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CLINICAL STUDY: Cortisol concentrations, stress‐coping styles after withdrawal and long‐term abstinence in alcohol dependence
Author(s) -
Walter Marc,
Gerhard Urs,
Gerlach Manfred,
Weijers HeinzGerd,
Boening Jobst,
Wiesbeck Gerhard A.
Publication year - 2006
Publication title -
addiction biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.445
H-Index - 78
eISSN - 1369-1600
pISSN - 1355-6215
DOI - 10.1111/j.1369-1600.2006.00018.x
Subject(s) - abstinence , psychology , coping (psychology) , alcohol dependence , medicine , personality , clinical psychology , alcohol , endocrinology , psychiatry , social psychology , biochemistry , chemistry
Alcohol‐dependent patients face a substantial risk of relapse after detoxification. A major risk factor for relapse is stress which is reflected biologically by various physiological changes that include an activation of the hypothalamic‐pituitary‐adrenal (HPA) axis and release of glucocorticoids. The prospective study examined cortisol concentrations and stress‐coping styles in relation to abstinence 1 year following discharge from treatment. Cortisol concentrations were measured in the plasma of 46 alcohol‐dependent patients (12 women) on initial presentation for treatment (day 1), and again in plasma and in cerebrospinal fluid (CSF) after 6 weeks of abstinence (day 40). These results were compared with those of 26 age‐ and sex‐matched, healthy control subjects. After withdrawal, the patients completed a comprehensive baseline assessment including a stress‐coping questionnaire (Stressverarbeitungsfragebogen SVF120) and were monitored for 1 year after discharge. Negative stress‐coping styles (e.g. flight, resignation) positively correlated with higher cortisol concentration in plasma and in CSF after withdrawal (day 40). Compared with relapsers after 1 year, abstainers had significantly lower levels for cortisol in CSF, whereas the stress‐coping styles did not differ between abstainers and relapsers in this sample. These findings suggest that relatively stable personality traits like stress‐coping styles have no measurable influence on abstinence. The lower cortisol concentration in CSF as an indicator for HPA axis functioning is associated with long‐term abstinence in detoxified alcoholics.