title: Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving.
abstract: OBJECTIVE
  The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving.
  
  
  METHODS
  95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample.
  
  
  RESULTS
  28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p<.01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p<.003), were found. BIS-11 (t=-2.36; p=.020), OCDS obsessive (Z=-4.13; p<.001), OCDS compulsive (Z=-2.12; p=.034) and VASc (Z=-4.94; p<.001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p=.012) and higher craving levels (VASc scores; OR=2.48; p<.001).
  
  
  CONCLUSIONS
  Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy. Electronic address: mdnicola@libero.it.
authors: Marco
authors: M
authors: Di Nicola
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Daniela
authors: D
authors: Tedeschi
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Luisa
authors: L
authors: De Risio
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Mauro
authors: M
authors: Pettorruso
authors: Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
authors: Giovanni
authors: G
authors: Martinotti
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Filippo
authors: F
authors: Ruggeri
authors: Centre Neuchâtelois de Psychiatrie, République et Canton de Neuchâtel, Site de Préfargier, 2074 Marin-Epagnier, Switzerland.
authors: Kevin
authors: K
authors: Swierkosz-Lenart
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Riccardo
authors: R
authors: Guglielmo
authors: Science of Education, LUMSA University, Borgo Sant'Angelo, 13, 00193 Rome, Italy.
authors: Antonino
authors: A
authors: Callea
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Giuseppe
authors: G
authors: Ruggeri
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy.
authors: Gino
authors: G
authors: Pozzi
authors: Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
authors: Massimo
authors: M
authors: Di Giannantonio
authors: Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy.
authors: Luigi
authors: L
authors: Janiri
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003192:Compulsive Behavior / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D066249:Craving; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory
keywords: Alcohol use disorder; Behavioral addictions; Craving; Gambling disorder; Impulsivity; Internet addiction