Socially stable alcoholics: What characterises them? Drinking patterns, personality and health aspects of psychosocial and clinical importance

Abstract: People who misuse alcohol are a heterogeneous group with different etiology, social and clinical characteristics. This thesis includes four studies whose aim was to characterise so called socially stable alcoholics (i.e. individuals with preserved psychosocial functioning) regarding personality, physical and mental health and drinking patterns. Specifically the aim of Study I was to describe demographic and clinical characteristics in male individuals with excessive alcohol intake (n = 367) recruited by advertisements and to compare these individuals according to their prior experience of treatment. The results showed that individuals with no prior treatment history (n = 238) were found to be more often cohabitant and employed. They also reported fewer on-going psychiatric symptoms than individuals with prior treatment histories. The aim of Study II was to study personality traits in relation to central serotonergic neurotransmission and years of excessive alcohol intake in 33 alcoholdependent male individuals. More individuals with low serotonergic neurotransmission as well as long time-period of excessive drinking had elevated levels of anxiety proneness. Long time-period of excessive drinking was the strongest predictor for anxiety proneness. The aim of Study III was to investigate personality profile of socially stable male alcoholics (n = 100) in comparison to a population-based male control group (n = 131). There were differences between the two groups although the differences were mainly small to moderate in magnitude. Further analyses showed a more heterogeneous pattern among alcoholics than controls in the personality traits impulsiveness and anxiety proneness. The aim of Study IV was to investigate alcohol-dependent men and women (n = 125) in an inpatient treatment setting and analyse specific characteristics such as substance use and health functioning in these individuals. Gender and two age-groups were compared, respectively, in these characteristics. Differences between genders were found in drinking patterns whereas differences between the two age-groups (29-47 years and 49-69 years) were found in drinking patterns as well as in somatic and mental health. The four studies reveal that there are several important characteristics among socially stable alcoholics that are related to personality, mental and somatic health, drinking patterns as well as treatment experience, barriers for helpseeking and serotonergic neurotransmission. Furthermore, the results suggest that one way to reach these alcoholics could be via alcohol treatment programs at working places and centres of learning and not via the health care system since many of them are less likely to seek treatment for psychiatric and somatic symptoms. It may also be of importance to have an ageperspective in treatment planning for alcohol-dependent individuals, where younger individuals need more of psychiatric consultations whereas their older counterparts instead need more of consultations by medical professionals. Key words: age, alcoholics, clinical characteristics, social stability, demography, gender, health functioning, personality, serotonin, substance use