Comparison of ego strength between aggressive and non-aggressive alcoholics: a cross-sectional study

AIM: To determine the differences between aggressive and non-aggressive alcoholics in sociodemographic and clinical characteristics and ego strength. METHODS: This cross-sectional study included 111 aggressive and 123 non-aggressive male alcoholics aged between 25 and 60 years who were admitted to the Department for Alcoholism, University Psychiatric Hospital Vrapče, Zagreb, Croatia, from January to December 2016. All participants met the diagnostic criteria for alcohol dependence according to the Croatian Mini International Neuropsychiatric Interview (MINI), 4th revised edition of Diagnostic and Statistical Manual of Mental Disorders, and the International Classification of Diseases. Participants were clinically assessed by an experienced psychiatrist using a clinical interview, MINI, Questionnaire from the Brown-Goodwin Lifetime History of Aggression, and Ego Identity Scale (EIS) according to Erikson. A clinical psychologist performed cognitive function measurements. EIS scores were analyzed using one-way analysis of variance. RESULTS: In comparison with non-aggressive alcoholics, aggressive alcoholics were more often divorced, unemployed, hospitalized, and first treated for alcoholism at an earlier age (P < 0.05 for all). They more frequently experienced depression (42.4% vs 19.4%, P = 0.013) and attempted suicide (34.7% vs 6.2%, P = 0.003), achieved a lower level of maturity at the second stage of psychosocial development related to shame and doubt (14.0 ± 4.1 vs 17.4 ± 3.7, P = 0.013) and at the fourth stage related to inferiority (13.1 ± 6.8 vs 18.1 ± 9.3, P = 0.011), and had lower total EIS score (75.8 ± 20.4 vs 85.2 ± 21.5, P < 0.012) than non-aggressive alcoholics. CONCLUSION: Aggressive alcoholics had weaker ego-strength than non-aggressive alcoholics, experienced more depressive reactions and suicide attempts, and showed poorer psychosocial functioning. Oxford Centre for Evidence-based Medicine level of evidence: 3**