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 Table of Contents  
Year : 2021  |  Volume : 5  |  Issue : 1  |  Page : 61-66

A comparative study of facial emotion recognition pattern and its determinants in patients of alcohol dependence syndrome versus matching controls

1 Department of Psychiatry, Narayana Medical College, Nellore, Andhra Pradesh, India
2 Department of Psychiatry, Acsr Medical College, Nellore, Andhra Pradesh, India
3 Department of Physiology, Kims, Amalapuram, Andhra Pradesh, India

Date of Submission02-Dec-2020
Date of Decision11-Feb-2021
Date of Acceptance12-Feb-2021
Date of Web Publication15-Apr-2021

Correspondence Address:
Dr. Ananda Reddy Endreddy
Associate Professor, Department of Psychiatry, Narayana Medical College and Hospital, Chinta Reddy Palem, Nellore, Andhra Pradesh - 524 003
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aip.aip_136_20

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Background: Facial emotional recognition plays a pivotal role in human interactions and behavior. Long-term alcohol use leads to brain dysfunction that causes impairment in social cognitive abilities including facial emotional recognition. Objectives: Our study was aimed to assess the facial emotional recognition pattern in patients with alcohol dependence syndrome (ADS) and compared with that of matching controls and to study the sociodemographic and clinical correlates of facial emotional recognition in ADS. Setting and Design: This cross-sectional study was conducted at a tertiary care teaching hospital for a period of 1½ years. Fifty participants having ADS and fifty controls were included in the study. Materials and Methods: Fifty participants having ADS and fifty controls were included in the study. In the group with ADS, a semi-structured pro forma was used to collect the sociodemographic and clinical profile. Rating scales such as Severity of Alcohol Dependence Questionnaire, the Clinical Institute Withdrawal Assessment for Alcohol scale-revised, and facial emotion recognition test (FERT) were administered. For the control group, FERT was administered after collecting the data regarding sociodemographic profile and clinical variables. Results: It was observed a significant impairment in FERT scores in individuals having ADS (mean score = 19.93 ± 7.67) when compared to the control population (mean score = 32.73 ± 4.96T-test = −10.86; P < 0.001). Lower scores on FERT were observed in persons with severe alcohol dependence (one-way ANOVA = 41.79, P < 0.001). Post hoc Tukey testing showed the difference between groups having moderate-to-severe dependence (P < 0.001) and mild-to-severe dependence (P < 0.001). Conclusions: Significant impairment in facial emotional recognition skills were observed in patients having ADS. The subjects in ADS group were able to identify happy and angry emotions better while facing difficulties in identifying sad and fear full stimulus.

Keywords: Alcohol, dependence, facial emotion recognition test, social cognition

How to cite this article:
Rajesh CL, Endreddy AR, Shaik S, Venu Gopala Raju S V. A comparative study of facial emotion recognition pattern and its determinants in patients of alcohol dependence syndrome versus matching controls. Ann Indian Psychiatry 2021;5:61-6

How to cite this URL:
Rajesh CL, Endreddy AR, Shaik S, Venu Gopala Raju S V. A comparative study of facial emotion recognition pattern and its determinants in patients of alcohol dependence syndrome versus matching controls. Ann Indian Psychiatry [serial online] 2021 [cited 2021 Aug 5];5:61-6. Available from: https://www.anip.co.in/text.asp?2021/5/1/68/313752

  Introduction Top

Alcohol dependence has resulted in serious public health issues worldwide, and more than 3 million deaths were occurring worldwide every year.[1] Many deleterious consequences of associated violence, effects on families, default on social role, and financial burden also exist with the alcohol abuse.[2] Chronic alcohol abuse leads to alteration in brain structures and function.[3],[4] Impairments in social cognitive abilities occur in alcohol dependence.[5] Emotional processing deficits perpetuate alcohol use and lead to relapse in individuals who use it as a pathological coping mechanism.[6]

Facial emotion recognition skills form a vital tool in an individual's social interactions and behavior.[7] Facial emotion recognition requires the synchronized activity of multiple brain areas, predominantly the right fusiform gyrus, and it has been described as the face area of the human brain.[8],[9] Emotional inputs involving the prefrontal circuits were implicated in decision-making, executive functioning, and regulation of affective reactions.[10] In alcohol dependence syndrome (ADS), many cognitive domains such as working memory, attention-span, and social cognition deficits arise due to the damage and dysfunction involving the prefrontal cortices.[11],[12] Impairment in neurocognitive functions had some correlation with treatment implications.[13]

ADS patients are known to have a negative impact on multiple facets of the affected individual and family life.[14] Impairment in facial emotional recognition skills have been reported in patients with the ADS which results in poor communication, interpersonal problems, problems at workplace, familial dispute, and poor quality of life.[15] Literature also reveals impaired facial emotion recognition in long-term alcohol use. Faces depicting fear and anger were mostly recognized as the higher intensity of emotions.[16],[17],[18],[19],[20] Maintaining abstinence revealed facial emotion recognition deficits and irreversible neurotoxic effects of alcohol.[21]

Facial emotional expressions also aid as communicative tools in expressing intentions during day-to-day social and interpersonal interactions.[22] Emotion recognition has thus got significance from an evolutionary biology point of view as well from infancy to adults.[23] Existing literature reports that chronic alcohol use leads to impairment in emotion recognition and other social cognitive abilities. However, the association between facial emotion recognition deficits and factors pertaining to alcohol use such as patterns of drinking, the severity, quantity, and duration of alcohol use have not been studied in detail hence in this study was attempted to study the association between facial emotional recognition scores and various sociodemographic and clinical parameters.

  Materials and Methods Top

The present study was aimed to assess the facial-emotion recognition pattern in patients with ADS and compared it with that of matching controls and to study the sociodemographic and clinical correlates of facial-emotional recognition in ADS. This study was a cross-sectional study conducted in the admitted patients of the Department of Psychiatry, Narayana Medical College and Hospital, between July 2018 and December 2019, among the patients of ADS. A purposive sampling technique was adopted for the recruitment of study subjects. Obtained IEC approval and informed consent were taken from study subjects.

Inclusion and exclusion criteria: patients with ADS, willing to give consent for the study, and aged between 18 and 60 years were included as cases. Individuals without ADS, age group 18–60 years, and willing to give consent were included as controls. Patients within withdrawal state as defined by CIWA-Ar, with a history of comorbid psychiatric illness, intellectual disability, debilitating medical illness, and comorbid substance use other than tobacco were excluded from the study.

Tools for assessment

  1. Semi-structured pro forma for collecting the sociodemographic data
  2. Modified Kuppuswamy Socioeconomic status scale: This scale was one of the established determinants of health. Modified Kuppuswamy socioeconomic status scale was an important tool in hospital- and community-based research in India, which was proposed in 1972. The main limitation of this scale was an overemphasis on income rather than on educational and occupational factors. Socioeconomic status was classified into five classes based on the score obtained on this scale[24]
  3. Severity of Alcohol Dependence Questionnaire (SADQ): This scale had 20-item questionnaires used to measure the severity of alcohol dependence score >30 indicates severe dependence, 16–30 moderate dependence, and score <16 indicates mild dependence[25]
  4. The Clinical Institute Withdrawal Assessment for Alcohol Scale-revised (CIWA-Ar): The scale was used to assess the severity of alcohol withdrawal and developed from 18 items CIWA-Ar. For administration of scale requires 5 min. A patient scoring <10 indicates mild withdrawal, 11–15 indicates moderate, and more than 15 indicates severe withdrawal[26]
  5. Facial emotion recognition test (FERT): FERT includes colored photographs of facial emotional expressions that include evoked or felt emotions such as happy, angry, fearful, sad, and neutral stimuli. There are low-intensity and high-intensity expressions for each emotion. There were eight faces for each of the five categories amounting to a total of forty faces to be decoded. The average testing time for this task was 5–10 min for comparison of control subjects and patients.[27]


A total of 100 participants, including fifty cases and fifty matched controls meeting the inclusion and exclusion criteria, were included in the study. Subjects were diagnosed with alcohol-dependent syndrome based on International Statistical Classification of Disease-10 criteria. CIWA-Ar and SADQ were administered in this group of cases. In the post detoxification phase, while they were in the in-patient de-addiction ward, 3 weeks after their last drink. The presence of withdrawal symptoms was excluded by administering the CIWA-Ar. Before the administration of the FERT, the participants were shown ten photographs depicting the happy, angry, fearful, sad, and neutral stimuli. The FERT was administered to the patients having ADS and the matched control group. Data were analyzed using SPSS 25 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.), and the descriptive statistics were used to summarize the baseline sociodemographic variables. The continuous variables were summarized as mean and standard deviation. Independent t-test was used to analyze any significant difference in the facial-emotion recognition score between the two groups. The association between various sociodemographic and clinical variables were studied using the Chi-square/Fisher's exact test. Wilcoxon matched pair test was performed to know the significant difference in emotion scores.

  Results Top

Fifty patients having ADS and 50 age- and sex-matched control subjects were included in the study. Mean age of the sample was 38.97 years with a standard deviation of 10.5. The details of the sociodemographic variables of participants are as given below.[Table 1]
Table 1: Details of the sociodemographic variables of the participants

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The estimated mean and standard deviation of facial emotion recognition pattern score for the alcohol group was observed as 19.93 (standard deviation [SD] 7.67) and in the control group 32.73 (SD 4.96). Results were interpreted as in alcohol group subjects able to identify around 50% of facial emotion patterns, while control was able to identify 80% of the facial emotions. The maximum score possible was 40. Higher scores indicate better performance in facial emotion recognition task. On the study sample, independent sample t-test was performed to know the significance of the data between the two groups. It was observed a statistically significant difference between the two groups (P < 0.001) [Table 2].
Table 2: Mean facial emotion recognition scores, comparison between the alcohol-dependent and control group

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In order to study the association of various sociodemographic and clinical variables, Chi-square/Fischer's exact test was done. It was observed that, among sociodemographic variables, family history of alcohol use group was found to be statistically significant (P < 0.001). Among the clinical variables, comorbid illness affecting the nervous system, gastrointestinal system, and genitourinary system were found to be significant (P < 0.001) [Table 3].
Table 3: Depicting details of family history and comorbidities in study subjects

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Based on the severity of alcohol use, the alcohol-dependent group was divided into mild, moderate, and severe on the severity of the alcohol-dependent questionnaire. Average scores of the mean and standard deviation of facial emotion recognition pattern scores were 29.80 (SD = 2.78), 25.50 (SD = 3.54), and 14.73 (SD = 5.90). It means that mild subgroup of alcohol dependence was able to interpret 30 faces, whereas the moderate group identified 26 and severe group 15, respectively. To estimate whether there is a statistically significant difference among two groups based on number of years of alcohol dependence, independent sample t-test was performed. It was observed that there is a statistically significant difference (P < 0.001) in the group having alcohol dependence since more than 5 years had significantly lower scores on the FERT [Table 4].
Table 4: The mean facial emotion recognition scores of alcohol group based on the severity, pattern, and duration of alcohol dependence in years

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The individuals having alcohol dependence were categorized into three groups, 1 – continuous use, 2 – binge drinking (is a pattern of drinking that brings a person's blood alcohol concentration to 0.08 g/dl or above), 3 – uses alcohol on <4 days. It was observed that the average scores for individuals having continuous use, binge pattern, and alcohol use on <4 days per week; were respectively 16.70 (SD = 7.30), 22.52 (SD = 6.12), and 28.67 (SD = 3.72). It means individuals having daily drinking were able to correctly decode an average of 17 out of the total 40 faces presented to them when compared to a total of 23 and 29 out of 40 faces in other subgroups [Table 4].

To estimate the median and interquartile range for the average number of mild and extreme intensity emotions by subjects of both groups, Wilcoxon-matched pair test was done.

It was found that there was a significant difference (P < 0.001), in the median and interquartile range for the average number of mild and extreme intensity emotions by subjects of both groups with the Wilcoxon matched-pair test [Table 5].
Table 5: Facial emotion recognition scores for mild and extreme emotions

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  Discussion Top

In our study, the participants having alcohol dependence did not differ from the control group in terms of various socio-demographic variables. Individuals from both groups had similar educational and occupational statuses. Their socioeconomic status, religion, habitat, and marital status were comparable. It was observed in studies done by French et al.,[28] Frigerio et al.,[29] and Hoffmann et al.,[30] reported comparable baseline sociodemographic details similar to our study.

In our study, it was observed that the mean score on the FERT was significantly lower for the alcohol-dependent group. The average facial emotion recognition score was around 19.93 (SD = 7.67) in the alcohol dependence group and 32.73 (SD = 4.96) in the control group. The individuals having ADS were able to identify only around 50% of the facial emotional patterns presented before them, similar results were reported by Donadon and Osório[31] and Maurage et al.[32]

It was observed in our study that participants belonging to both the groups identified extreme intensity emotions better than mild intensity emotions (alcohol group – Wilcoxon-matched pair test – 6.76 (P < 0.001); control group – Wilcoxon-matched pair test – 6.36 (P < 0.001); similar results were reported in the study done by Carmona-Perera et al.[33] and O'Daly et al.[34]

In our study, participants of the alcohol dependence group were able to identify happy and sad faces better, while they had difficulty in decoding fear and disgust emotions as well as neutral faces. Likewise, studies were done by Maurage et al.[32] and Donadon and Osório Fde,[10] reported difficulty in decoding fear and disgust emotions by participants having ADS. Enhanced perception of fearful stimuli was reported in the study done by Townshend and Duka.[35] Our study reported a significant association between the severity of alcohol dependence and facial emotion recognition scores (FERS). It was observed that the average (FERS) score for individuals having mild, moderate, and severe alcohol dependence were 29.80 (SD = 2.78), 25.50 (SD = 3.54), and 14.73 (SD = 5.90), respectively. The findings of our study are in accordance to findings of study done by kumar et .al,.[36]

In our study, the average FERS score for individuals having continuous use of alcohol, binge pattern, and the group with alcohol use on <4 days per week was 16.70 (SD = 7.30), 22.52 (SD = 6.12), and 28.67 (SD = 3.72), respectively. Individuals having daily drinking had significantly lower scores on the emotion scoring task (one-way ANOVA = 10.66, [P < 0.001]). A study was done by Kornreich et al.[37] reported similar findings to our study and also concluded that prolonged abstinence from alcohol use was associated with improved emotion recognition.

A study by Noble and Weimer[38] reported that a longer duration of alcohol use was associated with neurological changes that impaired the emotion recognition capabilities in a person having ADS. Our study also explored the association between alcohol use in dependence patterns and FERS. It was observed that participants having alcohol dependence for more than 5 years had significantly reduced scores on FERT (14.81, [SD = 6.74]) when compared to the individuals who had alcohol dependence for <5-year duration (23.85, [SD = 5.85]), t-test = 0.95 (P < 0.001). It suggests worsening of impairments in emotion recognition skills with increasing duration of alcohol dependence.

The family history of substance dependence was compared among both the groups; it was observed that the participants having ADS had a strong family history of substance abuse, which was a finding that had been replicated in studies done by Cservenka et al.[39] and Spadoni et al.[40] Family history again is a strong pointer toward genetic influence on alcohol dependence in a study by McCrady et al.[41]

In our study we had examined the occurrence of medical comorbidities in both the alcohol-dependent and control groups. The rate of medical comorbidities involving the nervous system, genitourinary system, and gastrointestinal system was found to be considerably higher among the participants belonging to the alcohol-dependent group as per the results derived from our study; these findings were comparable with the findings of studies done by Arackal and Benegal[42] and Lieber.[43]

  Conclusions Top

In ADS patients, there is a significant impairment in the facial-emotion recognition scores in individuals having ADS. Individuals having more quantity of alcohol per day and more years of alcohol use in dependence pattern exhibited deficits in emotion recognition. These patients were able to identify better with happy and angry emotions when compared to sad and fear stimulus. The impairment in emotion recognition will definitely impact the quality of life and social life of a patient with alcohol dependence.

Future directions

Emotion recognition training is involved in the treatment of alcohol-dependent individuals, along with the social skills training program. Future studies exploring the change in facial-emotion recognition scores in alcohol-dependent individuals after training emotion recognition skills may be done.


  1. Owing to practical concerns, we had to resort to a cross-sectional design of the study. A follow-up study would have been more informative
  2. We have included the four basic emotional categories along with neutral expressions. Studies exploring complex emotions may be done
  3. The entire sample has been collected from a group of people attending the treatment facilities at a tertiary care center, so the results cannot apply to the general population
  4. Ethnicity of images is limitation of our study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Murthy P, Manjunatha N, Subodh BN, Chand PK, Benegal V. Substance use and addiction research in India. Indian J Psychiatry 2010;52:S189-99.  Back to cited text no. 1
Ray R, Chopra A. Monitoring of substance abuse in India – Initiatives & experiences. Indian J Med Res 2012;135:806-8.  Back to cited text no. 2
[PUBMED]  [Full text]  
Sawyer KS, Oscar-Berman M, Mosher Ruiz S, Gálvez DA, Makris N, Harris GJ, et al. Associations between cerebellar subregional morphometry and alcoholism history in men and women. Alcohol Clin Exp Res 2016;40:1262-72.  Back to cited text no. 3
Harris CR, Albaugh B, Goldman D, Enoch MA. Neurocognitive impairment due to chronic alcohol consumption in an American Indian community. J Stud Alcohol 2003;64:458-66.  Back to cited text no. 4
Valmas MM, Mosher Ruiz S, Gansler DA, Sawyer KS, Oscar-Berman M. Social cognition deficits and associations with drinking history in alcoholic men and women. Alcohol Clin Exp Res 2014;38:2998-3007.  Back to cited text no. 5
Oscar-Berman M, Valmas MM, Sawyer KS, Ruiz SM, Luhar RB, Gravitz ZR. Profiles of impaired, spared, and recovered neuropsychologic processes in alcoholism. Handb Clin Neurol 2014;125:183-210.  Back to cited text no. 6
Phelps EA. The emotion and cognition: Few insights from the studies of the human amygdala. Annu Rev Psychol 2006;57:27-53.  Back to cited text no. 7
McCarthy G, Puce A, Gore JC, Allison T. Face-specific processing in the human fusiform gyrus. J Cogn Neurosci 1997;9:605-10.  Back to cited text no. 8
Haxby JV, Hoffman EA, Gobbini MI. Human neural systems for face recognition and social communication. Biol Psychiatry 2002;51:59-67.  Back to cited text no. 9
Donadon MF, Osório Fde L. Recognition of facial expressions by alcoholic patients: A systematic literature review. Neuropsychiatr Dis Treat 2014;10:1655-63.  Back to cited text no. 10
Mehta D, Siddiqui MF, Javaid AY. Facial emotion recognition: A survey and real-world user experiences in mixed reality. Sensors (Basel) 2018;18:416.  Back to cited text no. 11
Adolphs R, Damasio H, Tranel D, Damasio AR. Cortical systems for the recognition of emotion in facial expressions. J Neurosci 1996;16:7678-87.  Back to cited text no. 12
Uekermann J, Daum I, Schlebusch P, Trenckmann U. Processing of affective stimuli in alcoholism. Cortex 2005;41:189-94.  Back to cited text no. 13
Benegal V. India: Alcohol and public health. Addiction 2005;100:1051-6.  Back to cited text no. 14
Bernardin F, Maheut-Bosser A, Paille F. Cognitive impairments in alcohol-dependent subjects. Front Psychiatry 2014;5:78.  Back to cited text no. 15
Dolan RJ. Emotion, cognition, and behavior. Science 2002;298:1191-4.  Back to cited text no. 16
Marlatt GA, Kosturn CF, Lang AR. Provocation to anger and opportunity for retaliation as determinants of alcohol consumption in social drinkers. J Abnorm Psychol 1975;84:652-9.  Back to cited text no. 17
Kornreich C, Blairy S, Philippot P, Hess U, Noël X, Streel E, et al. Deficits in recognition of emotional facial expression are still present in alcoholics after mid- to long-term abstinence. J Stud Alcohol 2001;62:533-42.  Back to cited text no. 18
Foisy ML, Kornreich C, Petiau C, Parez A, Hanak C, Verbanck P, et al. The impairement in emotional facial expression of recognition in the alcoholics: Are these deficits specific to emotional cues? Psychiatry Res 2007;150:33-41.  Back to cited text no. 19
Maurage P, Campanella S, Philippot P, Martin S, de Timary P. Face processing in chronic alcoholism: A specific deficit for emotional features. Alcohol Clin Exp Res 2008;32:600-6.  Back to cited text no. 20
Gur RC, Schroeder L, Turner T, McGrath C, Chan RM, Turetsky BI, et al. Brain activation during facial emotion processing. Neuroimage 2002;16:651-62.  Back to cited text no. 21
Bates ME, Bowden SC, Barry D. Neurocognitive impairment associated with alcohol use disorders: Implications for treatment. Exp Clin Psychopharmacol 2002;10:193-212.  Back to cited text no. 22
McClure EB. Systematic meta-analytic review of the sex differences in the facial expression processing and their development in the infants, children, and adolescents. Psychol Bull 2000;126:424-53.  Back to cited text no. 23
Mishra D, Singh HP. Kuppuswamy's socioeconomic status scale – A revision. Indian J Pediatr 2003;70:273-4.  Back to cited text no. 24
Stockwell T, Murphy D, Hodgson R. The severity of alcohol dependence questionnaire: Its use, reliability and validity. Br J Addict 1983;78:145-55.  Back to cited text no. 25
Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: The revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict 1989;84:1353-7.  Back to cited text no. 26
Passarelli M, Masini M, Bracco F, Petrosino M, Chiorri C. Development and validation of the Facial Expression Recognition Test (FERT). Psychol Assess 2018;30:1479-90.  Back to cited text no. 27
French MT, Maclean JC, Sindelar JL, Fang H. The morning after: Alcohol misuse and employment problems. Appl Econ 2011;43:2705-20.  Back to cited text no. 28
Frigerio E, Burt DM, Montagne B, Murray LK, Perrett DI. Facial affect perception in alcoholics. Psychiatry Res 2002;113:161-71.  Back to cited text no. 29
Hoffmann H, Kessler H, Eppel T, Rukavina S, Traue HC. Expression intensity, gender and facial emotion recognition: Women recognize only subtle facial emotions better than men. Acta Psychol (Amst) 2010;135:278-83.  Back to cited text no. 30
Donadon MF, Osório FD. The current alcohol dependence and the emotional facial expression recognition: In a cross-sectional study. Arch Clin Psychiatry 2017;44:56-62.  Back to cited text no. 31
Maurage P, Campanella S, Philippot P, Charest I, Martin S, de Timary P. Impaired emotional facial expression decoding in alcoholism is also present for emotional prosody and body postures. Alcohol Alcohol 2009;44:476-85.  Back to cited text no. 32
Carmona-Perera M, Clark L, Young L, Pérez-García M, Verdejo-García A. Impaired decoding of fear and disgust predicts utilitarian moral judgment in alcohol-dependent individuals. Alcohol Clin Exp Res 2014;38:179-85.  Back to cited text no. 33
O'Daly OG, Trick L, Scaife J, Marshall J, Ball D, Phillips ML, et al. Withdrawal-associated increases and decreases in functional neural connectivity associated with altered emotional regulation in alcoholism. Neuropsychopharmacology 2012;37:2267-76.  Back to cited text no. 34
Townshend JM, Duka T. Mixed emotions: Alcoholics' impairments in the recognition of specific emotional facial expressions. Neuropsychologia 2003;41:773-82.  Back to cited text no. 35
Kumar SG, Premarajan KC, Subitha L, Suguna E, Vinayagamoorthy P, Kumar V. Prevalence and pattern of alcohol consumption using alcohol use disorders identification test (AUDIT) in Rural Tamil Nadu, India. J Clin Diagn Res 2013;7:1637-9.  Back to cited text no. 36
Kornreich C, Blairy S, Philippot P, Dan B, Foisy M, Hess U, et al. Impairment in the emotional facial expression recognition in the alcoholism compared with the obsessive-compulsive disorder and the normal controls. Psychiatry Res 2001;102:235-48.  Back to cited text no. 37
Noble JM, Weimer LH. Neurologic complications of alcoholism. Continuum (Minneap Minn) 2014;20:624-41.  Back to cited text no. 38
Cservenka A, Fair DA, Nagel BJ. Emotional processing and brain activity in youth at high risk for alcoholism. Alcohol Clin Exp Res 2014;38:1912-23.  Back to cited text no. 39
Spadoni AD, Simmons AN, Yang TT, Tapert SF. Family history of alcohol use disorders and neuromaturation: A functional connectivity study with adolescents. Am J Drug Alcohol Abuse 2013;39:356-64.  Back to cited text no. 40
McCrady BS, Zucker RA, Molina BS, Ammon L, Ames GM, Longabaugh R. The role of social environmental influences on the development and resolution of alcohol problems. Alcohol Clin Exp Res 2006;30:688-99.  Back to cited text no. 41
Arackal BS, Benegal V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian J Psychiatry 2007;49:109-12.  Back to cited text no. 42
[PUBMED]  [Full text]  
Lieber CS. Medical disorders of alcoholism. N Engl J Med 1995;333:1058-65.  Back to cited text no. 43


  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]


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