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IntroductionTobacco dependence (TD) often coexists with alcohol dependence. Previous research documented that both biological and environmental factors influence simultaneous development of the two disorders. However, it has not been determined whether the same psychological and psychopathological factors affect TD in alcohol-dependent males and females.AimThe objective of the study was to assess risk factors for high severity of TD in alcohol-dependent individuals considering gender differences.MethodsThe study entailed two groups: male (n = 284) and female (n = 102) subjects entering alcohol addiction treatment programs in Warsaw, Poland. Standardized instruments were used to assess: severity of TD – Fagerstrom Test for Nicotine Dependence, personality traits – NEO-Five Factor Inventory to assess, consequences of drinking – Short Inventory of Problems, impulsivity – Barratt Impulsivity Scale, and Sleep Disorder Questionnaire-7 as a measure of insomnia.ResultsIn the studied sample, current smokers comprised 79.1% (n = 225) of male and 79.4% (n = 81) of female participants. Multivariate regression model showed that high negative consequences of drinking (P = 0.001) and low NEO Openness score (P = 0.009) were associated with high risk of TD in female alcoholics (corr. R2 = 0.223; P < 0.0005). Bivariate analyses showed that TD was associated with impulsivity, openness, agreeableness and neuroticism in male alcohol-dependent subjects. Insomnia was the only significant predictor for high severity of TD in the males (corr. R2 = 0.068; P = 0.002).ConclusionsDifferent factors contribute to severity of tobacco dependence in male and female alcohol-dependent individuals entering addiction treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Objective Chronic pain and problematic alcohol use commonly co-exist, as the use of alcohol is commonly considered a useful pain self-management strategy. The purpose of this study was to characterize pain and pain-related problems in a group of primary alcohol-dependent individuals entering alcohol treatment facilities. Method A sample of 366 (73.5% men and 26.5% women) alcohol-dependent subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, social functioning, sexual and physical abuse during childhood, severity of alcohol and sleep problems as well as level of impulsivity and general psychopathology. The study group was divided into a ‘mild or no pain” group and a ‘moderate or greater pain” group. Results Among the study group, 34.4% of individuals reported moderate or greater physical pain during last 4 weeks. The statistical analysis revealed that the experience of physical pain was significantly associated with lower level of education, unemployment, experience of sexual abuse before 18 years of age, and also with severity of alcohol dependence as well as other potential predictors of relapse (global impulsivity, sleep problems, general psychopathology). When entered into logistic regression analysis with other dependent variables the level of general psychopathology, severity of sleep problems, age and education were all significantly associated with pain severity. Conclusion Physical pain is a prevalent and potentially-impairing experience in adults seeking treatment for alcohol dependence. Therapeutic interventions aimed at reducing pain in alcohol-dependent individuals should be studied to evaluate their impact on improving overall treatment outcomes.

Background The serotonin system is considered to contribute to both predisposition and course of addictions. A major, suggested link between low serotonin activity and alcohol drinking is impulsivity, which can be manifested by suicidal behavior. The objective of our study was to build a comprehensive model of mutual relationships between HTR2A T102C (rs6313) polymorphism, suicidality, impulsivity and relapse in alcohol dependence. Material and methods A sample of 254 alcohol dependent subjects were recruited in alcohol treatment centers and prospectively assessed at baseline and follow-up after 12 months. Information about demographics, psychopathological symptoms, history of suicide attempts and alcohol problems was obtained. The stop-signal task was performed and blood samples for genetic analysis were collected. Relapse was defined as any drinking during the follow up period. Results The statistical analysis revealed a significant association between CC genotype in HTR2A T102C polymorphism and relapse. Other factors that turned out to be significantly associated with relapse were history of impulsive suicide attempt and baseline depressive symptoms, with genetic factor being the strongest predictor of relapse in multivariate model (OR=2.125). In addition we observed a significant association between CC genotype and behavioral impulsivity as well as history of suicide attempts. We also found a significant association between stop reaction time and lifetime history of suicide attempts. Conclusions Our results provide a consistent perspective of importance of 5-HT2A receptor associated with impulsivity, suicidality and relapse. Based on these findings we propose a more comprehensive model of mutual relationships between relapse, impulsivity, suicidality and HTR2A polymorphism.

Introduction Impulsivity and alcohol drinking are both considered as important predictors of unintentional as well as intentional injuries. However, relationships between impulsivity and risky behaviors have not been investigated in alcohol dependence. Objectives The aim of this study was to analyze relationships between the frequency of risky behaviors and level of behavioral as well as cognitive impulsivity in alcohol-dependent patients. Methods By means of Barratt's Impulsiveness Scale and stop-signal task the levels of cognitive and behavioral impulsivity among 304 alcohol-dependent patients were measured. Also, patients were asked to answer questions from the Short Inventory of Problems applying to risky behaviors and accidents after alcohol drinking. In addition participants filled in a questionnaire to assess frequency of other behaviors from the analyzed spectrum (suicide attempts, use of other drugs, law problems). Results The statistical analysis revealed a significant association between impulsivity and frequency of risky behaviors in alcohol dependent patients. Individuals with higher scores in BIS behaved more frequently in a risky way (p = 0,000001) and had significantly more accidents (p = 0,00067) after alcohol drinking. The association for risky behaviors was strongest for non-planning (p = 0,000075) and attentional (p = 0,000002) impulsivity subscales, whereas frequency of accidents was particularly associated with motor impulsivity (p = 0,001). In addition, a significant association between global impulsivity and risk of suicide attempts, use of other drugs and frequency of law problems was observed. A multivariate analysis revealed that impulsivity and severity of alcohol dependence are the most important predictors of risky behaviors. Conclusion Impulsivity increases the frequency of risky behaviors in alcohol-dependent individuals.

IntroductionImpulsiveness is considered to be an important symptom of many psychiatric disorders and is often treated as one of the diagnostic criteria. Relationship between impulsivity and severity of depressive symptoms in alcohol-dependent individuals hasn’t been investigated yet, although both are considered to be important risk factors of relapse.ObjectivesThe aim of this study was to analyze relationships between depressive symptoms and level of behavioral as well as cognitive impulsiveness among alcohol-dependent patients.MethodsBy means of Barratt's Impulsiveness Scale and stop-signal task the level of impulsivity among 304 alcohol-dependent patients was measured. Stop-signal task was used as an independent, manipulation-free method of estimating the level of behavioral impulsiveness, and the Barratt's Impulsiveness Scale - as a self report measure of global as well as cognitive impulsivity. Patients were asked to fill in a questionnaire to asses depressive symptoms (BDI, BHS).ResultsThe statistical analysis revealed significant association between impulsiveness and severity of depressive symptoms. Individuals with higher scores in BDI scale were more impulsive in Barratt Impulsiveness Scale (r = 0,473; p < 0,0005), whereas patients with higher scores in BHS appeared to be more impulsive in both: stop-signal task (r = 0,21; p = 0,001) and BIS (r = 0,281; p < 0,0005). Depressive symptoms in both measures correlated most with indicators of attention impulsivity in BIS (r = 0,541; p < 0,0005 for BDI and r = 0,312; p < 0,0005 for BHS).ConclusionHigh level of impulsiveness may be treated as an element of depressive disorder in alcohol dependent patients.