title: Insomnia in alcohol dependent subjects is associated with greater psychosocial problem severity.
abstract: BACKGROUND
  Although psychosocial problems are commonly associated with both alcohol misuse and insomnia, very little is known about the combined effects of insomnia and current alcohol dependence on the severity of psychosocial problems. The present study evaluates whether the co-occurrence of insomnia and alcohol dependence is associated with greater psychosocial problem severity.
  
  
  METHODS
  Alcohol dependent individuals (N = 123) were evaluated prior to participation in a placebo-controlled medication trial. The Short Index of Problems (SIP), Addiction Severity Index (ASI), Insomnia Severity Index (ISI), and Time Line Follow Back (TLFB), were used to assess psychosocial, employment, and legal problems; insomnia symptoms; and alcohol consumption, respectively. Bivariate and multivariate analyses were used to evaluate the relations between insomnia and psychosocial problems.
  
  
  RESULTS
  Subjects' mean age was 44 years (SD = 10.3), 83% were male, and their SIP sub-scale scores approximated the median for normative data. A quarter of subjects reported no insomnia; 29% reported mild insomnia; and 45% reported moderate-severe insomnia. The insomnia groups did not differ on alcohol consumption measures. The ISI total score was associated with the SIP total scale score (β = 0.23, p = 0.008). Subjects with moderate-severe insomnia had significantly higher scores on the SIP total score, and on the social and impulse control sub-scales, and more ASI employment problems and conflicts with their spouses than others on the ASI.
  
  
  CONCLUSIONS
  In treatment-seeking alcohol dependent subjects, insomnia may increase alcohol-related adverse psychosocial consequences. Longitudinal studies are needed to clarify the relations between insomnia and psychosocial problems in these subjects.
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, United States; Washington University in St. Louis, St. Louis, MO 63110, United States.
authors.forename: Ninad S
authors.initials: NS
authors.lastname: Chaudhary
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, United States; Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, United States.
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Kampman
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, United States; Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, United States.
authors.forename: Henry R
authors.initials: HR
authors.lastname: Kranzler
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, United States; Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, United States.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, United States; Thomas Jefferson University, Philadelphia, PA 19107, United States.
authors.forename: Swarnalata
authors.initials: S
authors.lastname: Debbarma
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, United States; Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, United States. Electronic address: Subhajit.Chakravorty@uphs.upenn.edu.
authors.forename: Subhajit
authors.initials: S
authors.lastname: Chakravorty
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D012919:Social Behavior; D011795:Surveys and Questionnaires
keywords: Alcoholism; Insomnia and sleep and maintenance disorders; Psychosocial factors