Alcoholism in women: is it different in onset and outcome compared to men?

Abstract

Onset and course of alcohol dependence show gender related differences (telescoping effect) suggesting that women are more vulnerable to chronic alcohol consumption. This raises the question whether the differences are associated with a different treatment outcome as well. We hypothesized, that alcohol dependent women with a telescoping course show a less favourable treatment outcome compared to men. We investigated 212 alcohol dependent patients; matching 106 consecutively admitted women with 106 men drawn from a total sample of 343 male patients. The treatment program consisted of a 6 week inpatient treatment and 12 months of outpatient aftercare. We assessed milestone variables in development and course of alcoholism and carried out standardized diagnostic tests, physical and blood examinations to evaluate the course of the disease and treatment outcome. Overall, we confirm the telescoping effect, a faster progression in the course of alcoholism (developmental events and adverse consequences) in women compared to men ("telescoping effect"). However, despite the telescoping effect treatment outcome was similar in women and men. During the inpatient treatment program no alcohol relapse occurred. Throughout the 12 months outpatient treatment we found no significant differences in the survival analysis between women (283.29+/-11.26 days) and men (284.72+/-12.16 days). At the end of the 12 months both groups had an abstinence rate of approximately 50% and a drop-out rate of 33%.

Sex Differences in Animal Models: Focus on Addiction

“…The initial report of telescoping considered the onset and time course of alcohol dependence in men and women in a treatment program. This has been replicated a number of times, although not all studies have found evidence of greater telescoping in a treatmentseeking population of women compared with men (for a summary, see Diehl et al, 2007).…”

Alcohol Drinking Patterns and Differences in Alcohol-Related Harm: A Population-Based Study of the United States

“…Potentially influential predictors of progression to alcohol-related harm besides alcohol consumption include socioeconomic position (SEP) [24, 25], early age of alcohol initiation [26], being male (although females appear to suffer serious negative consequences of alcohol consumption earlier and to a greater degree than men) [27, 28], family history [29], comorbid substance use, with alcohol use increasing the risk for other drug use disorders [30, 31], poor physical and mental health [32], sex differences [33, 34], and ethnicity [35]. The adverse effects of alcohol drinking behavior affect not only the index drinker but also family members of the drinker [36] and the society as well.…”

A randomized clinical trial of behavioral couples therapy versus individually based treatment for women with alcohol dependence.

“…Although AUD may be less prevalent among women, women with AUD may suffer more adverse consequences than men as a result of their drinking. Women with AUD are shown to exhibit a later onset of AUD, and more quickly progress to serious AUD problems (Diehl et al., 2007). In comparison to men who are heavy drinkers, women who are heavy drinkers are prone to exhibit serious medical problems, such as liver cirrhosis (Rehm et al, 2010), and have higher mortality rates (Jacques-Lopez et al, 2001).…”