Assessment of the relationship between anhedonia, sleep quality and alcohol craving in patients with alcohol dependence and comorbid depression

Relevance: Comorbidity of alcohol dependence (AUD) and mental disorders is a widespread phenomenon. Depressive disorders, sleep disorders, and anhedonia significantly increase the risk of relapse in patients with various addictions. Research Objective: To assess the relationship between anhedonia, sleep quality, and pathological alcohol craving in patients with AUD and comorbid depression who did not respond to placebo therapy at the randomization stage of a clinical trial. Research Design: A cross-sectional study was conducted involving 100 patients diagnosed with alcohol dependence (F10.2). The study evaluated several parameters, including the level of alcohol craving, sleep disturbances, social functioning levels, depression, anxiety, and clinical and anamnestic data. Results: The study revealed several significant correlations. The level of depression, as measured by the Montgomery-Asberg scale, showed an inverse correlation with the social functioning scale (Spearman’s ρ = -0.416; p = 0.000). The sleep quality index demonstrated a direct correlation with the level of alcohol craving (Spearman’s ρ = 0.371; 0.366; 0.356; p = 0.000). Dysfunctional beliefs about sleep showed a direct correlation with the “enjoyment of life” subscale of the Ferguson anhedonia scale (ρ-Spearman = 0.366; p = 0.000). The level of alcohol craving also showed a direct correlation with the severity of anhedonia on both subscales of the Ferguson anhedonia scale. Specifically: for PSVA: Spearman’s ρ = 0.287, p = 0.004 (ILF); ρ = 0.368, p = 0.000 (ELF), for OCSVA: Spearman’s ρ = 0.276, p = 0.006 (ILF); ρ = 0.254, p = 0.011 (ELF), for VASVA: Spearman’s ρ = 0.266, p = 0.023 (ILF); ρ = 0.227, p = 0.023 (ELF). Conclusions: The findings indicate that in patients with alcohol dependence, sleep disorders were directly associated with alcohol craving, which in turn correlated with the level of anhedonia. Considering the significant impact of anhedonia levels on the relapse of addictive pathology, these results emphasize the critical need for timely pharmacological intervention to prevent relapse and maintain dependence remission.

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