title: Severity of alcohol dependence in decompensated alcoholic liver disease: comparison with heavy drinkers without liver disease and relationship to family drinking history.
abstract: OBJECTIVE
  The aim of this study was to compare alcohol dependence severity in patients with severe alcoholic liver disease (ALD) with that in heavy drinkers without liver disease.
  
  
  METHODS
  Short alcohol dependence data and lifetime alcohol questionnaires applied to unselected heavy alcohol drinkers (>60 units/week (M) or 40 units/week (F) for >5 years) with either (a) decompensated ALD (patients n = 136) or (b) no evidence of serious liver disease by clinical, biochemical and ultrasound evaluation ('controls' n = 148).
  
  
  RESULTS
  The SADD alcohol dependence severity score (range 0-42) in patients with ALD was >28 (severe dependence) in 36 cases (26%); slightly higher than that in heavy-drinking controls taken as a whole; similar to that in controls who were seeking healthcare but higher than that in controls who were not; and lower than that in controls who attended specialist alcohol services. In ALD patients and controls, the SADD score was higher in those with three or more heavy-drinking first-degree relatives than in those with none. In multiple regression analysis, the SADD score showed independent associations with young age, clinically manifest alcohol dependence, seeking healthcare and the presence of multiple heavy drinking relatives, but not with ALD.
  
  
  CONCLUSIONS
  Alcohol dependence severity in patients with ALD varies and tends to be lower than that in heavy drinkers seeking treatment at alcohol treatment centres but is not as low as implied in some previous studies. Alcohol dependence severity is associated with young age and family drinking history but is not specifically associated with the development of liver disease.
authors.affiliation: Royal Hallamshire Hospital, Sheffield S10 2JF, UK. dermot.gleeson@sth.nhs.uk
authors.forename: Dermot
authors.initials: D
authors.lastname: Gleeson
authors.forename: Jayne S
authors.initials: JS
authors.lastname: Jones
authors.forename: Elaine
authors.initials: E
authors.lastname: McFarlane
authors.forename: Rachel
authors.initials: R
authors.lastname: Francis
authors.forename: Claire
authors.initials: C
authors.lastname: Gellion
authors.forename: Martin P
authors.initials: MP
authors.lastname: Bradley
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Peck
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D005190:Family; D005260:Female; D006519:Hepatitis, Alcoholic / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D011795:Surveys and Questionnaires