Is withdrawal-induced anxiety in alcoholism based on beta-endorphin deficiency?
BACKGROUND
Associations between several psychopathological alterations and lowered beta-endorphin(beta E) plasma levels have already been stated in former studies. However, whereas single measures during static conditions generally failed in linking beta E levels with psychopathology, dynamic changes of beta E in particular have been shown to be associated with spells of anxiety and depression. During alcohol withdrawal, a decreased secretion of beta E with a delayed normalization has been reported, but up to now only few data became available regarding the interaction of plasma beta E and psychopathological parameters.


OBJECTIVE
The aim of our study was to test the hypothesis whether beta E during acute alcohol withdrawal is associated with anxiety, depression, and craving.


METHODS
We observed self-rated anxiety, depression, and craving during alcohol withdrawal and assessed beta E levels (RIA) in a consecutive sample of 60 alcoholics on day 1 and day 14 after onset of withdrawal, and in 30 healthy volunteers. To control for mutual interactions of beta E and the pituitary-adrenocortical hormone secretion, plasma corticotropin (ACTH) and cortisol were also determined.


RESULTS
In accordance with prior studies, beta E was significantly lowered on day 1 and day 14 of alcohol withdrawal relative to controls. Plasma levels of ACTH correlated significantly with beta E in alcoholics at both time points and in controls, without differing significantly between the groups. Self-rated anxiety, depression, and alcohol craving decreased significantly between day 1 and day 14. Levels of beta E were inversely correlated with anxiety day 1 (r=-0.58) and day 14 (r=-0.71). Partial correlation coefficients controlling for ACTH plasma levels revealed that this correlation was largely independent from ACTH. In addition, a significant inverse relationship was found between beta E and craving on day 14 (r=-0.28). No association appeared between beta E and depression.


CONCLUSIONS
Our results give first evidence that lowered beta E during alcohol withdrawal may contribute to anxiety as a common disturbance during this state.
Kiefer
Falk
F
Department of Psychiatry, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany. kiefer@psyunihh.de
Horntrich
Mirko
M
Jahn
Holger
H
Wiedemann
Klaus
K
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000097:blood; D000437:Alcoholism / Q000097:blood* / Q000150:complications; D001007:Anxiety / Q000097:blood* / Q000209:etiology; D003863:Depression / Q000097:blood / Q000209:etiology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000097:blood / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D013375:Substance Withdrawal Syndrome / Q000097:blood* / Q000209:etiology / Q000523:psychology; D013997:Time Factors; D001615:beta-Endorphin / Q000097:blood / Q000172:deficiency*
D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone