The most important comorbidities of alcoholism

Alcoholism is a very serious social, medical and psychological problem that affects both women and men. According to the World Health Organization (WHO), however, men are up to three times more likely than women to develop an addiction to alcohol.

Beyond the serious consequences that alcohol has in our lives, in our minds and in our body, it is widely recognized that there are numerous comorbidities in it.

In this article we will know the most frequent comorbidities of alcoholism, that is, the disorders and symptoms that usually appear associated with it, according to data from the DSM-5 and also from different scientific studies.

• Related article: "Alcoholism: these are the effects of drink dependency"

Comorbidities of alcoholism

Before delving into what are the comorbidities of alcoholism, let's clarify the concept of comorbidity. Comorbidity is a term coined in 1970 by the clinician and researcher Alvan. R. Feinstein. This concept refers to the presence of one or more disorders, in addition to the primary underlying disorder (we also refer to diseases).

In the case of alcoholism, there are multiple comorbidities to this disorder, both at the psychopathological (mental disorders) and medical (diseases themselves) level. In addition, both in the medical and psychological field, the comorbidities of alcoholism have been a topic of interest that has grown little by little over the years.

In clinical practice, it is observed that it is increasingly difficult to find "pure" cases of alcoholism., because most of them already come with one or more associated disorders.

It should also be noted that in the field of addictions, it is highly frequent to find in patients the so-called polydependence (addiction to more than one substance) (not to mention the also added psychopathological disorders of an emotional and affective nature and illnesses medical).

• You may be interested in: "The 14 most important types of addictions"

Disorders frequently associated with alcoholism: DSM-5

In the DSM-5 (Diagnostic Manual of Mental Disorders), alcoholism disorder is associated with other psychiatric conditions. This means that just by suffering from alcoholism, there is an added risk of also suffering from this type of disorder (during the onset of the addictive disorder or even over time). Said disorders/and/or symptoms are:

• Dependence and abuse of other substances, such as: sedatives, hypnotics, cannabis, cocaine, heroin, anxiolytics and amphetamines
• Schizophrenia
• Depression
• Anxiety
• Insomnia
• Increased risk of: accidents, violence and suicide
• Personality disorders: especially the antisocial (increased probability of committing criminal acts)
• Social problems (for example, family breakdown or job uprooting)

Studies

We have seen what the DSM-5 says in relation to the frequent comorbidities of alcoholism, but what does the scientific literature say about it?

1. psychopathological symptomatology

To talk about the comorbidities of alcoholism in terms of psychopathological symptoms, we are going to refer to the results of a study carried out in 2006 (Landa, Fernández-Montalvo, López-Goñi and Lorea). This study shows how the main disorders and/or symptoms associated with alcoholism, at a psychopathological level, are anxious-depressive in nature.

These symptoms are observed in alcoholism in a higher proportion than in the general population (without alcoholism). In addition, it should be noted that the frequency and intensity of such symptoms is related to the severity of alcohol dependence.

This translates into more severe associated symptoms in patients with more severe alcoholism. This comorbidity must be taken into account when considering treatment and the possible risk of relapse..

2. pathological gambling

Another frequently observed comorbidity of alcoholism is pathological gambling. Specifically, a 2005 study, developed by Fernández-Montalvo, establishes that 20% of the alcoholic patients in the sample also had an associated (comorbid) diagnosis of pathological gambling (gambling).

On the other hand, according to the aforementioned study, 12% of the patients in the sample also presented symptoms that could indicate a possible diagnosis of compulsive gambling, although without meeting the diagnostic criteria.

In addition, it was observed that the severity of gambling symptoms were related to a more serious alcohol problem.

• You may be interested in: "Pathological gambling: causes and symptoms of gambling addiction"

3. Personality disorders

The personality disorders are another of the frequently observed comorbidities of alcoholism (especially antisocial personality disorder, as we have already seen in the DSM-5 section).

There are also many studies that have been carried out on this subject; in this article we have selected two of them: the first, prepared in 2002 by Fernández-Montalvo, Landa, López-Goñi, Lorea and Zarzuela, and the second one a little later, in 2006, by Fernández-Montalvo, Landa, López-Goñi and Lorea.

According to the results of these studies, the existing comorbidity between alcoholism and certain types of personality disorders, is between 22 and 64% of cases, which is quite alarming.

Three major groups of alcoholism

Another 2001 study, developed by Valbuena et.al, found different types of alcoholic consumption with patterns well differentiated:

• Patients who had suffered alcohol intoxication
• High risk consumption patients
• Patients with alcohol dependence

It should be specified that these groups are not categorically independent, but rather many of its symptoms or consequences overlap. Also, people from each group may move to another over time, and/or return to the initial group, etc.

But let's get to the important thing; What was observed in each group at the level of comorbidity associated with alcoholism? Let's see it:

1. Alcohol poisoning group

It was found that in this first group (it was a young group), there were Associated transient emotional disturbances, but without somatic or psychiatric repercussions.

2. High risk consumption group

In the second group, the high risk consumption group (which includes harmful or abusive consumption of both alcohol and other substances), great social and family instability was found, as well as serious comorbid psychiatric disorders.

3. Group with alcohol dependence

In the group with alcohol dependence (mature age), serious organic and cerebral sequelae, added to a strong tendency to isolation and depressive symptoms.

Medical and organic problems and life expectancy

Beyond the numerous comorbidities of alcoholism mentioned, we must not forget its repercussions and consequences at an organic level, since alcohol is a highly harmful drug for health, which can originate major liver, pancreas, heart problems, sexual dysfunctions, etc.

All this without mentioning the serious social, personal and work consequences derived from its consumption.

On the other hand, referring to a study carried out by two German universities, Greifswald and Lübech, it revealed that the life expectancy of alcoholics is reduced, on average, by 20 years compared to the normal (non-alcoholic) population. Once again, an alarming fact.