Cortisol concentrations, stress-coping styles after withdrawal and long-term abstinence in alcohol dependence.
Alcohol-dependent patients face a substantial risk of relapse after detoxification. A major risk factor for relapse is stress which is reflected biologically by various physiological changes that include an activation of the hypothalamic-pituitary-adrenal (HPA) axis and release of glucocorticoids. The prospective study examined cortisol concentrations and stress-coping styles in relation to abstinence 1 year following discharge from treatment. Cortisol concentrations were measured in the plasma of 46 alcohol-dependent patients (12 women) on initial presentation for treatment (day 1), and again in plasma and in cerebrospinal fluid (CSF) after 6 weeks of abstinence (day 40). These results were compared with those of 26 age- and sex-matched, healthy control subjects. After withdrawal, the patients completed a comprehensive baseline assessment including a stress-coping questionnaire (Stressverarbeitungsfragebogen SVF120) and were monitored for 1 year after discharge. Negative stress-coping styles (e.g. flight, resignation) positively correlated with higher cortisol concentration in plasma and in CSF after withdrawal (day 40). Compared with relapsers after 1 year, abstainers had significantly lower levels for cortisol in CSF, whereas the stress-coping styles did not differ between abstainers and relapsers in this sample. These findings suggest that relatively stable personality traits like stress-coping styles have no measurable influence on abstinence. The lower cortisol concentration in CSF as an indicator for HPA axis functioning is associated with long-term abstinence in detoxified alcoholics.
Walter
Marc
M
Division of Substance Use Disorders, Psychiatric University Hospital Basel, Basel, Switzerland. marc.walter@upkbs.ch
Gerhard
Urs
U
Gerlach
Manfred
M
Weijers
Heinz-Gerd
HG
Boening
Jobst
J
Wiesbeck
Gerhard A
GA
D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000097:blood / Q000134:cerebrospinal fluid / Q000517:prevention & control; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000134:cerebrospinal fluid*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012008:Recurrence; D013315:Stress, Psychological / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013695:Temperance; D013995:Time
D006854:Hydrocortisone