Health Complaints In Teens Who Abuse Alcohol Tied To Anxiety And Depression, Say University Of Pittsburgh Researchers

PITTSBURGH, September 17, 2001 — Although most self-reported health problems in adolescents with alcohol use disorders (AUDs) can be traced to the emotional consequences of drinking and not to toxic effects of alcohol, there are serious physical consequences, including demonstrable liver injury, according to research from the University of Pittsburgh School of Medicine.

The study of 259 adolescents between the ages of 14 and 18, which assessed self-reported health problems in 15 areas, serum liver enzyme assays and physical examinations, is the largest to date comparing adolescents with AUDs to a group of healthy teens.

Results from the study, conducted at the Pittsburgh Adolescent Alcohol Research Center at the University of Pittsburgh Medical Center’s Western Psychiatric Institute and Clinic, are published in today’s issue of Alcoholism: Clinical & Experimental Research.

In one of the study’s most significant findings, the Pittsburgh researchers found that many physical complaints were psychosomatic and not related to organ damage caused by drinking. They did so by looking at “negative emotionality” in an attempt to assess how much of an effect anxiety and depression had on self-reported health problems.

“Prior research had shown a definite link between AUDs and self-reported health problems, but none had gone on to determine the origins of those complaints,” said Duncan B. Clark, M.D., Ph.D., associate professor of psychiatry at the University of Pittsburgh School of Medicine. “Our results place much of the blame for these health complaints on negative emotionality, although some complaints such as shortness of breath can be traced to cigarette smoking, which is common in this group.”

Adolescents with alcohol use disorders reported symptoms of health problems in many areas, including sleep difficulties, chest discomfort, breathing symptoms, abdominal complaints, muscle and joint pain and headaches.

The Pitt study also is one of very few studies to take physical measurements such as liver enzyme levels. Blood samples showed that young people with AUDs had elevated liver enzyme levels and had more abnormalities in physical exams, especially oral exams.

“The rise in liver enzymes is statistically significant, but in most cases was not clinically abnormal,” said Dr. Clark. “Although the enzyme levels in these teens is not an immediate health concern, it does show that their bodies are not invulnerable to the effects of alcohol. With continued excessive drinking, they may develop permanent liver damage.”

According to Dr. Clark, the clinically lower rates of liver damage in adolescents is most likely due to the lower levels of alcohol they consume compared to adults. Adolescents drink fewer times per month and usually drink less than half of the amount of adults with AUDs.

Physical exam abnormalities showed up mainly in oral exams. According to Dr. Clark, adolescents with alcohol problems have inadequate health maintenance behaviors, including less than regular tooth-brushing, manifested as dental cavities and gingivitis.

Dr. Clark and his colleagues plan to continue to follow this group of adolescents to determine adult outcomes in health and other areas.

Other study authors are Kevin G. Lynch, M.D., John E. Donovan, M.D., and Geoffrey D. Block, M.D.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism.