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Shen G, Chen YH, Wu Y, Jiahui H, Fang J, Jiayi T, Yimin K, Wang W, Liu Y, Wang F, Chen L. Exploring core symptoms of alcohol withdrawal syndrome in alcohol use disorder patients: a network analysis approach. Front Psychiatry 2024; 15:1320248. [PMID: 39267702 PMCID: PMC11390437 DOI: 10.3389/fpsyt.2024.1320248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 08/07/2024] [Indexed: 09/15/2024] Open
Abstract
Background Understanding the interplay between psychopathology of alcohol withdrawal syndrome (AWS) in alcohol use disorder (AUD) patients may improve the effectiveness of relapse interventions for AUD. Network theory of mental disorders assumes that mental disorders persist not of a common functional disorder, but from a sustained feedback loop between symptoms, thereby explaining the persistence of AWS and the high relapse rate of AUD. The current study aims to establish a network of AWS, identify its core symptoms and find the bridges between the symptoms which are intervention target to relieve the AWS and break the self-maintaining cycle of AUD. Methods Graphical lasso network were constructed using psychological symptoms of 553 AUD patients. Global network structure, centrality indices, cluster coefficient, and bridge symptom were used to identify the core symptoms of the AWS network and the transmission pathways between different symptom clusters. Results The results revealed that: (1) AWS constitutes a stable symptom network with a stability coefficient (CS) of 0.21-0.75. (2) Anger (Strength = 1.52) and hostility (Strength = 0.84) emerged as the core symptom in the AWS network with the highest centrality and low clustering coefficient. (3) Hostility mediates aggression and anxiety; anger mediates aggression and impulsivity in AWS network respectively. Conclusions Anger and hostility may be considered the best intervention targets for researching and treating AWS. Hostility and anxiety, anger and impulsiveness are independent but related dimensions, suggesting that different neurobiological bases may be involved in withdrawal symptoms, which play a similar role in withdrawal syndrome.
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Affiliation(s)
- Guanghui Shen
- Department of Behavioral Medicine, Wenzhou Seventh People's Hospital, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yu-Hsin Chen
- The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yuyu Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Huang Jiahui
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Juan Fang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Tang Jiayi
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Kang Yimin
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Wei Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Li Chen
- The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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Shen G, Chen L, Liu Y, Zhu Q, Kang Y, Luo X, Wang F, Wang W. ANK3 rs10994336 and ZNF804A rs7597593 polymorphisms: genetic interaction for emotional and behavioral symptoms of alcohol withdrawal syndrome. BMC Psychiatry 2024; 24:335. [PMID: 38702695 PMCID: PMC11067186 DOI: 10.1186/s12888-024-05787-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/24/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVE Alcohol withdrawal syndrome (AWS) is a complex condition associated with alcohol use disorder (AUD), characterized by significant variations in symptom severity among patients. The psychological and emotional symptoms accompanying AWS significantly contribute to withdrawal distress and relapse risk. Despite the importance of neural adaptation processes in AWS, limited genetic investigations have been conducted. This study primarily focuses on exploring the single and interaction effects of single-nucleotide polymorphisms in the ANK3 and ZNF804A genes on anxiety and aggression severity manifested in AWS. By examining genetic associations with withdrawal-related psychopathology, we ultimately aim to advance understanding the genetic underpinnings that modulate AWS severity. METHODS The study involved 449 male patients diagnosed with alcohol use disorder. The Self-Rating Anxiety Scale (SAS) and Buss-Perry Aggression Questionnaire (BPAQ) were used to assess emotional and behavioral symptoms related to AWS. Genomic DNA was extracted from peripheral blood, and genotyping was performed using PCR. RESULTS Single-gene analysis revealed that naturally occurring allelic variants in ANK3 rs10994336 (CC homozygous vs. T allele carriers) were associated with mood and behavioral symptoms related to AWS. Furthermore, the interaction between ANK3 and ZNF804A was significantly associated with the severity of psychiatric symptoms related to AWS, as indicated by MANOVA. Two-way ANOVA further demonstrated a significant interaction effect between ANK3 rs10994336 and ZNF804A rs7597593 on anxiety, physical aggression, verbal aggression, anger, and hostility. Hierarchical regression analyses confirmed these findings. Additionally, simple effects analysis and multiple comparisons revealed that carriers of the ANK3 rs10994336 T allele experienced more severe AWS, while the ZNF804A rs7597593 T allele appeared to provide protection against the risk associated with the ANK3 rs10994336 mutation. CONCLUSION This study highlights the gene-gene interaction between ANK3 and ZNF804A, which plays a crucial role in modulating emotional and behavioral symptoms related to AWS. The ANK3 rs10994336 T allele is identified as a risk allele, while the ZNF804A rs7597593 T allele offers protection against the risk associated with the ANK3 rs10994336 mutation. These findings provide initial support for gene-gene interactions as an explanation for psychiatric risk, offering valuable insights into the pathophysiological mechanisms involved in AWS.
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Affiliation(s)
- Guanghui Shen
- Key Laboratory of Psychoneuroendocrinology, Wenzhou Seventh People's Hospital, Wenzhou, 325006, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Qi Zhu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yimin Kang
- Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Hohhot, China
| | - Xinguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China.
| | - Wei Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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Xu X, Xu Z, Zhou F, Chen L, Li H, Niculescu M, Shen G, Wu L, Wang W, Chen L, Liu Y, He J, Wang F, Yang F. RETN gene polymorphisms interact with alcohol dependence in association with depression. J Clin Lab Anal 2023; 37:e24933. [PMID: 37387262 PMCID: PMC10431411 DOI: 10.1002/jcla.24933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/27/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Previous studies suggest that alcohol dependence is associated with increased risk of depression. The occurrence of depressive symptoms is related to polymorphisms in various genetic regions. This study aimed to investigate the interaction of RETN gene polymorphisms (rs1477341, rs3745368) with alcohol dependence on depressive symptoms in adult male during acute alcohol withdrawal. METHODS A total of 429 male adults were recruited in this study. Alcohol dependence was assessed using the Michigan alcoholism screening test (MAST). Depression was assessed using the 20-item self-rating depression scale (SDS). Hierarchical regression analysis was used to evaluate the interaction between genes and alcohol dependence on depression. Region of significance (ROS) test was used to explain the interaction effect. The strong and weak forms of the differential susceptibility and diathesis models were used to determine which fits the data better. RESULTS Our results showed that MAST scores were significantly positively associated with SDS scores (r = 0.23, p < 0.01) in alcohol-dependent patients during alcohol withdrawal. The interaction between genotype and alcohol dependence was significant (β = -0.14, p < 0.05) in a strong diathesis-stress model. Susceptibility for depression symptoms was associated with alcohol dependence in RETN rs1477341 A carriers. Specifically, those that showed more alcohol dependence and the A allele of RETN rs1477341 exhibited more depression symptoms. However, RETN rs3745368 had no significant interaction with alcohol dependence. CONCLUSIONS The A allele of RETN rs1477341 may correlate with susceptibility to depression symptoms in alcohol-dependent individuals during acute alcohol withdrawal.
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Affiliation(s)
- Xiaoyan Xu
- Huzhou Third People's HospitalZhejiangChina
| | - Zeping Xu
- Department of Pharmacy, Ningbo Medical Treatment CenterLi Huili HospitalNingboChina
| | - Fan Zhou
- Department of PediatricsThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Lijing Chen
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Huai Li
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Michelle Niculescu
- Department of Social SciencesChatham UniversityPittsburghPennsylvaniaUSA
| | - Guanghui Shen
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Liujun Wu
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
- Applied Psychology (Ningbo) Research CenterWenzhou Medical UniversityNingboChina
| | - Wei Wang
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Li Chen
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Yanlong Liu
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Jue He
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Fan Wang
- Beijing Hui‐Long‐Guan HospitalPeking UniversityBeijingChina
- Medical Neurobiology LabInner Mongolia Medical UniversityHuhhotChina
| | - Fan Yang
- The Affiliated Kangning HospitalWenzhou Medical UniversityWenzhouChina
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Hong L, Wen L, Niculescu M, Zhou F, Zou Y, Shen G, Wang W, Liu Y, Chen YH, Wang F, Chen L. The Interaction Between POMC rs2071345 Polymorphism and Alcohol Dependence in Anxiety Symptoms Among Chinese Male Problem Drinkers. Front Psychiatry 2022; 13:878960. [PMID: 35592377 PMCID: PMC9110641 DOI: 10.3389/fpsyt.2022.878960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/08/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Alcohol dependence can increase the level of anxiety. A growing body of research has identified a link between anxiety symptoms of problem drinkers and their genetic or environment factors, respectively. However, to date few studies have directly examined gene-environment (G × E) interaction on their anxiety symptoms during the acute alcohol withdrawal. The present study aims to examine the interaction between the proopiomelanocortin (POMC) rs2071345 polymorphism and alcohol dependence on anxiety symptoms of male problem drinkers, and further test the exact form of interaction on two competing models: the diathesis-stress model vs. the differential susceptibility model. METHODS A total of 440 male problem drinkers (M age = 44.5 years, SD = 9.45) were recruited from nine main psychiatric hospitals of northern China during acute alcohol withdrawal. Blood samples were collected for genotyping, self-reported anxiety symptoms, and levels of alcohol dependence were assessed. RESULTS Results indicated that the POMC rs2071345 polymorphism significantly moderated anxiety symptoms associated with alcohol dependence. A region of significance (RoS) test showed that male problem drinkers with T allele were more likely to experience more anxiety symptoms than those with CC homozygote when the standardized score of concurrent alcohol dependence was above 0.31. Confirmatory model evaluation indicated that the interaction effect involving POMC gene polymorphism conformed to the diathesis-stress model rather than differential-susceptibility model of person × environment interaction. CONCLUSIONS This study suggested that the SNP in POMC rs2071345 was associated with alcohol dependence in anxiety symptoms of male problem drinkers and further provided evidence in support of the diathesis-stress hypothesis of alcohol dependence in terms of anxiety symptoms.
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Affiliation(s)
- Liuzhi Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Lutong Wen
- Department of Neurosurgery, Affiliated Cixi Hospital, Wenzhou Medical University, Ningbo, China
| | - Michelle Niculescu
- Department of Social Sciences, Chatham University, Pittsburgh, PA, United States
| | - Fan Zhou
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yang Zou
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Guanghui Shen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wei Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.,The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.,The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yu-Hsin Chen
- Department of Psychology, College of Liberal Arts, Wenzhou-Kean University, Wenzhou, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China.,Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.,The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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