Alcohol dependence and anxiety increase error-related brain activity.
OBJECTIVE
Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in other psychiatric disorders with impaired response inhibition, such as attention-deficit hyperactivity disorder and borderline personality disorder, but increased in anxiety disorders. The objective of the current study was to assess error monitoring in alcohol-dependent patients in relation to psychiatric comorbidity. We expected decreased error monitoring in alcohol-dependent patients with impulse control disorders and increased error monitoring in anxious alcohol-dependent patients.


METHODS
In a case-control design alcohol-dependent patients were compared with healthy controls.


METHODS
A consecutive series of 29 male alcohol-dependent patients, between 18 and 55 years of age, applying for in-patient detoxification were recruited at Novadic Kentron Center for Addiction Treatment. Fifteen age-matched healthy controls were recruited through advertisements in regional newspapers.


METHODS
Event-related potentials were recorded while performing a speeded choice-reaction task, from which ERN amplitudes were calculated. Axis-I and -II psychiatric comorbidity were assessed using the MINI International Neuropsychiatric Interview and the Structured Interview for DSM-IV Personality disorders. All participants completed the Temperament and Character Inventory and Profile of Mood States.


RESULTS
ERN amplitudes were increased for alcohol-dependent patients compared to healthy controls, particularly in patients with comorbid anxiety disorders.


CONCLUSIONS
Increased error monitoring in alcohol-dependent patients, particularly those with comorbid anxiety disorders, is in contrast with previous studies that suggested decreased error monitoring to be a general feature in substance use disorders. Psychiatric disorders co-occurring with alcohol dependence, such as anxiety disorders, may indicate subpopulations of alcohol-dependent patients, with distinct neurobiological and genetic characteristics, possibly requiring different treatment strategies.
Schellekens
Arnt F A
AF
Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, the Netherlands.
de Bruijn
Ellen R A
ER
van Lankveld
Christa A A
CA
Hulstijn
Wouter
W
Buitelaar
Jan K
JK
de Jong
Cor A J
CA
Verkes
Robbert J
RJ
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000503:physiopathology* / Q000523:psychology; D001007:Anxiety / Q000503:physiopathology; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000503:physiopathology / Q000523:psychology; D004569:Electroencephalography; D005071:Evoked Potentials; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010552:Personality Assessment / Q000706:statistics & numerical data; D011930:Reaction Time; D055815:Young Adult