Which of the following is a physical sign of alcohol dependence?

Hyperpigmented skin is indeed associated with alcohol dependence. This condition can occur due to several factors related to chronic alcohol consumption, including liver damage. The liver plays a crucial role in metabolizing alcohol, and when it becomes impaired (such as in alcoholic liver disease), it can cause a buildup of certain substances in the body. This buildup may lead to changes in skin pigmentation.

In contrast, increased energy levels and improved motor coordination are not signs of alcohol dependence; in fact, alcohol generally leads to decreased energy and impaired coordination. Weight gain can occur in some individuals as a result of lifestyle factors or metabolic changes due to alcohol use, but it is not a universal physical sign of alcohol dependence and can vary widely among individuals. Therefore, hyperpigmented skin stands out as a more consistent physical manifestation associated with alcohol dependency issues.