[Psychosocial stress and alcohol consumption: interrelations, consequences and interventions]

Psychosocial stress can not only be considered as a result of chronic alcohol abuse, but also as a cause of high alcohol consumption and it maintains as a distress syndrome the subsequent course of the alcohol use disorder.

This review summarises empirical research results concerning the interrelations between psychosocial stress and alcohol consumption. The effects of psychosocial stress are regarded as an ideal-typical process leading to an increased alcohol intake and later to chronic alcohol abuse, often ending in alcohol dependence. The aim of the study is to demonstrate the relevance of stress and distress for diagnostics and therapy of alcohol- related disorders.

At the starting point of high alcohol consumption psychological relief due to the stress-reducing effects of alcohol is often assumed. A vicious circle begins, perpetuating psychosocial distress and reinforcing the anxious or depressive symptoms related to emerging distress syndromes. Associated frequent comorbidities during the progression are other substance- related disorders, anxiety and affective disorders. Following alcohol dependence severe somatic and psychosocial consequences have to be anticipated.

Psychosocial stress, distress and psychological effects can be understood as an important psychopathological developmental process of prolonged alcoholism. Symptoms of distress may be a first relevant evidence of high and hazardous alcohol consumption. Alcoholic patients should be motivated early to attend psychiatric and psychotherapeutic treatments to improve their chances for a positive development. Positive results can be achieved with stress management programs in alcohol dependent patients. These interventions appear to have comparable effects to other treatments.