A retrospective study of gender differences in depressive symptoms and risk of relapse in patients with alcohol dependence

Background and Objectives: The aim of this study was to investigate potential gender differences in situations associated with heavy alcohol drinking. Methods: Data from 395 alcohol dependent patients participating in the Mayo Clinic Intensive Addiction Program were evaluated. Each participant completed the inventory of drug taking situations (IDTS), Penn alcohol craving scale (PACS), patient health questionnaire (PHQ-9), and/or Beck depression inventory (BDI). Gender differences in IDTS scores representing three domains (negative, positive, and temptation) of situations associated with heavy alcohol use were examined. Results: Women with alcohol dependence report a higher frequency of heavy drinking in unpleasant emotional (IDTS negative scores mean +/- SD women vs. men: 52.3 +/- 22.1 vs. 43.8 +/- 21.8; p = .0006), and as a result of temptation (IDTS temptation scores mean +/- SD women vs. men: 40.4 +/- 23.0 vs. 35.3 +/- 20.8; p = .035). Upon admission, women also scored significantly higher on depressive symptoms as measured by the BDI (23.4 +/- 11.4 vs. 18.2 +/- 9.8, p < .001). After controlling for depressive symptom severity as a covariate, the IDTS gender differences were no longer significant. Conclusion and Scientific Significance: Our results suggest that unpleasant or temptation based emotional situations are a vulnerability risk factor for heavy drinking particularly in females. This risk appears to be at least partially driven by depressive symptom burden. Future research is needed to further investigate this finding.