Systematic review of symptom-level networks of alcohol use disorder

Network analysis is being used increasingly to study disorders such as alcohol use disorder (AUD) at the level of interacting symptoms. However, it remains unclear what insights AUD symptom networks have brought so far. Therefore, this pre-registered systematic review, following PRISMA reporting guidelines, aimed to collate and critically assess the literature on published AUD symptom networks.

1608 unique articles were collected from PsycINFO, Medline, Embase and Web of Science between January 2010 and May 2023. A total of six articles were included in the review, comprising seven unique cross-sectional networks. The general characteristics of the symptom networks are summarized (i.e. edge inclusion, whether the connection between nodes is present or absent; and node centrality, the importance of a node within an estimated network) and compared between population versus clinical samples.

The networks included many edges, with densities ranging from 60% to 100% (mean and mode of 80%, standard deviation of 28%). The edge connecting Tolerance and Time Spent consuming alcohol was most consistently present across samples, while edges connecting to Physical/Psychological Problems were consistently connected only in population samples. Consuming Larger/Longer than intended, and Physical/Psychological Problems had highest strength centrality, while failure to Cut Down and Hazardous Use were consistently lowest.

Alcohol use disorder symptom networks tend to be densely interconnected and characterized by a high proportion of included edges (dependencies between variables). Some edges are more consistently found in population samples than in clinical samples and vice versa.