이중진단을 가진 알코올 의존 환자들의 임상적 특성(II)

성상경(Sang-Kyung Sung):문석우(Seok-Woo Moon):강지언(Gi-Eun Kang),이규항(Kyu-Hang Lee) 한국중독정신의학회 2001 중독정신의학 Vol.5 No.1

Objectives:Abuse of alcohol or drugs can induce, or can result from psychiatric disorders. Any substance of habituation has psychotoxicity and can induce psychiatric symptoms. These symptoms usually disappear after the effect of the substance terminates, but the symptoms can be continued permanently. It is well known that depression, anxiety disorder, and personality disorder very often come together with the alcohol dependence. Therefore, we have selected groups having extra-psychopathology from alcohol dependence patients, and compared their clinical characteristics with patients of alcohol dependence only, to use the characteristics in the therapy. Methods:Among patients hospitalized in a mental hospital from Feb.-June of 1999 for the problem of alcohol dependence, patients diagnosed as alcohol abuse/dependence and dual diagnosis by DSM-Ⅳ were evaluated by the methods of chart review, the questionnaire of demographic characteristics, drinking history, past therapy history, family history, NAST and CAGE. Results:1)Among 179 patients diagnosed to be alcohol dependent during the period, 59 patients (33%) were dually diagnosed and their average age was 42.5±8.5, and 120 patients (67%) were diagnosed to be alcohol dependence only and their average age was 45.6±9.6. In the case of dual diagnosis, the average age diagnosed as alcohol dependence was earlier. The men/women ratio was 169 men:10 women (94.4%:5.5%). Age of first drinking was 20.3 in dually diagnosed patients and 21.2 in alcohol dependence only patients. Therefore, they started drinking in early 20s in both cases. 2) There were notable differences between them in drinking amount, self- recognition of dependence, the number of suicide attempts. 3) There were no statistical significances between them in age of first drinking, drinking period, age of withdrawal symptom experience, preference of alcohol beverage, therapy history, and demographic characteristics except age and gender Though there was no statistical significance in NAST score and the total number of questions of NAST and CAGE, the score and the total number in dual diagnosis were higher than the alcohol dependence only. This result indicates that the dually diagnosed patients recognize symptoms more seriously, and they are high risk group. Conclusions:The dually diagnosed patients among alcohol dependent patients showed higher level of self-recognition, higher score of NAST and CAGE, more number of therapy (recurrence), earlier onset age of alcohol dependence, less average drinking amount, and more suicide attempts. It is therefore believed that the dually diagnosed patients are higher risk group compared to the patients of alcohol dependence only, and it is required to do intensive evaluation and carefully designed therapy.

제주도 농촌지역 주민들의 음주습관과 우울증상 및 스트레스

김문두 대한신경정신의학회 2004 신경정신의학 Vol.43 No.1

Objectives:Stress has been known as one of the main reasons for drinking. Depression also is a risk factor for people to have alcohol related problem. Despite of high correlation between depression and stress, little study has been done to see the simultaneous effect of depression and stress to alcohol dependence. We tried to investigate the prevalences of depressive symptom, stress and alcohol dependence among Jeju rural population. Also, we have tried to find a relationship of alcohol dependence with depressive symptom and stress. Methods:The study subjects were 1,086, 531 (48.9%) male and 555 (51.1%) female living in rural Jeju area. We collected data through face-to face interviews in 2002. With the data we investigated the prevalences of alcohol dependence, depression and stress using CAGE, Alcohol use disorder identification test (AUDIT), Beck Depression Inventory (BDI), and Psychosocial Well Being Index Short Form (SF-PWI). Results:1) The prevalence of alcohol dependence in rural Jeju area is 22.3% in male, 3.6% in female. The prevalence of depressive symptom is 14.9% in male, 18.4 in female. The prevalence of moderate distress is 70.8% in male, 67.5% in female. The prevalence of severe distress is 16.7% in male, 26.7% in female. 2) In relationship between stress and alcohol dependence, odds ratio of moderate distress is 7.76 (95% CI 1.86-32.35), severe distress is 17.29 (95% CI 3.95-75.60) in male, and the odd ratio of depressive symptom is 2,96 (95% CI 1.12-7.84) in female. 3) Multiple logistic regression analysis showed that the risk factors for male alcohol dependence were potential stress (OR=8.15 95% CI 1.91-34.65), and stress risk (OR= 22.47 95% CI 4.86-103.704). The risk factor for female alcohol dependence was depressive symptom (OR=3.42 95% CI1.10-10.56). Conclusion:Compared with national survey result, the prevalence of alcohol dependence in rural Jeju area is relatively low. Stress in male, depressive symptom in female proved to be strong risk factors. This suggests that we can apply coping strategies to stress in male alcoholics, and treat depression in female alcoholics for improving their mental health.

입원한 알코올의존환자의 성격 기질 특성과 음주 특성, 그리고 금주 동기에 대한 연구

김진현(Jin Hyeon Kim),이덕기(Duk Ki Lee),정봉주(Bong Joo Jung),박영민(Young Min Park),김성곤(Sung Gon Kim) 한국중독정신의학회 2012 중독정신의학 Vol.16 No.1

Objectives : The purpose of this study is to investigate personality traits, investigate differences in onset times between the sexes, and compare schizophrenic patients with alcoholic patients using TCI. And we examined the correlation between TCI and drinking characteristics, and TCI and motivational status for abstinence. Methods : We enrolled 169 alcohol de-pendent patients (118 males, 51 females) by DSM-IV criteria, and 86 stable schizophrenic patients (42 males, 44 females) for the control group. We used TCI, SCL-90, AUI, URICA as a self reported questionnaire. We compared the score of those questionnaires of the early onset group with that of the late onset group in the alcohol dependent group. Results: 1) The mean values of Novelty Seeking (NS) and Reward Dependence (RD) were significantly higher in the alcohol dependent group than in the control group (schizophrenic patients). 2) In the alcohol dependent group, the early onset group had significantly higher Novelty Seeking (NS) and Self Directedness (SD) but lower Harm Avoidance (HA) than the late onset group. 3) The mean value of Novelty Seeking (NS) in female alcohol dependent patients was significantly higher than in male patients in the early onset group, and the mean value of NS in females was significantly lower than in males in the late onset group. 4) The mean value of Harm Avoidance (HA) was higher in female alcohol de-pendent patients than in the male patients group, and the late on-set group had a higher mean value than the early onset group. 5) Harm Avoidance (HA) had negative correlation with ‘anxiety related to drinking’, and Reward Dependence (RD) and Cooperativeness (CO) had positive correlation with ‘acknowledgement and awareness of use problem’. 6) The patients with lower Reward Dependence (RD) and Cooperativeness (CO) were included in the lower motivation group. Conclusion : The alcohol dependent patient group was more impulsive and intemperate, and had a stronger tendency to pursue new things than the schizophrenic patient group. Especially, female alcohol dependent patients had a higher tendency to seek stimulation, so they drink alcohol more impulsively, resulting in higher risks of acquiring alcohol-dependence problems earlier than the male alcohol dependent patient group. On the other hand, females who had anxiety and higher avoidant tendency acquired alcohol dependence later in life. Reward Dependence (RD) and Cooperativeness (CO) were related with patient’s motivation, so it will affect the prognosis of the treatment.

주의력결핍-과잉행동장애를 동반한 알코올 의존환자들의 특성 : 임상적/유전학적 자료분석

김붕년,손기현,전지현,곽욱환,유희정,조수철,박철수 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.3

Objectives : This study was conducted to estimate the comorbidity rate of ADHD in a group of patients with alcohol dependency and to find out the characteristics of alcoholic patients with ADHD using the diverse clinical and genetic variables. Methods : Eighty five patients with alcohol dependency were recruited from 4 mental hospitals in Kyoung-Nam and Kyoung-Ki province. For the evaluation of ADHD symptoms in both childhood and adulthood, the highly structured Diagnostic Interview Schedule for Children-IV (DISC-FV)-ADHD module was used. The various standardized scales and questionnaires were also applied to evaluate the comorbid conditions and psychopathological status. All the subjects' blood was collected and genetic study for the polymorphism of DRD2, TH, 5-HTTLPR, COMT, ALDH2 was performed. Results : 1) The comorbid rate of definite ADHD in alcoholic patients was 38% (28/85). 2) The frequency of unmarried status was significantly higher in ADHD group compared non-ADHD group. 3) The onset of pathologic drinking and auditory hallucination was significantly earlier in ADHD group than non-ADHD alcholic group. 4) In ADHD alcoholic group, antisocial behavior was more frequently reported, and the score of co-dependency scale, depression/anxiety, aggression and obsessive compulsive drinking scales were significantly higher compared to non-ADHD alcoholic group. 5) No signficant difference was found in the frequency of polymorphic alleles in COMT, DRD2, 5-HTTLPR, ALDH2, TH between ADHD and non-ADHD alcoholic group. Conclusion : In alcoholic patients, the rate of adult type ADHD was higher than expected rate in general population. The alcoholic patients with ADHD suffered from more sever degree of alcohol dependency and earlier alcohol related problems. ADHD-alcoholic group showed higher diverse comorbid psychopathology and lower marital status compared to non-ADHD-alcoholic group. No difference, however, was found in genetic data between two groups.

한국인 남성 알코올 의존증에서 나타난 도파민 D2 수용체의 대립유전자형 빈도

이종섭(Jong Sub Lee),오미희(Mee Hee Oh),이창훈(Chang Hoon Lee),송경순(Kyoung Soon Song),배종훈(Jong Hoon Bae),기선완(Sun Wan Ki),이홍식(Hong Shick Lee),유계준(Kae Joon You) 한국중독정신의학회 1997 중독정신의학 Vol.1 No.1

Dopamine D2 receptor(DRD2) gene is known to have a strong effect on susceptibility of alcohol dependence and to play an important role on appetite such as alcohol seeking behavior. It is known that alcohol induces excitatory effects on dopamine neurons and stimulates brain reward systems by which man craves euphorogenic reward effect of drug(such as alcohol). And it has been suggested that DRD2 has a direct role on alcohol seeking behavior. This study investigated polymorphic patterns of DRD2 gene of Korean male alcohol dependence by restriction fragment length polymorphism(RFLP) and associations of Korean character traits with susceptibility on alcohol. Also, this study examined allelic association of DRD2 gene in various chara cteristics and alcohol-related of alcohol dependence. Subjects of this study consisted of 71 patients with alcohol dependence and 139 healthy male subjects without alcohol dependence for the study of allelic association of DRD2 gene in Korean male alcohol dependence. Allelic association of DRD2 gene between two groups was tested by chi-square test, and those in severity and family history of alcohol dependence, age onset of alcohol drinking, and duration of alcohol drinking history were tested by ANOVA and t-test. The results were as followings; 1) A1A1, A1A2, A2A2 genotype frequency of DRD2 gene in Korean male alcohol dependence were 19.7%, 29.6%, 50.7% and those of control group were 15.8%, 51.8%, 33.1%. There was statistically significant difference between two groups. 2) Ratios of Korean male alcohol dependence with and without A1 allele were 0.49, 0.51 respectively, and those of control groups were 0.67, 0.33 respectively. The difference between two groups were statistically significant. But the difference between two groups on ratio of presence of A2 allele was not statistically insignificant. 3) A1 and A2 allelic frequencies of Korean male alcohol dependence were 0.35 and 0.65 and those of control group were 0.42, 0.58 respectively. So there was no evidence of DRD2 A1 allelic association in Korean alcohol dependence. 4) According to Diagnostic Criteria of National Council on Alcoholism(NCA) on severity alcohol dependence, the genotype of the most severe alcohol dependence was A1A1. on the other hand, the less severe type was A1A2, and the least severe type was A2A2. And A1 and A2 allele frequency of severe alcohol dependence were 0.46 and 0.54 respectively and those of less severe alcohol dependence were 0.18 and 0.72 respectively. Therefore, there was allelic association of DRD2 gene in severity of Korean male alcohol dependence. 5) There were statistically significant differences among subgroups with A1A1, A1A2, A2A2 genotypes on scores of NCA in total patients with alcohol dependence and also significant differences between patients with alcohol dependence with and without A1 allele on scores of NCA. Therefore, there was statistically significant possibility in allelic association of DRD2 gene in NCA scores of patients with alcohol dependence. 6) There were no allelic associations of DRD2 gene in the variable characteristics(age, family history of alcohol dependence, onset age of alcohol drinking, and onset age of alcohol problems). 7) In comparing A1 allelic frequencies of DRD2 gene in this study with those in other studies on various populations, there were no differences statistically among Asians in controls and statistically significant differences, however, in other populations elsewhere. And there were also higher in A1 allelic frequencies in Korean and Japanese with alcohol dependence than the whites. In summarizing above results, there was no allelic association of DRD2 gene in Korean male alcohol dependence, but there was the possibility of A1 allelic association in severity of alcohol dependence. So this study implied that Korean alcohol dependence were influenced by extenal factor like severity of alcohol dependence rather than genetic factor. Therefore

성인 음주자의 영양소 섭취실태: 2011 국민건강영양조사 자료 분석

김형태 ( Hyung Tae Kim ),천성수 ( Sung Soo Chun ),정선희 ( Sun Hee Joung ),윤미은 ( Mi Eun Yun ) 대한영양사협회 2013 대한영양사협회 학술지 Vol.19 No.4

본 연구는 성인 음주자의 음주행태별 식습관과 영양소 섭취실태를 국민건강영양조사 2011 자료를 사용하여 분석하였으며 그 결과는 다음과 같다. 1. 전체 4,968명 중 음주자가 91.5% 비음주자가 8.5%로 나타났으며, 알코올 사용 장애 진단검사(AUDIT) 점수에 의한 음주행태분류 결과 정상음주자가 64.5%, 문제음주자가 22.4%, 알코올의존자가 13.2%였다. RAPS4에 의한 알코올 의존성 여부에서는 알코올의존이 47%로 나타났다. 2. 아침결식 비율은 비음주자는 13.2%인 반면 알코올의존자는 31.1%로 음주행태간에 유의한 차이가 나타났다. “가족과 함께 식사를 한다”에서도 비음주자는 73.4%, 알코올의존자는 55.4%로 유의한 차이를 나타냈다. 3. 식이섭취에너지, 알코올섭취에너지, 총섭취에너지 모두 비음주자에서 알코올의존자로 갈수록 높아졌으며 유의한 차이를 나타냈다. 또한 단백질, 비타민 A, 비타민 B1, 비타민 B2, 니아신, 칼슘, 인, 철의 섭취가 비음주자보다 정상음주자, 정상음주자보다 문제음주자, 문제음주자보다 알코올의존자가 높아졌고, 음주행태 간에 유의한 차이를 나타냈다. 4. 단백질, 비타민 A, 비타민 B1, 비타민 B2, 니아신, 칼슘, 인, 철의 영양소 적정섭취비(NAR)가 비음주자보다 정상음주자, 정상음주자보다 문제음주자, 문제음주자보다 알코올의존자가 높아졌고, 음주행태 간에 유의한 차이를 나타냈다. 또한 평균 영양소 적정섭취비(MAR)도 비음주자보다 정상음주자, 정상음주자보다 문제음주자, 문제음주자보다 알코올의존자가 높아졌고, 음주행태 간에 유의한 차이를 나타냈다. 5. 음주행태별 1,000 kcal당 비타민 B1, 비타민 B2, 니아신 섭취량의 분석결과 비음주자보다 정상음주자, 정상음주자보다 문제음주자, 문제음주자보다 알코올의존자가 낮았고, 음주행태 간에 유의한 차이가 나타났다. 이상의 결과 비음주자보다 음주자와 문제음주자 그리고 알코올의존자의 영양소섭취가 높은 것으로 나타났으나 에너지 섭취에 따라 섭취량을 증가하여야 하는 티아민, 리보플라빈, 니아신의 경우 1,000kcal당 섭취 비율을 분석하였을 때 비율이 낮은 것으로 나타나 음주자의 경우 권장량 대비 영양소 섭취비율과 함께 섭취 에너지에 따른 영양소 섭취비율도 고려하는 것이 필요하다고 사료된다. This study analyzed the dietary habits and nutrient intake status of adult drinkers in Korea. Alcohol drinking patterns were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Among 4,968 persons, 91.5% were drinkers. Classification of their drinking patterns by the Alcohol Use Disorders Identification Test (AUDIT) score showed 64.5% of the drinkers were normal drinkers, 22.4% problem drinkers and 13.2% alcohol-dependent drinkers. Overall, 47% of the drinkers were considered alcohol- dependent in the Rapid Alcohol Problems Screen (RAPS4). Significant differences were found between those who abstained from alcohol (86.8%) and alcohol-dependent drinkers (68.9%); when asked about breakfast habits 73.4% of non-drinkers often had family meals, while only 55.4% of the alcohol-dependent drinkers had family meals. Dietary energy, alcohol energy, and total energy intake significantly increased for the alcohol- dependents (P<0.001). In addition, the intake of eight nutrients (protein, vitamin A, vitamin B1, vitamin B2, niacin, calcium, phosphorous and iron), significantly increased in the following order (least to highest): abstainers, normal drinkers, drinkers with a moderate addiction to alcohol and alcohol-dependent drinkers (P <0.05). Nutrient Adequacy Ratios (NAR) of all nutrients, except vitamin C, and the Mean nutrient Adequacy Ratio (MAR) significantly increased in the following order (least to highest): abstainers, normal drinkers, drinkers with a moderate addiction to alcohol and alcohol-dependent drinkers (P<0.05). The intake of vitamin B1, vitamin B2, and niacin per 1,000 kcal, according to drinking pattern, decreased in the order of abstainers, normal drinkers, drinkers with a moderate addiction to alcohol, and alcohol-dependent drinkers (P<0.001). The above results show that the nutrient intake of normal drinkers, drinkers with a moderate addiction to alcohol, and alcohol-dependent drinkers are higher than abstainers. However, overall intake of vitamin B1, vitamin B2, and niacin per 1,000 kcal was low. Therefore it is necessary to increase vitamin B1, vitamin B2, and niacin intake for drinkers.

안지오텐신 전환 효소 유전자 다형성과 알코올 의존

박선희(Sunny Park),이태경(Tae-Kyung Lee),이종일(Jong-Il Lee):김종우(Jong-Woo Kim),이희제(Hee-Jae Lee),박종득(Jong-Deuk Park),송지영(Ji-Young Song) 한국중독정신의학회 2004 중독정신의학 Vol.8 No.2

Objective:There is increasing evidence that Renin-Angiotensin System is involved in the pathophysiology of alcoholics. This study was performed to examine the relationship between Renin-Angiotensin System and alcoholics by analyzing polymorphism of Angiotensin converting enzyme (ACE), an compartment of Renin-Angiotensin System. Methods:We examined the frequency of a polymorphism of the ACE gene (located on chromosome 17q23) in groups of patients with alcohol dependence (n=99) compared to healthy control subjects (n=177). ACE genotype was determined by size-analysis of polymerase chain reaction products. Results:No difference was found between the alcohol dependent patients and the controls in genotype and allele frequencies of the ACE I/D polymorphism. Significant difference of FTND score was found among ACE genotype groups in alcohol dependent patients (F=3.657, df=2,96, p= 0.029). Significant difference of impulsiveness of non planning and impulsiveness of motor was found among ACE genotype groups in alcohol dependent patients who started first drinking at 19 years or more (IONP F=6.921, df=2,60, p=0.002;IOM F=3.913, df=2,60, p=0.025). Conclusion:These results do not support an association between polymorphism of ACE gene and alcohol dependence. It is suggested that I/D polymorphism in the ACE gene could be associated with nicotine dependence severity in alcohol dependent patients and with alcohol dependence patients who started first drinking at 19 years or more.impulsiveness in

알코올 의존 환자에서 Mirtazapine과 SSRI의 효과에 관한 전향적 비교 연구

천영일(Young- Il Cheon),이태경(Tae- Kyung Lee),이종일(Jong- Il Lee) 한국중독정신의학회 2004 중독정신의학 Vol.8 No.2

Objectives:There have been growing concerns about the pharmacological treatment of alcohol dependence. Serotonergic medications, particularly the selective serotonin reuptake inhibitors (SSRIs), have been extensively evaluated for the treatment of alcoholism. Of serotonergic agents, especially the effect of ondansetron, a 5-hydroxytryptamine-3 (5-HT3) antagonist, has also been studied. However mirtazapine, noradrenergic and specific serotonin 5-HT2 and 5-HT3 antagonist, have not yet been investigated. This study was performed to compare the efficacy of mirtazapine versus SSRIs in the treatment of alcohol dependence. Methods:The subjects were 46 inpatients with alcohol dependence. They were admitted to the Alcohol & Drug Addiction Center in Seoul National Hospital. They were randomly assigned into one of the two groups:mirtazapine group (n=20) or SSRIs group (n=26). All subjects received the psychosocial treatment program for alcoholism. All of the subjects were assessed by scales:The Korean version of Alcohol Use Disorders Identification Test (AUDIT-K), Obsessive Compulsive Drinking Scale (OCDS), Beck Depression Inventory (BDI), Aggression Questionnaire (AQ), and Three-dimensional Personality Questionnaire (TPQ) at baseline and 8 weeks later. Results:There were no differences between mirtazapine group and SSRIs group in baseline BDI, AUDIT-K, OCDS, AQ, TPQ scores and demographic characteristics. After 8-week treatment period, BDI, AUDIT-K and OCDS scores decreased significantly in total subjects. Mirtazapine group had a greater reduction of the BDI scores than SSRIs group at week 8. The aggression scores did not decrease significantly during treatment;the difference between the two groups was not significant. There was no significant change on TPQ. Conclusion:Both mirtazapine and SSRIs are effective to comorbid depressive symptoms and compulsive drinking of alcohol dependence. Moreover mirtazapine is resulted to be more effective in treating depressive symptoms of alcohol-dependent patients. Consequently, our results provide evidences that mirtazapine may be an effective pharmacological treatment for alcohol dependence with comorbid depression and compulsive drinking.

일 농촌지역에서 알코올 남용 및 의존의 유병률 및 연관 변수

홍진표(Jin-Pyo Hong),김성윤(Seong-Yoon Kim),이무송(Mu-Song Lee),안준호(Jun-Ho Ahn),이창화(Chang-Hwa Lee),최명기(Myung-Gee Choi),강혜영(Hae-Young Kang),이군희(Gun-Hee Lee),이철(Chul Lee) 한국중독정신의학회 1998 중독정신의학 Vol.2 No.2

Objective:The purpose of this study was to investigate the prevalence of alcohol abuse and alcohol dependence in a rural area of Korea and to examine the relationship between those prevalences and sociodemographic characteristics of subjects. Method:This study was done as a part of the chronic disease survey of rural area by the Asan Foundation. Among 30 years or older population from Jung Eup, a rural area of Korea, 1734 subjects was sampled using a cluster probability sampling method. Trained interviewers visited and interviewed subjects aged 30 years or older with the alcoholism part of Composite International Diagnostic Interview (CIDI). Response rate was 68.1% (N=1191). Results:The lifetime prevalence of alcohol abuse and dependence in male subjects were 36.0% and 17.5%, respectively. Those of female subjects were 6.7% and 1.6%, respectively. These estimate are similar to those of previous community study. The frequency of alcohol intake in male respondents was 10 times or more a month, but the amount of alcohol intake was dramatically dropped in group 60 years old and over. According to the logistic regression analysis, male and 50 to 69 aged group were significantly more likely to report lifetime or 12 month alcohol dependence. Low education seemed to be correlated with alcoholism, but did not reach statistically significant level. Conclusion:Alcohol abuse and dependence were highly prevalent in the rural community of Korea. Further study about the influence of the alcohol on brain and other organs in community indwellers will be needed for further understanding of the severity of alcohol use and related problems in Korea.

알코올 의존 환자의 알코올 관련 자극에 대한 암묵적 정서 평가

이은,안석균,정승용,박진영,이수정,남궁기 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : To study the mechanism of alcohol craving is difficult because it involves both cognitive and emotional processes, which are discordamtly influenced by patients' avoidance and denial. The objective of this study is to examine the mechanism of craving by evaluating responses of emotional component of alcohol-related stimuli, explicitly and implicitly. Methods : The subject group was composed of 19 patients with alcohol dependence, 25 heavy drinkers, and 20 social drinkers. An implicit association test (IAT) measuring differential association of 2 target concepts (alcohol versus beverage) with 2 attribute dimensions (positive versus negative) was completed. Explicit evaluation of emotional valence and arousal for alcohol-related and control stimuli was also completed. Results : The patient group reported alcohol-related stimuli more negatively on both implicit and explicit evaluation. In explicit arousal evaluation, they evaluated alcohol-related stimuli more arousing than control stimuli, whereos control groups did not. While the strength of alcohol-negativity association was not related to any clinical variables, the strength of aICOh01-positivity association was related to the arousal level of alcohol related stimuli, the severity of alcohol dependence, and the mean drinking amount per occasion. Conclusion : Alcohol craving can be regarded as negative emotion on both explicit and implicit levels in alcoholics. It seems that craving induced by alcohol-related stimuli may not be recognized by the patients but related to increased arousal or positive implicit evaluation of alcohol.