title: Alcohol misuse in patients with psoriasis: identification and relationship to disease severity and psychological distress.
abstract: BACKGROUND
  Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers provide an objective measure of alcohol consumption. Carbohydrate-deficient transferrin (CDT) is the single most sensitive and specific alcohol biomarker.
  
  
  OBJECTIVE
  To assess alcohol consumption in a cohort of patients with moderate to severe psoriasis using standard alcohol screening questionnaires and biomarkers. We investigated whether there was an association between alcohol intake, anxiety, depression and disease severity.
  
  
  METHODS
  Consecutive patients with chronic plaque psoriasis were recruited and completed a range of anonymized assessments. Psoriasis severity, anxiety and depression, and the impact of psoriasis on quality of life were assessed. Alcohol screening questionnaires were administered. Blood specimens were taken and γ-glutamyltransferase (γGT) and CDT were measured.
  
  
  RESULTS
  A total of 135 patients completed the study. Using validated questionnaires, between 22% and 32% had difficulties with alcohol. Seven per cent had CDT > 1·6% indicating a heavy alcohol intake. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was superior to other validated questionnaires in detecting alcohol misuse. There were no significant associations between measures of excessive alcohol consumption and disease severity. Excessive alcohol intake as measured by the CAGE questionnaire was associated with increased depression (P = 0·001) but other measures of alcohol excess did not correlate with psychological distress. Men had significantly more difficulties with alcohol than women (P < 0·001).
  
  
  CONCLUSIONS
  Alcohol misuse is common in patients with moderate to severe psoriasis. Screening with the AUDIT questionnaire and CDT may allow the identification of patients who are misusing alcohol and allow appropriate intervention.
authors: Department of Dermatology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
authors: M A
authors: MA
authors: McAleer
authors: D L
authors: DL
authors: Mason
authors: S
authors: S
authors: Cunningham
authors: S J
authors: SJ
authors: O'Shea
authors: P A
authors: PA
authors: McCormick
authors: C
authors: C
authors: Stone
authors: P
authors: P
authors: Collins
authors: S
authors: S
authors: Rogers
authors: B
authors: B
authors: Kirby
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D001008:Anxiety Disorders / Q000209:etiology; D015415:Biomarkers / Q000378:metabolism; D003866:Depressive Disorder / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000523:psychology*; D011788:Quality of Life; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology*; D014168:Transferrin / Q000031:analogs & derivatives / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D005723:gamma-Glutamyltransferase