Page 332 - merged

S077-1

Alcoholism Comorbidity with Other Substance Dependence and Behavioral
Addiction

Hisatsugu Miyata

Department of Psychiatry, Jikei University School of Medicine, Japan

Background/Objective: The National Epidemiological Survey on Alcohol and Related Conditions
(NESARC) conducted in the United States using the DSM-IV diagnostic criteria showed that 13.05%
of persons diagnosed with alcohol dependence experienced other substance dependence whereas
among persons diagnosed with substance abuse or dependence more than half (55.2%) were
diagnosed with an alcohol dependence.

Method: This type of comorbidity is particularly observed in an alcohol and tobacco use disorder.
According to NESARC, more than half of the persons with alcohol dependence (58.2%) use tobacco,
a rate two times higher than the prevalence observed for the tobacco use in the community.
Additionally, patients with a diagnosis of alcohol abuse or dependence were more frequently found
to be heavy smokers.

Result: A serious clinical issue is that alcoholism comorbidity with other substance dependence or
behavioral addiction forms the treatment-resistant factors for alcoholism. Recent advances in the
research on the risk factors of alcohol dependence have demonstrated that high vulnerability is
associated with preexisting schizophrenia or bipolar disorder, as well as impulsivity (producing
enhanced rates of all substance dependence and gambling disorder), and a high risk specifically for
alcohol dependence is associated with a low level response (low sensitivity) to alcohol.

Conclusion: A number of studies have indicated that the dysfunction of the brain dopamine reward
systems are involved in low response to alcohol. In this presentation, the latest findings of this issue
and the several treatment options will be discussed with the introduction of Japanese condition.