Quality of life, sleep, mood and alcohol consumption: a complex interaction

Socio-demographic information was collected from 52 (45 men, seven women) currently drinking moderately dependent alcohol misusers attending an outpatient clinic in South London for medical assessment and treatment. Assessments at baseline and 12-week follow-up included: (i) Severity of Alcohol Dependence (SADQ) (baseline only), (ii) Hospital Anxiety and Depression Scale (HADS); (iii) Nottingham Health Profile sleep subscale (NHP) and (iv) the EuroQoL (EQ-5D). The main outcome measure was drinking at a "sensible level" at 12-week follow-up as recommended by the Royal College of Psychiatrists. There were significant interactions between sleeping badly, lying awake at night and HADS depression scores. The Health-related Quality of Life (HrQoL) of this group was poor compared to general population norms. Lower EQ-5D index scores were associated with poorer educational attainment and lower EQ-5D Visual Analogue Scale (VAS) patient ratings with greater baseline alcohol consumption. Clinician ratings on the EQ-5D VAS were consistently lower than the patient ratings. The correlations between patient self-assessment and clinician ratings (EQ-5D VAS) were not significant. The forty-seven subjects (90%) who were successfully followed-up showed a significant reduction in the total amount of alcohol consumed. Ten (21%) subjects returned to sensible drinking levels at 12 weeks but there was not a corresponding improvement in HrQoL, sleep, or affective status scores or biochemical measures in these subjects.