A study on serum thiamine in patients of alcohol dependence syndrome at a tertiary care hospital

ABSTRACT Background: Alcohol use disorder is highly prevalent in India, with a pooled prevalence rate of 12%. Chronic alcohol use often results in thiamine deficiency due to various factors. This has been linked to neuropsychiatric syndromes such as Wernicke–Korsakoff syndrome, alcoholic cerebellar syndrome, and alcoholic peripheral neuropathy. Some studies suggest a correlation between thiamine deficiency and the severity of alcohol dependence. A case report indicated that alcohol withdrawal psychosis resistant to antipsychotics and electroconvulsive therapy improved with thiamine supplementation. This led to the hypothesis that thiamine deficiency may be associated with both withdrawal psychosis and alcohol dependence severity. Aims and Objectives: The objective of the study was to assess serum thiamine levels in patients with alcohol dependence syndrome (ADS), to compare serum thiamine levels between ADS with and without psychosis, and to compare serum thiamine levels among mild, moderate, and severe ADS. Methodology: Thirty patients diagnosed with ADS (15 with and 15 without withdrawal psychosis) admitted to SVRRGGH, Tirupati, were assessed. Diagnosis was based on the International Classification of Diseases, Tenth Revision criteria. The Severity of Alcohol Dependence Questionnaire (SAD-Q) was used, and serum thiamine levels were measured using enzyme-linked immunosorbent assay. Results: Of the 30 subjects, 3.3% had mild, 60% moderate, and 36.7% severe dependence (SAD-Q). No significant correlation was found with sociodemographic variables. Thiamine levels were slightly lower in ADS patients with psychosis compared to those without but not statistically significant ( P = 0.163). No association was found between thiamine levels and severity of dependence ( P = 0.692). Conclusion: Thiamine deficiency was present in ADS patients, but no significant association with withdrawal psychosis or dependence severity was observed. Further studies with larger samples and dietary assessment are recommended.