Lam et al., 1996), insomnia (Ohayon and Partinen, 2002), and alcohol abuse or dependence (McGrath and Yahia, 1993). Earlier, a link between the seasonal variations in mood and behavior and alcohol dependence has been identified (Sher, 2004; Morales-Muñoz et al., 2017). Thus, certain environmental factors may contribute to the development of seasonality in patients with alcohol dependence.
Earlier evidence suggests that the seasonal changes in mood and behavior are associated with mental disorders, especially with mood disorders. However, the extent of these associations has not been analyzed by using large samples of the general population.
A random sample of adults, aged 29 to 97 years and representative of the general population living in Finland, attended a nationwide health examination survey. Mental disorders were assessed with the Munich version of the Composite International Diagnostic Interview (M-CIDI, n = 4554). Of them, the seasonal variations in mood and behavior (seasonality) were assessed with the six items of the Global Seasonality Score (GSS, n = 4004) as well as with the experienced problem due to these variations.
After adjusting for age, gender, level of education, and region of residence, the GSS was associated with depressive, anxiety and alcohol use disorders (all p < 0.001). Of the GSS items, mood was associated with depressive disorders (p < 0.001), anxiety disorders (p = 0.003) and alcohol use disorders (p = 0.008), whereas appetite was associated only with depressive disorders (p = 0.012), and energy level only with anxiety disorders (p = 0.025).
This cross-sectional study was based on self-reported data on the seasonal pattern.
Seasonality had significant associations with depressive, anxiety and alcohol use disorders among the general adult population. This needs attention in clinical practice.
Relationship between ambient temperature and severe acute poisoning by alcohol and drugs
2021, Alcohol
Citation Excerpt :
Weather-related factors can affect substance abuse or misuse patterns and risks. Moreover, meteorological seasons can influence addictive behavior, and patients at risk are susceptible to these influences in individual ways and to varying extents (Sher, 2004). However, regarding this, the reported results are not consistent and, in part, even contrary.
To test the hypothesis that severe acute poisoning by alcohol and drugs is more frequent at higher rather than at lower ambient temperatures.
This was a prospective observational study performed in a prehospital setting under marine west coast climate conditions. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Temperature data were obtained and matched with the associated rescue mission data, which were divided into the following groups: 1) alcohol poisoning, 2) opioid poisoning, 3) poisoning by sedatives/hypnotics, multiple drugs, volatile solvents, and other psychoactive substances. Lowess-Regression analysis was performed to assess the relationship between ambient temperature and frequency of severe acute poisoning. Additionally, three temperature ranges were defined in order to compare them with each other with regard to frequency of severe poisoning (<10 °C vs. 10–20 °C vs. >20 °C). The severity of emergencies was assessed using the National Advisory Committee for Aeronautics (NACA) scoring system.
In 1535 patients, severe acute alcohol or drug poisoning associated with loss of consciousness, hypotension, and impaired respiratory function was treated (alcohol: n = 604; opioids: n = 295; sedatives/hypnotics/multiple drugs: n = 636). Compared to mild temperatures (10–20 °C), the frequency of poisoning increased in all three groups at higher temperatures and decreased at lower temperatures (p < 0.01). No significant correlation was found between severity of emergencies and temperature.
Our results suggest a continuously increasing probability of occurrence of severe acute poisoning by alcohol and drugs with rising temperature.
Suppression of voluntary ethanol intake in mice under constant light and constant darkness
2020, Alcohol
Seasonal variations in photoperiod are associated with alterations in human mood and behavior. Similarly, manipulation of the environmental lighting regimen can exert pronounced effects on affective behavior in experimental animals. These observations may be due, in part, to light-induced alterations in circadian rhythms, but it seems likely that other, non-circadian factors also contribute. Several studies have shown that voluntary alcohol (ethanol) consumption can be affected by lighting conditions in rodents, suggesting that photoperiodic variation may account for seasonal and geographic patterns of human alcohol consumption. Nevertheless, the existing animal data are somewhat inconsistent, and little work in this area has been performed in mice. In the present study, we monitored circadian activity rhythms and voluntary ethanol consumption under standard 12:12 light–dark (LD) cycles, and in constant light (LL) and constant darkness (DD). Experiment 1 employed male C3H/He inbred mice, while Experiment 2 employed males and females from a genetically heterogeneous line (WSC). Relative to LD conditions, ethanol intake and ethanol preference were reduced under both LL and DD in both experiments. Because similar effects were seen in both LL and DD, neither circadian disruption nor a classical photoperiodic mechanism are likely to account fully for these findings. Instead, we suggest that the absence of circadian entrainment may function as a mild stressor, resulting in reduced ethanol consumption.
Seasonal affective disorder and alcohol abuse disorder in a population-based study
2017, Psychiatry Research
Citation Excerpt :
In addition to this, they feel tired and lethargic, have difficulty concentrating, sleep more than normal, are lack of energy, decrease their activity levels, withdraw from social situations, crave carbohydrates and sugars, and tend to gain weight due to overeating (Forneris et al., 2015). Interestingly, seasonal changes in mood and behavior may be closely related to alcoholism, and certain environmental and social factors may contribute to the development of seasonality in patients with alcoholism (Sher, 2004a). Previous data suggest that some patients with alcoholism have a seasonal pattern associated to their alcohol-induced depression (Sher, 2002), and more specifically alcohol dependence has been found to consistently deteriorate during the fall and winter months in previous research (McGrath and Yahia, 1993).
Seasonal affective disorder (SAD) is a recurrent major depressive disorder with a seasonal pattern, which is characterized by sad mood, low energy, longer sleep duration and carbohydrate craving. Furthermore, seasonal changes in mood and behavior may be closely related to alcohol use disorder (AUD). Nevertheless, there is scarce research on the study of cognitive impairments in SAD and AUD. We aimed to examine the relationship between the prevalence between SAD and AUD patients, and how cognitive functioning might be related to these variables. To do this, a sample of 8135 Finnish subjects was invited to take part in the population-based Health 2011 Survey, of whom 5903 did participate and 4554 were interviewed for mental health status with the Munich version of Composite International Diagnostic Interview. They also completed the modified Seasonal Pattern Assessment Questionnaire, the Mini–Mental State Examination, the category (animals) verbal fluency test, and the Rey Auditory Verbal Learning Test. Our results reveal the existence of a strong link between SAD and AUD in a large sample of Finnish population, as well as association between SAD and short-term memory problems.
Photoperiodic modulation of voluntary ethanol intake in C57BL/6 mice
2015, Physiology and Behavior
Citation Excerpt :
The primary environmental factor influencing the circadian system is light, and indeed, seasonal and latitudinal variations in environmental photoperiod exert powerful effects on circadian physiology and behavior. Epidemiological studies indicate that alcohol use and abuse varies with both season [7,12,32,35,40,53] and latitude [33,34,39], and exhibits co-morbidity and genetic overlap with Seasonal Affective Disorder (SAD) [2,35,47,48]. While seasonal patterns in human alcohol consumption may reflect the combined influence of both geophysical and sociocultural factors [49], these observations suggest a significant role for photoperiod in the modulation of human alcohol consumption.
Seasonal and geographic variations in light exposure influence human mood and behavior, including alcohol consumption. Similarly, manipulation of the environmental lighting regimen modulates voluntary ethanol intake in experimental animals. Nevertheless, previous studies in rats and hamsters have been somewhat inconsistent, and little is known concerning such effects in mice. In the present study, we maintained male C57Bl/6 mice in running-wheel cages under either short- or long-photoperiod light–dark cycles (LD 6:18 vs. LD 18:6); subsequently, the same animals were maintained under short or long “skeleton photoperiods”, consisting of two daily 15-min light pulses signaling dusk and dawn (SP 6:18 vs. SP 18:6). Running wheels were locked mechanically for half the animals under each photoperiod. Analysis of running wheel patterns showed that mice displayed stable circadian adaptation to both standard LD cycles and skeleton photoperiods. Mice consumed more ethanol and less water, and thus showed higher ethanol preference, under LD 6:18 and SP 6:18 relative to the corresponding long-photoperiod regimens. While running-wheel access increased water intake, ethanol intake was unaffected by this manipulation. These effects are consistent with previous studies showing that short photoperiods or constant darkness increases ethanol intake in rodents. Further, the similarity of the effects of complete and skeleton photoperiods suggests that these effects are mediated by photoperiod-induced alterations in the circadian entrainment pattern, rather than by light exposure per se.

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Alcoholism and seasonal affective disorder

Abstract

Section snippets

Seasonality and seasonal affective disorder

Seasonality and alcoholism

Lancet

Compr Psychiatry

Compr Psychiatry

Biol Psychiatry

Biol Psychiatry

Neurobiol Dis

Biol Psychiatry

Alcohol

Alcohol

Neurosci Lett

Biol Psychiatry

Med Hypoth

Alcohol

Med Hypoth

Gen Hosp Psychiatry

Alcohol-related disorders

Alcohol abuse and alcoholisman overview

J Clin Psychiatry

Epidemiology of alcoholism. Alcohol Patterns and Problems

Alcoholism and affective disorderclinical course of depressive symptoms

Am J Psychiatry

Comorbidity of mental disorders with alcohol and other drug abuse

JAMA

Major depression in 6050 former drinkersassociation with past alcohol dependence

Arch Gen Psychiatry

Seasonal affective disordera description of the syndrome and preliminary findings with light therapy

Arch Gen Psychiatry

Pathophysiology of seasonal affective disordera review

J Psychiatry Neurosci

Epidemiological findings of seasonal changes in mood and behavior

Arch Gen Psychiatry

On the question of mechanism in phototherapy for seasonal affective disorderconsiderations of clinical efficacy and epidemiology

J Biol Rhythms

The Zurich Study, XIVepidemiology of seasonal depression

Eur Arch Psychiatry Clin Neurosci

Circadian clock

Preliminary data on seasonally related alcohol dependence

J Clin Psychiatry

Dawn simulation treatment of abstinent alcoholics with winter depression

J Clin Psychiatry

SPAQ and seasonality in alcohol- or drug-addicted patientsthe women are SAD and the men are subsyndromal—is it a problem?

Soc Light Treat Biol Rhythms Bull

Light therapy for detoxified male alcoholics

Soc Light Treat Biol Rhythms Bull

Depressive symptoms and family history in seasonal and nonseasonal mood disorders

Am J Psychiatry

Seasonal affective disorder—A Canadian sample

Ann Clin Psychiatry

Seasonal affective disorder—a British sample

J Affect Disord