Development of a 20-item questionnaire for drinking behavior pattern (DBP-20) toward personalized behavioral approaches for alcohol use disorder

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BackgroundHabitual behaviors, rather than goal‐oriented behaviors, mainly characterize drinking patterns in patients with alcohol use disorder (AUD). However, few studies have focused on the influence of drinking behavior on AUD relapse. This prospective study examined associations between drinking behavior patterns and alcohol‐use relapse using the 20‐item questionnaire for drinking behavior patterns (DBP‐20).MethodsWe enrolled patients with AUD and compared the cohort's demographic data and 6‐month outcomes based on the DBP‐20 and the Alcohol Use Disorders Identification Test between two groups (alcohol use relapse vs. abstinence). We also assessed the results for significant factors related to relapse.ResultsWe included 105 patients with AUD. More patients in the relapse group (n = 63) were active smokers and lived alone, while fewer took medication with cyanamide or disulfiram than those in the abstinence group (n = 42). The DBP‐20 automaticity subscale score was higher in the relapse group than that in the abstinence group. Current smoker, living alone, and automatic drinking habits were significantly associated with AUD relapse.ConclusionsAutomaticity may be a risky drinking behavior that leads to future relapse in patients with AUD, justifying behavioral strategies to combat automatic drinking for relapse prevention.

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confidence: 99%

Section: Other Background and Clinical Factors Assessed In This Studymentioning

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confidence: 99%

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Associations between relapse and drinking behaviors in patients with alcohol use disorders: A 6‐month prospective study

Kurihara,

Shinzato,

Takaesu

et al. 2023

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Drinking behavior patterns may be associated with persistent depressive symptoms after alcohol abstinence in alcohol use disorder

Kurihara,

Shinzato,

Takaesu

et al. 2024

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AimThis study examined the association between drinking behavior patterns and depressive symptoms after alcohol abstinence in patients with alcohol use disorder (AUD).MethodWe recruited 102 AUD inpatients with baseline depressive symptoms, indicated by scores ≥6 on the Quick Inventory of Depressive Symptomatology Self‐Report Japanese Version (QIDS‐SR‐J) pre‐detoxification. Post‐4‐week abstinence, remission was defined as QIDS‐SR‐J scores <6. Patients were classified into remitted (n = 51) and persistent (n = 51) groups. Comparative analyses were conducted using patient profiles and the Drinking Behavior Pattern 20‐item Questionnaire (DBP‐20). Logistic regression identified factors related to post‐abstinence persistent depression. Receiver operating characteristic curve analysis determined DBP‐20 cutoff scores differentiating between persistent and remitted depression.ResultsThe persistent group exhibited higher scores in the DBP‐20 “coping with negative affect” subscale. Logistic regression showed low education, unemployment, and using alcohol for coping as significant factors for persistent depression. Conversely, an automatic drinking pattern indicated natural remission post‐abstinence. A subscale score of ≥8 in alcohol use for coping, especially among unemployed patients, predicted persistent depression (sensitivity 86.8%, positive predictive value 73.3%).ConclusionUnemployed patients with AUD using alcohol to cope with negative affect may experience residual depression even after detoxification. In contrast, patients with AUD with predominantly automatic drinking behavior may exhibit natural remission post‐abstinence.

Cluster analysis of patients with alcohol use disorder featuring alexithymia, depression, and diverse drinking behavior

Kurihara,

Enoki,

Shinzato

et al. 2024

AimThis study aimed to identify subgroups of alcohol use disorder (AUD) based on a multidimensional combination of alexithymia, depression, and diverse drinking behavior.MethodWe recruited 176 patients with AUD, which were initially divided into non‐alexithymic (n = 130) and alexithymic (n = 46) groups using a cutoff score of 61 on the Toronto Alexithymia Scale (TAS‐20). Subsequently, the profiles of the two groups were compared. Thereafter, a two‐stage cluster analysis using hierarchical and K‐means methods was performed with the Z‐scores from the TAS‐20, the Quick Inventory of Depressive Symptomatology Self‐Report Japanese Version, the 12‐item questionnaire for quantitative assessment of depressive mixed state, and the 20‐item questionnaire for drinking behavior pattern.ResultsIn the first analysis, Alexithymic patients with AUD showed greater depressive symptoms and more pathological drinking behavior patterns than those without alexithymia. Cluster analysis featuring alexithymia, depression, and drinking behavior identified three subtypes: Cluster 1 (core AUD type) manifesting pathological drinking behavior highlighting automaticity; Cluster 2 (late‐onset type) showing relatively late‐onset alcohol use and fewer depressive symptoms or pathological drinking behavior; and Cluster 3 (alexithymic type) characterized by alexithymia, depression, and pathological drinking behavior featuring greater coping with negative affect.ConclusionThe multidimensional model with alexithymia, depression, and diverse drinking behavior provided possible practical classification of AUD. The alexithymic subtype may require more caution, and additional support for negative affect may be necessary due to accompanying mood problems and various maladaptive drinking behaviors.