Abstract
Background: A population-based study on early neurotoxic effects of environmental
exposure to manganese (Mn) enabled us to investigate the relation between blood Mn
levels (MnB), alcohol consumption, and risk for alcohol use disorders (AUD) on mental
health.
Methods: Participants were selected using a random stratified sampling procedure.
Self-administered questionnaires provided data on alcohol consumption, sociodemographics,
medical history, and lifestyle. Mood states were assessed with the Brief Symptom Inventory
(BSI), and risk for AUD was surveyed using a behavioral screening questionnaire and
categorized into no, low, and high risk. Of 297 participants, 253 current drinkers
who had responded to all questions on alcohol use were retained.
Results: Psychologic distress increased with risk for AUD and alcohol consumption
≥ 420 g/week. Higher MnB levels (≥7.5 μg/L) intensified the relation between risk
for AUD and BSI scale scores. The Prevalence odd ratios for positive cases of psychologic
distress with risk for AUD, 1.98 [1.13–3.46], differed when divided by MnB strata:
lower MnB: 1.34 [0.64–2.85]; higher MnB: 4.22 [1.65–10.77].
Conclusions: These findings suggest that higher levels of blood manganese significantly
increase neuropsychiatric symptoms associated with risk for alcohol use disorders.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Biological PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Effect of low-protein diet on manganese neurotoxicity. I. Development and biochemical changes.Neurobehav Toxicol Teratol. 1983; 5: 385-389
- Effect of low-protein diet on manganese neurotoxicity. II. Brain GABA and sizure susceptibility.Neurobehav Toxicol Teratol. 1983; 5: 385-389
- What you need to know.Singapore Med J. 1998; 39: 38-41
- Effects of lead and manganese on the release of lysosomal enzymes in vitro and in vivo.Clin Chim Acta. 1997; 261: 91-101
- Bioindicator and exposure data for a population based study of manganese.Neurotoxicology. 1999; 20: 259-270
- Etiology of Parkinson’s disease.Can J Neurol Sci. 1984; 11: 24-28
- Autonomic function in Manganese alloy workers.Environ Res Section A. 1998; 78: 50-58
- Substance abuse and employee assistance programs.in: LaDou J Occup Med. Appleton and Lange, East Norwalk, CT1990: 481-498
- A comparison of alcoholic and other adult children of alcoholics to other alcoholics on the BSI.Alcoholism Treat Q. 1991; 8: 81-93
- Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism.Lancet. 1982; 1: 325-328
- Quantification of neuromotor function for detection of the effects of manganese.Neurotoxicology. 1999; 20: 355-366
- Antioxidant status and alcohol-related diseases.Alcohol Alcoholism. 1993; 28: 111-116
- The co-occurrence of substance use in other mental disorders.Clin Psychol Rev. 2000; 20: 145-148
- Lifetime prevalence of psychiatric disorders in Edmonton.Acta Psychiatr Scand. 1988; 77: 24-32
- La récupération en post-réadaptation externe selon les divers profils de toxicomanes.Sciences Comportement. 1997; 25: 279-298
- Résultats d’une étude réalisée auprès de personnes alcooliques, en réadaptation externe. 1990 (Unpublished manuscript)
- Increased GABA content in caudate nucleus of rats after chronic manganese chloride administration.J Neurochem. 1978; 31: 551-552
- Neuropsychiatric effects of manganese on mood.Neurotoxicology. 1999; 20: 367-378
- Detecting alcohol use disorders in the severely mentally ill.Comm Ment Health J. 1998; 34: 165-174
- Manganese injection into the rat striatum produces excitotoxic lesions by impairing energy metabolism.Exper Neurol. 1993; 120: 89-94
- Screening for alcohol abuse using the CAGE questionnaire.Am J Med. 1987; 82: 231-235
- Manganism and idiopathic parkinsonism.Neurology. 1994; 44: 1583-1586
- Psychiatric sequelae of manganese exposure in the adult, foetal and neonatal nervous system.Aust N Z J Psychiatry. 1985; 19: 211-217
- A manganic milieu in North Australia.Int J Biosocial Med Res. 1989; 11: 43-56
- Genetic susceptibility to manganese intoxication in professionals of a manganese alloy production plant. A genetic epidemiological approach.Neurotoxicology. 1998; 19: 466
- Role of iron deficiency in inducing susceptibility to manganese toxicity.Arch Toxicol. 1976; 35: 319-323
- An exploratory study of manganese exposure to welders.Ind Toxicol Res Center. 1981; 15: 407-417
- Combined effect of metals on biogenic amines and their distribution in the brain of mice.Arch Environ Contam Toxicol. 1980; 9: 79-85
- Neurobehavioral functions among workers exposed to manganese ore.Scand J Work Environ Health. 1993; 19: 264-270
- Neurotoxicology of manganese.in: Chang L.W Dyer R.S Handbook of Neurotoxicology. Marcel Dekker, New York1995: 91-100
- Monitoring oxidative damage in patients with liver cirrhosis and different daily alcohol intake.Gut. 1994; 35: 1637-1643
- Hair mineral analysis.Psychol Rep. 1989; 64: 259-266
- Coefficient alpha and the internal structure of tests.Psychometrika. 1951; 16: 297-334
- The utility of the Brief MAST′ and the CAGE′ in identifying alcohol problems.Arch Fam Med. 1997; 6: 477-483
- Inhalation health risks of manganese.Neurotoxicology. 1999; 20: 511-518
- Brief Symptom Inventory. National Computer Systems, Minneapolis, MN1993
- Screening for psychiatric disorder in medical populations.in: Fava G Rosenbaum G Birnbaum R Research Designs and Methods in Psychiatry. Elsevier, Amsterdam1992: 323
- The Brief Symptom Inventory.Psychol Med. 1983; 13: 595-605
- Dystonia, hyperintense basal ganglia, and high whole blood manganese levels in Alagille’s syndrome.Gastroenterology. 1994; 106: 1068-1071
- Manganses neurotoxicity.Can J Physiol Pharmacol. 1982; 60: 1389-1405
- Interactions between trace elements and alcohol in rats.CIBA Found Symp. 1984; 105: 103-123
- Detecting alcoholism.JAMA. 1984; 252: 1905-1907
- Manganese in the US gasoline supply.Am J Ind Med. 1997; 31: 107-115
- Abnormalities in hair trace elements as indicators of aberrant behavior.Comp Psychiatry. 1991; 32: 229-237
- Grande consommation d’alcool et problèmes connexes.in: Aspects Sociaux Reliés à la Santé. Vol 2. Ministère de la Santé et des Services Sociaux, Gouvernement du Québec, Montréal1995: 81-112
- Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease.Can J Neurol Sci. 1996; 23: 95-98
- Manganese intoxication and chronic liver failure.Ann Neurol. 1994; 36: 871-875
- The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment.J Stud Alcohol. 1988; 49: 219-224
- N-Methyl-D-aspartate receptors and ethanol.J Neurochem. 1989; 52: 1937-1940
- Applied Logistic Regression. John Wiley & Sons, Toronto1989
- Chronic manganese intoxication.Arch Neurol. 1989; 46: 1104-1106
- Progression after chronic manganese exposure.Neurology. 1993; 43: 1479-1483
- Effects from environmental Mn exposure.Neurotoxicology. 1999; 20: 379-398
- Motor neuron disease on the Kii Peninsula of Japan.Sci Total Environ. 1994; 149: 121-135
- National Inventory of Sources and Emissions of Manganese (1984). Vol 39. Environmental Analysis Branch, Environmental Protection, Conservation and Protection, Ministry of Supply and Services Canada, Ottawa1987
- DSM III. 6th ed. Williams & Wilkins, Baltimore1991
- Introduction to a special section.J Consult Clin Psychol. 1992; 60: 833-834
- Lifetime co-occurrence of DSM-III-R alcohol disorders in the National Comorbidity Survey.Arch Gen Psychiatry. 1997; 54: 313-321
- Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United-States.Arch Gen Psychiatry. 1994; 51: 8-19
- The epidemiology of co-occurring addictive and mental disorders.Am J Orthopsychiatry. 1996; 66: 17-31
- An endemic neurological disorder in tribal Australian aborigines.J Neurol, Neurosurg Psychiatry. 1980; 43: 661-668
- At risk drinking among general practice attenders.Psychol Med. 1986; 16: 213-217
- Possible health effects of high managnese concentration in drinking water.Arch Environ Health. 1989; 44: 175-178
- The tip of the iceberg.Int J Psychiatry Med. 1988; 18: 375-382
- Interrelationships among self-reported alcohol intake, physiological indices and alcoholism screening measures.J Stud Alcohol. 1988; 49: 532-537
- Manganese intoxication.Arch Neurol. 2000; 57: 597-599
- Selective vulnerability of glutathione metabolism and cellular defense mechanism in rats striatum to manganese.J Pharmacol Exper Ther. 1988; 247: 156-161
- Effect of manganese on the concentration of amino acids in different regions of the rat brain.J Environ Sci Health. 1999; B43: 119-132
- Oxygen radicals and neuropsychiatric illness.Arch Gen Psychiatry. 1991; 48: 1097-1106
- Environmental and occupational exposure to manganese.Int Arch Occup Environ Health. 1995; 67: 101-110
- Increased manganese-superoxide dismutase activity in postmortem brain from neuroleptic-treated psychotic patients.Biol Psychiatry. 1996; 40: 230-232
- Alcohol neurotoxicity.in: Chang L.W Dyer R.S Handbook of Neurotoxicology. Marcel Dekker, New York1995: 769-800
- Ethanol inhibits NMDA-activated ion current in hyppocampal neurons.Science. 1989; 243: 57-60
- Mechanism of neurobehavioral alteration.Toxicol Lett. 2000; 112–113: 35-39
- Drug Use and Abuse. Hartcourt Press, Montréal, Canada1995
- Environmental pollution, neurotoxicity, and criminal violence.in: Rose J Environmental Toxicology. Gordon and Breach Publishers, London1997
- The CAGE Questionnaire.Am J Psychiatry. 1974; 131: 1121-1123
- Parkinsonism after chronic exposure to the fungicide maneb (manganese ethylene-bis-dithiocarbamate).Scand J Work Environ Health. 1994; 20: 301-305
- Chronic manganese poisoning.Neurology. 1969; 19: 1000-1006
- Chronic manganese poisoning.Neurology. 1967; 17: 128-136
- Manganese.Can J Neurol Sci. 1996; 23: 93-94
- Early manifestations of manganese neurotoxicity in humans.Environ Res. 1997; 73: 92-100
- Manganese neurotoxicity, a continuum of dysfunction.Neurotoxicology. 1999; 20: 327-342
- Preliminary evidence of neurotoxicity associated with eating fish from the upper St. Lawrence River lakes.Neurotoxicology. 1998; 19: 691-702
- Colour vision impairment and alcohol consumption.J Neurotoxicol Teratol. 1988; 10: 255-263
- Nervous system dysfunction among workers with long-term exposure to manganese.Environ Res. 1994; 64: 151-180
- Confounding and effect-modification.Am J Epidemiol. 1995; 141: 1113-1116
- Ethanol-induced oxygen radical formation and lipid peroxidation in rat brain.J Neurochem. 1994; 63: 1855-1862
- Problem drinking in Northern Ireland.Alcohol Alcoholism. 1993; 28: 477-483
- Serum prolactin in subjects occupationally exposed to manganese.Ann Clin Lab Sci. 1996; 26: 10-17
- Selective vulnerability of dopaminergic systems to industrial chemicals.Toxicol Ind Health. 1998; 14: 311-323
- Recommended Dietary Allowances. 10th ed. National Research Council, National Academy Press, Washington, DC1989
- Manganese encephalopathy.Br J Ind Med. 1993; 50: 510-513
- Maganese poisoning.Ind Med Surg. 1955; 24: 1-7
- Schizophrenia, alcohol abuse, and violent behavior.Schizophr Bull. 1998; 24: 437-441
- Comorbidity of mental disorders with alcohol and other drug abuse.JAMA. 1990; 264: 2511-2518
- Possible roles of free radicals in alcoholic tissue damage.Free Radic Res Commun. 1990; 9: 205-211
- Manganese poisoning in Moroccan miners.Br J Ind Med. 1955; 12: 21-35
- Epidemiological survey among workers exposed to manganese.Am J Ind Med. 1987; 11: 307-327
- Preclinical toxic effects of manganese in workers from a Mn salts and oxides producing plant.Sci Total Environ. 1985; 42: 201-206
- Assessment of the permissible exposure level to manganese in workers exposed to manganese dioxide dust.Br J Ind Med. 1992; 49: 25-34
- DSM-III-R alcohol abuse and dependence and psychiatric comorbidity in Ontario.Drug Alcohol Depen. 1995; 39: 111-128
- Modern Epidemiology. Lippincott-Raven, Philadelphia1998
- Liver dysfunction and probable manganese accumulation in the brainstem and basal ganglia.J Neurol Neurosurg Psychiatry. 1995; 58: 760-761
- Aspect Sociaux Reliés à la Santé. Vol 2. Ministère de la Santé et des Services Sociaux, Gouvernement du Québec, Montréal, Canada1995
- Et la Santé, Ça Va en 1992–1993? Rapport de l’Enquête Sociale et de Santé 1992–1993. Vol 1. Montréal, Canada, Ministère de la Santé et des Services Sociaux, Gouvernement du Québec1995
- Acute effect of alcohol on estradiol, estrone, progesterone, prolactin, cortisol, and luteinizing hormone in premenopausal women.Alcohol Clin Exper Res. 1999; 23: 976-982
SAS Institute. Base SAS Software, 6.12 ed. Cary, NC: SAS Institute.
- StatView Software. 5th ed. SAS Institute, Cary, NC1998
- Et la santé en Montérégie, ça va? Rapport régional Montérégie. Régies Régionales de la Santé et des Services Sociaux de la Montérégie, Ministère de la Santé et des Services Sociaux, Gouvernement du Québec, Montérégie, Canada1996
- Clinical ecology treatment for juvenile offenders.J Behav Ecol Biosoc. 1981; 2: 1
- Manganese poisoning.Indust Med Surg. 1957; 26: 167-173
- Alcoholism, anxiety and depression.Br J Addiction. 1988; 83: 1373-1380
- Dual diagnosis.Psychiatr Q. 1993; 64: 107-134
- The interaction between manganese and ethanol in rats.Acta Pharmacol Toxicol. 1978; 43: 354-362
- MMT.Environ Res. 1999; 80: 93-95
- The interaction between ethanol and manganese in rat brain.Arch Toxicol. 1979; 41: 307-316
- Effects on the nervous system among welders exposed to aluminum and manganese.Occup Environ Med. 1996; 53: 32-40
- Peripheral markers of catecholamine metabolism among workers occupationally exposed to manganese.Toxicol Lett. 1995; 77: 329-333
- Peripheral biomarkers and exposure to manganese.Neurotoxicology. 1999; 20: 401-406
- Ethnic and sex bias in primary care screening tests for alcohol use disorders.Ann Intern Med. 1998; 129: 353-362
- Mood and alcohol consumption.J Abnorm Psychol. 2000; 109: 198-204
- Screening for risk factors for alcohol consumption in the Quebec Health Survey.Can J Public Health. 1996; 87: 183-186
- Changes in blood manganese levels during pregnancy in iron supplemented and non supplemented women.J Trace Elem Med Biology. 1995; 9: 13-17
- Manganese toxicity.Neurotoxicology. 1999; 20: 489-498
- Long term exposure to manganese in rural well water has no neurological effects.Can J Neurol Sci. 1995; 22: 286-289
- Item bias in the CAGE screening test for alcohol use disorders.J Gen Intern Med. 1997; 12: 763-769
- Correcting the incorrigible.Am Lab. 1977; 107: 22-49
- Biological significance of manganese in mammalian systems.in: Progress in Medicinal Chemistry. Vol 30. Elsevier Science, Amsterdam1993: 89-133
- Manganese in the context of an integrated risk and decision process.Neurotoxicology. 1999; 20: 519-526
- Neurobehavioral Toxicity. Raven Press, New York1994
- Manganese exposure in steel smelters—a health hazard to the nervous system.Scand J Work Environ Health. 1991; 17: 255-262
- Influence of comorbid alcohol and psychiatric disorders on utilization of mental health services in the National Comorbidity Survey.Am J Psychiatry. 1999; 156: 1230-1236
- Lipid peroxidation in workers exposed to manganese.Scand J Work Environ Health. 1996; 22: 381-386
- An efficient method for psychosocial screening of cancer patients.Psychosomatics. 1990; 31: 192-196
- Thiamine deficiency as predisposition to, and consequence of, increased alcohol consumption.Alcohol Alcoholism. 1996; 31: 421-427
Article info
Publication history
Accepted:
November 15,
2001
Received in revised form:
November 12,
2001
Received:
June 14,
2001
Identification
Copyright
© 2002 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
