Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies
BackgroundWe conducted a review of all studies comparing clinical aspects of alcohol withdrawal syndrome (AWS) between men and women.MethodsFive databases (PubMed, Cochrane, EMBASE, Scopus and Clinical Trials) were searched for clinical studies using the keywords “alcohol withdrawal syndrome” or “de...
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| Format: | Article |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1266424/full |
| _version_ | 1827809149249912832 |
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| author | Hayrunnisa Unlu Hayrunnisa Unlu Marie Michele Macaron Hande Ayraler Taner Duygu Kaba Burcu Akin Sari Terry D. Schneekloth Lorenzo Leggio Osama A. Abulseoud Osama A. Abulseoud |
| author_facet | Hayrunnisa Unlu Hayrunnisa Unlu Marie Michele Macaron Hande Ayraler Taner Duygu Kaba Burcu Akin Sari Terry D. Schneekloth Lorenzo Leggio Osama A. Abulseoud Osama A. Abulseoud |
| author_sort | Hayrunnisa Unlu |
| collection | DOAJ |
| description | BackgroundWe conducted a review of all studies comparing clinical aspects of alcohol withdrawal syndrome (AWS) between men and women.MethodsFive databases (PubMed, Cochrane, EMBASE, Scopus and Clinical Trials) were searched for clinical studies using the keywords “alcohol withdrawal syndrome” or “delirium tremens” limited to “sex” or “gender” or “sex difference” or “gender difference.” The search was conducted on May 19, 2023. Two reviewers selected studies including both male and female patients with AWS, and they compared males and females in type of AWS symptoms, clinical course, complications, and treatment outcome.ResultsThirty-five observational studies were included with a total of 318,730 participants of which 75,346 had AWS. In twenty of the studies, the number of patients presenting with or developing AWS was separated by sex, resulting in a total of 8,159 (12.5%) female patients and a total of 56,928 (87.5%) male patients. Despite inconsistent results, males were more likely than females to develop complicated AWS [delirium tremens (DT) and AW seizures, collective DT in Males vs. females: 1,792 (85.4%) vs. 307 (14.6%), and collective seizures in males vs. females: 294 (78%) vs. 82 (22%)]. The rates of ICU admissions and hospital length of stay did not show sex differences. Although variable across studies, compared to females, males received benzodiazepine treatment at higher frequency and dose. One study reported that the time from first hospitalization for AWS to death was approximately 1.5 years shorter for males and males had higher mortality rate [19.5% (197/1,016)] compared to females [16% (26/163)].ConclusionDespite the significant heterogeneity of the studies selected and the lack of a focus on investigating potential sex differences, this review of clinical studies on AWS suggests that men and women exhibit different AWS manifestations. Large-scale studies focusing specifically on investigating sex difference in AWS are needed. |
| first_indexed | 2024-03-11T22:38:47Z |
| format | Article |
| id | doaj.art-6e8639d3db83431faa89d8e0fe84414f |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-11T22:38:47Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-6e8639d3db83431faa89d8e0fe84414f2023-09-22T10:33:26ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-09-011410.3389/fpsyt.2023.12664241266424Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studiesHayrunnisa Unlu0Hayrunnisa Unlu1Marie Michele Macaron2Hande Ayraler Taner3Duygu Kaba4Burcu Akin Sari5Terry D. Schneekloth6Lorenzo Leggio7Osama A. Abulseoud8Osama A. Abulseoud9Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United StatesDepartment of Child and Adolescent Psychiatry, Baskent University School of Medicine Hospital, Ankara, TurkeyMedical School, St George’s University of London, London, United KingdomDepartment of Child and Adolescent Psychiatry, Baskent University School of Medicine Hospital, Ankara, TurkeyDepartment of Child and Adolescent Psychiatry, Baskent University School of Medicine Hospital, Ankara, TurkeyDepartment of Child and Adolescent Psychiatry, Baskent University School of Medicine Hospital, Ankara, TurkeyDepartment of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United StatesSection on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Translational Addiction Medicine Branch, National Institute on Drug Abuse, and National Institute on Alcohol Abuse and Alcoholism, Baltimore, MD, United StatesDepartment of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United StatesDepartment of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, AZ, United StatesBackgroundWe conducted a review of all studies comparing clinical aspects of alcohol withdrawal syndrome (AWS) between men and women.MethodsFive databases (PubMed, Cochrane, EMBASE, Scopus and Clinical Trials) were searched for clinical studies using the keywords “alcohol withdrawal syndrome” or “delirium tremens” limited to “sex” or “gender” or “sex difference” or “gender difference.” The search was conducted on May 19, 2023. Two reviewers selected studies including both male and female patients with AWS, and they compared males and females in type of AWS symptoms, clinical course, complications, and treatment outcome.ResultsThirty-five observational studies were included with a total of 318,730 participants of which 75,346 had AWS. In twenty of the studies, the number of patients presenting with or developing AWS was separated by sex, resulting in a total of 8,159 (12.5%) female patients and a total of 56,928 (87.5%) male patients. Despite inconsistent results, males were more likely than females to develop complicated AWS [delirium tremens (DT) and AW seizures, collective DT in Males vs. females: 1,792 (85.4%) vs. 307 (14.6%), and collective seizures in males vs. females: 294 (78%) vs. 82 (22%)]. The rates of ICU admissions and hospital length of stay did not show sex differences. Although variable across studies, compared to females, males received benzodiazepine treatment at higher frequency and dose. One study reported that the time from first hospitalization for AWS to death was approximately 1.5 years shorter for males and males had higher mortality rate [19.5% (197/1,016)] compared to females [16% (26/163)].ConclusionDespite the significant heterogeneity of the studies selected and the lack of a focus on investigating potential sex differences, this review of clinical studies on AWS suggests that men and women exhibit different AWS manifestations. Large-scale studies focusing specifically on investigating sex difference in AWS are needed.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1266424/fullsex differencesalcohol withdrawaldelirium tremensalcohol withdrawal syndromegender differencealcohol withdrawal seizures |
| spellingShingle | Hayrunnisa Unlu Hayrunnisa Unlu Marie Michele Macaron Hande Ayraler Taner Duygu Kaba Burcu Akin Sari Terry D. Schneekloth Lorenzo Leggio Osama A. Abulseoud Osama A. Abulseoud Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies Frontiers in Psychiatry sex differences alcohol withdrawal delirium tremens alcohol withdrawal syndrome gender difference alcohol withdrawal seizures |
| title | Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies |
| title_full | Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies |
| title_fullStr | Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies |
| title_full_unstemmed | Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies |
| title_short | Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies |
| title_sort | sex difference in alcohol withdrawal syndrome a scoping review of clinical studies |
| topic | sex differences alcohol withdrawal delirium tremens alcohol withdrawal syndrome gender difference alcohol withdrawal seizures |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1266424/full |
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