WorldWideScience

Sample records for alcohol amnestic disorder

  1. Amnestic disorders

    NARCIS (Netherlands)

    Kessels, R.P.C.; Savage, G.

    2015-01-01

    Amnestic disorders may involve deficits in the encoding or storage of information in memory, or in retrieval of information from memory. Etiologies vary and include traumatic brain injury, neurodegenerative disease, and psychiatric illness. Different forms of amnesia can be distinguished: anterograd

  2. Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Caley, Linda M.; Kramer, Charlotte; Robinson, Luther K.

    2005-01-01

    Fetal alcohol spectrum disorder (FASD) is a serious and widespread problem in this country. Positioned within the community with links to children, families, and healthcare systems, school nurses are a critical element in the prevention and treatment of those affected by fetal alcohol spectrum disorder. Although most school nurses are familiar…

  3. Alcohol use disorder

    Science.gov (United States)

    ... be a combination of a person's: Genes Environment Psychology, such as being impulsive or having low self- ... Examine you Ask about your medical and family history Ask about your alcohol use, and if you ...

  4. Alcohol Use Disorder

    Science.gov (United States)

    ... to approach that person. Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. ... that may be crowding your mind and causing stress. Acupuncture. With ... under the skin. Acupuncture may help reduce anxiety and depression. Many ...

  5. Bipolar Disorder and Alcoholism: Are They Related?

    Science.gov (United States)

    ... Is there a connection between bipolar disorder and alcoholism? Answers from Daniel K. Hall-Flavin, M.D. Bipolar disorder and alcoholism often occur together. Although the association between bipolar ...

  6. Alcohol Abuse and Other Psychiatric Disorders

    Science.gov (United States)

    ... other mental health disorders, including the effects of stress and gender differences on these disorders. With a fuller understanding of all the ways alcohol and other mental health disorders affect one another, researchers may be able to better ...

  7. ALCOHOL AND HEART RHYTHM DISORDERS

    Directory of Open Access Journals (Sweden)

    A. O. Yusupova

    2015-01-01

    Full Text Available Alcohol abuse and particularly extension of alcohol consumption in alcohol diseas increases the risk of cardiac arrhythmias development and aggravates existing arrhythmias. Patients do not always receive the necessary specific treatment due to lack of detection of the ethanol genesis of these arrhythmias. Management of patients with alcohol abuse and alcohol dependence, including its cardiac complications among other cardiac arrhythmias should use both antiarrhythmic and anti-alcohol drugs and antidepressants. Such issues as diagnosis and management of patients with alcohol-induced cardiac arrhythmias are presented.

  8. Eyeblink Classical Conditioning in Alcoholism and Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Cheng, Dominic T; Jacobson, Sandra W; Jacobson, Joseph L; Molteno, Christopher D; Stanton, Mark E; Desmond, John E

    2015-01-01

    Alcoholism is a debilitating disorder that can take a significant toll on health and professional and personal relationships. Excessive alcohol consumption can have a serious impact on both drinkers and developing fetuses, leading to long-term learning impairments. Decades of research in laboratory animals and humans have demonstrated the value of eyeblink classical conditioning (EBC) as a well-characterized model system to study the neural mechanisms underlying associative learning. Behavioral EBC studies in adults with alcohol use disorders and in children with fetal alcohol spectrum disorders report a clear learning deficit in these two patient populations, suggesting alcohol-related damage to the cerebellum and associated structures. Insight into the neural mechanisms underlying these learning impairments has largely stemmed from laboratory animal studies. In this mini-review, we present and discuss exemplary animal findings and data from patient and neuroimaging studies. An improved understanding of the neural mechanisms underlying learning deficits in EBC related to alcoholism and prenatal alcohol exposure has the potential to advance the diagnoses, treatment, and prevention of these and other pediatric and adult disorders.

  9. Mortality from alcohol consumption and alcohol use disorder

    DEFF Research Database (Denmark)

    Lundin, Andreas; Mortensen, Laust Hvas

    2015-01-01

    BACKGROUND: To examine the relationship of alcohol consumption, alcohol use disorder and mortality. METHOD: A cohort of 4316 male former Vietnam-era US army personnel participating in telephone survey and medical examination in middle age (mean age 38.3 years) in 1985-1986 was used. Alcohol...... consumption was reported in face-to-face interview on medical history and information on DSM-III alcohol use disorder was obtained from structured psychiatric interview (using the Diagnostic Interview Schedule). Mortality hazard during 15 years of follow-up was assessed with Cox proportional hazard regression...... modeling. RESULT: A total of 4251 individuals participated in the psychiatric interview and the medical history interview. Of these 998 were abstainers, and for the remaining 3253 we calculated weekly average consumption and monthly frequency of binge drinking. A total of 1988 had alcohol dependence, abuse...

  10. Slowing the Tide of Alcohol Use Disorders.

    Science.gov (United States)

    Chamsi-Pasha, Hassan; Chamsi-Pasha, Majed; Albar, Mohammed Ali

    2016-09-28

    Alcohol use disorders (AUDs)-a spectrum including at-risk drinking, alcohol abuse, dependence, and addiction-is a highly prevalent problem worldwide with a substantial economic impact. The toll of alcohol on individual health and healthcare systems is devastating. Alcohol is estimated to be the fifth leading risk factor for global disability-adjusted life years. Tackling the problem of AUD requires a comprehensive strategy that includes solid action on price, availability, and marketing of alcohol. Restricting or banning alcohol advertising may reduce exposure to the risk posed by alcohol at the individual and general population level. Warning labels about the cancer risks associated with drinking have a high degree of public support and may be an inexpensive and acceptable way to educate the public. Religiosity may reduce risk behaviors and contribute to health decision making related to alcohol use.

  11. Alcohol, nicotine, caffeine, and mental disorders

    OpenAIRE

    Crocq, Marc-Antoine

    2003-01-01

    Alcohol, nicotine, and caffeine are the most widely consumed psychotropic drugs worldwide. They are largely consumed by normal individuals, but their use is even more frequent in psychiatric patients, Thus, patients with schizophrenia tend to abuse all three substances. The interrelationships between depression and alcohol are complex. These drugs can all create dependence, as understood in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Alcohol abuse is cl...

  12. Neuroimaging and Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Norman, Andria L.; Crocker, Nicole; Mattson, Sarah N.; Riley, Edward P.

    2009-01-01

    The detrimental effects of prenatal alcohol exposure on the developing brain include structural brain anomalies as well as cognitive and behavioral deficits. Initial neuroimaging studies of fetal alcohol spectrum disorders (FASD) using magnetic resonance imaging (MRI) confirmed previous autopsy reports of overall reduction in brain volume and…

  13. [Diagnosis of fetal alcohol spectrum disorders].

    Science.gov (United States)

    van Wieringen, Hester; Letteboer, Tom G W; Pereira, Rob Rodrigues; de Ruiter, Sanne; Balemans, Walter A F; Lindhout, Dick

    2010-01-01

    Prenatal alcohol exposure may cause decreased growth of the child, congenital abnormalities, specific facial characteristics, and, most importantly, mental retardation and behavioural disorders, all known as fetal alcohol spectrum disorders (FASD). A significant number of pregnant women in the Netherlands drink alcohol, but the prevalence of FASD in our country is unknown. Repeated and high peak blood alcohol concentrations, for example in the case of binge drinking by the mother, result in more severe abnormalities; a safe limit for alcohol consumption in pregnancy cannot be defined. In 2007 and 2008, Dutch paediatricians reported a total of 56 diagnosed cases of FASD, mostly adopted and foster children. Possibly the condition has not always been diagnosed. Use of international guidelines for diagnosis by the medical profession may improve detection. The guidelines of the Canadian Public Health Agency provide a useful and generally accepted classification, with strict cut-off points to avoid overdiagnosis; attention should always be paid to the broad differential diagnosis.

  14. Understanding alcohol use disorders with neuroelectrophysiology.

    Science.gov (United States)

    Rangaswamy, Madhavi; Porjesz, Bernice

    2014-01-01

    Neurocognitive deficits associated with impairments in various brain regions and neural circuitries, particularly involving frontal lobes, have been associated with chronic alcoholism, as well as with a predisposition to develop alcohol use and related disorders (AUDs). AUD is a multifactorial disorder caused by complex interactions between behavioral, genetic, and environmental liabilities. Neuroelectrophysiologic techniques are instrumental in understanding brain and behavior relationships and have also proved very useful in evaluating the genetic diathesis of alcoholism. This chapter describes findings from neuroelectrophysiologic measures (electroencephalogram, event-related potentials, and event-related oscillations) related to acute and chronic effects of alcohol on the brain and those that reflect underlying deficits related to a predisposition to develop AUDs and related disorders. The utility of these measures as effective endophenotypes to identify and understand genes associated with brain electrophysiology, cognitive networks, and AUDs has also been discussed.

  15. Alcohol abuse and related disorders treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Yu. P. Sivolap

    2014-01-01

    Full Text Available Alcohol abuse and alcoholism are the leading causes of worse health and increased mortality rates. Excessive alcohol consumption is the third leading cause of the global burden of diseases and a leading factor for lower lifespan and higher mortality. Alcohol abuse decreases working capacity and efficiency and requires the increased cost of the treatment of alcohol-induced disorders, which entails serious economic losses. The unfavorable medical and social consequences of excessive alcohol use determine the importance of effective treatment for alcoholism. The goals of rational pharmacotherapy of alcohol dependence are to enhance GABA neurotransmission, to suppress glutamate neurotransmission, to act on serotonin neurotransmission, to correct water-electrolyte balance, and to compensate for thiamine deficiency. Alcoholism treatment consists of two steps: 1 the prevention and treatment of alcohol withdrawal syndrome and its complications (withdrawal convulsions and delirium alcoholicum; 2 antirecurrent (maintenance therapy. Benzodiazepines are the drugs of choice in alleviating alcohol withdrawal and preventing its convulsive attacks and delirium alcoholicum. Diazepam and chlordiazepoxide are most commonly used for this purpose; the safer drugs oxazepam and lorazepam are given to the elderly and patients with severe liver lesions. Anticonvulsants having normothymic properties, such as carbamazepine, valproic acid, topiramate, and lamotrigine, are a definite alternative to benzodiazepines. The traditional Russian clinical practice (clearance detoxification has not a scientific base or significant impact on alcohol withdrawal-related states in addicts. Relapse prevention and maintenance therapy for alcohol dependence are performed using disulfiram, acamprosate, and naltrexone; since 2013 the European Union member countries have been using, besides these agents, nalmefene that is being registered in Russia. Memantine and a number of other

  16. Kids with Bipolar Disorder More Likely to Abuse Drugs, Alcohol

    Science.gov (United States)

    ... html Kids With Bipolar Disorder More Likely to Abuse Drugs, Alcohol: Study And those who also have conduct disorder ... with bipolar disorder, the risk that they will abuse alcohol and drugs may increase as they get older, ...

  17. Neuromuscular disorders in chronic alcohol intoxication

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  18. Overview of Fetal Alcohol Spectrum Disorders for Mental Health Professionals

    OpenAIRE

    Clarke, Margaret E.; Gibbard, W. Benton

    2003-01-01

    Fetal Alcohol Spectrum Disorders (FASD), including Fetal Alcohol Syndrome (FAS) and related disorders such as Alcohol Related Neurodevelopmental Disorder (ARND) are the most common form of developmental disability and birth defects in the western world. Early recognition and accurate diagnosis by mental health professionals remains a key issue. This article reviews history, mechanisms of alcohol exposure, epidemiology, diagnosis and management of FASD.

  19. [The relationship between alcohol abuse and conduct disorders in adolescents].

    Science.gov (United States)

    Grechanyĭ, S V

    2013-01-01

    Fifty-two adolescents with different forms of conduct disorders (ICD-10 items F90-92 and F10.1) were examined using "The Nisonger Child Behavior Rating Form" ("NCBRF, TIQ version") and "The Adolescent Drug Abuse Diagnosis (ADAD)" (a "EvroADAD" version). Factor analysis of quantitative data revealed 3 factors attributed to main clinical types of alcohol abuse in adolescents: 1) alcohol abuse associated with personal disorders; 2) alcohol abuse associated with attention deficit hyperactivity disorder - ADHD; 3) alcohol abuse associated with the sensitivity within personal-neurotic reactions.

  20. Pemoline in attention deficit disorder and alcoholism: a case study.

    Science.gov (United States)

    Turnquist, K; Frances, R; Rosenfeld, W; Mobarak, A

    1983-05-01

    Diagnosis of attention deficit disorder in a 35-year-old man and treatment with pemoline substantially improved his response to alcoholism treatment and aftercare. The authors conclude that treatment of attention deficit disorder may aid in rehabilitation of alcoholic patients.

  1. Harm Reduction as "Continuum Care" in Alcohol Abuse Disorder

    OpenAIRE

    Icro Maremmani; Mauro Cibin; Pier Paolo Pani; Alessandro Rossi; Giuseppe Turchetti

    2015-01-01

    Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been consid...

  2. Alcohol consumption and symptoms as predictors for relapse of DSM-5 alcohol use disorder.

    NARCIS (Netherlands)

    Tuithof, Marlous; ten Have, Margreet; van den Brink, Wim; Vollebergh, Wilma; de Graaf, Ron

    2014-01-01

    Background: Alcohol consumption levels and alcohol use disorder (AUD) symptoms may serve as easily quantifiable markers for AUD relapse after remission and might help prevention workers identify at-risk individuals. We investigated the predictive value of alcohol consumption and AUD symptoms on rela

  3. Age of Alcohol Drinking Onset Precursors and the Mediation of Alcohol Disorder

    Science.gov (United States)

    Dooley, David; Prause, JoAnne; Ham-Rowbottom, Kathleen A.; Emptage, Nicholas

    2006-01-01

    This study explored early alcohol drinking onset (ADO), its precursors, and the mechanisms by which it leads to later alcohol disorder. Data came from the National Longitudinal Survey of Youth with ADO items from 1982 and 1983 and alcohol symptoms from 1989 and 1994. Drinking began earlier for respondents who were male, younger, non-Hispanic,…

  4. Amnestic mild cognitive impairment with low myocardial metaiodobenzylguanidine uptake

    Science.gov (United States)

    Sakakibara, Ryuji; Ogata, Takeshi; Haruta, Masayuki; Kishi, Masahiko; Tsuyusaki, Yohei; Tateno, Akihiko; Tateno, Fuyuki; Mouri, Takayuki

    2012-01-01

    Objectives: We reported cases of amnestic mild cognitive impairment (MCI) without the core clinical features of dementia with Lewy bodies (DLB) (dementia and spontaneous parkinsonism) with low uptake in 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. Methods: During a 3-year period at a university clinic, we had 254 patients with memory complaints; 106 men, 148 women; mean age 72.5 years (48-95 years). In all patients we performed neurologic examination; memory tests including the MMSE, ADAScog, FAB and additional WMS-R; and imaging tests including brain MRI, SPECT and MIBG scintigraphy. Results: The criteria of amnestic MCI were fulfilled in 44 patients; and 13 of them (30%) showed low MIBG uptake. They had the following: uniformly elderly, with an equal sex ratio, have relatively slow progression, preserved general cognitive function (MMSE 24.8/30). In addition to memory impairment, they commonly showed low frontal function by FAB (12.5/18) and some had mild visual hallucination (5). Other than memory disorder, they had autonomic disorder (nocturia in 7, constipation in 2, postural hypotension in one), REM sleep behavioral disorder (in 3) and occipital hypoperfusion by SPECT (in 5). Conclusion: This cohort of multidomain amnestic MCI cases may present with early stage DLB because of the presence of low MIBG uptake. Clinically, they commonly have low FAB, and may have visual hallucination, autonomic and sleep disorders. PMID:23383388

  5. Social Anxiety Disorders and Alcohol Abuse

    Science.gov (United States)

    ... Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Depression Bipolar Disorder Suicide and Prevention Stress Related Illnesses Myth-Conceptions Find ...

  6. A review of Indian research on co-occurring psychiatric disorders and alcohol use disorders

    Directory of Open Access Journals (Sweden)

    Shalini Singh

    2016-01-01

    Full Text Available Excessive use of alcohol has been identified as a major contributor to the global burden of disease. Excessive use of alcohol is a component cause of more than 200 disease and injury conditions. Alcohol use has been associated with increased morbidity and mortality across all regions of the world including South-East Asia. Epidemiological as well as clinic-based studies from Western countries have reported a high prevalence of co-occurrence of alcohol use disorder and psychiatric disorders. The research has established the clinical relevance of this comorbidity as it is often associated with poor treatment outcome, severe illness course, and high service utilization. Understandably, dual disorders in from of alcohol use disorders and psychiatric disorders present diagnostic and management challenge. The current article is aimed to review systematically the published Indian literature on comorbid alcohol use disorders and psychiatric disorders.

  7. Fetal Alcohol Spectrum Disorders (FASDs): Treatments

    Science.gov (United States)

    ... and the Public Identifying Alcohol-Exposed Pregnancies through Biomarkers International Research National Task Force on Fetal Alcohol ... manage high energy levels, inability to focus, or depression. Following are some examples of medications used to ...

  8. Psychiatry Trainees' Training and Experience in Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Eyal, Roy; O'Connor, Mary J.

    2011-01-01

    Background/Objective: Alcohol is a teratogen. Fetal alcohol spectrum disorders (FASDs) affect about 1% of live births, causing severe impairment. Individuals affected by FASDs are overrepresented in psychiatric settings. This study reports on the education and experience of psychiatry trainees in approaching FASDs. Method: Data were collected from…

  9. Predicting an Alcohol Use Disorder in Urban American Indian Youths

    Science.gov (United States)

    Stanley, Linda R.; Miller, Kimberly A.; Beauvais, Fred; Walker, Patricia Silk; Walker, R. Dale

    2014-01-01

    This study examines predictors of alcohol use disorders (AUDs) among an urban American Indian cohort who were followed from approximately age 11 to age 20. Approximately 27% of the sample had a lifetime diagnosis of alcohol abuse or dependence. The results indicated that externalizing, but not internalizing, behaviors, family conflict, and school…

  10. Alcohol Use Disorders, Use and Abuse | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Alcohol Use and Abuse Alcohol Use Disorders Past Issues / Winter 2013 Table of Contents NIAAA guidelines for low-risk drinking for alcohol use disorders call for men to drink no ...

  11. Childhood ADHD and conduct disorder as independent predictors of male alcohol dependence at age 40

    DEFF Research Database (Denmark)

    Knop, Joachim; Penick, Elizabeth C; Nickel, Elizabeth J;

    2009-01-01

    The Danish Longitudinal Study on Alcoholism was designed to identify antecedent predictors of adult male alcoholism. The influence of premorbid behaviors consistent with childhood conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) on the development of alcohol misuse...

  12. Prevention of Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Floyd, R. Louise; Weber, Mary Kate; Denny, Clark; O'Connor, Mary J.

    2009-01-01

    Alcohol use among women of childbearing age is a leading, preventable cause of birth defects and developmental disabilities in the United States. Although most women reduce their alcohol use upon pregnancy recognition, some women report drinking during pregnancy and others may continue to drink prior to realizing they are pregnant. These findings…

  13. The Epidemiology of Alcohol Use and Alcohol Use Disorders among Young People in Northern Tanzania.

    Directory of Open Access Journals (Sweden)

    Joel M Francis

    Full Text Available Alcohol use is a global public health problem, including as a risk factor for HIV infection, but few data are available on the epidemiology of alcohol use and alcohol use disorders (AUD among young people in sub-Saharan Africa.We conducted a cross-sectional survey among 4 groups of young people aged 15-24 years old (secondary school students, college/university students, employees of local industries and casual labourers in two regions (Kilimanjaro and Mwanza of northern Tanzania. Using a multistage stratified random sampling strategy, we collected information on demographics, alcohol use, and behavioural factors. We screened severity of alcohol use using the Alcohol Use Disorder Identification Test (AUDIT and estimated the quantity and frequency of alcohol consumption using the timeline-follow-back-calendar (TLFB method.A total of 1954 young people were surveyed. The prevalence of reported alcohol use was higher among males (47-70% ever users and 20-45% current users than females (24-54% ever users and 12-47% current users. Prevalence of use was substantially higher in Kilimanjaro than Mwanza region. In both regions, participants reported high exposure to alcohol advertisements, and wide alcohol availability. College students reported the highest prevalence of current alcohol use (45% among males; 26% among females and of heavy episodic drinking (71% among males; 27% among females followed by casual labourers. Males were more likely to have AUD (an AUDIT score ≥8 than females, with 11-28% of males screening positive for AUD. Alcohol use was associated with male gender, being in a relationship, greater disposable income, non-Muslim religion and a higher number of sexual partners.Alcohol use is a significant problem among young people in northern Tanzania. There is an urgent need to develop, pilot and deliver interventions to help young people delay initiation and reduce levels of harmful drinking, particularly among college students and casual

  14. Facts About Fetal Alcohol Spectrum Disorders (FASDs)

    Science.gov (United States)

    ... types of alcohol are equally harmful, including all wines and beer. To prevent FASDs, a woman should ... medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches. No ...

  15. Alcohol Use Disorders: Implications for the Clinical Toxicologist

    Directory of Open Access Journals (Sweden)

    Michael McDonough

    2015-03-01

    Full Text Available Alcohol use disorders (AUDs are a health problem of high prevalence in most communities and such problems account for 5% of the total burden of disease worldwide. Clinical toxicologists are commonly required to treat patients having AUDs and associated drug/alcohol-related harm. There have been recent changes to some of the diagnostic criteria (notably in DSM V relevant to AUDs, with older terms “alcohol abuse” and “alcohol dependence” no longer being classified. AUDs may sometimes not be clearly recognizable and use of evidence-based screening interventions can help identify such conditions and lead to effective brief interventions (e.g. SBIRT programs in emergency departments. AUDs are viewed as chronic disorders of alcohol consumption occurring across a spectrum of severity. While most AUDs are mild to moderate in severity and usually self-limiting conditions, more severe presentations are more commonly encountered by physicians in emergency settings. Hence, clinical toxicologists are more likely to see patients within the more severe form of disorder, at end of the spectrum of AUDs. Among this group of patients, multi-morbidity and particularly high mortality risk exists, and thus they usually require management collaboration with specialist services. Patients with AUDs are most likely to be recognized by a clinical toxicologist in the following scenarios: following acute heavy alcohol ingestion and subsequently developing acute alcohol intoxication (ethanol toxidrome, following accidental or intentional drug overdosage where alcohol has also been consumed, following acute alcohol consumption that has been associated with behavioral risk-taking and/or self-harming (e.g. poisoning, envenomation, etc., when alcohol withdrawal reactions are severe requiring hospitalization and possibly following an adverse drug reaction.

  16. Screening for alcohol use disorders in HIV patients

    Directory of Open Access Journals (Sweden)

    C Ward

    2012-11-01

    Full Text Available Many chronic health conditions have been linked to alcohol consumption, as well as excess morbidity, mortality and an increased financial burden on the National Health Service (NHS. The British HIV Association (BHIVA recommends that HIV patients be asked about alcohol due to its effect on adherence to antiretroviral therapy. National Institute of Health and Clinical Excellence (NICE guidelines recommend screening for alcohol use disorders in patients attending genitourinary medicine (GUM clinics. In this study we looked at the use of a screening tool for alcohol use disorders in HIV patients in a metropolitan city. We assessed HIV patients over a 6-month period for alcohol use disorders using the AUDIT-C questionnaire. Patients with a score >4 were identified as higher risk and provided with brief advice about alcohol and offered written information and support. Demographic data was collected along with hepatitis B and C status, information on sexually transmitted infection (STI testing and diagnosis. 352 patients were reviewed with a mean age of 41. 297 (84.4% patients were male, 235 (66.8% were white British and 251 (71.3% were men who have sex with men (MSM. 277 (78.7% patients were on antiretroviral therapy with 254 (91.7% of these having an undetectable viral load. Alcohol use disorders were assessed using the AUDIT-C score in 332 (94.3% patients with no patient declining assessment. 166 (50% patients had an AUDIT-C score >4 signifying higher risk. Alcohol advice was provided to 161 (97% of these patients and a Drink Smart guide offering advice on alcohol self help offered to 103 (64% patients and accepted by 45 (43.7%. An opportunistic STI screen was offered to 258 (73.3% patients on that visit in line with best practice guidelines and was accepted by 83 (32.2%. 25 infections were found in 20 patients, of which 13 (65% had AUDIT-C scores >4. There were 8 active hepatitis C co-infected patients of which 3 had an AUDIT-C score >4 and 12

  17. [Pharmacological therapies for alcohol use disorder in Japan].

    Science.gov (United States)

    Yumoto, Yosuke; Higuchi, Susumu

    2015-09-01

    We reviewed the available pharmacological therapies for alcohol use disorder in Japan. For treatment of withdrawal delirium, therapists prefer to use antipsychotic drugs rather than benzodiazepines, which is different from other countries. Japan does not have any substantial treatment guidelines for withdrawal delirium. Therefore, so treatment strategies matching the environment of each facility need to be formulated. Moreover, current choices for prescribing anti-alcoholic drugs to cope with alcohol craving are limited to drugs such as cyanamide and disulfiram. However, the use of acamprosate has recently begun and a clinical trial for nalmefene is starting soon. We anticipate that these newer pharmacological therapies will contribute to better treatment of alcohol use disorder also in Japan.

  18. Beverage preference and risk of alcohol-use disorders

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Knop, Joachim; Mortensen, Erik Lykke;

    2008-01-01

    OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data...... had a risk of 3.1 (CI: 1.8-5.4), whereas those whose total alcohol intake comprised more than 35% wine had a risk of 0.8 (CI: 0.3-2.1). Consuming more than 35% beer increased the risk of AUD for women, whereas the percentage of distilled spirits intake did not influence the risk of AUD for either...... on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women...

  19. Physical activity and risk of alcohol use disorders

    DEFF Research Database (Denmark)

    Kristiansen Ejsing, Louise; Becker, Ulrik; Tolstrup, Janne;

    2015-01-01

    Aims: To examine the effect of physical activity on risk of developing alcohol use disorders in a large prospective cohortstudy with focus on leisure-time physical activity. Methods: Data came from the four examinations of the Copenhagen City HeartStudy (CCHS), performed in 1976–1978, 1981......–1983, 1991–1994 and 2001–2003. Information on physical activity (classified asModerate/high, low or sedentary) and covariates was obtained through self-administered questionnaires, and information on alcohol usedisorders was obtained from the Danish Hospital Discharge Register, the Danish Psychiatric Central...... increased risk of developing alcohol use disorder (Hazard ratios for men 1.64; 95% CI 1.29–2.10 and women 1.45; 1.01–2.09) in individuals with a sedentary leisure-time physical activity, compared with a moderate to high level.However, when stratifying by presence of other psychiatric disorders...

  20. Alcohol use disorders and the course of depressive and anxiety disorders

    NARCIS (Netherlands)

    Boschloo, Lynn; Vogelzangs, Nicole; van den Brink, Wim; Smit, Johannes H.; Veltman, Dick J.; Beekman, Aartjan T. F.; Penninx, Brenda

    2012-01-01

    Background Inconsistent findings have been reported on the role of comorbid alcohol use disorders as risk factors for a persistent course of depressive and anxiety disorders. Aims To determine whether the course of depressive and/or anxiety disorders is conditional on the type (abuse or dependence)

  1. Serum alcohol dehydrogenase levels in patients with mental disorders.

    Science.gov (United States)

    Kravos, Matej; Malesic, Ivan; Levanic, Suzana

    2005-11-01

    Alcohol dehydrogenase (ADH) was assessed in 81 patients admitted to hospital for treatment for alcohol dependence with or without liver cirrhosis, 20 patients with bipolar disorder treated with lithium carbonate and 41 patients with various mental disorders treated with psychopharmacologic agents. Testing the hypothesis of the arithmetic mean showed that in alcohol dependents the arithmetic mean of ADH activity (12.19 nkat/l+/-5.61) differs significantly from that in healthy subjects (4.45 nkat/l+/-2.31) and in the group with ethanol poisoning (6.24 nkat/l+/-3.65) there is none. In the group with bipolar disorder, treated with lithium (7.39 nkat/l+/-3.11) and, in the group of patients treated with psychiatric drugs because of various mental disorders (7.79 nkat/l+/-8.51), the differences are statistically significant. In our opinion, assessing ADH activity in the sera of alcohol dependents could be an additional marker advantageous to the diagnostics, course and monitoring of therapy in such patients. In the groups of patients with mental disorders treated with psychotropic drugs, the increased ADH activity was found to be a more sensitive marker for the detection of drug hepatotoxicity.

  2. [Comorbidity of panic disorder and alcoholism in a sample of 100 alcoholic patients].

    Science.gov (United States)

    Segui, J; Salvador, L; Canet, J; Herrera, C; Aragón, C

    1994-01-01

    Among one hundred patients with alcohol dependence (DSM-III-R) studied in a drug abuse center in the "Bajo Llobregat" area (Barcelona industrial belt it was detected that 27% had life time rate of panic disorder. The age of onset of alcoholism was earlier than the one for panic disorder. In 78.8% of these patients alcoholismo appeared first. 70.4% refer worsening of the panic attacks when drinking large amounts of alcohol. Patients with Panic Disorder: a) are younger (p < 0.05); b) have attended school longer and have higher education (p < 0.01); c) have more alcoholism family history (p < 0.05); d) have more major depressive disorders (0.05) and dysthimic disorder (p < 0.01); e) Worse social functioning according to the GAS (p < 0.01); f) higher score for the Psychological disorders Scale (p < 0.001) and a lower performance at work (p < 0.001) measured by the ASI. The clinical significance of these findings is discussed.

  3. The contribution of parental alcohol use disorders and other psychiatric illness to the risk of alcohol use disorders in the offspring

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Manzardo, Ann M; Knop, Joachim;

    2011-01-01

    Few population-based studies have investigated associations between parental history of alcoholism and the risk of alcoholism in offspring. The aim was to investigate in a large cohort the risk of alcohol use disorders (AUD) in the offspring of parents with or without AUD and with or without...... hospitalization for other psychiatric disorder (OPD)....

  4. Acupuncture for Alcohol Use Disorder: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Na Young Shin

    2017-01-01

    Full Text Available Empirical research has produced mixed results regarding the effects of acupuncture on the treatment of alcohol use disorder in humans. Few studies have provided a comprehensive review or a systematic overview of the magnitude of the treatment effect of acupuncture on alcoholism. This study investigated the effects of acupuncture on alcohol-related symptoms and behaviors in patients with this disorder. The PubMed database was searched until 23 August 2016, and reference lists from review studies were also reviewed. Seventeen studies were identified for a full-text inspection, and seven (243 patients of these met our inclusion criteria. The outcomes assessed at the last posttreatment point and any available follow-up data were extracted from each of the studies. Our meta-analysis demonstrated that an acupuncture intervention had a stronger effect on reducing alcohol-related symptoms and behaviors than did the control intervention (g=0.67. A beneficial but weak effect of acupuncture treatment was also found in the follow-up data (g=0.29. Although our analysis showed a significant difference between acupuncture and the control intervention in patients with alcohol use disorder, this meta-analysis is limited by the small number of studies included. Thus, a larger cohort study is required to provide a firm conclusion.

  5. Acupuncture for Alcohol Use Disorder: A Meta-Analysis

    Science.gov (United States)

    Shin, Na Young; Lim, Young Jin

    2017-01-01

    Empirical research has produced mixed results regarding the effects of acupuncture on the treatment of alcohol use disorder in humans. Few studies have provided a comprehensive review or a systematic overview of the magnitude of the treatment effect of acupuncture on alcoholism. This study investigated the effects of acupuncture on alcohol-related symptoms and behaviors in patients with this disorder. The PubMed database was searched until 23 August 2016, and reference lists from review studies were also reviewed. Seventeen studies were identified for a full-text inspection, and seven (243 patients) of these met our inclusion criteria. The outcomes assessed at the last posttreatment point and any available follow-up data were extracted from each of the studies. Our meta-analysis demonstrated that an acupuncture intervention had a stronger effect on reducing alcohol-related symptoms and behaviors than did the control intervention (g = 0.67). A beneficial but weak effect of acupuncture treatment was also found in the follow-up data (g = 0.29). Although our analysis showed a significant difference between acupuncture and the control intervention in patients with alcohol use disorder, this meta-analysis is limited by the small number of studies included. Thus, a larger cohort study is required to provide a firm conclusion. PMID:28167975

  6. Prevention of Fetal Alcohol Spectrum Disorders: Educational Needs in Academia

    Science.gov (United States)

    Brems, Christiane; Boschma-Wynn, Rachel V.; Dewane, Sarah L.; Edwards, Alexandra; Robinson, Rebecca Volino

    2011-01-01

    As many as 4.5 live births per 1000 are affected by fetal alcohol spectrum disorders (FASDs), preventable birth defects with life-long consequences. Prevention of FASDs is gaining in importance, and recruitment of diverse disciplines in delivering prevention to women of childbearing age is essential. This needs assessment explored to what extent…

  7. Shaping the Future for Children with Foetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Blackburn, Carolyn; Carpenter, Barry; Egerton, Jo

    2010-01-01

    This article describes work undertaken in connection with an ongoing research project funded by the Training and Development Agency for Schools. It illustrates the educational implications of foetal alcohol spectrum disorders (FASD) and its implications for the educational workforce in seeking to meet the needs of those children who are affected.

  8. Special Education of Children with Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Popova, Svetlana; Lange, Shannon; Burd, Larry; Nam, Seungree; Rehm, Jürgen

    2016-01-01

    The current study aimed to estimate the cost associated with special education among children (5 to 14 years) with Fetal Alcohol Spectrum Disorder (FASD) in elementary and middle school by sex, age group, and province and territory in Canada. It was estimated that there were 6,520 students with FASD receiving special education in Canada in…

  9. Fetal Alcohol Spectrum Disorders and the Criminal Justice System

    Science.gov (United States)

    Fast, Diane K.; Conry, Julianne

    2009-01-01

    The life-long neurological impairments found in people with fetal alcohol spectrum disorders (FASDs), including learning disabilities, impulsivity, hyperactivity, social ineptness, and poor judgment, can increase susceptibility to victimization and involvement in the criminal justice system (CJS). Individuals with FASDs become involved in the CJS…

  10. Postsecondary Educational Experiences of Adults with Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Duquette, Cheryll; Orders, Shari

    2013-01-01

    The postsecondary experiences of adults diagnosed with Fetal Alcohol Spectrum Disorder (FASD) were examined in this qualitative research. Tinto's Student Integration Model (SIM) (1975, 1997) provided the theoretical framework that guided the study. Tinto posits that the interplay of background characteristics, academic integration, and social…

  11. "Family Matters:" Fetal Alcohol Spectrum Disorders and the Family

    Science.gov (United States)

    Olson, Heather Carmichael; Oti, Rosalind; Gelo, Julie; Beck, Sharon

    2009-01-01

    Information about "family matters" is vital to developing targeted interventions, reducing placement disruption, and enhancing outcome in fetal alcohol spectrum disorders (FASD). The quality of the caregiving environment and family function are associated with long-term outcome in natural history study of individuals with FASD. This article…

  12. Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Jong, C.A.J. de; Buitelaar, J.; Verkes, R.J.

    2015-01-01

    INTRODUCTION: Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized

  13. Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Jong, C.A.J. de; Buitelaar, J.K.; Verkes, R.J.

    2015-01-01

    Introduction Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized

  14. Embryonic alcohol exposure: Towards the development of a zebrafish model of fetal alcohol spectrum disorders.

    Science.gov (United States)

    Gerlai, Robert

    2015-11-01

    Fetal alcohol spectrum disorder (FASD) is a devastating disease of the brain caused by exposure to alcohol during prenatal development. Its prevalence exceeds 1%. The majority of FASD cases represent the milder forms of the disease which often remain undiagnosed, and even when diagnosed treatment options for the patient are limited due to lack of information about the mechanisms that underlie the disease. The zebrafish has been proposed as a model organism for exploring the mechanisms of FASD. Our laboratory has been studying the effects of low doses of alcohol during embryonic development in the zebrafish. This review discusses the methods of alcohol exposure, its effects on behavioral performance including social behavior and learning, and the potential underlying biological mechanisms in zebrafish. It is based upon a recent keynote address delivered by the author, and it focuses on findings obtained mainly in his own laboratory. It paints a promising future of this small vertebrate in FASD research.

  15. Autism Spectrum Disorder and Fetal Alcohol Spectrum Disorder. Part I: A Comparison of Parenting Stress

    Science.gov (United States)

    Watson, Shelley L.; Coons, Kelly D.; Hayes, Stephanie A.

    2013-01-01

    Background: There is a long history of research on parents of children with disabilities, but to the authors' knowledge, no study has compared the stress of parents of children with fetal alcohol spectrum disorder (FASD) to parents of children with autism spectrum disorder (ASD). Method: Twenty-five parents of children with ASD and 25 parents of…

  16. [Comorbidity of alcohol dependence with other psychiatric disorders. Part I. Epidemiology of dual diagnosis].

    Science.gov (United States)

    Klimkiewicz, Anna; Klimkiewicz, Jakub; Jakubczyk, Andrzej; Kieres-Salomoński, Ilona; Wojnar, Marcin

    2015-01-01

    The paper is a review of the literature on the comorbidity of alcohol dependence with other psychiatric disorders. A condition when alcohol dependence is accompanied by another mental disorder is much more common than it is commonly believed. It is estimated that more than one third of people diagnosed with mental disorders, abuses or is dependent on psychoactive substances, especially alcohol; among alcohol-dependent patients 37% suffer from other mental disorders. Alcohol dependence is associated with increased risk of mood disorders - more than three times higher, depression - almost four times higher, bipolar disorder - more than six times higher, anxiety disorders in general - more than twice, generalized anxiety disorder - more than four times higher, panic disorders - almost double, posttraumatic stress disorder - more than twice. Underestimating of comorbidity is an important problem during treatment of such population of patients. Social skills training can improve a stress management and decrease alcohol and drug use among dual diagnosed patients.

  17. Fetal alcohol-spectrum disorders: identifying at-risk mothers

    Directory of Open Access Journals (Sweden)

    Montag AC

    2016-07-01

    Full Text Available Annika C Montag Department of Pediatrics, Division of Dysmorphology and Teratology, University of California San Diego, San Diego, CA, USA Abstract: Fetal alcohol-spectrum disorders (FASDs are a collection of physical and neuro­behavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children. Keywords: fetal alcohol-spectrum disorder (FASD, alcohol, pregnancy, screening, biomarkers, SBIRT

  18. Alcohol and Substance Use Disorders in DSM-5

    Directory of Open Access Journals (Sweden)

    Gulcan Gulec

    2015-12-01

    Full Text Available When we compare the categories about alcohol, and substance-related disorders in DSM-IV and DSM-5, the new category, named addictive disorders is the most striking change. Only gambling disorder have been identified currently in this category. This may be the most remarkable change among the changes in the DSM-5. Because the expansion of the existing diagnostic criteria may cause the assessment of and lsquo;normal behavior' as a disorder. Additionally, withdrawal of caffeine and cannabis are defined in the DSM-5. Disorders collected under the title of substance-related disorders in the DSM-IV were collected under the name of substance-related and addictive disorders in the DSM-5. Specific criterias for substance abuse and substance addiction have been combined into the name of "substance use disorders". In substance abuse, "experienced legal problems" criteria was removed and "a strong desire or urge or craving for substance use" criteria has been introduced. Henceforth, substance abuse is defined as a mild form of substance use disorders in the DSM-5. A change in the prevalence of substance use disorders should be investigated by the new researches.

  19. Alcohol use disorder: pathophysiology, effects, and pharmacologic options for treatment

    Directory of Open Access Journals (Sweden)

    Wackernah RC

    2014-01-01

    Full Text Available Robin C Wackernah,1 Matthew J Minnick,1 Peter Clapp2 1Department of Pharmacy Practice, 2Department of Pharmaceutical Sciences, School of Pharmacy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO, USA Abstract: Alcohol use disorders (AUD continue to be a concerning health issue worldwide. Harmful alcohol use leads to 2.5 million deaths annually worldwide. Multiple options exist for the management of dependence on alcohol, not all of which are approved by drug-regulating agencies. Current practice in treating AUD does not reflect the diversity of pharmacologic options that have potential to provide benefit, and guidance for clinicians is limited. Few medications are approved for treatment of AUD, and these have exhibited small and/or inconsistent effects in broad patient populations with diverse drinking patterns. The need for continued research into the treatment of this disease is evident in order to provide patients with more specific and effective options. This review describes the neurobiological mechanisms of AUD that are amenable to treatment and drug therapies that target pathophysiological conditions of AUD to reduce drinking. In addition, current literature on pharmacologic (both approved and non-approved treatment options for AUD offered in the United States and elsewhere are reviewed. The aim is to inform clinicians regarding the options for alcohol abuse treatment, keeping in mind that not all treatments are completely successful in reducing craving or heavy drinking or increasing abstinence. Keywords: abuse, alcohol, alcoholism, craving, dependence, relapse

  20. Fetal Alcohol Spectrum Disorders: an overview from the glia perspective

    Directory of Open Access Journals (Sweden)

    Clare J. Wilhelm

    2016-01-01

    Full Text Available Alcohol consumption during pregnancy can produce a variety of central nervous system abnormalities in the offspring resulting in a broad spectrum of cognitive and behavioral impairments that constitute the most severe and long-lasting effects observed in fetal alcohol spectrum disorders (FASD. Alcohol-induced abnormalities in glial cells have been suspected of contributing to the adverse effects of alcohol on the developing brain for several years, although much research still needs to be done to causally link the effects of alcohol on specific brain structures and behavior to alterations in glial cell development and function. Damage to radial glia due to prenatal alcohol exposure may underlie observations of abnormal neuronal and glial migration in humans with Fetal Alcohol Syndrome (FAS, as well as primate and rodent models of FAS. A reduction in cell number and altered development has been reported for several glial cell types in animal models of FAS. In utero alcohol exposure can cause microencephaly when alcohol exposure occurs during the brain growth spurt a period characterized by rapid astrocyte proliferation and maturation; since astrocytes are the most abundant cells in the brain, microenchephaly may be caused by reduced astrocyte proliferation or survival, as observed in in vitro and in vivo studies. Delayed oligodendrocyte development and increased oligodendrocyte precursor apoptosis has also been reported in experimental models of FASD, which may be linked to altered myelination/white matter integrity found in FASD children. Children with FAS exhibit hypoplasia of the corpus callosum and anterior commissure, two areas requiring guidance from glial cells and proper maturation of oligodendrocytes. Finally, developmental alcohol exposure disrupts microglial function and induces microglial apoptosis; given the role of microglia in synaptic pruning during brain development, the effects of alcohol on microglia may be involved in the

  1. Biomarker-Based Approaches for Assessing Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    Onni Niemelä

    2016-01-01

    Full Text Available Although alcohol use disorders rank among the leading public health problems worldwide, hazardous drinking practices and associated morbidity continue to remain underdiagnosed. It is postulated here that a more systematic use of biomarkers improves the detection of the specific role of alcohol abuse behind poor health. Interventions should be initiated by obtaining information on the actual amounts of recent alcohol consumption through questionnaires and measurements of ethanol and its specific metabolites, such as ethyl glucuronide. Carbohydrate-deficient transferrin is a valuable tool for assessing chronic heavy drinking. Activities of common liver enzymes can be used for screening ethanol-induced liver dysfunction and to provide information on the risk of co-morbidities including insulin resistance, metabolic syndrome and vascular diseases. Conventional biomarkers supplemented with indices of immune activation and fibrogenesis can help to assess the severity and prognosis of ethanol-induced tissue damage. Many ethanol-sensitive biomarkers respond to the status of oxidative stress, and their levels are modulated by factors of life style, including weight gain, physical exercise or coffee consumption in an age- and gender-dependent manner. Therefore, further attention should be paid to defining safe limits of ethanol intake in various demographic categories and establishing common reference intervals for biomarkers of alcohol use disorders.

  2. Harm Reduction as "Continuum Care" in Alcohol Abuse Disorder.

    Science.gov (United States)

    Maremmani, Icro; Cibin, Mauro; Pani, Pier Paolo; Rossi, Alessandro; Turchetti, Giuseppe

    2015-11-19

    Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.

  3. Social Network as predictor for onset of alcohol use disorder

    DEFF Research Database (Denmark)

    Mikkelsen, Stine Schou; Tolstrup, Janne; Becker, Ulrik;

    2015-01-01

    , were separated or divorced or widowers had a higher risk of developing alcohol use disorder: HR among men living alone vs. men not living alone was 2.28 (95% CI: 1.59–3.27), and HR among separated/divorced men vs. married men was 2.55 (95% CI: 1.33–4.89). No such associations were found among women...

  4. Beverage preference and risk of alcohol-use disorders

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Knop, Joachim; Mortensen, Erik Lykke

    2008-01-01

    on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women......OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data...... drinking 15-21 drinks per week of only beer and distilled spirits had a risk of 15.8 (95% confidence interval [CI]: 7.8-33.3) for AUD, whereas those whose total alcohol intake comprised more than 35% wine had a risk of 2.0 (CI: 0.7-5.2). Men drinking 15-21 drinks per week of only beer and distilled spirits...

  5. Fetal alcohol-spectrum disorders: identifying at-risk mothers.

    Science.gov (United States)

    Montag, Annika C

    2016-01-01

    Fetal alcohol-spectrum disorders (FASDs) are a collection of physical and neurobehavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children.

  6. Fetal Alcohol Spectrum Disorder: Potential Role of Endocannabinoids Signaling

    Directory of Open Access Journals (Sweden)

    Balapal S. Basavarajappa

    2015-10-01

    Full Text Available One of the unique features of prenatal alcohol exposure in humans is impaired cognitive and behavioral function resulting from damage to the central nervous system (CNS, which leads to a spectrum of impairments referred to as fetal alcohol spectrum disorder (FASD. Human FASD phenotypes can be reproduced in the rodent CNS following prenatal ethanol exposure. Several mechanisms are expected to contribute to the detrimental effects of prenatal alcohol exposure on the developing fetus, particularly in the developing CNS. These mechanisms may act simultaneously or consecutively and differ among a variety of cell types at specific developmental stages in particular brain regions. Studies have identified numerous potential mechanisms through which alcohol can act on the fetus. Among these mechanisms are increased oxidative stress, mitochondrial damage, interference with the activity of growth factors, glia cells, cell adhesion molecules, gene expression during CNS development and impaired function of signaling molecules involved in neuronal communication and circuit formation. These alcohol-induced deficits result in long-lasting abnormalities in neuronal plasticity and learning and memory and can explain many of the neurobehavioral abnormalities found in FASD. In this review, the author discusses the mechanisms that are associated with FASD and provides a current status on the endocannabinoid system in the development of FASD.

  7. Fetal alcohol-spectrum disorders: identifying at-risk mothers

    Science.gov (United States)

    Montag, Annika C

    2016-01-01

    Fetal alcohol-spectrum disorders (FASDs) are a collection of physical and neurobehavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children. PMID:27499649

  8. Drinking Distilled. Onset, course and treatment of alcohol use disorders in the general population

    NARCIS (Netherlands)

    Tuithof, M.

    2015-01-01

    Although most people in Western society drink alcohol and regard this to be harmless and normal, some people drink excessively and develop an alcohol use disorder. This thesis examined the onset, course and treatment of alcohol use disorders in the general population using 3-year longitudinal data f

  9. Practitioner Review: Adolescent Alcohol Use Disorders--Assessment and Treatment Issues

    Science.gov (United States)

    Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan

    2008-01-01

    Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…

  10. Assessment of Alcohol Use Disorders among Court-Mandated DWI Offenders

    Science.gov (United States)

    Stasiewicz, Paul R.; Nochajski, Thomas H.; Homish, D. Lynn

    2007-01-01

    Convicted DWI offenders (N = 549) were assessed for alcohol use disorders. Repeat offenders had twice the rate of both lifetime and current alcohol use disorders compared with 1st-time offenders. Guidelines for determining alcohol problems in DWI offenders are recommended.

  11. Alcoholism Risk Reduction in France: A Modernised Approach Related to Alcohol Misuse Disorders

    Directory of Open Access Journals (Sweden)

    Georges Brousse

    2014-11-01

    Full Text Available During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages relative to controlled consumption were difficult to transmit because of the importance of this product in the culture of the country. In addition, methods of treatment of alcoholism rested on the dogma of abstinence. Several factors have recently led to an evolution in the treatment of alcohol use disorders integrating the reduction of consumption in strategies. Strategies for reducing consumption should aim for consumption below recommended thresholds (two drinks per day for women, three for the men or, at least, in that direction. It must also be supported by pharmacotherapy and psychotherapy, which offer possibilities. Failure to manage reduction will allow the goals to be revisited and to reconsider abstinence. Finally this evolution or revolution is a new paradigm carried in particular by a pragmatic approach of the disease and new treatments. The aims of this article are to give elements of comprehension relating to the evolution of the practices in France in prevention and treatment of alcohol use disorders and in particular with regard to the reduction of consumption.

  12. [Diagnostic criteria for fetal alcohol syndrome and fetal alcohol spectrum disorders].

    Science.gov (United States)

    Evrard, Sergio Gustavo

    2010-02-01

    Prenatal ethanol exposure, in our professional practice, is an almost neglected condition as an important etiological factor for the induction of a wide spectrum of neuropsychiatric diseases that may appear during childhood, adolescence or adulthood. Children born to alcoholic mothers may show a profound mental retardation ranging to an apparent normality, and extending through epilepsy, attention deficit disorders with or without hyperactivity, autism and pervasive developmental disorders, and different types of learning disorders. When adolescents, they may develop different kinds of personality disorders and substance abuse disorders. Finally, in adulthood, they may suffer from different types of affective and psychotic disorders, among others. A great number of those children may not develop their full mental and social potentiality as free individuals. They usually have diverse types of cognitive, attentional, mnemonic and affective impairments. Not infrequently, they engage in antisocial behaviors or have school or work troubles. In this work, the present clinical classifications and diagnostic criteria for the disorders emerging from a prenatal ethanol exposure are reviewed in order to call attention to the medical pediatric and neuropsychiatric community about the increasingly, although underdiagnosed, frequency of these disorders in our country.

  13. Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders.

    Science.gov (United States)

    Hammond, Christopher J; Niciu, Mark J; Drew, Shannon; Arias, Albert J

    2015-04-01

    Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

  14. Female alcoholics: electrocardiographic changes and associated metabolic and electrolytic disorders

    Directory of Open Access Journals (Sweden)

    Borini Paulo

    2003-01-01

    Full Text Available OBJECTIVE: To identify the electrocardiographic changes and their associations with metabolic and electrolytic changes in female alcoholics. METHODS: The study comprised 44 female alcoholics with no apparent physical disorder. They underwent the following examinations: conventional electrocardiography; serologic tests for syphilis, Chagas' disease, and hepatitis B and C viruses; urinary pregnancy testing; hematimetric analysis; biochemical measurements of albumin, fibrinogen, fasting and postprandial glycemias, lipids, hepatic enzymes, and markers for tissue necrosis and inflammation. RESULTS: Some type of electrocardiographic change was identified in 33 (75% patients. In 17 (38.6% patients, more than one of the following changes were present: prolonged QTc interval in 24 (54.5%, change in ventricular repolarization in 11(25%, left ventricular hypertrophy in 6 (13.6%, sinus bradycardia in 4 (9.1%, sinus tachycardia in 3 (6.8%, and conduction disorder in 3 (6.8%. The patients had elevated mean serum levels of creatine phosphokinase, aspartate aminotransferases, and gamma glutamyl transferase, as well as hypocalcemia and low levels of total cholesterol and LDL-cholesterol. The patients with altered electrocardiograms had a more elevated age, a lower alcohol consumption, hypopotassemia, and significantly elevated levels of triglycerides, postprandial glucose, sodium and gamma glutamyl transferase than those with normal electrocardiograms. The opposite occurred with fasting glycemia, magnesium, and alanine aminotransferase. CONCLUSION: The electrocardiographic changes found were prolonged QTc interval, change in ventricular repolarization, and left ventricular hypertrophy. Patients with normal and abnormal electrocardiograms had different metabolic and electrolytic changes.

  15. Role of astrocytic glutamate transporter in alcohol use disorder.

    Science.gov (United States)

    Ayers-Ringler, Jennifer R; Jia, Yun-Fang; Qiu, Yan-Yan; Choi, Doo-Sup

    2016-03-22

    Alcohol use disorder (AUD) is one of the most widespread neuropsychiatric conditions, having a significant health and socioeconomic impact. According to the 2014 World Health Organization global status report on alcohol and health, the harmful use of alcohol is responsible for 5.9% of all deaths worldwide. Additionally, 5.1% of the global burden of disease and injury is ascribed to alcohol (measured in disability adjusted life years, or disability adjusted life years). Although the neurobiological basis of AUD is highly complex, the corticostriatal circuit contributes significantly to the development of addictive behaviors. In-depth investigation into the changes of the neurotransmitters in this circuit, dopamine, gamma-aminobutyricacid, and glutamate, and their corresponding neuronal receptors in AUD and other addictions enable us to understand the molecular basis of AUD. However, these discoveries have also revealed a dearth of knowledge regarding contributions from non-neuronal sources. Astrocytes, though intimately involved in synaptic function, had until recently been noticeably overlooked in their potential role in AUD. One major function of the astrocyte is protecting neurons from excitotoxicity by removing glutamate from the synapse via excitatory amino acid transporter type 2. The importance of this key transporter in addiction, as well as ethanol withdrawal, has recently become evident, though its regulation is still under investigation. Historically, pharmacotherapy for AUD has been focused on altering the activity of neuronal glutamate receptors. However, recent clinical evidence has supported the animal-based findings, showing that regulating glutamate homeostasis contributes to successful management of recovery from AUD.

  16. [Screening, Brief Intervention, Referral to Treatment(SBIRT) model for alcohol use disorder in Japan].

    Science.gov (United States)

    Isono, Hiroki; Yoshimoto, Hisashi

    2015-09-01

    The prevalence of alcohol dependence in Japan was 0.9% in 2013, but up to 16% adults drink alcohol at levels of unhealthy use. Primary care physicians play an important role in recognizing alcohol use disorder, helping patients change their behavior, and preventing its medical complications. The Screening, Brief Intervention, Referral to Treatment (SBIRT) model is an evidence-based, cost-effective intervention implemented worldwide to reduce alcohol use disorder.

  17. Theoretical frameworks and mechanistic aspects of alcohol addiction: alcohol addiction as a reward deficit disorder.

    Science.gov (United States)

    Koob, George F

    2013-01-01

    Alcoholism can be defined by a compulsion to seek and take drug, loss of control in limiting intake, and the emergence of a negative emotional state when access to the drug is prevented. Alcoholism impacts multiple motivational mechanisms and can be conceptualized as a disorder that includes a progression from impulsivity (positive reinforcement) to compulsivity (negative reinforcement). The compulsive drug seeking associated with alcoholism can be derived from multiple neuroadaptations, but the thesis argued here is that a key component involves the construct of negative reinforcement. Negative reinforcement is defined as drug taking that alleviates a negative emotional state. The negative emotional state that drives such negative reinforcement is hypothesized to derive from dysregulation of specific neurochemical elements involved in reward and stress within the basal forebrain structures involving the ventral striatum and extended amygdala, respectively. Specific neurochemical elements in these structures include not only decreases in reward neurotransmission, such as decreased dopamine and γ-aminobutyric acid function in the ventral striatum, but also recruitment of brain stress systems, such as corticotropin-releasing factor (CRF), in the extended amygdala. Acute withdrawal from chronic alcohol, sufficient to produce dependence, increases reward thresholds, increases anxiety-like responses, decreases dopamine system function, and increases extracellular levels of CRF in the central nucleus of the amygdala. CRF receptor antagonists also block excessive drug intake produced by dependence. A brain stress response system is hypothesized to be activated by acute excessive drug intake, to be sensitized during repeated withdrawal, to persist into protracted abstinence, and to contribute to the compulsivity of alcoholism. Other components of brain stress systems in the extended amygdala that interact with CRF and that may contribute to the negative motivational state

  18. Comorbid mental disorders among the patients with alcohol abuse and dependence in Korea.

    OpenAIRE

    Cho, Maeng Je; Hahm, Bong-Jin; Suh, Tongwoo; Suh, Guk-Hee; Cho, Seong-Jin; Lee, Chung Kyoon

    2002-01-01

    This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pat...

  19. Childhood ADHD and conduct disorder as independent predictors of male alcohol dependence at age 40

    DEFF Research Database (Denmark)

    2009-01-01

    interviews and criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, to quantify lifetime alcoholism severity and to diagnose alcohol-use disorder. Of the original subjects, 110 had complete data for the two childhood measures and the adult alcoholism outcomes...... childhood measures were correlated, a multiple regression showed that each independently predicted a measure of lifetime alcoholism severity. Conclusions: ADHD comorbid with CD was the strongest predictor of later alcohol dependence. (J. Stud. Alcohol Drugs 70: 169-177, 2009)....

  20. Risk Factors for Treatment Failure in Smokers: Relationship to Alcohol Use and to Lifetime History of an Alcohol Use Disorder

    OpenAIRE

    Leeman, Robert F.; McKee, Sherry A.; Toll, Benjamin A.; Krishnan-Sarin, Suchitra; Cooney, Judith L.; Makuch, Robert W.; O’Malley, Stephanie

    2008-01-01

    Little is known about the impact of alcohol involvement on smoking cessation relapse or possible mechanisms for these associations. We addressed these issues using data from a randomized clinical trial of 2 types of framed messages (gain vs. loss) in conjunction with open label sustained-release (SR) bupropion (Toll et al., 2007) (N = 249). Participants were categorized according to whether or not they were diagnosed with a lifetime alcohol use disorder (AUD; i.e., current or past alcohol abu...

  1. Exploring the Relationship between Experiential Avoidance, Alcohol Use Disorders, and Alcohol-Related Problems among First-Year College Students

    Science.gov (United States)

    Levin, Michael E.; Lillis, Jason; Seeley, John; Hayes, Steven C.; Pistorello, Jacqueline; Biglan, Anthony

    2012-01-01

    Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in…

  2. The Relationship Between Excessive Alcohol Consumption and Alcohol Use Disorders According to DSM-IV and DSM-5

    NARCIS (Netherlands)

    Tuithof, Marlous; ten Have, Margreet; van den Brink, Wim; Vollebergh, Wilma; de Graaf, Ron

    2014-01-01

    BackgroundAlthough it seems intuitive that alcohol use disorders (AUDs) include excessive alcohol consumption (EAC), this notion is not well established. This study investigates to which degree EAC (defined as >14/21 drinks weekly for women/men and at least three 5+ drinking days per week) and AUD o

  3. Paternal alcoholism and offspring conduct disorder: evidence for the 'common genes' hypothesis.

    Science.gov (United States)

    Haber, Jon R; Jacob, Theodore; Heath, Andrew C

    2005-04-01

    Not only are alcoholism and externalizing disorders frequently comorbid, they often co-occur in families across generations; for example, paternal alcoholism predicts offspring conduct disorder just as it does offspring alcoholism. To clarify this relationship, the current study examined the 'common genes' hypothesis utilizing a children-of-twins research design. Participants were male monozygotic (MZ) and dizygotic (DZ) twins from the Vietnam Era Twin Registry who were concordant or discordant for alcohol dependence together with their offspring and the mothers of those offspring. All participants were conducted through a structured psychiatric interview. Offspring risk of conduct disorder was examined as a function of alcoholism genetic risk (due to paternal and co-twin alcohol dependence) and alcoholism environmental risk (due to being reared by a father with an alcohol dependence diagnosis). After controlling for potentially confounding variables, the offspring of alcohol-dependent fathers were significantly more likely to exhibit conduct disorder diagnoses than were offspring of nonalcohol-dependent fathers, thus indicating diagnostic crossover in generational family transmission. Comparing offspring at high genetic and high environmental risk with offspring at high genetic and low environmental risk indicated that genetic factors were most likely responsible for the alcoholism-conduct disorder association. The observed diagnostic crossover (from paternal alcoholism to offspring conduct disorder) across generations in the context of both high and low environmental risk (while genetic risk remained high) supported the common genes hypothesis.

  4. Relationship of attention-deficit/hyperactivity disorder symptom severity with severity of alcohol-related problems in a sample of inpatients with alcohol use disorder

    Directory of Open Access Journals (Sweden)

    Bozkurt M

    2016-07-01

    Full Text Available Muge Bozkurt,1 Cuneyt Evren,1 Gokhan Umut,1 Bilge Evren2 1Research, Treatment and Training Center for Alcohol and Substance Dependence, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey Purpose: Attention-deficit/hyperactivity disorder (ADHD has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods: Participants (n=190 were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients

  5. Animal Models of Fetal Alcohol Spectrum Disorders: Impact of the Social Environment

    Science.gov (United States)

    Kelly, Sandra J.; Goodlett, Charles R.; Hannigan, John H.

    2009-01-01

    Animal models of fetal alcohol spectrum disorder (FASD) have been used to demonstrate the specificity of alcohol's teratogenic effects and some of the underlying changes in the central nervous system (CNS) and, more recently, to explore ways to ameliorate the effects of alcohol. The main point of this review is to highlight research findings from…

  6. Gender differences in prevalence, risk, and clinical correlates of alcoholism comorbidity in bipolar disorder

    NARCIS (Netherlands)

    Frye, MA; Altshuler, LL; McElroy, SL; Suppes, T; Keck, PE; Denicoff, K; Nolen, WA; Kupka, R; Leverich, GS; Pollio, C; Grunze, H; Walden, J; Post, RM

    2003-01-01

    Objective: The prevalence of lifetime alcohol abuse and/or dependence (alcoholism) in patients with bipolar disorder has been reported to be higher than in all other axis I psychiatric diagnoses. This study examined gender-specific relationships between alcoholism and bipolar illness, which have pre

  7. Effect of acute alcohol use on the lethality of suicide attempts in patients with mood disorders.

    Science.gov (United States)

    Sher, Leo; Oquendo, Maria A; Richardson-Vejlgaard, Randall; Makhija, Nita M; Posner, Kelly; Mann, J John; Stanley, Barbara H

    2009-07-01

    Acute alcohol use is an important risk factor for attempted and completed suicide. We evaluated the effect of acute alcohol intake on the lethality of suicide attempts to test the hypothesis that acute alcohol intoxication is associated with more lethal suicide attempts. This retrospective study included 317 suicide attempters enrolled in mood disorders protocols. Demographic and clinical parameters were assessed. The use of alcohol at the time of the most lethal suicide attempt was determined. On the basis of their responses participants were classified into three groups: participants who reported "Enough alcohol intake to impair judgment, reality testing and diminish responsibility" or "Intentional intake of alcohol in order to facilitate implementation of attempt" were included in the group "Alcohol" (A); participants who reported "Some alcohol intake prior to but not related to attempt, reportedly not enough to impair judgment, reality testing" were included in the group "Some Alcohol" (SA); and participants who reported "No alcohol intake immediately prior to attempt" were included in the group "No Alcohol" (NA). Lethality of the most lethal suicide attempts was higher in the A group compared to the SA and NA groups. Prevalence of patients with alcohol use disorders was higher in the A group compared to the SA and NA groups. SA participants reported more reasons for living and lower suicide intent scores at the time of their most lethal suicide attempt compared to the A and NA groups. Acute alcohol use increases the lethality of suicide attempts in individuals with mood disorders.

  8. The alcohol use disorders identification test (AUDIT: validation of a Nepali version for the detection of alcohol use disorders and hazardous drinking in medical settings

    Directory of Open Access Journals (Sweden)

    Pradhan Bickram

    2012-10-01

    Full Text Available Abstract Background Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse. Methods This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females. Results A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%, alcohol abusers (n= 78; 8.3% and alcohol dependent (n=304; 32.2%. The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females. For alcohol dependence/abuse the cut off values was ≥9 for both males and females. Conclusion The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university

  9. Alcohol Use Disorders and Depression: Protective Factors in the Development of Unique versus Comorbid Outcomes

    Science.gov (United States)

    Mason, W. Alex; Hawkins, J. David; Kosterman, Rick; Catalano, Richard F.

    2010-01-01

    This study examines protective factors for young adult alcohol use disorders, depression, and comorbid alcohol use disorders and depression. Participants were recruited from all fifth-grade students attending 18 Seattle elementary schools. Of the 1,053 students eligible, 808 (77%) agreed to participate. Youths were surveyed when they were 10 years…

  10. Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden

    DEFF Research Database (Denmark)

    Westman, J; Wahlbeck, K; Laursen, T M;

    2014-01-01

    OBJECTIVE: To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. METHOD: A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1 158 486 person-years) from 1987 to 2006 in Denmark......, Finland and Sweden. RESULTS: Life expectancy was 24-28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland......, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (-0.8 years) and Sweden (-1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0-5.2), all diseases...

  11. Unintentional baclofen intoxication in the management of alcohol use disorder.

    Science.gov (United States)

    Reichmuth, Philipp; Blanc, Anne-Laure; Tagan, Damien

    2015-09-22

    In recent years, there has been a growing interest in using baclofen for the management of alcohol use disorder. This off-label indication usually involves high doses of the medication. We report a case of severe baclofen overdose in a 66-year-old man. The patient was found severely agitated, and he presented with delirium and auditory hallucinations. At hospital admission, his daily dose was 180 mg baclofen. He was admitted to the intensive care unit for sedation and supportive care. When sedation was withdrawn, the patient presented with a normal neurological status. In this clinical context, baclofen intoxication was suspected. This was confirmed by measuring blood baclofen levels. This intoxication was probably mediated by a combination of risk factors including a high daily dose of baclofen and acute renal failure, conducive to drug accumulation.

  12. Early Life Stress, Nicotinic Acetylcholine Receptors and Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    Joan Y. Holgate

    2015-06-01

    Full Text Available Stress is a major driving force in alcohol use disorders (AUDs. It influences how much one consumes, craving intensity and whether an abstinent individual will return to harmful alcohol consumption. We are most vulnerable to the effects of stress during early development, and exposure to multiple traumatic early life events dramatically increases the risk for AUDs. However, not everyone exposed to early life stress will develop an AUD. The mechanisms determining whether an individual’s brain adapts and becomes resilient to the effects of stress or succumbs and is unable to cope with stress remain elusive. Emerging evidence suggests that neuroplastic changes in the nucleus accumbens (NAc following early life stress underlie the development of AUDs. This review discusses the impact of early life stress on NAc structure and function, how these changes affect cholinergic signaling within the mesolimbic reward pathway and the role nicotinic acetylcholine receptors (nAChRs play in this process. Understanding the neural pathways and mechanism determining stress resilience or susceptibility will improve our ability to identify individuals susceptible to developing AUDs, formulate cognitive interventions to prevent AUDs in susceptible individuals and to elucidate and enhance potential therapeutic targets, such as the nAChRs, for those struggling to overcome an AUD.

  13. Patients with alcohol use disorder: initial results from a prospective multicenter registry in the Spanish Network on Addiction Disorders. CohRTA Study.

    Science.gov (United States)

    Sanvisens, Arantza; Zuluaga, Paola; Rivas, Inmaculada; Rubio, Gabriel; Gual, Antoni; Torrens, Marta; Short, Antoni; Álvarez, Francisco Javier; Tor, Jordi; Farré, Magí; Rodríguez de Fonseca, Fernando; Muga, Roberto

    2017-01-12

    The Alcohol Program of the Spanish Network on Addictive Disorders-RTA requires a longitudinal study to address different research questions related to alcoholism. The cohort study (CohRTA) focuses on patients seeking treatment for alcohol use disorder, as a multicentre, collaborative research project aimed to improve secondary prevention and early diagnosis of pathological processes associated with the disorder.

  14. Identifying the Characteristics of Fetal Alcohol Spectrum Disorders (FASD) among Children with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Someki, Fumio

    2011-01-01

    Fetal alcohol spectrum disorder (FASD), characterized by various levels of dysmorphia and behavioral and cognitive dysfunctions, is the result of prenatal alcohol exposure. FASD characteristics can be masked by many other conditions. As a result, early identification of FASD is often difficult, leading to a delay of children with FASD receiving…

  15. Do young people with comorbid mental and alcohol disorders experience worse behavioural problems?

    Science.gov (United States)

    Salom, Caroline L; Betts, Kim S; Williams, Gail M; Najman, Jackob M; Scott, James G; Alati, Rosa

    2014-10-30

    This article examines whether young individuals in the general population with comorbid alcohol use and mental health disorders experience worse internalizing and externalizing behaviour problems than those with single disorders. A large cohort of women at the Mater Misericordiae Hospital in Brisbane, Australia, was enroled during pregnancy in a longitudinal study. Mother/offspring dyads were followed over 21 years. At age 21, offspring behaviour problems were examined using the Young Adult Self Report, alcohol and mental health disorders with the Composite International Diagnostic Interview. Associations between comorbidity and behaviour problems were assessed using multinomial logistic regression, accounting for life-course factors. Twelve per cent of young adults had alcohol/mental health DSM-IV disorders with significant temporal overlap. A further 16% had alcohol disorders only and 23% mental health disorders only. The comorbid group scored significantly higher on total and externalizing behaviour problems but not internalizing behaviour problems. Stronger associations of aggression/delinquency with comorbidity were not fully accounted for by factors known to influence separate development of mental health and alcohol disorders. Young adults with comorbid alcohol/mental health disorders experience more, and more severe, behavioural problems than those with single disorder types, indicating an increased burden from comorbidity, with implications for treatment and public order.

  16. Brain proton magnetic resonance spectroscopy of alcohol use disorders.

    Science.gov (United States)

    Meyerhoff, Dieter J

    2014-01-01

    This chapter critically reviews brain proton magnetic resonance spectroscopy ((1)H MRS) studies performed since 1994 in individuals with alcohol use disorders (AUD). We describe the neurochemicals that can be measured in vivo at the most common magnetic field strengths, summarize our knowledge about their general brain functions, and briefly explain some basic human (1)H MRS methods. Both cross-sectional and longitudinal research of individuals in treatment and of treatment-naïve individuals with AUD are discussed and interpreted on the basis of reported neuropathology. As AUDs are highly comorbid with chronic cigarette smoking and illicit substance abuse, we also summarize reports on their respective influences on regional proton metabolite levels. After reviewing research on neurobiologic correlates of relapse and genetic influences on brain metabolite levels, we finish with suggestions on future directions for (1)H MRS studies in AUDs. The review demonstrates that brain metabolic alterations associated with AUDs as well as their cognitive correlates are not simply a consequence of chronic alcohol consumption. Future MR research of AUDs in general has to be better prepared - and supported - to study clinically complex relationships between personality characteristics, comorbidities, neurogenetics, lifestyle, and living environment, as all these factors critically affect an individual's neurometabolic profile. (1)H MRS is uniquely positioned to tackle these complexities by contributing to a comprehensive biopsychosocial profile of individuals with AUD: it can provide non-invasive biochemical information on select regions of the brain at comparatively low overall cost for the ultimate purpose of informing more efficient treatments of AUDs.

  17. Client Evaluation of Treatment for Alcohol Use Disorder in COMBINE.

    Science.gov (United States)

    Kirouac, Megan; Witkiewitz, Katie; Donovan, Dennis M

    2016-08-01

    Practitioners and researchers across disciplines have been interested in identifying variables that act as indicators of treatment success or failure and one straightforward approach to measuring treatment success is to assess client satisfaction with treatment. Existing measures of treatment satisfaction do not address the specific aspects relevant to alcohol use disorder (AUD) treatment. Researchers in the COMBINE Study developed a new measure of treatment satisfaction to assess satisfaction in AUD treatment: The Evaluation of Treatment (EOT) measure. The aims of the present study were to examine the factor structure of items from the EOT measure and to examine the association between the EOT measure and other measures of client engagement, as well as AUD treatment outcomes. We also extended the model to test for possible mediation effects of treatment evaluation on the relationship between client treatment engagement components and AUD treatment outcomes. Confirmatory factor analyses indicated a 6-factor model with a higher order treatment satisfaction factor provided an excellent fit to the data (χ2 (246)=499.44, p<0.001, CFI=0.99, TLI=0.98, RMSEA =0.040 (90% CI: 0.035, 0.045). Overall, the latent factor of treatment satisfaction was significantly associated with client engagement predictors and treatment evaluation significantly mediated the associations between both working alliance and treatment expectations in the prediction of alcohol-related problems and global severity. Findings suggest that client evaluations of treatment play a substantial role in predicting AUD treatment outcomes and should be considered in future treatment and research.

  18. Efficacy of High-Dose Baclofen for Alcohol Use Disorder and Comorbid Bulimia: A Case Report.

    Science.gov (United States)

    Weibel, Sébastien; Lalanne, Laurence; Riegert, Myriam; Bertschy, Gilles

    2015-01-01

    High-dose baclofen is a promising treatment for alcohol use disorder, with a specific action on craving. A more general action on craving in other addictive disorders has been suggested based on the hypothesis of a common neurobiological pathway in addictions. We report the case of a woman with both alcohol use disorder and bulimia nervosa. There was a positive response to high-dose baclofen on alcohol craving, but no response on food craving. The case illustrates that craving could be differentially responsive to anti-craving drugs.

  19. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    Science.gov (United States)

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  20. Dr. George Koob: "Alcohol Use Disorders Are a Major Problem..."

    Science.gov (United States)

    ... addressing alcohol problems is increasing our understanding of underage drinking, particularly how high risk drinking by college students ... BAC) Increases, So Does Impairment / Women and Alcohol / Underage Drinking / College Drinking / Older Adults and Drinking Spring 2014 ...

  1. A randomized controlled study of exposure therapy as aftercare for alcohol use disorder

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Nielsen, Bent; Nielsen, Anette Søgaard;

    2016-01-01

    Background It is well documented that individuals with Alcohol Use Disorder (AUD) respond well during evidence-based psychological treatment, but also that a large proportion relapses when discharged from treatment and confronted with alcohol in real life. Cue Exposure Treatment (CET) focuses...... on exposing individuals to alcohol cues in order to reduce cravings as well as the likelihood of relapse. The aims of the study are: 1) to investigate whether CET aftercare delivered via a smartphone or in group sessions increases the effect of Cognitive Behavioural Treatment in groups of alcohol dependent...... as an investigator-blinded randomized controlled trial. A total of 300 consecutively enrolled alcohol use disorder individuals recruited from an alcohol outpatient clinic will be randomized into one of the three following aftercare groups after concluding primary treatment: (1) CET as a smartphone application; (2...

  2. Can attention deficit hyperactivity disorder and fetal alcohol spectrum disorder be differentiated by motor and balance deficits?

    NARCIS (Netherlands)

    Kooistra, Libbe; Ramage, Barbara; Crawford, Susan; Cantell, Marja; Wormsbecker, Shirley; Gibbard, Ben; Kaplan, Bonnie J

    2009-01-01

    There is an ongoing debate regarding the diagnostic overlap between Attention Deficit Hyperactivity Disorder (ADHD) and Fetal Alcohol Spectrum Disorder (FASD). Differential diagnosis is important because of treatment implications. Children aged 7-10years (47 ADHD, 30 FASD, 39 controls) participated.

  3. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder

    OpenAIRE

    Fang Wang; Ya Li; Yu-Jie Zhang; Yue Zhou; Sha Li; Hua-Bin Li

    2016-01-01

    Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the pro...

  4. Comorbidity and temporal ordering of alcohol use disorders and other psychiatric disorders: results from a Danish register-based study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Mortensen, Erik Lykke; Knop, Joachim

    2009-01-01

    . The study population was linked to national Danish hospital registers and a greater Copenhagen alcohol unit treatment register to detect registrations with AUD and other psychiatric disorders. RESULTS: Of the individuals invited to the study, 7.6% were registered with AUD, and among these, 50.3% had......BACKGROUND: Understanding the comorbidity of alcohol use disorders (AUD) and other psychiatric disorders may have important implications for treatment and preventive interventions. However, information on the epidemiology of this comorbidity is lacking. The objective of this study was to present...

  5. Disordered eating and alcohol use among college women: associations with race and big five traits.

    Science.gov (United States)

    Martin, Jessica L; Groth, Gabrielle; Longo, Laura; Rocha, Tracey L; Martens, Matthew P

    2015-04-01

    Excessive alcohol use and disordered eating are considerable health-related problems among college women. The purpose of the present study was to examine how specific patterns of disordered eating (i.e., anorexia, bulimia, binge eating) are related to alcohol use and related problems and the influence of racial group membership and Big Five personality traits on the co-occurrence of these behaviors. Participants were 153 undergraduate women. Results indicated that White women reported more binge drinking, alcohol-related problems, disordered eating, anorexia nervosa symptoms, and bulimia nervosa symptoms than non-White women. Women with higher levels of openness and who engage in extreme exercise, dieting, fasting, or purging were more at risk for heavy and problematic alcohol use. Implications for the treatment of co-occurring disorders among college students and further research are discussed.

  6. Longitudinal Risk Factors for Intimate Partner Violence among Men in Treatment for Alcohol Use Disorders

    Science.gov (United States)

    Taft, Casey T.; O'Farrell, Timothy J.; Doron-Lamarca, Susan; Panuzio, Jillian; Suvak, Michael K.; Gagnon, David R.; Murphy, Christopher M.

    2010-01-01

    Objective: This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders. Method: Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years.…

  7. Evidence-Based Practice Guidelines for Fetal Alcohol Spectrum Disorder and Literacy and Learning

    Science.gov (United States)

    Mitten, H. Rae

    2013-01-01

    Evidence-based Practice Guidelines for Fetal Alcohol Spectrum Disorder (FASD) and Literacy and Learning are derived from an inductive analysis of qualitative data collected in field research. FASD is the umbrella term for a spectrum of neurocognitive and physical disabilities caused by prenatal exposure to alcohol. Data from a sample of N =150 was…

  8. Treated and Untreated Alcohol-Use Disorders: Course and Predictors of Remission and Relapse

    Science.gov (United States)

    Moos, Rudolf H.; Moos, Bernice S.

    2007-01-01

    The research described here focused on personal, life context, and help-related factors to trace the long-term course of treated and untreated alcohol-use disorders. A group of 461 individuals who sought help for alcohol problems was surveyed at baseline and 1, 3, 8, and 16 years later. Compared with individuals who remained untreated, individuals…

  9. Efficacy of Outpatient Aftercare for Adolescents with Alcohol Use Disorders: A Randomized Controlled Study

    Science.gov (United States)

    Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.

    2008-01-01

    The effectiveness of active aftercare for adolescents with alcohol use disorders in maintaining treatment gains is evaluated. Findings show that active aftercare interventions were effective in slowing the posttreatement relapse of alcohol use in adolescents. Impacts of active aftercare on number of drinking days and heavy drinking days are also…

  10. Reducing Sexual Risk Behaviors for HIV/STDs in Women with Alcohol Use Disorders

    Science.gov (United States)

    Langhorst, Diane M.; Choi, Y. Joon; Keyser-Marcus, Lori; Svikis, Dace S.

    2012-01-01

    Objective: A pilot randomized clinical trial (RCT) examined effectiveness of HIV/STD Safer Sex Skills Building + Alcohol (SSB+A) intervention for women with Alcohol Use Disorders (AUDs) in a residential treatment setting. Method: After randomizing thirty-six women with AUDs and reporting having intercourse with a male partner in the past 180 days…

  11. Canadian Children and Youth in Care: The Cost of Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Popova, Svetlana; Lange, Shannon; Burd, Larry; Rehm, Jürgen

    2014-01-01

    Background: A high prevalence of prenatal alcohol exposure has been reported among children in care and thus, the risk of fetal alcohol spectrum disorder (FASD) in this population is high. Objective: The purpose of the current study was to estimate the number of children (0-18 years) in care with FASD and to determine the associated cost by age…

  12. Behavioral couples therapy (BCT) for alcohol and drug use disorders: A meta-analysis

    NARCIS (Netherlands)

    Powers, M.B.; Vedel, E.; Emmelkamp, P.M.G.

    2008-01-01

    Narrative reviews conclude that behavioral couples therapy (BCT) produces better outcomes than individual-based treatment for alcoholism and drug abuse problems (e.g., [Epstein, E. E., & McCrady, B. S. (1998). Behavioral couples treatment of alcohol and drug use disorders: Current status and innovat

  13. Risk factors for treatment failure in smokers: relationship to alcohol use and to lifetime history of an alcohol use disorder.

    Science.gov (United States)

    Leeman, Robert F; McKee, Sherry A; Toll, Benjamin A; Krishnan-Sarin, Suchitra; Cooney, Judith L; Makuch, Robert W; O'Malley, Stephanie S

    2008-12-01

    Little is known about the impact of alcohol involvement on smoking cessation relapse or possible mechanisms for these associations. We addressed these issues using data from a randomized clinical trial of two types of framed messages (gain vs. loss) in conjunction with open label sustained-release (SR) bupropion (Toll et al., 2007) (N = 249). Participants were categorized according to whether or not they were diagnosed with a lifetime alcohol use disorder (AUD; i.e., current or past alcohol abuse or past alcohol dependence) and according to three levels of alcohol use: abstinence, moderate, or hazardous use. Alcohol use categories were established for drinking at baseline, during the 6-week treatment period and through 12 weeks post-quit. There were few significant differences by baseline alcohol use level or AUD history for a series of predictors of smoking cessation failure (e.g., depressive symptoms). During treatment and follow-up, the probability of any smoking on heavy drinking days was significantly higher than the probability of smoking on moderate drinking or abstinent days. AUD history did not predict smoking cessation relapse in any analysis, nor were any alcohol usexAUD history interactions significant. Moderate alcohol users and, to a lesser extent, abstainers from alcohol at baseline were less likely than hazardous drinkers to have relapsed at 12 weeks post-quit. Based on these findings, it appears that risk of any smoking and of relapse was associated primarily with heavy drinking days and a hazardous pattern of use respectively, rather than with moderate drinking.

  14. Progress in mind: focus on alcohol use disorders, an elsevier resource centre.

    Science.gov (United States)

    Nutt, D J; Rehm, J; van den Brink, W; Gorwood, P; Buchsbaum, M S

    2015-04-30

    Harmful use of alcohol is one of the top five risks for burden of disease globally and in Europe; in 2012, 3.3 million net deaths (approximately 6% of all global deaths) were attributable to this risk factor. It is also linked to the development of a wide spectrum of alcohol use disorders, ranging from mild manifestations to a severe disease known as alcohol dependence. Alcohol dependence is a progressive, chronic, and relapsing brain disease resulting from the prolonged effects of alcohol on the brain. Alcohol dependence imposes a significant societal burden, with indirect societal costs reaching up to 0.64% of European countries׳ annual gross domestic product. With these facts in mind, it is important to recognize and manage alcohol dependence. Although the biological mechanisms behind the development of alcohol dependence are not fully known, factors that have been shown to influence its development include genetic predisposition, psychological problems, and social interactions. Alcohol use has also been linked to the development of hypertension, liver cirrhosis, chronic pancreatitis, multiple types of cancer, and psychiatric comorbidities such as depression and anxiety disorders. With such severe effects on both individuals and society, it is important to recognize the characteristic signs and symptoms of alcohol dependence and explore new ways to better manage patients with this brain disease. Effective treatment approaches for alcohol dependence include biological, behavioral, and social components addressing the multiple aspects of this disease. Comprehensive, educational platforms in which to explore the many facets of this disease such as the Progress in Mind: Focus on Alcohol Use Disorders Resource Centre, will provide clinicians with the tools necessary for recognizing patients with alcohol dependence and managing their disease along with related comorbidities. Online Access: http://progressinmind.elsevierresource.com.

  15. Alcohol abuse and dependence criteria as predictors of a chronic course of alcohol use disorders in the general population

    NARCIS (Netherlands)

    De Bruijn, C; Van den Brink, W; De Graaf, R; Vollebergh, WAM

    2005-01-01

    Aims: To investigate whether DSM-IV abuse and dependence criteria and the ICD-10 criterion for craving differentially predict a chronic course of alcohol use disorders (AUD) in the general population. Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study, a large r

  16. Risks of major depressive disorder and anxiety disorders among Thais with alcohol use disorders and illicit drug use: findings from the 2008 Thai National Mental Health survey.

    Science.gov (United States)

    Suttajit, Sirijit; Kittirattanapaiboon, Phunnapa; Junsirimongkol, Boonsiri; Likhitsathian, Surinporn; Srisurapanont, Manit

    2012-12-01

    Little is known about the risks of mood and anxiety disorders among Asians with alcohol use disorders and the effect of illicit drug use in this population. All participants from the 2008 Thai National Mental Health survey (N=17,140) were assessed for current major depressive disorder, anxiety disorders, and alcohol use disorders by using the Mini International Neuropsychiatric Interview (MINI) and were interviewed for illicit drug use within one year prior to their assessment. Logistic regression modeling was used to determine (a) whether alcohol use disorders were associated with major depressive disorder and anxiety disorders and (b) whether the use of illicit drugs increased these associations. Sex, age, marital status, region, and educational level were found to be significantly associated with major depressive disorder and anxiety disorders and were taken into account in the regression analysis. Compared with the general population, individuals with alcohol use disorders alone had significantly increased risks of major depressive disorder (OR 2.49, 95%CI 1.76-3.53 in men and OR 4.09, 95%CI 2.31-7.26 in women) and anxiety disorders (OR 2.21, 95%CI 1.46-3.36 in men and OR 4.34, 95%CI 2.35-8.03 in women). The risks became higher among individuals with both alcohol use disorders and illicit drug use (OR 3.62, 95% CI 1.64-8.01 in men and OR 11.53, 95%CI 1.32-100.65 in women for major depressive disorder, and OR 3.20, 95%CI 1.36-7.51 in men and OR 13.10, 95%CI 1.48-115.60 in women for anxiety disorders). In conclusion, alcohol use disorders were significantly associated with major depressive disorder and anxiety disorders. Illicit drug use was an important factor in increasing these associations, especially in women. Screening for depression, anxiety, and illicit drug use should be done in individuals with alcohol use disorders.

  17. Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders

    Directory of Open Access Journals (Sweden)

    Kittirattanapaiboon P

    2014-03-01

    Full Text Available Phunnapa Kittirattanapaiboon,1 Sirijit Suttajit,2 Boonsiri Junsirimongkol,1 Surinporn Likhitsathian,2 Manit Srisurapanont2 1Department of Mental Health, Ministry of Public Health, Nonthaburi, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods: Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI, current suicidality (1 month prior to assessment, mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results: Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59% and (methamphetamine (24%. Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537 had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81. While those who used illicit drugs alone (no mental/alcohol use disorder (n=348 had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65, the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively. Conclusion: A key

  18. Monsters, Monkeys, & Mandalas: Art Therapy with Children Experiencing the Effects of Trauma and Fetal Alcohol Spectrum Disorder (FASD)

    Science.gov (United States)

    Gerteisen, June

    2008-01-01

    Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of effects associated with the diagnoses of Fetal Alcohol Effects (FAE) and Fetal Alcohol Syndrome (FAS). FASD itself is not a diagnosis, but rather encompasses a wide range of symptomatic behaviors that occur in an individual whose mother drank alcohol during…

  19. Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Amy A. Herrold, PhD

    2015-02-01

    Full Text Available Mental health disorders (MHDs, mild traumatic brain injury (mTBI, and alcohol use disorder (AUD are endemic among recent Veterans, resulting in a population with heterogeneous, co-occurring conditions. While alcohol craving negatively affects rehabilitation and leads to relapse, no studies have examined alcohol craving among Veterans with co-occurring MHDs and mTBI. The purpose of this preliminary cohort study is to describe alcohol craving in a convenience sample of Iraq and Afghanistan Veterans (n = 48, including those exposed to traumatic events and experiencing active symptoms. Veterans completed weekly telephone interviews that included the Alcohol Use Disorder Identification Test, consumption questions (AUDIT-C (week 1 and the Penn Alcohol Craving Scale (PACS (weeks 1–6. Sixty percent of the sample screened positive on the AUDIT-C for probable AUD. Using Rasch analysis, the person separation reliability of the PACS was strong (0.87 among AUDIT-C positive Veterans. Higher PACS scores were reported among AUDIT-C positive versus AUDIT-C negative Veterans (mixed effects analysis, p < 0.001. PACS scores were higher among AUDIT-C positive Veterans with MHDs with and without mTBI versus AUDIT-C positive combat comparison Veterans (pairwise comparison, p < 0.001. Rates of hazardous alcohol use are high among Iraq and Afghanistan conflict Veterans and suggest that alcohol craving is elevated among those with MHDs with and without mTBI.

  20. Multidisciplinary View of Alcohol Use Disorder: From a Psychiatric Illness to a Major Liver Disease.

    Science.gov (United States)

    Gitto, Stefano; Golfieri, Lucia; Caputo, Fabio; Grandi, Silvana; Andreone, Pietro

    2016-01-15

    Alcohol use disorder is a significant health problem being a cause of increased morbidity and mortality worldwide. Alcohol-related illness has a relevant economic impact on the society and a negative influence on the life of patients and their family members. Psychosocial support might be useful in the management of people affected by alcohol use disorder since psychiatric and pharmaceutical approaches show some limits. In fact, many drugs are accessible for the treatment of alcohol disorder, but only Baclofen is functional as an anti-craving drug in patients with advanced liver disease. The alcohol-related liver damage represents the most frequent cause of advanced liver disease in Europe, and it is the main cause of death among adults with high alcohol consumption. The multidisciplinary action of clinical-psychologists, psychiatrics and hepatologists, is essential in the management of patients with alcohol liver disease especially in the case of liver transplantation. In general, the multidisciplinary approach is necessary in prevention, in framing patients and in the treatment. More resources should be used in prevention and research with the main aim of decreasing the harmful alcohol consumption.

  1. Multidisciplinary View of Alcohol Use Disorder: From a Psychiatric Illness to a Major Liver Disease

    Directory of Open Access Journals (Sweden)

    Stefano Gitto

    2016-01-01

    Full Text Available Alcohol use disorder is a significant health problem being a cause of increased morbidity and mortality worldwide. Alcohol-related illness has a relevant economic impact on the society and a negative influence on the life of patients and their family members. Psychosocial support might be useful in the management of people affected by alcohol use disorder since psychiatric and pharmaceutical approaches show some limits. In fact, many drugs are accessible for the treatment of alcohol disorder, but only Baclofen is functional as an anti-craving drug in patients with advanced liver disease. The alcohol-related liver damage represents the most frequent cause of advanced liver disease in Europe, and it is the main cause of death among adults with high alcohol consumption. The multidisciplinary action of clinical-psychologists, psychiatrics and hepatologists, is essential in the management of patients with alcohol liver disease especially in the case of liver transplantation. In general, the multidisciplinary approach is necessary in prevention, in framing patients and in the treatment. More resources should be used in prevention and research with the main aim of decreasing the harmful alcohol consumption.

  2. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder

    Directory of Open Access Journals (Sweden)

    Fang Wang

    2016-01-01

    Full Text Available Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s and related mechanism(s of action.

  3. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder.

    Science.gov (United States)

    Wang, Fang; Li, Ya; Zhang, Yu-Jie; Zhou, Yue; Li, Sha; Li, Hua-Bin

    2016-01-07

    Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s) and related mechanism(s) of action.

  4. Alcohol Related Disorders in Asia Pacific Region: Prevalence, Health Consequences and Impacts on the Nations

    Directory of Open Access Journals (Sweden)

    Seyed Mostafa Monzavi

    2015-03-01

    Full Text Available Background: In Asia Pacific (AP region, the exact picture of the alcohol use problems has remained relatively obscure. In this study, the profile of alcohol consumption and alcohol related disorders in AP countries are presented.     Methods: Official statistics on average alcohol consumption (alcohol per capita consumption, APC, alcohol related health variables, income group and alcohol policy of countries geographically related to Asia and Oceania continents were extracted from the 2014 edition of World Health Organization report on global status of alcohol and health. Results: The data of 57 AP countries were analyzed. Two-third of the countries did not establish comprehensive national monitoring systems (NMSs. Median of total APC in people aged 15 years and older was 2.4 (1-4.6 L during 2003 to 2005, while this indicator was 2.8 (1-5.5 L during 2008 to 2010 which accounts for about 0.4 L (in median increase in consumption. In 13 countries which were mostly located in South-east Asia and the Pacific region, APC was higher than average global consumption. Comparing the countries with and without total ban policy, the countries with total ban policy had significantly lower APC (P = 0.003, higher rate of abstainers (P = 0.002 and lower rate of alcohol related disorders (P < 0.001. Higher APC and higher rates of alcohol related disorders were observed in higher income countries. Conclusion: Alcohol consumption in AP region is comparatively lower than global average. However, the status of some countries in Southeast Asia and Pacific region is alarming and needs serious attention. Moreover, establishment of comprehensive NMSs, proper data registry and holistic harm reduction and rehabilitation programs for users should receive meaningful governmental and public support.

  5. Family history of alcohol dependence modulates functional neurophysiology in mood/anxiety disorders

    NARCIS (Netherlands)

    Sjoerds, Z.; van Tol, M.J.; van den Brink, W.; van der Wee, N.J.A.; Aleman, A.; Beekman, A.T.F.; Penninx, B.W.J.H.; Veltman, D.J.

    2013-01-01

    Background. A family history (FH) of alcohol dependence (AD) not only increases the risk for AD, but is also associated with an increased risk for mood and anxiety disorders. However, it is unknown how a FH of AD affects neural substrates in patients with mood and anxiety disorders. In this study we

  6. The role of negative emotionality and impulsivity in depressive/anxiety disorders and alcohol dependence

    NARCIS (Netherlands)

    Boschloo, L.; Vogelzangs, N.; van den Brink, W.; Smit, J. H.; Beekman, A.T.F.; Penninx, Brenda

    2013-01-01

    Background. Much is still unclear about the role of personality in the structure of common psychiatric disorders such as depressive/anxiety disorders and alcohol dependence. This study will therefore examine whether various traits of negative emotionality and impulsivity showed shared or specific as

  7. 49 CFR 240.119 - Criteria for consideration of data on substance abuse disorders and alcohol/drug rules compliance.

    Science.gov (United States)

    2010-10-01

    ... abuse disorders and alcohol/drug rules compliance. 240.119 Section 240.119 Transportation Other... Process § 240.119 Criteria for consideration of data on substance abuse disorders and alcohol/drug rules.... (b) Fitness requirement. (1) A person who has an active substance abuse disorder shall not...

  8. Convergent functional genomic studies of ω-3 fatty acids in stress reactivity, bipolar disorder and alcoholism.

    Science.gov (United States)

    Le-Niculescu, H; Case, N J; Hulvershorn, L; Patel, S D; Bowker, D; Gupta, J; Bell, R; Edenberg, H J; Tsuang, M T; Kuczenski, R; Geyer, M A; Rodd, Z A; Niculescu, A B

    2011-04-26

    Omega-3 fatty acids have been proposed as an adjuvant treatment option in psychiatric disorders. Given their other health benefits and their relative lack of toxicity, teratogenicity and side effects, they may be particularly useful in children and in females of child-bearing age, especially during pregnancy and postpartum. A comprehensive mechanistic understanding of their effects is needed. Here we report translational studies demonstrating the phenotypic normalization and gene expression effects of dietary omega-3 fatty acids, specifically docosahexaenoic acid (DHA), in a stress-reactive knockout mouse model of bipolar disorder and co-morbid alcoholism, using a bioinformatic convergent functional genomics approach integrating animal model and human data to prioritize disease-relevant genes. Additionally, to validate at a behavioral level the novel observed effects on decreasing alcohol consumption, we also tested the effects of DHA in an independent animal model, alcohol-preferring (P) rats, a well-established animal model of alcoholism. Our studies uncover sex differences, brain region-specific effects and blood biomarkers that may underpin the effects of DHA. Of note, DHA modulates some of the same genes targeted by current psychotropic medications, as well as increases myelin-related gene expression. Myelin-related gene expression decrease is a common, if nonspecific, denominator of neuropsychiatric disorders. In conclusion, our work supports the potential utility of omega-3 fatty acids, specifically DHA, for a spectrum of psychiatric disorders such as stress disorders, bipolar disorder, alcoholism and beyond.

  9. PREVALENCE AND PATTERNS OF ALCOHOL INTAKE AMONG INDUSTRIAL WORKERS IN MANGALORE: AN APPRAISAL BY ALCOHOL USE DISORDER IDENTIFICATION TEST (AUDIT

    Directory of Open Access Journals (Sweden)

    Mir Viquar

    2015-08-01

    Full Text Available BACKGROUND: WHO estimates two billion alcoholic beverages consumers and 76.7 million people with diagnosable alcohol - use disorders worldwide(WHOand ranks 5th as a risk factor for avoidable disease measured by Disability Adjusted Life Years (DALY (WHO , 2002. OBJECTIVE: 1. To Assess Prevalence alcohol use among the selected Industr ial workers. 2. Factors associated with alcohol use . METHODS: This cross - sectional study was conducted in one of selected wood and plywood industry among all the industrial workers aged 18 years and above from October to November 2013. Socio - demographic pr ofile of all the participants was collected, questions on prevalence and dependence on alcohol use and its dependence was assessed using AUDIT questionnaire modified as per local needs and validated was used. The data collected was analyzed using SPSS 16.0 . RESULTS: Mean age of the study subjects was 33.4 years, most of the participants (44.8% were in the age group of 18 - 28 years and majority were Hindu and were belonging to class IV socio - economic status. MAJORITY: (55.2% of the study participants were a lcohol users and majority (61.6% was in the age group of 18 - 28 years. Religion and socio - economic status were the factors found to be statistically significant with alcohol use. CONCLUSION: Prevalence of alcohol use was significantly higher in the selecte d industry were religion and socio - economic status were the significant factors associated with tobacco use. Counseling and continuous monitoring is needed to reduce the prevalence of alcohol use and also further study is recommended on a larger scale.

  10. Association of Alcohol Consumption and Sleep Disordered Breathing In Men And Women

    Science.gov (United States)

    Peppard, Paul E.; Austin, Diane; Brown, Richard L

    2007-01-01

    Study Objectives: Experimental evidence indicates that alcohol use near bedtime may exacerbate sleep disordered breathing (SDB). However, scarce research has examined the relation between moderate habitual alcohol use and objectively assessed SDB, and it is unclear whether patients with SDB, or those at risk for SDB, should be counseled to avoid alcohol regardless of proximity to bedtime. In this population-based epidemiology study, our objective is to measure the association of SDB with usual alcohol consumption habits. Methods: Men (N = 775) and women (N = 645)—initially randomly selected from a working population—participating in the Wisconsin Sleep Cohort Study were evaluated for alcohol consumption and SDB. The apnea-hypopnea index (AHI, events/hour) was determined by in-laboratory polysomnography. AHI>5 defined “mild or worse” SDB and AHI>15 defined “moderate or worse” SDB. Alcohol consumption (drinks/day) was assessed by questionnaire. Potential confounding or interacting variables such as smoking, body mass index, and medication use, were measured by clinical assessment and questionnaire. Results: Relative to men who consumed less alcohol, for each increment of one drink per day, men who consumed more alcohol had 25% greater odds of mild or worse SDB (OR = 1.25, 95% CI = 1.07–1.46, p = 0.006). Among women, minimal to moderate alcohol consumption was not significantly associated with increased risk of SDB. Discussion: In men, increased usual alcohol consumption was associated with increased risk of mild or worse SDB. Persons with SDB might benefit from generally reduced alcohol consumption and not just avoidance near bedtime. Citations: Peppard P; Austin D; Brown R. Association of Alcohol Consumption and Sleep Disordered Breathing In Men And Women. J Clin Sleep Med 2007;3(3):265–270 PMID:17561593

  11. Alcohol consumption and later risk of hospitalization with psychiatric disorders: prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Becker, Ulrik; Grønbæk, Morten

    2011-01-01

    measured through registers. For women, the overall pattern showed that drinking above the sensible limits increased the risk of psychiatric disorders in general, especially for anxiety disorders where women drinking above the sensible drinking limits had a risk of 2.00 (confidence interval: 1.......31-3.04) compared to women drinking below the sensible drinking limits. For men, the risk functions were slightly U-shaped; thus, a weekly low or moderate alcohol intake seemed to have a protective effect towards developing psychiatric disorders. The findings suggest sex differences in the association between......The potential effects of alcohol intake upon the risk of psychiatric disorders have not often been investigated. The purpose of this study was to investigate, in a population sample, the association between self-reported amount of alcohol intake and the later risk of being registered in a Danish...

  12. Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers

    Science.gov (United States)

    Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina

    2015-01-01

    Background and Aims Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers. Methods The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT). Results 7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender. Discussion The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions. PMID:26690622

  13. GABAB receptor ligands for the treatment of alcohol use disorder: preclinical and clinical evidence

    Directory of Open Access Journals (Sweden)

    Roberta eAgabio

    2014-06-01

    Full Text Available The present paper summarizes the preclinical and clinical studies conducted to define the anti-alcohol pharmacological profile of the prototypic GABAB receptor agonist, baclofen, and its therapeutic potential for treatment of alcohol use disorder (AUD. Numerous studies have reported baclofen-induced suppression of alcohol drinking (including relapse- and binge-like drinking and alcohol reinforcing, motivational, stimulating, and rewarding properties in rodents and monkeys. The majority of clinical surveys conducted to date – including case reports, retrospective chart reviews, and randomized placebo-controlled studies – suggest the ability of baclofen to suppress alcohol consumption, craving for alcohol, and alcohol withdrawal symptomatology in alcohol-dependent patients. The recent identification of a positive allosteric modulatory binding site, together with the synthesis of in vivo effective ligands, represents a novel, and likely more favorable, option for pharmacological manipulations of the GABAB receptor. Accordingly, data collected to date suggest that positive allosteric modulators of the GABAB receptor reproduce several anti-alcohol effects of baclofen and display a higher therapeutic index (with larger separation – in terms of doses – between anti-alcohol effects and sedation.

  14. A 3 year case study of alcohol related psychotic disorders at Hospital Seremban.

    Science.gov (United States)

    George, S; Chin, C N

    1998-09-01

    This paper reports the characteristics and psychopathology of alcohol dependents with alcohol induced psychotic disorder admitted to the Seremban Hospital. The method is that of a case study of all alcohol dependents with alcohol induced psychotic disorder admitted to the Psychiatric Ward, Hospital Seremban over 3 years (1993-1995). There were 34 subjects, 30 Indians, 3 Chinese and 1 Malay with a mean age of 43 years. 32 were men and predominantly of Social Class IV and V (91%). They had a mean duration of drinking of 14.2 years and had a mean weekly consumption of 69.5 units of alcohol. There was a family history of alcohol dependence in (44%). The majority (68%) consumed samsu with beer the second choice. Auditory hallucinations (26) and delusions (16) were common while visual hallucinations (3) and depression (2) were less frequent. Speech disorder occurred in 4 subjects. 2 developed delirium tremens and 1 died. Liver function test was normal in 55%. All except the death from delirium tremens responded to treatment with a combination of anxiolytics, thiamine and antipsychotics and were rapidly discharged. The mean stay was 7 days. However, (68%) did not return for follow up and only 4 were abstinent from alcohol at the time of follow up.

  15. Exploration of the comorbidity of alcohol use disorders and mental health disorders among inpatients presenting to all hospitals in New South Wales, Australia.

    Science.gov (United States)

    Lai, Harry Man Xiong; Sitharthan, Thiagarajan; Huang, Qi Rong

    2012-01-01

    Alcohol is one of the most commonly used legal psychoactive substances, and its use often coexists with mental health disorders. This study explores the relationships between alcohol use and some common mental health disorders. Admissions to all New South Wales (NSW) hospitals were analyzed. The data were extracted from the NSW Department of Health Inpatient Statistics Data Collection for the period 1 July 2006 to 30 June 2007. Readmissions within 28 days were excluded. Data extraction and analyses were performed by using the SAS program. Chi-square tests and odds ratio were used to measure the association. Of the 1.8 million admissions, associations between alcohol use disorders and mental health disorders were strong (odds ratio 7.8 to 10.7, P alcohol had at least 1 identifiable mental disorder. Higher comorbidity rates were observed for females (39.6%) and for those aged between 30 and 49 years. The most common mental disorders were anxiety disorders, bipolar affective disorders, major depressive disorders, personality disorders, schizophrenia, and severe stress disorders. Comorbidity with one of these mental disorders ranged from 1% to 17.6%, with significant associations (odds ratio 5.6 to 14.1). The average length of stay (ALOS) for alcohol use disorders were 6.4 days and the ALOS for the most common mental health admissions was 11.2 days. This study provides detailed information about the association between alcohol use and mental health disorders and extends our understanding of comorbidity presentations in inpatient admissions.

  16. Adopting and Fostering Children with Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    ... toughest but most fulfilling job in the world. Parenting children with special needs, such as fetal alcohol spectrum ... about FASD can help parents understand how their children are affected, which parenting strategies work best, and how to get services ...

  17. Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders.

    Science.gov (United States)

    Sannibale, Claudia; Teesson, Maree; Creamer, Mark; Sitharthan, Thiagarajan; Bryant, Richard A; Sutherland, Kylie; Taylor, Kirsten; Bostock-Matusko, Delphine; Visser, Alicia; Peek-O'Leary, Marie

    2013-08-01

    Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.

  18. Neurophysiological features of Internet gaming disorder and alcohol use disorder: a resting-state EEG study.

    Science.gov (United States)

    Son, K-L; Choi, J-S; Lee, J; Park, S M; Lim, J-A; Lee, J Y; Kim, S N; Oh, S; Kim, D J; Kwon, J S

    2015-09-01

    Despite that Internet gaming disorder (IGD) shares clinical, neuropsychological and personality characteristics with alcohol use disorder (AUD), little is known about the resting-state quantitative electroencephalography (QEEG) patterns associated with IGD and AUD. Therefore, this study compared the QEEG patterns in patients with IGD with those in patients with AUD to identify unique neurophysiological characteristics that can be used as biomarkers of IGD. A total of 76 subjects (34 with IGD, 17 with AUD and 25 healthy controls) participated in this study. Resting-state, eyes-closed QEEGs were recorded, and the absolute and relative power of brains were analyzed. The generalized estimating equation showed that the IGD group had lower absolute beta power than AUD (estimate = 5.319, P < 0.01) and the healthy control group (estimate = 2.612, P = 0.01). The AUD group showed higher absolute delta power than IGD (estimate = 7.516, P < 0.01) and the healthy control group (estimate = 7.179, P < 0.01). We found no significant correlations between the severity of IGD and QEEG activities in patients with IGD. The current findings suggest that lower absolute beta power can be used as a potential trait marker of IGD. Higher absolute power in the delta band may be a susceptibility marker for AUD. This study clarifies the unique characteristics of IGD as a behavioral addiction, which is distinct from AUD, by providing neurophysiological evidence.

  19. Alcohol use disorders (AUD among tuberculosis patients: a study from Chennai, South India.

    Directory of Open Access Journals (Sweden)

    Mohanarani Suhadev

    Full Text Available BACKGROUND: Alcohol Use Disorders (AUDs among tuberculosis (TB patients are associated with nonadherence and poor treatment outcomes. Studies from Tuberculosis Research Centre (TRC, Chennai have reported that alcoholism has been one of the major reasons for default and mortality in under the DOTS programme in South India. Hence, it is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India. METHODOLOGY: This is a cross-sectional cohort study covering 10 corporation zones at Chennai and it included situational assessment followed by screening of TB patients by a WHO developed Alcohol Use Disorders Identification Test AUDIT scale. Four zones were randomly selected and all TB patients treated during July to September 2009 were screened with AUDIT scale for alcohol consumption. RESULTS: Out of 490 patients, 66% were males, 66% were 35 years and above, 57% were married, 58% were from the low monthly income group of 8. Age (>35 years, education (less educated, income (alcohol use than those TB patients without alcohol use. CONCLUSIONS: AUD among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care.

  20. Transdermal delivery of cannabidiol attenuates binge alcohol-induced neurodegeneration in a rodent model of an alcohol use disorder.

    Science.gov (United States)

    Liput, Daniel J; Hammell, Dana C; Stinchcomb, Audra L; Nixon, Kimberly

    2013-10-01

    Excessive alcohol consumption, characteristic of alcohol use disorders, results in neurodegeneration and behavioral and cognitive impairments that are hypothesized to contribute to the chronic and relapsing nature of alcoholism. Therefore, the current study aimed to advance the preclinical development of transdermal delivery of cannabidiol (CBD) for the treatment of alcohol-induced neurodegeneration. In Experiment 1, 1.0%, 2.5% and 5.0% CBD gels were evaluated for neuroprotection. The 5.0% CBD gel resulted in a 48.8% reduction in neurodegeneration in the entorhinal cortex assessed by Fluoro-Jade B (FJB), which trended to statistical significance (p=0.069). Treatment with the 5.0% CBD gel resulted in day 3 CBD plasma concentrations of ~100.0 ng/mL so this level was used as a target concentration for development of an optimized gel formulation. Experiment 2 tested a next generation 2.5% CBD gel formulation, which was compared to CBD administration by intraperitoneal injection (IP; 40.0 mg/kg/day). This experiment found similar magnitudes of neuroprotection following both routes of administration; transdermal CBD decreased FJB+ cells in the entorhinal cortex by 56.1% (p<0.05), while IP CBD resulted in a 50.6% (p<0.05) reduction in FJB+ cells. These results demonstrate the feasibility of using CBD transdermal delivery systems for the treatment of alcohol-induced neurodegeneration.

  1. Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders.

    Science.gov (United States)

    Streissguth, A P; O'Malley, K

    2000-07-01

    Prenatal alcohol exposure can cause a whole spectrum of central nervous system (CNS) sequelae that persist throughout the life span and manifest in a spectrum of effects from clinically indistinguishable to severely impairing. The greatest impact of alcohol as a teratogen is to the brain-the greatest need is for holistic treatment and management of the associated mental disorders. The interaction of this subtle brain damage with the complex psychosocial circumstances surrounding the birth of a child to a mother with alcohol problems can further compound development and result in costly and devastating social consequences. Research is urgently needed on the chronic neuropsychiatric sequelae of these subtle birth defects of the brain. Identification of these fetal alcohol spectrum disorders (FASD) in the psychiatric nomenclature is a necessary step to focus the attention and resources of the mental health field on this personally and socially significant problem.

  2. Differential cortical neurotrophin and cytogenetic adaptation after voluntary exercise in normal and amnestic rats.

    Science.gov (United States)

    Hall, J M; Vetreno, R P; Savage, L M

    2014-01-31

    Voluntary exercise (VEx) has profound effects on neural and behavioral plasticity, including recovery of CNS trauma and disease. However, the unique regional cortical adaption to VEx has not been elucidated. In a series of experiments, we first examined whether VEx would restore and retain neurotrophin levels in several cortical regions (frontal cortex [FC], retrosplenial cortex [RSC], occipital cortex [OC]) in an animal model (pyrithiamine-induced thiamine deficiency [PTD]) of the amnestic disorder Wernicke-Korsakoff syndrome. In addition, we assessed the time-dependent effect of VEx to rescue performance on a spontaneous alternation task. Following 2-weeks of VEx or stationary housing conditions (Stat), rats were behaviorally tested and brains were harvested either the day after VEx (24-h) or after an additional 2-week period (2-wk). In both control pair-fed (PF) rats and PTD rats, all neurotrophin levels (brain-derived neurotrophic factor [BDNF], nerve growth factor [NGF], and vascular endothelial growth factor) increased at the 24-h period after VEx in the FC and RSC, but not OC. Two-weeks following VEx, BDNF remained elevated in both FC and RSC, whereas NGF remained elevated in only the FC. Interestingly, VEx only recovered cognitive performance in amnestic rats when there was an additional 2-wk adaptation period after VEx. Given this unique temporal profile, Experiment 2 examined the cortical cytogenetic responses in all three cortical regions following a 2-wk adaptation period after VEx. In healthy (PF) rats, VEx increased the survival of progenitor cells in both the FC and RSC, but only increased oligodendrocyte precursor cells (OLPs) in the FC. Furthermore, VEx had a selective effect of only recovering OLPs in the FC in PTD rats. These data reveal the therapeutic potential of exercise to restore cortical plasticity in the amnestic brain, and that the FC is one of the most responsive cortical regions to VEx.

  3. The Role of Sexual Assault and Sexual Dysfunction in Alcohol and Other Drug Use Disorders

    OpenAIRE

    Sanjuan, Pilar M.; Langenbucher, James W.; Labouvie, Erich [UNIFESP

    2006-01-01

    Many women with sexual assault histories receive care in alcohol and other drug treatment programs. Affected women frequently suffer from sexual dysfunction, leading investigators to suggest self-medication may be one path to alcohol and other drug use disorders and relapse. This preliminary study examined sexual dysfunction and sexual assault in 71 women receiving treatment for addiction. Women with prior sexual assault scored higher than non-assaulted women on sexual dysfunction overall, a ...

  4. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

    Directory of Open Access Journals (Sweden)

    Jinhee Lee

    2015-01-01

    Full Text Available Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

  5. Beverage preference and risk of alcohol-use disorders: a Danish prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Knop, Joachim; Mortensen, Erik Lykke;

    2008-01-01

    OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data...... had a risk of 3.1 (CI: 1.8-5.4), whereas those whose total alcohol intake comprised more than 35% wine had a risk of 0.8 (CI: 0.3-2.1). Consuming more than 35% beer increased the risk of AUD for women, whereas the percentage of distilled spirits intake did not influence the risk of AUD for either...... on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women...

  6. An Update on CRF Mechanisms Underlying Alcohol Use Disorders and Dependence

    Science.gov (United States)

    Quadros, Isabel Marian Hartmann; Macedo, Giovana Camila; Domingues, Liz Paola; Favoretto, Cristiane Aparecida

    2016-01-01

    Alcohol is the most commonly used and abused substance worldwide. The emergence of alcohol use disorders, and alcohol dependence in particular, is accompanied by functional changes in brain reward and stress systems, which contribute to escalated alcohol drinking and seeking. Corticotropin-releasing factor (CRF) systems have been critically implied in the transition toward problematic alcohol drinking and alcohol dependence. This review will discuss how dysregulation of CRF function contributes to the vulnerability for escalated alcohol drinking and other consequences of alcohol consumption, based on preclinical evidence. CRF signaling, mostly via CRF1 receptors, seems to be particularly important in conditions of excessive alcohol taking and seeking, including during early and protracted withdrawal, relapse, as well as during withdrawal-induced anxiety and escalated aggression promoted by alcohol. Modulation of CRF1 function seems to exert a less prominent role over low to moderate alcohol intake, or to species-typical behaviors. While CRF mechanisms in the hypothalamic–pituitary–adrenal axis have some contribution to the neurobiology of alcohol abuse and dependence, a pivotal role for extra-hypothalamic CRF pathways, particularly in the extended amygdala, is well characterized. More recent studies further suggest a direct modulation of brain reward function by CRF signaling in the ventral tegmental area, nucleus accumbens, and the prefrontal cortex, among other structures. This review will further discuss a putative role for other components of the CRF system that contribute for the overall balance of CRF function in reward and stress pathways, including CRF2 receptors, CRF-binding protein, and urocortins, a family of CRF-related peptides.

  7. Proton magnetic resonance spectroscopy in children with fetal alcohol spectrum disorders

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Rita de Cassia Ferreira; Vasconcelos, Marcio Moacyr; Faleiros, Leticia Oliveira; Brito, Adriana Rocha; Werner Junior, Jairo; Herdy, Gesmar Volga Haddad [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina], e-mail: rcgonc@hotmail.com; Cruz Junior, Luiz Celso Hygino da; Domingues, Romeu Cortes [Multi-Imagem, Rio de Janeiro, RJ (Brazil)

    2009-06-15

    To analyze the metabolic constitution of brain areas through proton magnetic resonance spectroscopy in children affected with fetal alcohol spectrum disorder compared with normal children. Method: The sample of this case-control study included eight boys with epidemiologic history of in utero exposure to alcohol (median age 13.6{+-}3.8 years) who were diagnosed with fetal alcohol spectrum disorder, and eight controls (median age 12.1{+-}3,4 years). An 8 cm{sup 3} single voxel approach was used, with echo time 30 ms, repetition time 1500 ms, and 128 acquisitions in a 1.5T scanner, and four brain areas were analyzed: anterior cingulate, left frontal lobe, left striatum, and left cerebellar hemisphere. Peaks and ratios of metabolites N-acetylaspartate, choline, creatine, and myo-inositol were measured. Results: Children with fetal alcohol spectrum disorder showed a decrease in choline/creatine ratio (p=0.020) in left striatum and an increase in myo-inositol/creatine ratio (p=0.048) in left cerebellum compared with controls. There was no statistically significant difference in all peaks and ratios from the anterior cingulate and frontal lobe between the two groups. Conclusion: This study found evidence that the left striatum and left cerebellum are affected by intrauterine exposure to alcohol. Additional studies with larger samples are necessary to expand our knowledge of the effects of fetal exposure to alcohol. (author)

  8. Ethanol Exposure Alters Protein Expression in a Mouse Model of Fetal Alcohol Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Stephen Mason

    2012-01-01

    Full Text Available Alcohol exposure during development can result in variable growth retardation and facial dysmorphology known as fetal alcohol spectrum disorders. Although the mechanisms underlying the disorder are not fully understood, recent progress has been made that alcohol induces aberrant changes in gene expression and in the epigenome of embryos. To inform the gene and epigenetic changes in alcohol-induced teratology, we used whole-embryo culture to identify the alcohol-signature protein profile of neurulating C6 mice. Alcohol-treated and control cultures were homogenized, isoelectrically focused, and loaded for 2D gel electrophoresis. Stained gels were cross matched with analytical software. We identified 40 differentially expressed protein spots (P<0.01, and 9 spots were selected for LC/MS-MS identification. Misregulated proteins include serotransferrin, triosephosphate isomerase and ubiquitin-conjugating enzyme E2 N. Misregulation of serotransferrin and triosephosphate isomerase was confirmed with immunologic analysis. Alteration of proteins with roles in cellular function, cell cycle, and the ubiquitin-proteasome pathway was induced by alcohol. Several misregulated proteins interact with effectors of the NF-κB and Myc transcription factor cascades. Using a whole-embryo culture, we have identified misregulated proteins known to be involved in nervous system development and function.

  9. Alcohol-related dementia: an update of the evidence.

    Science.gov (United States)

    Ridley, Nicole J; Draper, Brian; Withall, Adrienne

    2013-01-01

    The characteristics of dementia relating to excessive alcohol use have received increased research interest in recent times. In this paper, the neuropathology, nosology, epidemiology, clinical features, and neuropsychology of alcohol-related dementia (ARD) and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome, or WKS) are reviewed. Neuropathological and imaging studies suggest that excessive and prolonged use of alcohol may lead to structural and functional damage that is permanent in nature; however, there is debate about the relative contributions of the direct toxic effect of alcohol (neurotoxicity hypothesis), and the impact of thiamine deficiency, to lasting damage. Investigation of alcohol-related cognitive impairment has been further complicated by differing definitions of patterns of alcohol use and associated lifestyle factors related to the abuse of alcohol. Present diagnostic systems identify two main syndromes of alcohol-related cognitive impairment: ARD and WKS. However, 'alcohol-related brain damage' is increasingly used as an umbrella term to encompass the heterogeneity of these disorders. It is unclear what level of drinking may pose a risk for the development of brain damage or, in fact, whether lower levels of alcohol may protect against other forms of dementia. Epidemiological studies suggest that individuals with ARD typically have a younger age of onset than those with other forms of dementia, are more likely to be male, and often are socially isolated. The cognitive profile of ARD appears to involve both cortical and subcortical pathology, and deficits are most frequently observed on tasks of visuospatial function as well as memory and higher-order (executive) tasks. The WKS appears more heterogeneous in nature than originally documented, and deficits on executive tasks commonly are reported in conjunction with characteristic memory deficits. Individuals with alcohol-related disorders have the potential to at least

  10. RE-AIM evaluation of the Alcohol and Pregnancy Project: educational resources to inform health professionals about prenatal alcohol exposure and fetal alcohol spectrum disorder.

    Science.gov (United States)

    Payne, Janet M; France, Kathryn E; Henley, Nadine; D'Antoine, Heather A; Bartu, Anne E; O'Leary, Colleen M; Elliott, Elizabeth J; Bower, Carol; Geelhoed, Elizabeth

    2011-03-01

    The objective was to evaluate the Alcohol and Pregnancy Project that provided health professionals in Western Australia (WA) with educational resources to inform them about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder (FASD). The authors developed, produced, and distributed educational resources to 3,348 health professionals in WA. Six months later, they surveyed 1,483 of these health professionals. The authors used the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) to evaluate the project. The educational resources were effective in producing a 31% increase in the proportion of health professionals who routinely provided pregnant women with information about the consequences of drinking alcohol during pregnancy. One hundred percent of the settings adopted the project, it reached 96.3% of the target population, it was implemented as intended, and the resources were maintained (http://www.ichr.uwa.edu.au/alcoholandpregnancy). The educational resources for health professionals have potential to contribute to reducing prenatal alcohol exposure and FASD.

  11. Alcohol

    Science.gov (United States)

    ... that's how many accidents occur. continue What Is Alcoholism? What can be confusing about alcohol is that ... develop a problem with it. Sometimes, that's called alcoholism (say: al-kuh-HOL - ism) or being an ...

  12. Alcohol

    Science.gov (United States)

    If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking ... risky. Heavy drinking can lead to alcoholism and alcohol abuse, as well as injuries, liver disease, heart ...

  13. Celiac disease and alcohol use disorders: increased length of hospital stay, overexpenditures and attributable mortality

    Directory of Open Access Journals (Sweden)

    Miguel Gili

    2013-10-01

    Full Text Available Background and objectives: alcohol use disorders are associated with a greater incidence of certain comorbidities in patients with celiac disease. Currently there is no available information about the impact that these disorders may have on length of hospital stays, overexpenditures during hospital stays, and excess mortality in these patients. Methods: a case-control study was conducted with a selection of patients 18 years and older hospitalized during 2008-2010 in 87 hospitals in Spain. Estimations of excess length of stays, costs, and attributable mortality were calculated using a multivariate analysis of covariance, which included age, gender, hospital group, alcohol use disorders, tobacco related disease and 30 other comorbidities. Results: patients who had both celiac disease and alcohol use disorders had an increased length of hospital stay, an average of 3.1 days longer in women, and 1.7 days longer in men. Excess costs per stay ranged from 838.7 euros in female patients, to 389.1 euros in male patients. Excess attributable mortality was 15.1% in women, 12.2% in men. Conclusions: apart from a gluten-free diet and other medical measures, the prevention of alcohol abuse is indicated in these patients. Patients hospitalized who present these disorders should receive specialized attention after leaving the hospital. Early detection and treatment should be used to prevent the appearance of organic lesions and should not be solely focused on male patients.

  14. Screening for alcohol and drug use disorders among adults in primary care: a review

    Directory of Open Access Journals (Sweden)

    Pilowsky DJ

    2012-04-01

    Full Text Available Daniel J Pilowsky1, Li-Tzy Wu21Departments of Epidemiology and Psychiatry, Columbia University, and the New York State Psychiatric Institute, New York City, NY, 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USABackground: The Patient Protection and Affordable Care Act of 2010 supports integration of substance abuse interventions and treatments into the mainstream health care system. Thus, effective screening and intervention for substance use disorders in health care settings is a priority.Objective: This paper reviews the prevalence of alcohol and drug use disorders (abuse or dependence in primary care settings and emergency departments, as well as current screening tools and brief interventions.Methods: MEDLINE was searched using the following keywords: alcohol use, alcohol use disorder, drug use, drug use disorder, screening, primary care, and emergency departments. Using the related-articles link, additional articles were screened for inclusion. This review focuses on alcohol and drug use and related disorders among adults in primary care settings.Conclusion: Screening, brief intervention, and referral for treatment are feasible and effective in primary care settings, provided that funding for screening is available, along with brief interventions and treatment facilities to which patients can be referred and treated promptly.Keywords: brief intervention, emergency departments

  15. Fetal alcohol spectrum disorders and fetal alcohol syndrome: the state of the art and new diagnostic tools.

    Science.gov (United States)

    Memo, Luigi; Gnoato, Elisa; Caminiti, Stefania; Pichini, Simona; Tarani, Luigi

    2013-06-01

    Ethanol consumption during pregnancy is a widespread problem which is increasing in the generation of young women. Gestational alcohol consumption causes fetal exposure to this teratogen and is associated with the onset of fetal alcohol spectrum disorders (FASD) including fetal alcohol syndrome (FAS). FASD and FAS can lead to several physical, cognitive and behavioral disabilities, whose early diagnosis is of primary importance to perform primary prevention with total abstinence from alcohol during pregnancy and secondary prevention in newborns and children for a proper follow up to reduce risk of secondary consequences. In recent years significant efforts have been made to understand the underlying mechanisms of this disease and to identify objective biological and instrumental diagnostic tools, such as exposure biomarkers in neonatal meconium and advanced magnetic resonance imaging. Nonetheless, further studies are still needed to implement our knowledge on fetal effects of ethanol, and multidisciplinary actions are necessary to raise awareness among women of childbearing age about the danger of consuming even small amounts of ethanol during pregnancy.

  16. Prevalence and correlates of alcohol dependence disorder among TB and HIV infected patients in Zambia.

    Directory of Open Access Journals (Sweden)

    Rebecca O'Connell

    Full Text Available To determine the prevalence and correlates of alcohol dependence disorders in persons receiving treatment for HIV and Tuberculosis (TB at 16 Primary Health Care centres (PHC across Zambia.649 adult patients receiving treatment for HIV and/or TB at PHCs in Zambia (363 males, 286 females were recruited between 1st December 2009 and 31st January 2010. Data on socio-demographic variables, clinical disease features (TB and HIV, and psychopathological status were collected. The Mini International Neuropsychiatric Interview (MINI was used to diagnose alcohol dependence disorder. Correlates of alcohol dependence were analyzed for men only, due to low prevalence in women. Univariable and multivariable logistic regression models were used to estimate odds ratios (OR and 95% confidence intervals (CI, using general estimating equations to allow for within-PHC clustering.The prevalence of alcohol dependence was 27.2% (95%CI: 17.7-39.5% for men and 3.9% (95%CI: 1.4-0.1% for women. Factors associated with alcohol dependence disorder in men included being single, divorced or widowed compared with married (adjusted OR = 1.47, 95%CI: 1.00-2.14 and being unemployed (adjusted OR=1.30, 95%CI: 1.01-1.67. The highest prevalence of alcohol dependence was among HIV-test unknown TB patients (34.7%, and lowest was among HIV positive patients on treatment but without TB (14.1%, although the difference was not statistically significant (p=0.38.Male TB/HIV patients in this population have high prevalence of alcohol dependence disorder, and prevalence differs by HIV/TB status. Further work is needed to explore interventions to reduce harmful drinking in this population.

  17. Analysis of Verbal Fluency Ability in Amnestic and Non-Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Weakley, Alyssa; Schmitter-Edgecombe, Maureen; Anderson, Jonathan

    2013-01-01

    The purpose of this study was to investigate the pattern of performance on letter and category fluency tests of individuals with mild cognitive impairment (MCI). Previous research has suggested that organization strategies, including “clustering” (i.e., groups of related words) and “switching” (i.e., shift from one cluster to another), are important for efficient verbal fluency performance. Participants were 25 individuals with single-domain amnestic MCI (aMCI), 49 with multidomain aMCI, 16 with non-amnestic MCI (naMCI), and 90 cognitively healthy older adults. Fluency performances were analyzed across two 30-s intervals for total words produced, cluster size, and switching. Analyses of variance (ANOVAs) with follow-up tests revealed that the single-domain aMCI group performed comparably with healthy controls on each dependent measure across both fluency tasks. In contrast, the multidomain aMCI group showed performance decrements in total words and switching production compared with healthy controls on both fluency tasks, whereas the naMCI group produced fewer words and switches on letter fluency. Each group generated more words and switches during the first 30-s on both fluency tasks, with the exception of the naMCI group, whose switching on letter fluency did not decrease as the task progressed. As indicated by the single-domain aMCI group's unimpaired performance, our findings demonstrate that verbal fluency performance decreases as domains beyond memory become impaired in MCI. Reduced switching ability, which has been linked to prefrontal executive functioning, contributed the most to the poorer performance of individuals with multidomain MCI and naMCI. PMID:23917346

  18. Glycosylation defects underlying fetal alcohol spectrum disorder: a novel pathogenetic model. "When the wine goes in, strange things come out" - S.T. Coleridge, The Piccolomini.

    NARCIS (Netherlands)

    Binkhorst, M.; Wortmann, S.B.; Funke, S.; Kozicz, T.L.; Wevers, R.A.; Morava, E.

    2012-01-01

    Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe the craniofacial dysmorphic features, malformations, and disturbances in growth, neurodevelopment and behavior occurring in individuals prenatally exposed to alcohol. Fetal alcohol syndrome (FAS) represents the severe end of

  19. Hybrid Cognitive Behavioral Therapy versus Relaxation Training for Co-Occurring Anxiety and Alcohol Disorder: A Randomized Clinical Trial

    Science.gov (United States)

    Kushner, Matt G.; Maurer, Eric W.; Thuras, Paul; Donahue, Chris; Frye, Brenda; Menary, Kyle R.; Hobbs, Jennifer; Haeny, Angela M.; Van Demark, Joani

    2013-01-01

    Objective: Treatment for alcohol use disorder (AUD) is far less effective for those with a co-occurring anxiety disorder. Surprisingly, adding an independent anxiety treatment to AUD treatment does not substantially improve the poor alcohol outcomes of these patients. This may reflect the lack of attention from independent treatments to the…

  20. The Feasibility of Screening for Fetal Alcohol Spectrum Disorders Risk in Early Intervention Settings: A Pilot Study of Systems Change

    Science.gov (United States)

    Watson, Enid; Finkelstein, Norma; Gurewich, Deborah; Morse, Barbara

    2011-01-01

    Prenatal alcohol exposure can result in fetal alcohol spectrum disorders (FASD), which can include physical and neurobehavioral disorders, including cognitive, social, language, and motor impairments that can persist throughout life. In order for children with FASD to receive the full benefit of services, recognition of their disability needs to…

  1. What is fetal alcohol spectrum disorders (FASDs) and why is it important that I know about it?

    Science.gov (United States)

    ... fetal alcohol spectrum disorders (FASDs) and why is it important that I know about it? Recommend on Facebook Tweet Share Compartir What should ... fetal alcohol spectrum disorders(FASDs) and why is it important for me to know about them? What ...

  2. Alcohol Use Disorders in National Samples of Mexicans and Mexican-Americans: The Mexican National Addiction Survey and the U.S. National Alcohol Survey

    Science.gov (United States)

    Borges, Guilherme; Medina-Mora, Maria Elena; Lown, Anne; Ye, Yu; Robertson, Marjorie J.; Cherpitel, Cheryl; Greenfield, Tom

    2006-01-01

    The authors show associations between immigration and alcohol disorders using data from the 1995 and 2000 U.S. National Alcohol Surveys and the 1998 Mexico National Household Survey on Addictions. The prevalence of alcohol dependence was 4.8% for the Mexicans, 4.2% for the Mexico-born immigrants, and 6.6% for the U.S.-born Mexican Americans. They…

  3. Acetaldehyde-Mediated Neurotoxicity: Relevance to Fetal Alcohol Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Ming Tong

    2011-01-01

    Full Text Available Ethanol-induced neuro-developmental abnormalities are associated with impaired insulin and IGF signaling, and increased oxidative stress in CNS neurons. We examined the roles of ethanol and its principal toxic metabolite, acetaldehyde, as mediators of impaired insulin/IGF signaling and oxidative injury in immature cerebellar neurons. Cultures were exposed to 3.5 mM acetaldehyde or 50 mM ethanol ± 4-methylpyrazole (4-MP, an inhibitor of ethanol metabolism, and viability, mitochondrial function, oxidative stress, DNA damage, and insulin responsiveness were measured 48 hours later. Acetaldehyde or ethanol increased neuronal death and levels of 8-OHdG and 4-HNE, and reduced mitochondrial function. Ethanol inhibited insulin responsiveness, whereas acetaldehyde did not. 4-MP abated ethanol-induced oxidative stress and mitochondrial dysfunction, but failed to restore insulin responsiveness. Furthermore, alcohol and aldehyde metabolizing enzyme genes were inhibited by prenatal ethanol exposure; this effect was mediated by acetaldehyde and not ethanol + 4MP. These findings suggest that brain insulin resistance in prenatal alcohol exposure is caused by direct effects of ethanol, whereas oxidative stress induced neuronal injury is likely mediated by ethanol and its toxic metabolites. Moreover, the adverse effects of prenatal ethanol exposure on brain development may be exacerbated by down-regulation of genes needed for metabolism and detoxification of alcohol in the brain.

  4. Neurophysiological Endophenotypes, CNS Disinhibition, and Risk for Alcohol Dependence and Related Disorders

    Directory of Open Access Journals (Sweden)

    Bernice Porjesz

    2007-01-01

    Full Text Available Biological endophenotypes are more proximal to gene function than psychiatric diagnosis, providing a powerful strategy in searching for genes in psychiatric disorders. These intermediate phenotypes identify both affected and unaffected members of an affected family, including offspring at risk, providing a more direct connection with underlying biological vulnerability. The Collaborative Study on the Genetics of Alcoholism (COGA has employed heritable neurophysiological features (i.e., brain oscillations as endophenotypes, making it possible to identify susceptibility genes that may be difficult to detect with diagnosis alone. We found significant linkage and association between brain oscillations and genes involved with inhibitory neural networks (e.g., GABRA2, CHRM2, including frontal networks that are deficient in individuals with alcohol dependence, impulsivity, and related disinhibitory disorders. We reported significant linkage and linkage disequilibrium for the beta frequency of the EEG and GABRA2, a GABAA receptor gene on chromosome 4, which we found is also associated with diagnosis of alcohol dependence and related disorders. More recently, we found significant linkage and association with GABRA2 and interhemispheric theta coherence. We also reported significant linkage and linkage disequilibrium between the theta and delta event-related oscillations underlying P3 to target stimuli and GABRA2, a cholinergic muscarinic receptor gene on chromosome 7, which we found is also associated with diagnosis of alcohol dependence and related disorders. Thus, the identification of genes important for the expression of the endophenotypes (brain oscillations helps when identifying genes that increase the susceptibility for risk of alcohol dependence and related disorders. These findings underscore the utility of quantitative neurophysiological endophenotypes in the study of the genetics of complex disorders. We will present our recent genetic

  5. Neurophysiological endophenotypes, CNS disinhibition, and risk for alcohol dependence and related disorders.

    Science.gov (United States)

    Porjesz, Bernice; Rangaswamy, Madhavi

    2007-01-01

    Biological endophenotypes are more proximal to gene function than psychiatric diagnosis, providing a powerful strategy in searching for genes in psychiatric disorders. These intermediate phenotypes identify both affected and unaffected members of an affected family, including offspring at risk, providing a more direct connection with underlying biological vulnerability. The Collaborative Study on the Genetics of Alcoholism (COGA) has employed heritable neurophysiological features (i.e., brain oscillations) as endophenotypes, making it possible to identify susceptibility genes that may be difficult to detect with diagnosis alone. We found significant linkage and association between brain oscillations and genes involved with inhibitory neural networks (e.g., GABRA2, CHRM2), including frontal networks that are deficient in individuals with alcohol dependence, impulsivity, and related disinhibitory disorders. We reported significant linkage and linkage disequilibrium for the beta frequency of the EEG and GABRA2, a GABAA receptor gene on chromosome 4, which we found is also associated with diagnosis of alcohol dependence and related disorders. More recently, we found significant linkage and association with GABRA2 and interhemispheric theta coherence. We also reported significant linkage and linkage disequilibrium between the theta and delta event-related oscillations underlying P3 to target stimuli and CHRM2, a cholinergic muscarinic receptor gene on chromosome 7, which we found is also associated with diagnosis of alcohol dependence and related disorders. Thus, the identification of genes important for the expression of the endophenotypes (brain oscillations) helps when identifying genes that increase the susceptibility for risk of alcohol dependence and related disorders. These findings underscore the utility of quantitative neurophysiological endophenotypes in the study of the genetics of complex disorders. We will present our recent genetic findings related to

  6. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    Science.gov (United States)

    Jiménez-Murcia, Susana; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Hakänsson, Anders; Tárrega, Salomé; Valdepérez, Ana; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Sauvaget, Anne; Romeu, Maria; Steward, Trevor; Menchón, José M.

    2016-01-01

    Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10–14 patients attending 16 weekly outpatient sessions lasting 90 min each. Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment. PMID:27065113

  7. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    Directory of Open Access Journals (Sweden)

    Susana eJiménez-Murcia

    2016-03-01

    Full Text Available Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT program.Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD= 12.2. All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10-14 patients attending 16 weekly outpatient sessions lasting 90 min each.Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes.Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment.

  8. Fatty acids and oxidative stress in psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Tonello Lucio

    2008-04-01

    Full Text Available Abstract Background The aim of this study was to determine whether there is published evidence for increased oxidative stress in neuropsychiatric disorders. Methods A PubMed search was carried out using the MeSH search term 'oxidative stress' in conjunction with each of the DSM-IV-TR diagnostic categories of the American Psychiatric Association in order to identify potential studies. Results There was published evidence of increased oxidative stress in the following DSM-IV-TR diagnostic categories: mental retardation; autistic disorder; Rett's disorder; attention-deficit hyperactivity disorder; delirium; dementia; amnestic disorders; alcohol-related disorders; amphetamine (or amphetamine-like-related disorders; hallucinogen-related disorders; nicotine-related disorders; opioid-related disorders; schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; sexual dysfunctions; eating disorders; and sleep disorders. Conclusion Most psychiatric disorders are associated with increased oxidative stress. Patients suffering from that subgroup of these psychiatric disorders in which there is increased lipid peroxidation might therefore benefit from fatty acid supplementation (preferably with the inclusion of an antioxidant-rich diet while patients suffering from all these psychiatric disorders might benefit from a change to a whole-food plant-based diet devoid of refined carbohydrate products.

  9. Alcohol use, cigarette consumption and chronic post-traumatic stress disorder

    NARCIS (Netherlands)

    Op den Velde, W; Aarts, PGH; Falger, PRJ; Hovens, JE; van Duijn, H; de Groen, JHM; van Duijn, MAJ

    2002-01-01

    Aims: The relationship between alcohol consumption, cigarette smoking and post-traumatic stress disorder (PTSD) was studied in 147 male former members of the civilian resistance against the Nazi occupation of Holland during World War II. Methods: The subjects were interviewed at home. Measures inclu

  10. Executive functioning before and after onset of alcohol use disorder in adolescence : A TRAILS study

    NARCIS (Netherlands)

    Boelema, Sarai R; Harakeh, Zeena; van Zandvoort, Martine J E; Reijneveld, Sijmen A; Verhulst, Frank C; Ormel, Johan; Vollebergh, Wilma A M

    2016-01-01

    INTRODUCTION: The aim of the present study was to investigate whether executive functioning (EF) in early adolescence predicted alcohol use disorder (AUD) in late adolescence and whether adolescents with AUD differed in maturation of EF from controls without a diagnosis. METHODS: We used the data fr

  11. Prenatal Alcohol Exposure Is Associated with Conduct Disorder in Adolescence: Findings from a Birth Cohort

    Science.gov (United States)

    Larkby, Cynthia A.; Goldschmidt, Lidush; Hanusa, Barbara H.; Day, Nancy L.

    2011-01-01

    Objective: To evaluate the association between prenatal alcohol exposure and the rate of conduct disorder in exposed compared with unexposed adolescents. Method: Data for these analyses are from a longitudinal study of prenatal substance exposures. Women were interviewed at their fourth and seventh prenatal months, and with their children, at…

  12. Behavioural aspects of impulsivity in alcoholics with and without a cluster-B personality disorder

    NARCIS (Netherlands)

    G. Dom; B. de Wilde; W. Hulstijn; W. van den Brink; B. Sabbe

    2006-01-01

    Aims: Studies have shown that alcoholics with a cluster-B personality disorder (cluster-B PD) are characterized by high levels of impulsivity. However, impulsivity has mainly been studied as a broad concept without its different aspects being considered. The present study compared abstinent alcoholi

  13. Educational Advocacy among Adoptive Parents of Adolescents with Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Duquette, Cheryll Ann; Stodel, Emma J.; Fullarton, Stephanie; Hagglund, Karras

    2012-01-01

    The purpose of this qualitative study was to examine the educational advocacy experiences of 36 adoptive parents of adolescents and young adults with fetal alcohol spectrum disorder (FASD). The participants responded to a questionnaire and 29 of them also engaged in an in-depth individual interview. Data were analysed inductively. Emerging from…

  14. Supporting Individuals with Fetal Alcohol Spectrum Disorders:a Summary of Effective Practices

    Science.gov (United States)

    Riggie, Jennifer; Xu, Tingting

    2013-01-01

    Fetal alcohol spectrum disorder (FASD) is a lifelong condition that significantly affects the individual's learning, development, behavior, family, and quality of life. Diagnosing children with this condition and providing effective supports is challenging for professionals because little intervention research has been performed with the…

  15. The Relation between Mathematics and Working Memory in Young Children with Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Rasmussen, Carmen; Bisanz, Jeffrey

    2011-01-01

    The goal of this study was to examine the relation between mathematics and working memory in young children with Fetal Alcohol Spectrum Disorders (FASD). Children with FASD and comparison children (4 to 6 years old) completed standardized tests of mathematics and working memory. Children with FASD showed impairments on mathematics (applied…

  16. Children and Youth with Fetal Alcohol Spectrum Disorders: Summary of Intervention Recommendations after Clinical Diagnosis

    Science.gov (United States)

    Jirikowic, Tracy; Gelo, Julie; Astley, Susan

    2010-01-01

    Children with fetal alcohol spectrum disorders (FASDs) present with a wide range of developmental disabilities; however, clinical standards of care after a diagnosis are not well established. This retrospective review summarizes the types of intervention recommendations generated by an interdisciplinary FASD diagnostic team for 120 children ages…

  17. Educating Children and Young People with Fetal Alcohol Spectrum Disorders: Constructing Personalised Pathways to Learning

    Science.gov (United States)

    Blackburn, Carolyn; Carpenter, Barry; Egerton, Jo

    2012-01-01

    The range of learning difficulties associated with children and young people who have Fetal Alcohol Spectrum Disorders (FASD) has been highlighted as an emerging but little understood area of Special Educational Needs. This engaging, timely and highly practical book will raise awareness about FASD and its associated difficulties across the entire…

  18. Alcohol Medical Scholars Program--A Mentorship Program for Improving Medical Education regarding Substance Use Disorders

    Science.gov (United States)

    Neufeld, Karin J.; Schuckit, Marc A.; Hernandez-Avila, Carlos A.

    2011-01-01

    The Alcohol Medical Scholars Program (AMSP) is designed to improve medical education related to substance use disorders (SUDs) through mentorship of junior, full-time academic faculty from medical schools across the United States. Scholarship focuses on literature review and synthesis, lecture development and delivery, increasing SUD education in…

  19. Pedagogically Bereft! Improving Learning Outcomes for Children with Foetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Carpenter, Barry

    2011-01-01

    Foetal alcohol spectrum disorder (FASD) is the most common non-genetic cause of learning disability, affecting around 1% of live births in Europe, and costing an estimated $2.9 million per individual across their lifespan. In adulthood, non-reversible brain damage is often compounded by secondary disabilities in adulthood, such as mental health…

  20. Instructional Tips: Supporting the Educational Needs of Students with Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Ryan, Susan Marie

    2006-01-01

    The Center on Disease Control, Substance Abuse and Mental Health Administration (2005) identified the prevalence of Fetal Alcohol Spectrum Disorders (FASD) as being 10 per 1,000. The Substance Abuse and Mental Health Services Administration (SAMHSA) has further explained (2005) that FASD now outranks autism and Down syndrome in prevalence.…

  1. Exploring Continuity of Care in Patients with Alcohol Use Disorders Using Time-Variant Measures

    NARCIS (Netherlands)

    S.C. de Vries (Sjoerd); A.I. Wierdsma (André)

    2009-01-01

    textabstractBackground/Aims: We used time-variant measures of continuity of care to study fluctuations in long-term treatment use by patients with alcohol-related disorders. Methods: Data on service use were extracted from the Psychiatric Case Register for the Rotterdam Region, The Netherlands. Cont

  2. Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: clinical guidelines

    Directory of Open Access Journals (Sweden)

    Elizabeth Peadon

    2010-08-01

    Full Text Available Elizabeth Peadon, Elizabeth J ElliottDiscipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, AustraliaAbstract: Fetal alcohol spectrum disorders (FASD are the physical and neurodevelopmental outcomes of fetal alcohol exposure. The behavioral phenotype of children with FASD includes difficulties with executive function, memory, planning, processing speed, and attention. Although attention deficit hyperactivity disorder (ADHD is diagnosed in up to 94% of individuals with heavy prenatal alcohol exposure, the exact relationship between FASD and ADHD is unclear. There is some evidence that ADHD in FASD may be a specific clinical subtype and thus may require a different treatment approach. Although traditional behavioral observation scales may not distinguish between the two groups, there is evidence that children with FASD have a different profile on the four-factor model of attention than children with ADHD who do not have FASD. There is a paucity of good scientific evidence on effective interventions for individuals with ADHD and FASD. There is weak evidence that children with FASD and ADHD may have a better response to dexamphetamine than methylphenidate. There is a strong need for larger, high quality studies to examine the relationship between ADHD and FASD and identify effective treatments because management of inattention and hyperactivity may improve learning and ameliorate the common secondary disabilities associated with FASD.Keywords: fetal alcohol spectrum disorders, attention deficit hyperactivity disorder

  3. Gut-brain peptides in corticostriatal-limbic circuitry and alcohol use disorders

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    Chelsea A Vadnie

    2014-09-01

    Full Text Available Peptides synthesized in endocrine cells in the gastrointestinal tract and neurons are traditionally considered regulators of metabolism, energy intake, and appetite. However, recent work has demonstrated that many of these peptides act on corticostriatal-limbic circuitry and, in turn, regulate addictive behaviors. Given that alcohol is a source of energy and an addictive substance, it is not surprising that increasing evidence supports a role for gut-brain peptides specifically in alcohol use disorders (AUD. In this review, we discuss the effects of several gut-brain peptides on alcohol-related behaviors and the potential mechanisms by which these gut-brain peptides may interfere with alcohol-induced changes in corticostriatal-limbic circuitry. This review provides a summary of current knowledge on gut-brain peptides focusing on five peptides: neurotensin, glucagon-like peptide 1, ghrelin, substance P, and neuropeptide Y. Our review will be helpful to develop novel therapeutic targets for AUD.

  4. Metabotropic and ionotropic glutamate receptors as potential targets for the treatment of alcohol use disorder.

    Science.gov (United States)

    Goodwani, Sunil; Saternos, Hannah; Alasmari, Fawaz; Sari, Youssef

    2017-02-24

    Emerging evidence indicates that dysfunctional glutamate neurotransmission is critical in the initiation and development of alcohol and drug dependence. Alcohol consumption induced downregulation of glutamate transporter 1 (GLT-1) as reported in previous studies from our laboratory. Glutamate is the major excitatory neurotransmitter in the brain, which acts via interactions with several glutamate receptors. Alcohol consumption interferes with the glutamatergic signal transmission by altering the functions of these receptors. Among the glutamate receptors involved in alcohol-drinking behavior are the metabotropic receptors such as mGluR1/5, mGluR2/3, and mGluR7, as well as the ionotropic receptors, NMDA and AMPA. Preclinical studies using agonists and antagonists implicate these glutamatergic receptors in the development of alcohol use disorder (AUD). Therefore, the purpose of this review is to discuss the neurocircuitry involving glutamate transmission in animals exposed to alcohol and further outline the role of metabotropic and ionotropic receptors in the regulation of alcohol-drinking behavior. This review provides ample information about the potential therapeutic role of glutamatergic receptors for the treatment of AUD.

  5. Alcohol use disorders increase the risk of completed suicide - Irrespective of other psychiatric disorders. A longitudinal cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Knop, Joachim; Mortensen, Erik Lykke

    2009-01-01

    Knowledge of the epidemiology of suicide is a necessary prerequisite for developing prevention programs. The aim of this study was to analyze the risk of completed suicide among individuals with alcohol use disorders (AUD), and to assess the role of other psychiatric disorders in this association....... A prospective cohort study was used, containing three updated sets of lifestyle covariates and 26 years follow-up of 18,146 individuals between 20 and 93 years of age from the Copenhagen City Heart Study in Denmark. The study population was linked to four different registers in order to detect: Completed...

  6. The Influence of Gene-Environment Interactions on Alcohol Consumption and Alcohol Use Disorders: A Comprehensive Review

    Science.gov (United States)

    Young-Wolff, Kelly C.; Enoch, Mary-Anne; Prescott, Carol A.

    2011-01-01

    Since 2005, a rapidly expanding literature has evaluated whether environmental factors such as socio-cultural context and environmental adversity interact with genetic influences on drinking behaviors. This article critically reviews empirical research on alcohol-related genotype-environment interactions (GxE) and provides a contextual framework for understanding how genetic factors combine with (or are shaped by) environmental influences to influence the development of drinking behaviors and alcohol use disorders. Collectively, evidence from twin, adoption, and molecular genetic studies indicates that the degree of importance of genetic influences on risk for drinking outcomes can vary in different populations and under different environmental circumstances. However, methodological limitations and lack of consistent replications in this literature make it difficult to draw firm conclusions regarding the nature and effect size of alcohol-related GxE. On the basis of this review, we describe several methodological challenges as they relate to current research on GxE in drinking behaviors and provide recommendations to aid future research. PMID:21530476

  7. Outpatient treatment of alcohol use disorders among subjects 60+ years

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Bogenschutz, Michael P; Bühringer, Gerhard;

    2015-01-01

    disorders (AUD). We present the rationale and design of a multisite, multinational AUD treatment study for subjects aged 60+ years. METHODS/DESIGN: 1,000 subjects seeking treatment for AUD according to DSM-5 in outpatient clinics in Denmark, Germany, and New Mexico (USA) are invited to participate in a RCT...

  8. Anxiety Sensitivity as a Prospective Predictor of Alcohol Use Disorders

    Science.gov (United States)

    Schmidt, Norman B.; Buckner, Julia D.; Keough, Meghan E.

    2007-01-01

    Emerging evidence suggests that elevated anxiety sensitivity (AS) is associated with substance use disorders. However, prospective evidence regarding this association is currently lacking. The primary aim of the present study was to determine whether AS is involved in the pathogenesis of substance-related psychopathology. A large, nonclinical…

  9. An economic evaluation of the parent-child assistance program for preventing fetal alcohol spectrum disorder in Alberta, Canada.

    Science.gov (United States)

    Thanh, Nguyen Xuan; Jonsson, Egon; Moffatt, Jessica; Dennett, Liz; Chuck, Anderson W; Birchard, Shelley

    2015-01-01

    Parent-Child Assistance Program (P-CAP) is a 3-year home visitation/harm reduction intervention to prevent alcohol exposed births, thereby births with fetal alcohol spectrum disorder, among high-risk women. This article used a decision analytic modeling technique to estimate the incremental cost-effectiveness ratio and the net monetary benefit of the P-CAP within the Alberta Fetal Alcohol Spectrum Disorder Service Networks in Canada. The results indicate that the P-CAP is cost-effective and support placing a high priority not only on reducing alcohol use during pregnancy, but also on providing effective contraceptive measures when a program is launched.

  10. Clock genes × stress × reward interactions in alcohol and substance use disorders.

    Science.gov (United States)

    Perreau-Lenz, Stéphanie; Spanagel, Rainer

    2015-06-01

    Adverse life events and highly stressful environments have deleterious consequences for mental health. Those environmental factors can potentiate alcohol and drug abuse in vulnerable individuals carrying specific genetic risk factors, hence producing the final risk for alcohol- and substance-use disorders development. The nature of these genes remains to be fully determined, but studies indicate their direct or indirect relation to the stress hypothalamo-pituitary-adrenal (HPA) axis and/or reward systems. Over the past decade, clock genes have been revealed to be key-players in influencing acute and chronic alcohol/drug effects. In parallel, the influence of chronic stress and stressful life events in promoting alcohol and substance use and abuse has been demonstrated. Furthermore, the reciprocal interaction of clock genes with various HPA-axis components, as well as the evidence for an implication of clock genes in stress-induced alcohol abuse, have led to the idea that clock genes, and Period genes in particular, may represent key genetic factors to consider when examining gene × environment interaction in the etiology of addiction. The aim of the present review is to summarize findings linking clock genes, stress, and alcohol and substance abuse, and to propose potential underlying neurobiological mechanisms.

  11. Methods for inducing alcohol craving in individuals with co-morbid alcohol dependence and posttraumatic stress disorder: behavioral and physiological outcomes.

    Science.gov (United States)

    Kwako, Laura E; Schwandt, Melanie L; Sells, Joanna R; Ramchandani, Vijay A; Hommer, Daniel W; George, David T; Sinha, Rajita; Heilig, Markus

    2015-07-01

    Alcohol addiction is a chronic relapsing disorder that presents a substantial public health problem, and is frequently co-morbid with posttraumatic stress disorder (PTSD). Craving for alcohol is a predictor of relapse to alcohol use, and is triggered by cues associated with alcohol and trauma. Identification of reliable and valid laboratory methods for craving induction is an important objective for alcoholism and PTSD research. The present study compares two methods for induction of craving via stress and alcohol cues in individuals with co-morbid alcohol dependence (AD) and PTSD: the combined Trier social stress test and cue reactivity paradigm (Trier/CR), and a guided imagery (Scripts) paradigm. Outcomes include self-reported measures of craving, stress and anxiety as well as endocrine measures. Subjects were 52 individuals diagnosed with co-morbid AD and PTSD seeking treatment at the National Institute on Alcohol Abuse and Alcoholism inpatient research facility. They participated in a 4-week inpatient study of the efficacy of a neurokinin 1 antagonist to treat co-morbid AD and PTSD, and which included the two challenge procedures. Both the Trier/CR and Scripts induced craving for alcohol, as well as elevated levels of subjective distress and anxiety. The Trier/CR yielded significant increases in adrenocorticotropic hormone and cortisol, while the Scripts did not. Both paradigms are effective laboratory means of inducing craving for alcohol. Further research is warranted to better understand the mechanisms behind craving induced by stress versus alcohol cues, as well as to understand the impact of co-morbid PTSD and AD on craving.

  12. Meta-analysis of supplemental treatment for depressive and anxiety disorders in patients being treated for alcohol dependence.

    Science.gov (United States)

    Hobbs, Jennifer D J; Kushner, Matt G; Lee, Susanne S; Reardon, Sean M; Maurer, Eric W

    2011-01-01

    Approximately half of those receiving treatment for an alcohol use disorder (AUD) also suffer with an anxiety or depressive (internalizing) disorder. Because all internalizing disorders mark a poor alcohol treatment outcome, it seems reasonable to supplement AUD treatment with a psychiatric intervention when these disorders co-occur with AUD. However, this conclusion may be faulty given that the various possible interrelationships between AUD and internalizing disorders do not uniformly imply a high therapeutic yield from this approach. Unfortunately, the studies conducted to date have been too few and too small to resolve this important clinical issue with confidence. Therefore, we used a meta-analytic method to synthesize the effects from published randomized controlled trials examining the impact of supplementing AUD treatment with a psychiatric treatment for co-occurring internalizing disorder (N = 15). We found a pooled effect size (d) of .32 for internalizing outcomes and .22 for a composite of alcohol outcomes; however, the alcohol outcomes effect sizes were greater than this for some specific outcome domains. Subgroups that differed in terms of internalizing outcomes included treatment type (medication vs. cognitive behavioral therapy) and treatment focus (anxiety vs. depression). There was also a trend for the studies with better internalizing disorder outcomes to have better alcohol outcomes. These results indicate that clinical outcomes (both psychiatric and alcohol-related) could be somewhat improved by supplementing AUD treatment with psychiatric treatment for co-occurring internalizing disorder.

  13. Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders: findings from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    L. Boschloo; N. Vogelzangs; J.H. Smit; W. van den Brink; D.J. Veltman; A.T.F. Beekman; B.W.J.H. Penninx

    2011-01-01

    This study examines comorbidity of alcohol abuse and alcohol dependence as well as its risk indicators among anxious and/or depressed persons, also considering temporal sequencing of disorders. Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 2329 perso

  14. Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

    Directory of Open Access Journals (Sweden)

    Kåreholt Ingemar

    2011-07-01

    Full Text Available Abstract Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735. Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.

  15. [Early detection, negotiation and treatment of alcohol use disorders in primary care].

    Science.gov (United States)

    Reimer, J; Cimander, K F; Reimer, C

    2014-05-01

    Subjects with alcohol dependence or alcohol-related health problems frequently use the primary care system without receiving the correct diagnosis or specific interventions. Stigma, lack of knowledge and know-how with regards to diagnosis and treatment of alcohol-related disorders on the site of the health care professionals may contribute to the treatment gap. General anamnesis, clinical evaluation, and laboratory parameters can serve as indicators, and validated screening tests can further corroborate the hypothesis. However, a diagnosis should only be made according to ICD-10 criteria. Adequate counselling techniques substantially contribute to successful physician-patient interaction. Motivational Interviewing combines a positive, appreciative attitude with communicative techniques to create a motivation to change. It includes general approaches as open questions, appreciation of the patient, active listening, summarizing results as well as specific approaches such as change and confidence talk and dealing with resistance. Within a positive relationship, the conversation can lead to change. Brief interventions cover four to five sessions with a duration between five and sixty minutes. Brief interventions based on an empathic attitude und reflection of findings, a brief advice leaving the responsibility on the patient's side and supporting self-efficacy can improve alcohol-related disorders. The transtheoretical model of change may help the health care provider to adapt intervention strategies to the patient's state. Primary health care provides an adequate framework for screening, diagnosis and intervention for alcohol-related disorders with the aim of reduction or abstinence. Further institutions in addiction treatment such as self-help and clinical institutions may complement the treatment system.

  16. People with gambling disorder and risky alcohol habits benefit more from motivational interviewing than from cognitive behavioral group therapy.

    Science.gov (United States)

    Josephson, Henrik; Carlbring, Per; Forsberg, Lars; Rosendahl, Ingvar

    2016-01-01

    Background. Effective psychological treatment, including cognitive behavioral therapy and motivational interviewing (MI), is available for people with problematic gambling behaviors. To advance the development of treatment for gambling disorder, it is critical to further investigate how comorbidity impacts different types of treatments. The purpose of this study was to investigate whether screening for risky alcohol habits can provide guidance on whether people with gambling disorder should be recommended cognitive behavioral group therapy (CBGT) or MI. Methods. The present study is a secondary analysis of a previous randomized controlled trial that compared the effects of CBGT, MI and a waitlist control group in the treatment of disordered gambling. Assessment and treatment was conducted at an outpatient dependency clinic in Stockholm, Sweden, where 53 trial participants with gambling disorder began treatment. A modified version of the National Opinion Research Centre DSM-IV Screen for gambling problems was used to assess gambling disorder. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen for risky alcohol habits. Results. The interaction between treatment and alcohol habits was significant and suggests that patients with gambling disorder and risky alcohol habits were better helped by MI, while those without risky alcohol habits were better helped by CBGT. Conclusions. The results support a screening procedure including the AUDIT prior to starting treatment for gambling disorder because the result of the screening can provide guidance in the choice of treatment. Patients with gambling disorder and risky alcohol habits are likely to be best helped if they are referred to MI, while those without risky alcohol habits are likely to be best helped if they are referred to CBGT.

  17. People with gambling disorder and risky alcohol habits benefit more from motivational interviewing than from cognitive behavioral group therapy

    Directory of Open Access Journals (Sweden)

    Henrik Josephson

    2016-03-01

    Full Text Available Background. Effective psychological treatment, including cognitive behavioral therapy and motivational interviewing (MI, is available for people with problematic gambling behaviors. To advance the development of treatment for gambling disorder, it is critical to further investigate how comorbidity impacts different types of treatments. The purpose of this study was to investigate whether screening for risky alcohol habits can provide guidance on whether people with gambling disorder should be recommended cognitive behavioral group therapy (CBGT or MI. Methods. The present study is a secondary analysis of a previous randomized controlled trial that compared the effects of CBGT, MI and a waitlist control group in the treatment of disordered gambling. Assessment and treatment was conducted at an outpatient dependency clinic in Stockholm, Sweden, where 53 trial participants with gambling disorder began treatment. A modified version of the National Opinion Research Centre DSM-IV Screen for gambling problems was used to assess gambling disorder. The Alcohol Use Disorders Identification Test (AUDIT was used to screen for risky alcohol habits. Results. The interaction between treatment and alcohol habits was significant and suggests that patients with gambling disorder and risky alcohol habits were better helped by MI, while those without risky alcohol habits were better helped by CBGT. Conclusions. The results support a screening procedure including the AUDIT prior to starting treatment for gambling disorder because the result of the screening can provide guidance in the choice of treatment. Patients with gambling disorder and risky alcohol habits are likely to be best helped if they are referred to MI, while those without risky alcohol habits are likely to be best helped if they are referred to CBGT.

  18. Visual personal familiarity in amnestic mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Luisa Jurjanz

    Full Text Available BACKGROUND: Patients with amnestic mild cognitive impairment are at high risk for developing Alzheimer's disease. Besides episodic memory dysfunction they show deficits in accessing contextual knowledge that further specifies a general concept or helps to identify an object or a person. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging, we investigated the neural networks associated with the perception of personal familiar faces and places in patients with amnestic mild cognitive impairment and healthy control subjects. Irrespective of stimulus type, patients compared to control subjects showed lower activity in right prefrontal brain regions when perceiving personally familiar versus unfamiliar faces and places. Both groups did not show different neural activity when perceiving faces or places irrespective of familiarity. CONCLUSIONS/SIGNIFICANCE: Our data highlight changes in a frontal cortical network associated with knowledge-based personal familiarity among patients with amnestic mild cognitive impairment. These changes could contribute to deficits in social cognition and may reduce the patients' ability to transition from basic to complex situations and tasks.

  19. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Soo Ryon Kim

    2015-01-01

    Full Text Available The aims of this study were to investigate concrete and abstract word definition ability (1 between patients with amnestic mild cognitive impairment (aMCI and normal adults and (2 between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train and five abstract nouns (e.g., jealousy. Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI.

  20. Clinical and psychopatological features of organic depressive disorder in the individual abusing alcohol (case report

    Directory of Open Access Journals (Sweden)

    Spirina I.D.

    2015-03-01

    Full Text Available The article describes a clinical case of organic depressive disorder in the personality who sustained a traumatic brain injury and who abused alcohol, with distinguishing number of clinical and psychopathological features. Depressed mood, slowed thinking process, sleep disturbances, low self-esteem, hypochondriacal tendencies allowed to diagnose depressive disorder. Clinical history on sustained brain concussion, as well as inertness of nervous and mental processes revealed in psychodiagnostic study testified to organic genesis of the disease. Alcohol abuse by the person having an adverse organic background contributed to appearance of psychotic symptoms in clinical picture. Hallucinatory and delusional inclusions relatively quickly stopped on a background of antipsychotic treatment; this testified that they are secondary to the affective (depressive symptoms.

  1. Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

    Directory of Open Access Journals (Sweden)

    Icro Maremmani

    2015-11-01

    Full Text Available Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.

  2. Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

    Science.gov (United States)

    Maremmani, Icro; Cibin, Mauro; Pani, Pier Paolo; Rossi, Alessandro; Turchetti, Giuseppe

    2015-01-01

    Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention. PMID:26610535

  3. Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): Proposed DSM-5 Diagnosis.

    Science.gov (United States)

    Kable, Julie A; O'Connor, Mary J; Olson, Heather Carmichael; Paley, Blair; Mattson, Sarah N; Anderson, Sally M; Riley, Edward P

    2016-04-01

    Over the past 40 years, a significant body of animal and human research has documented the teratogenic effects of prenatal alcohol exposure (PAE). Neurobehavioral Disorder associated with PAE is proposed as a new clarifying term, intended to encompass the neurodevelopmental and mental health symptoms associated with PAE. Defining this disorder is a necessary step to adequately characterize these symptoms and allow clinical assessment not possible using existing physically-based diagnostic schemes. Without appropriate diagnostic guidelines, affected individuals are frequently misdiagnosed and treated inappropriately (often to their considerable detriment) by mental health, educational, and criminal justice systems. Three core areas of deficits identified from the available research, including neurocognitive, self-regulation, and adaptive functioning impairments, are discussed and information regarding associated features and disorders, prevalence, course, familial patterns, differential diagnosis, and treatment of the proposed disorder are also provided.

  4. Assessment and treatment of insomnia in adult patients with alcohol use disorders.

    Science.gov (United States)

    Brower, Kirk J

    2015-06-01

    Insomnia in patients with alcohol dependence has increasingly become a target of treatment due to its prevalence, persistence, and associations with relapse and suicidal thoughts, as well as randomized controlled studies demonstrating efficacy with behavior therapies and non-addictive medications. This article focuses on assessing and treating insomnia that persists despite 4 or more weeks of sobriety in alcohol-dependent adults. Selecting among the various options for treatment follows a comprehensive assessment of insomnia and its multifactorial causes. In addition to chronic, heavy alcohol consumption and its effects on sleep regulatory systems, contributing factors include premorbid insomnia; co-occurring medical, psychiatric, and other sleep disorders; use of other substances and medications; stress; environmental factors; and inadequate sleep hygiene. The assessment makes use of history, rating scales, and sleep diaries as well as physical, mental status, and laboratory examinations to rule out these factors. Polysomnography is indicated when another sleep disorder is suspected, such as sleep apnea or periodic limb movement disorder, or when insomnia is resistant to treatment. Sobriety remains a necessary, first-line treatment for insomnia, and most patients will have some improvement. If insomnia-specific treatment is needed, then brief behavioral therapies are the treatment of choice, because they have shown long-lasting benefit without worsening of drinking outcomes. Medications work faster, but they generally work only as long as they are taken. Melatonin agonists; sedating antidepressants, anticonvulsants, and antipsychotics; and benzodiazepine receptor agonists each have their benefits and risks, which must be weighed and monitored to optimize outcomes. Some relapse prevention medications may also have sleep-promoting activity. Although it is assumed that treatment for insomnia will help prevent relapse, this has not been firmly established. Therefore

  5. Role for mammalian target of rapamycin complex 1 signaling in neuroadaptations underlying alcohol-related disorders.

    OpenAIRE

    Neasta, Jérémie; Ben Hamida, Sami; Yowell, Quinn; Carnicella, Sebastien; RON, DORIT

    2010-01-01

    Present adress of Sébastien Carnicella: Grenoble Institute of Neuroscience, Institut National de la Santé et de la Recherche Médicale U836, 38100 Grenoble, France. Equipe 10, Dynamique des réseaux neuronaux du mouvement; International audience; Alcohol addiction is a chronically relapsing disorder that includes certain maladaptive learning and memory. The serine and threonine kinase complex, mammalian target of rapamycin complex 1 (mTORC1), has been implicated in synaptic plasticity, learning...

  6. 126例使用酒精所致精神和行为障碍患者的脑电图分析%Analysis of electroencephalogram in 126 cases with ethyl alcohol-induced mental and behavioural disorders

    Institute of Scientific and Technical Information of China (English)

    王玉明

    2016-01-01

    目的:探讨使用酒精所致精神和行为障碍患者的脑电图变化及其与饮酒量、饮酒史和临床类型的关系。方法回顾性分析126例使用酒精所致精神和行为障碍患者的住院资料。结果126例患者中脑电图正常66例(正常组),异常60例(异常组),正常组饮酒量为125~800 g/d,平均饮酒量(295.2±94.6)g/d,异常组饮酒量为130~875 g/d,平均饮酒量(299.0±94.0)g/d,两组比较差异无统计学意义(P>0.05)。饮酒史正常组为2~36年,平均饮酒史(17.2±9.02)年,异常组3~45年,平均饮酒史(21.0±9.6)年,两组比较差异无统计学意义(P>0.05);两组震颤谵妄、遗忘综合征发生情况比较差异有统计学意义(P0.05). The normal group had history of alcohol intake as 2~36 years, with the average time as (17.2±9.02) years, and the abnormal group had history of alcohol intake as 3~45 years, with the average time as (21.0±9.6) years. The difference between the two groups had no statistical significance (P>0.05). The difference of occurrence of delirium tremens and amnestic syndrome between the two groups had statistical significance (P<0.05).Conclusion Ethyl alcohol-induced mental and behavioural disorders shows diffuse damage to brain function and tissue. Electroencephalogram is related with classification of clinical manifestations, while not with drinking amount and history of alcohol intake.

  7. Alcohol and Opioid Use Disorder in Older Adults: Neglected and Treatable Illnesses.

    Science.gov (United States)

    Le Roux, Christoffel; Tang, Yilang; Drexler, Karen

    2016-09-01

    The purpose of this article is to provide an overview of alcohol use disorder (AUD) and opioid use disorder (OUD) in older adults for general psychiatrists. The rapid growth of the geriatric population in the USA has wide-ranging implications as the baby boomer generation ages. Various types of substance use disorders (SUDs) are common in older adults, and they often take a greater toll on affected older adults than on younger adults. Due to multiple reasons, SUDs in older adults are often under-reported, under-detected, and under-treated. Older adults often use substances, which leads to various clinical problems. Space limitations prevents a comprehensive review; therefore, we primarily focus on alcohol use disorder and the problem of opioid use disorder, with more emphasis given to the latter, because the opioid use epidemic in the USA has gained much attention. We reviewed the literature on the topics, integrated across geriatric psychiatry, addiction psychiatry, research, and national trends. We discuss unique vulnerabilities of older adults to SUDs with regard to management of SUDs in older adults, medication-assisted treatment (MAT), and psychosocial treatments. We encourage general psychiatrists to raise their awareness of SUDs in older adults and to provide brief intervention or referral for further assessment.

  8. Beverage preference and risk of alcohol-use disorders: a Danish prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Knop, Joachim; Mortensen, Erik Lykke

    2008-01-01

    on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women......OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data...... drinking 15-21 drinks per week of only beer and distilled spirits had a risk of 15.8 (95% confidence interval [CI]: 7.8-33.3) for AUD, whereas those whose total alcohol intake comprised more than 35% wine had a risk of 2.0 (CI: 0.7-5.2). Men drinking 15-21 drinks per week of only beer and distilled spirits...

  9. Regulatory Behaviors and Stress Reactivity among Infants at High Risk for Fetal Alcohol Spectrum Disorders: An Exploratory Study

    Science.gov (United States)

    Jirikowic, Tracy; Chen, Maida; Nash, Jennifer; Gendler, Beth; Olson, Heather Carmichael

    2016-01-01

    Introduction: This article examines regulatory behaviors and physiological stress reactivity among 6-15 month-old infants with moderate to heavy prenatal alcohol exposure (PAE), a group at very high risk for fetal alcohol spectrum disorders and self-regulation impairments, compared to low risk infants with no/low exposure. Participants: Eighteen…

  10. Learning the Dance of Connection: Helping a Foster Mother and a Child with Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Zarnegar, Zohreh

    2011-01-01

    Prenatal exposure to alcohol results in complex problems for the developing child, some of which are long lasting, and may be irreversible. The earlier the intervention, the higher the probability of a positive outcome. In this article, the author illustrates the complex challenges stemming from Fetal Alcohol Spectrum Disorder (FASD) and how a…

  11. Executive Function Deficits in Children with Fetal Alcohol Spectrum Disorders (FASD) Measured Using the Cambridge Neuropsychological Tests Automated Battery (CANTAB)

    Science.gov (United States)

    Green, C. R.; Mihic, A. M.; Nikkel, S. M.; Stade, B. C.; Rasmussen, C.; Munoz, D. P.; Reynolds, J. N.

    2009-01-01

    Background: Chronic prenatal alcohol exposure causes a spectrum of deleterious effects in offspring, collectively termed fetal alcohol spectrum disorders (FASD), and deficits in executive function are prevalent in FASD. The goal of this research was to test the hypothesis that children with FASD exhibit performance deficits in tasks that assess…

  12. Intimate Partner Aggression Reporting Concordance and Correlates of Agreement among Men with Alcohol Use Disorders and Their Female Partners

    Science.gov (United States)

    Panuzio, Jillian; O'Farrell, Timothy J.; Marshall, Amy D.; Murphy, Christopher M.; Murphy, Marie; Taft, Casey T.

    2006-01-01

    This study examined relationship aggression reporting concordance among 303 men with alcohol use disorders and their female partners enrolled in couples-based alcohol abuse treatment. Agreement for physical and psychological aggression was generally consistent with, or higher than, concordance rates reported among other populations. Men's…

  13. The protective effect of astaxanthin on fetal alcohol spectrum disorder in mice.

    Science.gov (United States)

    Zheng, Dong; Li, Yi; He, Lei; Tang, Yamei; Li, Xiangpen; Shen, Qingyu; Yin, Deling; Peng, Ying

    2014-09-01

    Astaxanthin is a strong antioxidant with the ability of reducing the markers of inflammation. To explore the protective effect of astaxanthin on maternal ethanol induced embryonic deficiency, and to investigate the underlying mechanisms, we detected the morphology, expression of neural marker genes, oxidative stress indexes, and inflammatory factors in mice model of fetal alcohol spectrum disorder with or without astaxanthin pretreatment. Our results showed that astaxanthin blocked maternal ethanol induced retardation of embryonic growth, and the down-regulation of neural marker genes, Otx1 and Sox2. Moreover, astaxanthin also reversed the increases of malondialdehyde (MDA), hydrogen peroxide (H2O2), and the decrease of glutathione peroxidase (GPx) in fetal alcohol spectrum disorder. In addition, maternal ethanol induced up-regulation of toll-like receptor 4 (TLR4), and the down-streaming myeloid differentiation factor 88 (MyD88), NF-κB, TNF-α, and IL-1β in embryos, and this was inhibited by astaxanthin pretreatment. These results demonstrated a protective effect of astaxanthin on fetal alcohol spectrum disorder, and suggested that oxidative stress and TLR4 signaling associated inflammatory reaction are involved in this process.

  14. Possible new ways in the pharmacological treatment of bipolar disorder and comorbid alcoholism

    Directory of Open Access Journals (Sweden)

    Jean-Michel Azorin

    2010-03-01

    deserves to be investigated in bipolar patients with comorbid alcoholism since this compound effectively improves physical health and quality of life of alcohol-dependent individuals. In conclusion, randomized, controlled research is still needed to provide guidelines for possible use of valproate and other agents in patients with a dual diagnosis of bipolar disorder and substance abuse or dependence.Keywords: bipolar disease, alcohol, alcoholism, comorbidity, valproate

  15. Alcohol during Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Is it safe? > Alcohol during pregnancy Alcohol during pregnancy E-mail to a friend Please ... and fetal alcohol spectrum disorders. How does drinking alcohol during pregnancy affect your baby's health? Drinking alcohol ...

  16. The Alcohol Use Disorders Identification Test (AUDIT: reliability and validity of the Greek version

    Directory of Open Access Journals (Sweden)

    Bratis Dimitris

    2009-05-01

    Full Text Available Abstract Background Problems associated with alcohol abuse are recognised by the World Health Organization as a major health issue, which according to most recent estimations is responsible for 1.4% of the total world burden of morbidity and has been proven to increase mortality risk by 50%. Because of the size and severity of the problem, early detection is very important. This requires easy to use and specific tools. One of these is the Alcohol Use Disorders Identification Test (AUDIT. Aim This study aims to standardise the questionnaire in a Greek population. Methods AUDIT was translated and back-translated from its original language by two English-speaking psychiatrists. The tool contains 10 questions. A score ≥ 11 is an indication of serious abuse/dependence. In the study, 218 subjects took part: 128 were males and 90 females. The average age was 40.71 years (± 11.34. From the 218 individuals, 109 (75 male, 34 female fulfilled the criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV, and presented requesting admission; 109 subjects (53 male, 56 female were healthy controls. Results Internal reliability (Cronbach α was 0.80 for the controls and 0.80 for the alcohol-dependent individuals. Controls had significantly lower average scores (t test P 8 was 0.98 and its specificity was 0.94 for the same score. For the alcohol-dependent sample 3% scored as false negatives and from the control group 1.8% scored false positives. In the alcohol-dependent sample there was no difference between males and females in their average scores (t test P > 0.05. Conclusion The Greek version of AUDIT has increased internal reliability and validity. It detects 97% of the alcohol-dependent individuals and has a high sensitivity and specificity. AUDIT is easy to use, quick and reliable and can be very useful in detection alcohol problems in sensitive populations.

  17. Validation of the Alcohol Use Disorders Identification Test in university students: AUDIT and AUDIT-C.

    Science.gov (United States)

    García Carretero, Miguel Ángel; Novalbos Ruiz, José Pedro; Martínez Delgado, José Manuel; O'Ferrall González, Cristina

    2016-03-02

    The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbach's Alpha, the Kappa index, Spearman's correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbach's alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD.

  18. Alcohol

    NARCIS (Netherlands)

    Hendriks, H.F.; Tol, A. van

    2005-01-01

    Alcohol consumption affects overall mortality. Light to moderate alcohol consumption reduces the risk of coronary heart disease; epidemiological, physiological and genetic data show a causal relationship. Light to moderate drinking is also associated with a reduced risk of other vascular diseases an

  19. Effects of baseline problematic alcohol and drug use on internet-based cognitive behavioral therapy outcomes for depression, panic disorder and social anxiety disorder.

    Directory of Open Access Journals (Sweden)

    Mikael Gajecki

    Full Text Available PURPOSE: Patients' problematic substance use prevalence and effects were explored in relation to internet-based cognitive behavioral therapy (ICBT outcomes for depression, panic disorder and social anxiety disorder. METHODS: At baseline and treatment conclusion, 1601 ICBT patients were assessed with self-rated measures for alcohol and drug use (AUDIT/DUDIT, depressive symptoms (MADRS-S, panic disorder symptoms (PDSS-SR and social anxiety symptoms (LSAS-SR. RESULTS: Problematic substance use (AUDIT ≥ 8 for men, ≥ 6 for women; DUDIT ≥ 1 occurred among 32.4% of the patients; 24.1% only alcohol, 4.6% only drugs, and 3.7% combined alcohol and drug use. Hazardous alcohol use and probable alcohol dependence negatively affected panic disorder outcomes, and hazardous drug use led to worse social anxiety outcomes. Depression outcomes were not affected by substance use. Treatment adherence was negatively affected by problematic drug use among men and 25-34 year olds; combined substance use negatively affected adherence for women and 35-64 year olds. CONCLUSION: Problematic substance use does not preclude ICBT treatment but can worsen outcomes, particularly problematic alcohol use for panic disorder patients and hazardous drug use for social anxiety patients. ICBT clinicians should exercise particular caution when treating men and younger patients with problematic drug use, and women or older patients with combined substance use.

  20. Acceptance and Commitment Therapy in the Treatment of Alcohol Use Disorder and Comorbid Affective Disorder: A Pilot Matched Control Trial.

    Science.gov (United States)

    Thekiso, Thekiso B; Murphy, Philip; Milnes, Jennie; Lambe, Kathryn; Curtin, Aisling; Farren, Conor K

    2015-11-01

    This study examined whether acceptance and commitment therapy (ACT) enhances treatment as usual (TAU) in improving treatment outcomes in patients with alcohol use disorder (AUD) and comorbid affective disorder. Fifty-two participants were included in the study, of whom 26 were patients with AUD and either depression or bipolar disorder treated with ACT group therapy in parallel with TAU (inpatient integrated treatment) and 26 were matched controls who had received TAU alone. Drinking and craving outcomes were total alcohol abstinence, cumulative abstinence duration (CAD) and Obsessive Compulsive Drinking Scale (OCDS) scores at 3 and 6 months postintervention. Affective and anxiety outcomes were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Young Mania Rating Scale (YMRS) scores at these follow-ups. Baseline demographic and clinical characteristics were similar in both groups. Retention rates were high: 100% of the ACT group were followed up at 3 and 6 months; 92.3% and 84.6% of the TAU alone group were followed up at 3 and 6 months, respectively. Patients in the ACT group reported significantly higher CAD at 3 and 6 months, significantly lower BDI and BAI scores at 3 and 6 months, and significantly lower OCDS scores at 3 months, than those who received only TAU. No other significant differences in treatment outcomes were found between the groups. ACT provides added benefit to TAU in improving drinking, craving, depression and anxiety outcomes in patients with AUD and comorbid affective disorder. Most treatment improvements were sustained over a 6-month follow-up period.

  1. Alcohol-related dementia: an update of the evidence

    OpenAIRE

    2013-01-01

    The characteristics of dementia relating to excessive alcohol use have received increased research interest in recent times. In this paper, the neuropathology, nosology, epidemiology, clinical features, and neuropsychology of alcohol-related dementia (ARD) and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome, or WKS) are reviewed. Neuropathological and imaging studies suggest that excessive and prolonged use of alcohol may lead to structural and functional damage that...

  2. A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders.

    Science.gov (United States)

    Graeber, David A; Moyers, Theresa B; Griffith, Gayle; Guajardo, Eliseo; Tonigan, Scott

    2003-06-01

    Thirty subjects with comorbid schizophrenia and alcohol use disorders were randomly assigned to receive either a Motivational Interviewing (MI) or Educational Treatment (ET) intervention with treatment goals of abstinence and/or decreased alcohol use. Subjects were followed up at 4, 8 and 24-weeks upon completion of the interventions. Outcome measures included number of drinking days, abstinence rates, average blood alcohol concentration and standard ethanol content per drinking day. Subjects randomized to the MI intervention had a significant reduction in drinking days and an increase in abstinence rates when compared to subjects receiving ET. Motivational Interviewing may be a useful treatment intervention for individuals with schizophrenia and alcoholism.

  3. Chronic Ethanol Exposure Effects on Vitamin D Levels Among Subjects with Alcohol Use Disorder

    Science.gov (United States)

    Ogunsakin, Olalekan; Hottor, Tete; Mehta, Ashish; Lichtveld, Maureen; McCaskill, Michael

    2016-01-01

    Vitamin D has been previously recognized to play important roles in human immune system and function. In the pulmonary system, vitamin D regulates the function of antimicrobial peptides, especially cathelicidin/LL-37. Human cathelicidin/LL-37 is a bactericidal, bacteriostatic, and antiviral endogenous peptide with protective immune functions. Chronic exposure to excessive alcohol has the potential to reduce levels of vitamin D (inactive vitamin D [25(OH)D3] and active vitamin D [1, 25(OH)2D3]) and leads to downregulation of cathelicidin/LL-37. Alcohol-mediated reduction of LL-37 may be partly responsible for increased incidence of more frequent and severe respiratory infections among subjects with alcohol use disorder (AUD). The objective of this study was to investigate the mechanisms by which alcohol exerts its influence on vitamin D metabolism. In addition, the aim was to establish associations between chronic alcohol exposures, levels of pulmonary vitamin D, and cathelicidin/LL-37 using broncho-alveolar lavage fluid samples of subjects with AUD and healthy controls. Findings from the experiment showed that levels of inactive vitamin D (25(OH)D3), active vitamin D (1, 25(OH)2D3), cathelicidin/LL-37, and CYP27B1 proteins were significantly reduced (P < 0.05) when compared with the matched healthy control group. However, CYP2E1 was elevated in all the samples examined. Chronic exposure to alcohol has the potential to reduce the levels of pulmonary vitamin D and results in subsequent downregulation of the antimicrobial peptide, LL-37, in the human pulmonary system. PMID:27795667

  4. Adolescent-onset alcohol abuse exacerbates the influence of childhood conduct disorder on late adolescent and early adult antisocial behaviour.

    Science.gov (United States)

    Howard, Richard; Finn, Peter; Jose, Paul; Gallagher, Jennifer

    2011-12-16

    This study tested the hypothesis that adolescent-onset alcohol abuse (AOAA) would both mediate and moderate the effect of childhood conduct disorder on antisocial behaviour in late adolescence and early adulthood. A sample comprising 504 young men and women strategically recruited from the community were grouped using the criteria of the Diagnostic and Statistical Manual (DSM-IV, American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA), as follows: neither childhood conduct disorder (CCD) nor alcohol abuse/dependence; CCD but no alcohol abuse or dependence; alcohol abuse/dependence but no CCD; both CCD and alcohol abuse/dependence. The outcome measure was the sum of positive responses to 55 interview items capturing a variety of antisocial behaviours engaged in since age 15. Severity of lifetime alcohol-related and CCD problems served as predictor variables in regression analysis. Antisocial behaviour problems were greatest in individuals with a history of co-occurring conduct disorder (CD) and alcohol abuse/dependence. While CCD was strongly predictive of adult antisocial behaviour, this effect was both mediated and moderated (exacerbated) by AOAA.

  5. Emotional face recognition deficit in amnestic patients with mild cognitive impairment: behavioral and electrophysiological evidence

    Directory of Open Access Journals (Sweden)

    Yang L

    2015-08-01

    Full Text Available Linlin Yang, Xiaochuan Zhao, Lan Wang, Lulu Yu, Mei Song, Xueyi Wang Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, People’s Republic of China Abstract: Amnestic mild cognitive impairment (MCI has been conceptualized as a transitional stage between healthy aging and Alzheimer’s disease. Thus, understanding emotional face recognition deficit in patients with amnestic MCI could be useful in determining progression of amnestic MCI. The purpose of this study was to investigate the features of emotional face processing in amnestic MCI by using event-related potentials (ERPs. Patients with amnestic MCI and healthy controls performed a face recognition task, giving old/new responses to previously studied and novel faces with different emotional messages as the stimulus material. Using the learning-recognition paradigm, the experiments were divided into two steps, ie, a learning phase and a test phase. ERPs were analyzed on electroencephalographic recordings. The behavior data indicated high emotion classification accuracy for patients with amnestic MCI and for healthy controls. The mean percentage of correct classifications was 81.19% for patients with amnestic MCI and 96.46% for controls. Our ERP data suggest that patients with amnestic MCI were still be able to undertake personalizing processing for negative faces, but not for neutral or positive faces, in the early frontal processing stage. In the early time window, no differences in frontal old/new effect were found between patients with amnestic MCI and normal controls. However, in the late time window, the three types of stimuli did not elicit any old/new parietal effects in patients with amnestic MCI, suggesting their recollection was impaired. This impairment may be closely associated with amnestic MCI disease. We conclude from our data that face recognition processing and emotional memory is

  6. Autism and attention-deficit/hyperactivity disorder among individuals with a family history of alcohol use disorders.

    Science.gov (United States)

    Sundquist, Jan; Sundquist, Kristina; Ji, Jianguang

    2014-08-19

    Recent studies suggest de novo mutations may involve the pathogenesis of autism and attention-deficit/hyperactivity disorder (ADHD). Based on the evidence that excessive alcohol consumption may be associated with an increased rate of de novo mutations in germ cells (sperms or eggs), we examine here whether the risks of autism and ADHD are increased among individuals with a family history of alcohol use disorders (AUDs). The standardized incidence ratios (SIRs) of autism and ADHD among individuals with a biological parental history of AUDs were 1.39 (95% CI 1.34-1.44) and 2.19 (95% CI 2.15-2.23), respectively, compared to individuals without an affected parent. Among offspring whose parents were diagnosed with AUDs before their birth, the corresponding risks were 1.46 (95% CI 1.36-1.58) and 2.70 (95% CI 2.59-2.81), respectively. Our study calls for extra surveillance for children with a family history of AUDs, and further studies examining the underlying mechanisms are needed.

  7. Remediation therapy in patients with alcohol use disorders and neurocognitive disorders: A Pilot Study.

    Science.gov (United States)

    Teixidor López, Lídia; Frías-Torres, Cindy; Moreno-España, José; Ortega, Lluisa; Barrio, Pablo; Gual, Antoni

    2016-09-29

    Many alcohol-dependent patients suffer from cognitive impairment of variable severity, manifested by alterations in retrograde and anterograde memory, visuospatial processing, cognitive abilities and attention, some of which are reversible. In this context, cognitive remediation therapies could significantly improve patients' performance; therefore, these are considered a valuable alternative. The aim of this study was to implement cognitive remediation therapy in patients with alcohol dependence and cognitive impairment and evaluate its viability and effectiveness. The participants were sixteen abstinent, alcohol-dependent patients (mean age of 59 years, 63% males) from the Addictive Behaviours Unit of a tertiary hospital. Over 6 months, a nurse led 1-hour weekly sessions (24 sessions in total) during which exercises for improving functional, social and cognitive performance were completed. Patients were assessed at baseline, at the end of the study and 6 months later, using the Mini-Mental State Examination (MMSE) and the Memory Alteration Test (M@T). Their respective scores were 26.4 (SD 3.16), 29 (SD 1.67) and 27 (SD 3.1) for the MMSE and 38.7 (SD 6.81), 45.7 (SD 5.6) and 41.1 (SD 7.86) for the M@T. Changes were assessed with both Friedman and Wilcoxon signed-rank tests, with mostly statistically significant differences (p < 0.05). Assistance and satisfaction were high. Therefore, the therapy was viable, widely accepted and effective.

  8. Alcohol and drug dependence in adults with attention-deficit/hyperactivity disorder: Data from Germany

    Directory of Open Access Journals (Sweden)

    Martin D. Ohlmeier

    2011-09-01

    Full Text Available Background and Objectives: The objective of the present study was to obtain information about the prevalence of addiction disorders in ADHD patients in a German study population, to compare the prevalence of addiction disorders in ADHD patients to that in the normal population according to the German Epidemiological Addiction Survey, and to determine which drugs are consumed most by ADHD patients. Participants: The sample consisted of 61 patients (average age 35.11 ± 9.33 years from our ADHD consultation who were consecutively included in our study over a period of 12 months. Measurements: We diagnosed ADHD according to DSM-IV-R and by assessing the WURS-k, CAARS and BROWN ADD scales. For diagnosing addiction we conducted the EuropASI, the IDCL, the QOD and the FTNA. For differential diagnosis we assessed the SCL-K. Results: About half of our study population of ADHD patients were diagnosed with a dependence disorder (50.8%, n = 31. Twenty one dot three percent (n = 13 were suffering from an alcohol dependence, 13.1% (n = 8 from a substance use disorder (SUD and 18% (n = 11 from a combination of both addictions. The drug consumed most commonly by ADHD patients was cannabis. Alcohol and substance abuse commenced significantly earlier in patients with ADHD than in patients with addiction disorders without comorbid ADHD. Conclusions: Our data show that the risk of developing a dependence disorder is elevated in ADHD patients. Clinicians should bear in mind that the characteristics of a dependence in ADHD patients are clinically more pronounced and that an addiction in ADHD patients starts earlier than usually expected.

  9. From research to practice: an integrative framework for the development of interventions for children with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Kodituwakku, Piyadasa W; Kodituwakku, E Louise

    2011-06-01

    Since fetal alcohol syndrome was first described over 35 years ago, considerable progress has been made in the delineation of the neurocognitive profile in children with prenatal alcohol exposure. Preclinical investigators have made impressive strides in elucidating the mechanisms of alcohol teratogenesis and in testing the effectiveness of pharmacological agents and dietary supplementation in the amelioration of alcohol-induced deficits. Despite these advances, only limited progress has been made in the development of evidence-based comprehensive interventions for functional impairment in alcohol-exposed children. Having performed a search in PubMed and PsycINFO using key words, interventions, treatment, fetal alcohol syndrome, prenatal alcohol exposure, and fetal alcohol spectrum disorders, we found only 12 papers on empirically-based interventions. Only two of these interventions had been replicated and none met the criteria of "well-established," as defined by Chambless and Hollon (Journal of Consulting and Clinical Psychology 66(1):7-18, 1998). There has been only limited cross-fertilization of ideas between preclinical and clinical research with regard to the development of interventions. Therefore, we propose a framework that allows integrating data from preclinical and clinical investigations to develop comprehensive intervention programs for children with fetal alcohol spectrum disorders. This framework underscores the importance of multi-level evaluations and interventions.

  10. Genetic polymorphisms: impact on the risk of fetal alcohol spectrum disorders.

    Science.gov (United States)

    Warren, Kenneth R; Li, Ting-Kai

    2005-04-01

    Clinical reports on monozygotic and dizygotic twins provided the initial evidence for the involvement of genetic factors in risk vulnerability for fetal alcohol spectrum disorders (FASD) including fetal alcohol syndrome (FAS). Research with selectively bred and inbred rodents, genetic crosses of these lines and strains, and embryo culture studies have further clarified the role of both maternal and fetal genetics in the development of FASD. Research to identify specific polymorphisms contributing to FASD is still at an early stage. To date, polymorphisms of only one of the genes for the alcohol dehydrogenase enzyme family, the ADH1B, have been demonstrated to contribute to FASD vulnerability. In comparison with ADH1B*1, both maternal and fetal ADH1B*2 have been shown to reduce risk for FAS in a mixed ancestry South African population. ADH1B*3 appears to afford protection for FASD outcomes in African-American populations. Other candidate genes should be examined with respect to FASD risk, including those for the enzymes of serotonin metabolism, in particular the serotonin transporter. By its very nature, alcohol teratogenesis is the expression of the interaction of genes with environment. The study of genetic factors in FASD falls within the new field of ecogenetics. Understanding of the array of genetic factors in FASD will be enhanced by future genetic investigations, including case-control, family association, and linkage studies.

  11. What Choline Metabolism Can Tell Us About the Underlying Mechanisms of Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    2013-01-01

    The consequences of fetal exposure to alcohol are very diverse and the likely molecular mechanisms involved must be able to explain how so many developmental processes could go awry. If pregnant rat dams are fed alcohol, their pups develop abnormalities characteristic of fetal alcohol spectrum disorders (FASD), but if these rat dams were also treated with choline, the effects from ethanol were attenuated in their pups. Choline is an essential nutrient in humans, and is an important methyl group donor. Alcohol exposure disturbs the metabolism of choline and other methyl donors. Availability of choline during gestation directly influences epigenetic marks on DNA and histones, and alters gene expression needed for normal neural and endothelial progenitor cell proliferation. Maternal diets low in choline alter development of the mouse hippocampus, and decrement memory for life. Women eating low-choline diets have an increased risk of having an infant with a neural tube or or ofacial cleft birth defect. Thus, the varied effects of choline could affect the expression of FASD, and studies on choline might shed some light on the underlying molecular mechanisms responsible for FASD. PMID:21259123

  12. Improving the diagnostic criteria for alcohol use disorders through survey methodology and cognitive interviewing.

    Science.gov (United States)

    Mewton, Louise; Slade, Tim; Teesson, Maree; Memedovic, Sonja; Krueger, Robert F

    2014-09-01

    This study aims to identify problems in the structure and wording of questions designed to operationalize four DSM-IV diagnostic criteria for alcohol use disorders (AUDs): (1) use of alcohol in hazardous situations (hazard); (2) tolerance; (3) use of alcohol in larger amounts/longer periods than intended (larger/longer); (4) unsuccessful attempts to cut down or control alcohol use (quit/cut down). Ten experts appraised the questions related to these criteria in the WMH-CIDI according to a standardized checklist. These experts identified three main problems: (1) the double-barrelled nature of some of the questions; (2) definitional issues; and (3) unclear thresholds for criterion endorsement. Cognitive interviews of 100 young adult drinkers aged 18-24 were then conducted. The double-barrelled nature of the DSM-IV criteria led to their subsequent over- or under-endorsement. Key terms in the questions under investigation were defined inconsistently. There was also a large amount of variability in the thresholds at which larger/longer and quit/cut down were endorsed. Many of these problems could be linked back to the DSM-IV text. The findings raise questions as to the validity of AUD diagnoses when established via structured diagnostic interview. Further research should focus on testing alternative structure and wording of key AUD criteria to ensure accurate operationalizations of these criteria in structured diagnostic interviews.

  13. Research of microRNAs on alcohol dependence%MicroRNA在酒精依赖机制中的作用

    Institute of Scientific and Technical Information of China (English)

    辛凤; 刘丽萍; 胡建

    2015-01-01

    目的 系统评价microRNA在酒精依赖发病机制中的作用.方法 用计算机检索Medline,mirbase,PubMed,中文期刊全文数据库(CNKI),万方数据库和维普数据库,手工检索相关参考文献.文献检索时限均从建库至2014年7月.英文数据库以“Alcoholism、Alcohol Dependence、Alcohol Abstinence、Alcohol Amnestic Disorder Fetal Alcohol Spectrum Disorders、microRNA”等作为关键词检索;中文数据库以“酒中毒、酒依赖、胎儿酒精谱群障碍、酒精戒断、酒精性遗忘症、miRNA”等作为关键词检索.检索从建库至2014年7月的相关文献.结果 最终纳入英文文献18条,中文文献8条.结论 miRNA在酒精依赖的发生发展过程中发挥重要作用,异常表达的miRNAs的作用将成为下一步研究方向.miRNA可能成为酒精依赖诊断的新的生物学标记,还可能使得这一分子成为药靶,或是模拟这一分子进行新药研发,这将可能会给酒精依赖的治疗提供一种新的手段.%Objective To evaluate the microRNA role in the pathogenesis of alcohol dependence.Methods By computer retrieval Medline,mirbase,PubMed,Chinese journal full-text database (CNKI),ten thousand database and VIP database,manual retrieval relevant references.Literature retrieval time limit are built from the library until July 2014.English database to "Alcoholism,Alcohol Dependence,Alcohol Abstinence,Alcohol Amnestic Disorder Fetal Alcohol Spectrum Disorders,mirna" as keywords retrieval;Chinese database to "Alcoholism,Alcohol Dependence,Alcohol Abstinence,Alcohol Amnestic Disorder Fetal Alcohol Spectrum Disorders,microRNA,etc".Retrieved from the database to the related literature in July 2014.Results A total of 26 studies were recruited including 8 Chinese literatures and 18 English literatures.Conclusion Abnormal expression of miRNAs will become the next research direction.MicroRNAs may become new biomarker of alcohol dependence on diagnosis,may also makes the molecular drug

  14. Prevalence of alcohol use disorders and associated factors among people with epilepsy attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Waja T

    2016-11-01

    Full Text Available Tsegereda Waja,1 Jemal Ebrahim,2 Zegeye Yohannis,1 Asres Bedaso2 1Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, 2School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, SNNPR, Ethiopia Introduction: Alcohol use disorders represent one of the leading causes of preventable death, illness, and injury in many societies throughout the world. Heavy alcohol consumption has multiple negative consequences for people with epilepsy such as precipitation of seizure, exacerbation of seizure, poor seizure control, increased side effects of antiepileptic drugs, noncompliance to antiepileptic drugs, alcohol withdrawal seizures, long-term hospital admission, status epilepticus, sudden unexpected death, and premature mortality. Methods: An institution-based cross sectional study was conducted from April 15, 2014 to May 15, 2014 with the aim of assessing prevalence of alcohol use disorders and associated factors among people with epilepsy attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. A total of 413 randomly selected epileptic patients were included in this study. Data were structured using the 10-item Alcohol Use Disorders Identification questionnaire. Data were analyzed using SPSS Version 20. Bivariate and multivariate logistic regression analyses were performed to study the association, and variables with P-value <0.05 were considered as having a statistically significant association at 95% confidence interval. Results: A total of 423 study participants were selected, of whom 413 completely filled the questionnaire making the response rate 97.6%. The mean age of the respondents was 31.9 years with standard deviation of ±10.97, and 248 (60% were males. The prevalence of alcohol use disorder was 17.4%. Educational status (grade 9–12 (adjusted odds ratio [AOR] =3.25, [1.21, 8.69], not living with family members (AOR =1.89, [1.06, 3.39], availability of house (AOR

  15. Treatment seeking for alcohol and drug use disorders by immigrants to the Netherlands : Retrospective, population-based, cohort study

    NARCIS (Netherlands)

    Selten, Jean-Paul; Wierdsma, Andre; Mulder, Niels; Burger, Huibert

    2007-01-01

    Background We compared risks of first contact with services for an alcohol use disorder (AUD) or drug use disorder (DUD) between the largest immigrant groups to the Netherlands and Dutch nationals. We tested the hypothesis that the ethnic pattern for DUD is similar to the previously demonstrated pat

  16. The roles of familial alcoholism and adolescent family harmony in young adults' substance dependence disorders: mediated and moderated relations.

    Science.gov (United States)

    Zhou, Qing; King, Kevin M; Chassin, Laurie

    2006-05-01

    This study examined the prospective relations among family history density of alcoholism (FHD), adolescent family harmony, and young adults' alcohol and drug dependence. Family harmony was rated by mothers and fathers in adolescence, and young adults' substance dependence diagnoses were obtained through structured interviews. Higher FHD predicted lower adolescent family harmony, which in turn increased young adults' odds of being diagnosed with drug dependence (with and without alcohol dependence) compared to no diagnoses or to alcohol dependence only. Family harmony also interacted with FHD such that the protective effect of family harmony on young adults' drug dependence with or without alcohol dependence decreased as FHD rose, and was nonsignificant at high levels of FHD. The findings suggest the importance of distinguishing among alcohol and drug dependence disorders and examining their differential etiological pathways, and also suggest that the protective effects of harmonious family environments on substance dependence may be limited at high levels of FHD.

  17. Alcohol

    Science.gov (United States)

    ... changes that come from drinking alcohol can make people do stupid or embarrassing things, like throwing up or peeing on themselves. Drinking also gives people bad breath, and no one enjoys a hangover. ...

  18. The Efficacy of Disulfiram for the Treatment of Alcohol Use Disorder

    DEFF Research Database (Denmark)

    Jørgensen, Charlotte H; Pedersen, Bolette; Tønnesen, Hanne

    2011-01-01

    Background: Alcohol use disorders (AUD) involving hazardous, harmful, and addictive misuse of alcohol are widespread in most parts of the world. The aim of this study was to review the effect of disulfiram in the treatment of patients with AUD. The effect of disulfiram was evaluated according...... Register of Controlled Trials (CENTRAL). Results: Eleven randomized controlled trials were included with a total of 1,527 patients. They compared disulfiram treatment with placebo, none or other abstinence-supportive treatments. Overall, 6 studies reported of a significant better effect on abstinence......-analyses, but valid results were found regarding the effect of disulfiram versus placebo over 12 months and unsupervised disulfiram versus other or no treatment. The vast majority of significant studies were of shorter duration, while only 3 studies of 12 months were significant regarding more days until relapse and...

  19. Cancer incidence among patients with alcohol use disorders--long-term follow-up

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Mikkelsen, Pernille; Andersen, Tina Veje

    2009-01-01

    to 1140.8 expected cases (SIR = 1.9; 95% confidence interval (CI) 1.8-2.0), while 601 women developed cancer compared to 239.1 expected cases (SIR = 2.5; 95% CI 2.3-2.7). Highly significant and strongly elevated incidence rates were found for cancer of the tongue, mouth, pharynx, oesophagus, liver, larynx......AIMS: The aim of this study was to compare the cancer morbidity in a large cohort of patients with alcohol use disorders in the general Danish population. METHODS: We included 15,258 men and 3552 women free of cancer when attending the Copenhagen Outpatient Clinic for Alcoholics in the period from...... 1954 to 1992. The cancer incidence until 1999 of the patients and the general Danish population was obtained through linkage with the Danish Cancer Registry. The incidence rates were standardized (SIR) according to sex, age and calendar time. RESULTS: A total of 2145 men developed cancer compared...

  20. Vitamin D and Calcium Status in South African Adolescents with Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    George Fein

    2012-08-01

    Full Text Available Adequate vitamin D and calcium are essential for optimal adolescent skeletal development. Adolescent vitamin D insufficiency/deficiency and poor calcium intake have been reported worldwide. Heavy alcohol use impacts negatively on skeletal health, which is concerning since heavy adolescent drinking is a rising public health problem. This study aimed to examine biochemical vitamin D status and dietary intakes of calcium and vitamin D in 12–16 year-old adolescents with alcohol use disorders (AUD, but without co-morbid substance use disorders, compared to adolescents without AUD. Substance use, serum 25-hydroxyvitamin D (s-25(OHD concentrations, energy, calcium and vitamin D intakes were assessed in heavy drinkers (meeting DSM-IV criteria for AUD (n = 81 and in light/non-drinkers without AUD (non-AUD (n = 81, matched for age, gender, language, socio-economic status and education. Lifetime alcohol dose was orders of magnitude higher in AUD adolescents compared to non-AUD adolescents. AUD adolescents had a binge drinking pattern and “weekends-only” style of alcohol consumption. Significantly lower (p = 0.038 s-25(OHD (adjusted for gender, smoking, vitamin D intake were evident in AUD adolescents compared to non-AUD adolescents. High levels of vitamin D insufficiency/deficiency (s-25(OHD < 29.9 ng/mL were prevalent in both groups, but was significantly higher (p = 0.013 in the AUD group (90% compared to the non-AUD group (70%. All participants were at risk of inadequate calcium and vitamin D intakes (Estimated Average Requirement cut-point method. Both groups were at risk of inadequate calcium intake and had poor biochemical vitamin D status, with binge drinking potentially increasing the risk of the latter. This may have negative implications for peak bone mass accrual and future osteoporosis risk, particularly with protracted binge drinking.

  1. Smoking, alcohol consumption, and drug use among adolescents with psychiatric disorders compared with a population based sample.

    Science.gov (United States)

    Mangerud, Wenche Langfjord; Bjerkeset, Ottar; Holmen, Turid Lingaas; Lydersen, Stian; Indredavik, Marit Sæbø

    2014-10-01

    This study investigated frequencies of smoking, alcohol use, and illicit drug use by diagnostic category in 566 adolescent psychiatric patients, comparing this sample with 8173 adolescents from the general population in Norway who completed the Young-HUNT 3 survey. Frequencies of current alcohol use were high in both samples but were lower among psychiatric patients. Compared with adolescents in the general population, adolescents in the clinical sample had a higher prevalence of current smoking and over four times higher odds of having tried illicit drugs. In the clinical sample, those with mood disorders reported the highest frequencies of smoking, alcohol use, and illicit drug use, whereas those with autism spectrum disorders reported the lowest frequencies. Our results show an increased prevalence of risky health behaviors among adolescents with psychiatric disorders compared with the general population. The awareness of disorder-specific patterns of smoking and substance use may guide preventive measures.

  2. Relations Between Cognitive Functioning and Alcohol Use, Craving, and Post-Traumatic Stress: An Examination Among Trauma-Exposed Military Veterans With Alcohol Use Disorder.

    Science.gov (United States)

    Heinz, Adrienne J; Pennington, David L; Cohen, Nicole; Schmeling, Brandi; Lasher, Brooke A; Schrodek, Emily; Batki, Steven L

    2016-07-01

    Cognitive dysfunction is commonly observed among individuals with alcohol use disorder (AUD) and trauma exposure and is, in turn, associated with worse clinical outcomes. Accordingly, disruptions in cognitive functioning may be conceptualized as a trans-disease phenomenon representing a potential high-yield target for intervention. Less is known though about how different cognitive functions covary with alcohol use, craving, and post-traumatic stress symptom severity among trauma-exposed individuals with AUD. Sixty-eight male and female trauma-exposed military veterans with AUD, entering treatment trials to reduce alcohol use, completed measures assessing alcohol use and craving, post-traumatic stress symptom severity, and cognitive functioning. In multivariate models, after controlling for post-traumatic stress symptom severity, poorer learning and memory was associated with higher alcohol consumption and higher risk taking/impulsivity was associated with stronger preoccupations with alcohol and compulsions to drink. Alcohol consumption and craving, but not performance on cognitive tests, were positively associated with post-traumatic stress symptom severity. Findings suggest that interventions to strengthen cognitive functioning might be used as a preparatory step to augment treatments for AUD. Clinicians are encouraged to consider a standard assessment of cognitive functioning, in addition to post-traumatic stress symptom severity, in treatment planning and delivery for this vulnerable and high-risk population.

  3. Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder.

    Science.gov (United States)

    Payne, Janet; France, Kathryn; Henley, Nadine; D'Antoine, Heather; Bartu, Anne; O'Leary, Colleen; Elliott, Elizabeth; Bower, Carol

    2011-07-01

    We provided health professionals in Western Australia (WA) with educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder and assessed changes in their knowledge, attitudes and practice concerning fetal alcohol syndrome (FAS) and alcohol consumption in pregnancy. Following our 2002 survey of health professionals in WA, we developed and distributed educational resources to 3348 health professionals in WA in 2007. Six months later we surveyed 1483 of these health professionals. Prevalence rate ratios [PRR] and 95% confidence intervals [CI] were calculated to compare 2007 results with results from the 2002 survey. Of the 1001 responding health professionals, 69.8% had seen the educational resources; of these 77.1% have used them and 48.5% said the resources had assisted them to change their practice or their intention to change their practice. Compared with 2002, there was an increase in the proportion who knew all the essential features of FAS from 11.7% to 15.8% [PRR 1.35; 95% CI 1.09, 1.67] and had diagnosed FAS, from 4.8% to 7.3% [PRR 1.52; 95% CI 1.08, 2.13]. In 2007, 98.1% of health professionals stated they would advise pregnant women to consider not drinking at all or advise them that no alcohol in pregnancy is the safest choice. Health professionals surveyed in 2007 have increased their knowledge, changed their attitudes and practice about FAS, and altered the advice they give to pregnant women about alcohol consumption since our survey in 2002. It is essential that we build on this change and continue to support health professionals' knowledge, attitudes and practice about the prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. The educational resources for health professionals may be ordered as hard copies and downloaded from the internet http://www.ichr.uwa.edu.au/alcoholandpregnancy.

  4. Predicting Post-Treatment-Initiation Alcohol Use among Patients with Severe Mental Illness and Alcohol Use Disorders

    Science.gov (United States)

    Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.

    2009-01-01

    Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of…

  5. Understanding HIV Risk Behavior among Tuberculosis Patients with Alcohol Use Disorders in Tomsk, Russian Federation.

    Science.gov (United States)

    Miller, Ann C; Nelson, A Katrina; Livchits, Viktoria; Greenfield, Shelly F; Yanova, Galina; Yanov, Sergei; Connery, Hilary S; Atwood, Sidney; Lastimoso, Charmaine S; Shin, Sonya S

    2016-01-01

    Russian Federation's (RF) HIV epidemic is the fastest growing of any country. This study explores factors associated with high HIV risk behavior in tuberculosis (TB) patients with alcohol use disorders in Tomsk, RF. This analysis was nested within the Integrated Management of Physician-delivered Alcohol Care for TB Patients (IMPACT, trial number NCT00675961) randomized controlled study of integrating alcohol treatment into TB treatment in Tomsk. Demographics, HIV risk behavior (defined as participant report of high-risk intravenous drug use and/or multiple sexual partners with inconsistent condom use in the last six months), clinical data, alcohol use, depression and psychosocial factors were collected from 196 participants (161 male and 35 female) at baseline. Forty-six participants (23.5%) endorsed HIV risk behavior at baseline. Incarceration history(Odds Ratio (OR)3.93, 95% confidence interval (CI) 1.95, 7.95), age under 41 (OR:2.97, CI:1.46, 6.04), drug addiction(OR: 3.60 CI:1.10, 11.77), history of a sexually transmitted disease(STD)(OR 2.00 CI:1.02, 3.90), low social capital (OR:2.81 CI:0.99, 8.03) and heavier alcohol use (OR:2.56 CI: 1.02, 6.46) were significantly more likely to be associated with HIV risk behavior at baseline. In adjusted analysis, age under 41(OR: 4.93, CI: 2.10, 11.58), incarceration history(OR: 3.56 CI:1.55, 8.17) and STD history (OR: 3.48, CI: 1.5, 8.10) continued to be significantly associated with HIV risk behavior. Understanding HIV transmission dynamics in Russia remains an urgent priority to inform strategies to address the epidemic. Larger studies addressing sex differences in risks and barriers to protective behavior are needed.

  6. Understanding HIV Risk Behavior among Tuberculosis Patients with Alcohol Use Disorders in Tomsk, Russian Federation.

    Directory of Open Access Journals (Sweden)

    Ann C Miller

    Full Text Available Russian Federation's (RF HIV epidemic is the fastest growing of any country. This study explores factors associated with high HIV risk behavior in tuberculosis (TB patients with alcohol use disorders in Tomsk, RF. This analysis was nested within the Integrated Management of Physician-delivered Alcohol Care for TB Patients (IMPACT, trial number NCT00675961 randomized controlled study of integrating alcohol treatment into TB treatment in Tomsk. Demographics, HIV risk behavior (defined as participant report of high-risk intravenous drug use and/or multiple sexual partners with inconsistent condom use in the last six months, clinical data, alcohol use, depression and psychosocial factors were collected from 196 participants (161 male and 35 female at baseline. Forty-six participants (23.5% endorsed HIV risk behavior at baseline. Incarceration history(Odds Ratio (OR3.93, 95% confidence interval (CI 1.95, 7.95, age under 41 (OR:2.97, CI:1.46, 6.04, drug addiction(OR: 3.60 CI:1.10, 11.77, history of a sexually transmitted disease(STD(OR 2.00 CI:1.02, 3.90, low social capital (OR:2.81 CI:0.99, 8.03 and heavier alcohol use (OR:2.56 CI: 1.02, 6.46 were significantly more likely to be associated with HIV risk behavior at baseline. In adjusted analysis, age under 41(OR: 4.93, CI: 2.10, 11.58, incarceration history(OR: 3.56 CI:1.55, 8.17 and STD history (OR: 3.48, CI: 1.5, 8.10 continued to be significantly associated with HIV risk behavior. Understanding HIV transmission dynamics in Russia remains an urgent priority to inform strategies to address the epidemic. Larger studies addressing sex differences in risks and barriers to protective behavior are needed.

  7. Cognitive functioning in patients with bipolar disorder: association with depressive symptoms and alcohol use.

    Directory of Open Access Journals (Sweden)

    Marieke J van der Werf-Eldering

    Full Text Available BACKGROUND: Cognitive dysfunction is clearly recognized in bipolar patients, but the degree of impairment varies due to methodological factors as well as heterogeneity in patient populations. The goal of this study was to evaluate cognitive functioning in bipolar patients and to assess its association with depressive symptoms. Post hoc the relationship with lifetime alcohol use disorder was explored. METHODOLOGY/PRINCIPAL FINDINGS: The study included 110 bipolar patients and 75 healthy controls. Patients with severe depressive symptoms, (hypomanic symptoms and current severe alcohol use disorder were excluded. Diagnoses were evaluated via the Mini-International Neuropsychiatric Interview. Cognitive functioning was measured in domains of psychomotor speed, speed of information processing, attentional switching, verbal memory, visual memory, executive functioning and an overall mean score. Severity of depression was assessed by the Inventory of Depressive Symptomatology-self rating. Patients were euthymic (n = 46 or with current mild (n = 38 or moderate (n = 26 depressive symptoms. Cognitive impairment was found in 26% (z-score 2 or more above reference control group for at least one domain of patients, most prominent in executive functioning (effect size; ES 0.49 and speed of information processing (ES 0.47. Depressive symptoms were associated with dysfunction in psychomotor speed (adjusted beta 0.43; R(2 7%, speed of information processing (adjusted beta 0.36; R(2 20%, attentional switching (adjusted beta 0.24; R(2 16% and the mean score (adjusted beta 0.23; R(2 24%, but not with verbal and visual memory and executive functioning. Depressive symptoms explained 24% of the variance in the mean z-score of all 6 cognitive domains. Comorbid lifetime alcohol use (n = 21 was not associated with cognitive dysfunction. CONCLUSIONS/SIGNIFICANCE: Cognitive dysfunction in bipolar disorder is more severe in patients with depressive symptoms, especially

  8. Cognitive control network function in alcohol use disorder before and during treatment with lorazepam.

    Science.gov (United States)

    Wilcox, Claire E; Mayer, Andrew R; Bogenschutz, Michael P; Ling, Josef; Dekonenko, Charlene; Cumbo, Heather

    2015-01-01

    Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009-2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function.

  9. Alcohol Use Disorder Identification Test (AUDIT): explorando seus parâmetros psicométricos

    OpenAIRE

    2012-01-01

    OBJETIVO: O presente estudo teve como objetivo conhecer evidências de validade e precisão do Alcohol Use Disorder Identification Test (AUDIT). MÉTODOS: Contou-se com uma amostra de conveniência (não probabilística) de 547 estudantes universitários de Fortaleza (CE), com idade média de 21,6 anos (dp = 4,86; amplitude de 18 a 53), a maioria do sexo masculino (51,5%), solteira (91,4%) e católica (62,5%). Os participantes responderam ao AUDIT e a perguntas demográficas. Procurando conhecer a estr...

  10. High doses of Baclofen as suicide attempt in patients with alcohol use disorders - A serious concern.

    Science.gov (United States)

    Holla, Bharath; Gowda, Guru S; Prabhu, Lokesh; Baby, Sojan; Viswanath, Biju; Chand, Prabhat; Murthy, Pratima

    2015-10-01

    Baclofen is increasingly being used as an off label anti-craving agent in alcohol use disorders in various parts of the world. The lack of proper recommendations regarding the dosage has important implications for safety in clinical management. In this context, we report two patients who were started with Baclofen as an anti-craving agent, and later developed serious complications following acute self inflicted overdose. We also highlight the important mechanisms of such complications and precautions that needs to be exerted while prescribing.

  11. Autism Spectrum Disorder and Fetal Alcohol Spectrum Disorder. Part II: A Qualitative Comparison of Parenting Stress

    Science.gov (United States)

    Watson, Shelley L.; Hayes, Stephanie A.; Coons, Kelly D.; Radford-Paz, Elisa

    2013-01-01

    Background: Researchers investigating the impact of parenting children with disabilities suggest that regardless of the specific diagnosis, parents experience increased levels of stress. However, particular disabilities may be associated with distinct stressors and strains. Method: Parents of children with autism spectrum disorder (ASD) and…

  12. Growth in Adolescent Delinquency and Alcohol Use in Relation to Young Adult Crime, Alcohol Use Disorders, and Risky Sex: A Comparison of Youth from Low- versus Middle-Income Backgrounds

    Science.gov (United States)

    Mason, W. Alex; Hitch, Julia E.; Kosterman, Rick; McCarty, Carolyn A.; Herrenkohl, Todd I.; Hawkins, J. David

    2010-01-01

    Background: This study examined adolescent delinquency and alcohol use in relation to young adult crime, alcohol use disorders (AUDs), and risky sex. Analyses further examined the influences of late childhood involvement in these problem behavior outcomes, with mediation through teen delinquency and alcohol use, and examined differences in the…

  13. Association between alcohol and substance use disorders and all-cause and cause-specific mortality in schizophrenia, bipolar disorder, and unipolar depression

    DEFF Research Database (Denmark)

    Hjorthøj, Carsten; Østergaard, Marie Louise Drivsholm; Benros, Michael Eriksen

    2015-01-01

    significantly associated with increased risk of all-cause mortality, both individually (alcohol, HR 1·52 [95% CI 1·40-1·65], pdepression, only substance use disorders of alcohol...... (bipolar disorder, HR 1·52 [95% CI 1·27-1·81], pdepression, 2·01 [1·86-2·18], pdepression, 2·27 [1·98-2·60], pcause mortality individually. INTERPRETATION: Mortality in people with mental illness......BACKGROUND: People with severe mental illness have both increased mortality and are more likely to have a substance use disorder. We assessed the association between mortality and lifetime substance use disorder in patients with schizophrenia, bipolar disorder, or unipolar depression. METHODS...

  14. Is it time for Newborn Screening for Fetal Alcohol Spectrum Disorders: A Commentary?

    Directory of Open Access Journals (Sweden)

    Kenneth A PASS

    2009-11-01

    Full Text Available Fetal Alcohol Spectrum Disorder (FASD is one of the most common causes of acquired mental retardation in the United States and worldwide. The fetal brain is highly susceptible to the teratogenic effects of alcohol from maternal consumption during pregnancy resulting in newborns with mental deficits and congenital malformations. FAS diagnosis is difficult to diagnose in newborns where distinct anatomical defects are not apparent from mothers of moderate to light alcohol use. Hence, medical diagnoses are often not ascertained until mid-childhood after irreparable brain damage has already occurred. Such infants will have been deprived of available socioclinical interventions, trainings, measures, and future treatments that may someday be implemented soon after birth. Presently, there are no FASD newborn biomarker screening programs in place despite cost benefit analyses revealing an annual societal cost of $1.3 million per FASD incident case. Since newborn biomarkers have been reported in the biomedical literature, can we afford not to implement newborn screening for FASD?

  15. Fetal Alcohol Spectrum Disorder (FASD Associated Neural Defects: Complex Mechanisms and Potential Therapeutic Targets

    Directory of Open Access Journals (Sweden)

    James A. Marrs

    2013-06-01

    Full Text Available Fetal alcohol spectrum disorder (FASD, caused by prenatal alcohol exposure, can result in craniofacial dysmorphism, cognitive impairment, sensory and motor disabilities among other defects. FASD incidences are as high as 2% to 5 % children born in the US, and prevalence is higher in low socioeconomic populations. Despite various mechanisms being proposed to explain the etiology of FASD, the molecular targets of ethanol toxicity during development are unknown. Proposed mechanisms include cell death, cell signaling defects and gene expression changes. More recently, the involvement of several other molecular pathways was explored, including non-coding RNA, epigenetic changes and specific vitamin deficiencies. These various pathways may interact, producing a wide spectrum of consequences. Detailed understanding of these various pathways and their interactions will facilitate the therapeutic target identification, leading to new clinical intervention, which may reduce the incidence and severity of these highly prevalent preventable birth defects. This review discusses manifestations of alcohol exposure on the developing central nervous system, including the neural crest cells and sensory neural placodes, focusing on molecular neurodevelopmental pathways as possible therapeutic targets for prevention or protection.

  16. Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

    Directory of Open Access Journals (Sweden)

    Marlene M. de Vries

    2015-12-01

    Full Text Available In the Western Cape Province of South Africa (ZA a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD. FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI techniques and the Community Reinforcement Approach (CRA. Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD.

  17. Alcohol Related Endocrine Disorders and Alcoholic Liver Disease%酒精相关内分泌障碍及肝脏疾病

    Institute of Scientific and Technical Information of China (English)

    杨雪; 盛利霞; 汤宜朗

    2015-01-01

    目的:介绍酒精所致的内分泌障碍及酒精性肝病(ALD)的机制及治疗进展。方法:对近年文献进行复习。结果:本文对酒精对内分泌系统的影响及所致的功能障碍(尤其是对 HPA 轴、HPT 轴及性腺轴的影响)的机制、治疗的进展,酒精性肝病的发生机制、分类及治疗进展进行了介绍。结论:酒精可导致内分泌系统功能障碍及肝功能障碍,酒精引起的障碍早期或可通过戒酒逆转,但晚期病变(如肝硬化)则很难逆转。对晚期患者,除戒酒之外,支持治疗是主要的手段。%Objective:To review the updates on alcohol-related endocrine disorders and alcoholic liver disease mechanism and treatment. Methods:Literature review and hand-picked literature. Results:We review the mechanism(especially the influence on the HPA axis,the HPT axis and the gonad axis)and treatment of alcohol related endocrine disorders,and the mechanism,classification and treatment of alcoholic liver disease(ALD). Conclusion:Alcohol can cause endocrine disorders and liver damage. While some dis-orders are reversible by stop drinking,some(such as cirrhosis)are not. For advanced or patients in terminal stage,in addition to stop-ping drinking,supportive care plays an important role.

  18. Glutamatergic and HPA-axis pathway genes in bipolar disorder comorbid with alcohol- and substance use disorders.

    Science.gov (United States)

    Dalvie, Shareefa; Fabbri, Chiara; Ramesar, Raj; Serretti, Alessandro; Stein, Dan J

    2016-02-01

    Glutamatergic neurotransmission has been shown to be dysregulated in bipolar disorder (BD), alcohol use disorder (AUD) and substance use disorder (SUD). Similarly, disruption in the hypothalamic-pituitary-adrenal (HPA)-axis has also been observed in these conditions. BD is often comorbid with AUD and SUD. The effects of the glutamatergic and HPA systems have not been extensively examined in individuals with BD-AUD and BD-SUD comorbidity. The aim of this investigation was to determine whether variants in the glutamatergic pathway and HPA-axis are associated with BD-AUD and BD-SUD comorbidity. The research cohort consisted of 498 individuals with BD type I from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). A subset of the cohort had comorbid current AUD and current SUD. A total of 1935 SNPs from both the glutamatergic and HPA pathways were selected from the STEP-BD genome-wide dataset. To identify population stratification, IBS clustering was performed using the program Plink 1.07. Single SNP association and gene-based association testing were conducted using logistic regression. A pathway analysis of glutamatergic and HPA genes was performed, after imputation using IMPUTE2. No single SNP was associated with BD-AUD or BD-SUD comorbidity after correction for multiple testing. However, from the gene-based analysis, the gene PRKCI was significantly associated with BD-AUD. The pathway analysis provided overall negative findings, although several genes including GRIN2B showed high percentage of associated SNPs for BD-AUD. Even though the glutamatergic and HPA pathways may not be involved in BD-AUD and BD-SUD comorbidity, PRKCI deserves further investigation in BD-AUD.

  19. Committee opinion no. 633: Alcohol abuse and other substance use disorders: ethical issues in obstetric and gynecologic practice.

    Science.gov (United States)

    2015-06-01

    Alcohol abuse and other substance use disorders are major, often underdiagnosed health problems for women, regardless of age, race, ethnicity, and socioeconomic status, and have resulting high costs for individuals and society. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines substance use disorder as a pathologic pattern of behaviors related to the use of any of 10 separate classes of substances, including alcohol and licit and illicit substances. In order to optimize care of patients with substance use disorder, obstetrician-gynecologists are encouraged to learn and appropriately use routine screening techniques, clinical laboratory tests, brief interventions, and treatment referrals. The purpose of this Committee Opinion is to propose an ethical framework for incorporating such care into obstetric and gynecologic practice and for resolving common ethical dilemmas related to substance use disorder.

  20. A cluster randomised controlled trial protocol of an adapted intervention for alcohol use disorders in people living with HIV and AIDS: impact on alcohol use, general functional ability, quality of life and adherence to HAART

    OpenAIRE

    Madhombiro, Munyaradzi; Dube-Marimbe, Bazondlile; Dube, Michelle; Chibanda, Dixon; Zunza, Moleen; Rusakaniko, Simbarashe; Stewart, David; Seedat, Soraya

    2017-01-01

    Background Interventions for alcohol use disorders (AUDs) in HIV infected individuals have been primarily targeted at HIV risk reduction and improved antiretroviral treatment adherence. However, reduction in alcohol use is an important goal. Alcohol use affects other key factors that may influence treatment course and outcome. In this study the authors aim to administer an adapted intervention for AUDs to reduce alcohol use in people living with HIV/AIDS (PLWHA). Methods This study is a clust...

  1. Pattern and predictors of alcohol use disorders in a family practice in Nigeria

    Directory of Open Access Journals (Sweden)

    Adetunji Obadeji

    2015-01-01

    Full Text Available Background: Primary care has been identified as a key setting for the reduction of alcohol-related harm, while general practitioners are expected to play a significant role. The study aimed at identifying pattern of, and factors that are associated with alcohol use disorders (AUDs among patients attending Family Medicine unit of State University Teaching Hospital. Materials and Methods: Sample was selected through a random sampling from a population of patients, aged 18-65 years, attending the general medical out-patients unit of the hospital from January to April 2013. A pretested, semi-structured questionnaire was administered, incorporating sociodemographics and the diagnoses made by the attending Physician. The participants also completed the alcohol use disorders identification test (AUDIT questionnaire and the patient health questionnaire-9. Results: The prevalence of AUDs among the population of general out-patients was 9.7%. The AUDIT scores of the participants range from 0 to 29 with a mean of 1.3 (standard deviation = 4.08. AUDs were significantly associated with gender, level of education, occupational class, and the presence of significant depressive symptoms (P < 0.05. There was no statistically significant association found for age, employment status, marital status, and religion. Conclusion: The prevalence of AUDs among population studied was lower compared with a similar study in similar setting, but however, significant. AUDs were predicted by gender, lower education level, occupational group, and the presence of significant depressive symptoms mostly in the mild to moderate form. Identifying the group at risk in clinical setting may go a long way in reducing the adverse effect of AUDs in our society.

  2. Adequacy of maternal iron status protects against behavioral, neuroanatomical, and growth deficits in fetal alcohol spectrum disorders.

    Directory of Open Access Journals (Sweden)

    Echoleah S Rufer

    Full Text Available Fetal alcohol spectrum disorders (FASD are the leading non-genetic cause of neurodevelopmental disability in children. Although alcohol is clearly teratogenic, environmental factors such as gravidity and socioeconomic status significantly modify individual FASD risk despite equivalent alcohol intake. An explanation for this variability could inform FASD prevention. Here we show that the most common nutritional deficiency of pregnancy, iron deficiency without anemia (ID, is a potent and synergistic modifier of FASD risk. Using an established rat model of third trimester-equivalent binge drinking, we show that ID significantly interacts with alcohol to impair postnatal somatic growth, associative learning, and white matter formation, as compared with either insult separately. For the associative learning and myelination deficits, the ID-alcohol interaction was synergistic and the deficits persisted even after the offsprings' iron status had normalized. Importantly, the observed deficits in the ID-alcohol animals comprise key diagnostic criteria of FASD. Other neurobehaviors were normal, showing the ID-alcohol interaction was selective and did not reflect a generalized malnutrition. Importantly ID worsened FASD outcome even though the mothers lacked overt anemia; thus diagnostics that emphasize hematological markers will not identify pregnancies at-risk. This is the first direct demonstration that, as suggested by clinical studies, maternal iron status has a unique influence upon FASD outcome. While alcohol is unquestionably teratogenic, this ID-alcohol interaction likely represents a significant portion of FASD diagnoses because ID is more common in alcohol-abusing pregnancies than generally appreciated. Iron status may also underlie the associations between FASD and parity or socioeconomic status. We propose that increased attention to normalizing maternal iron status will substantially improve FASD outcome, even if maternal alcohol abuse

  3. Pulmonary cytokine composition differs in the setting of alcohol use disorders and cigarette smoking.

    Science.gov (United States)

    Burnham, Ellen L; Kovacs, Elizabeth J; Davis, Christopher S

    2013-06-15

    Alcohol use disorders (AUDs), including alcohol abuse and dependence, and cigarette smoking are widely acknowledged and common risk factors for pneumococcal pneumonia. Reasons for these associations are likely complex but may involve an imbalance in pro- and anti-inflammatory cytokines within the lung. Delineating the specific effects of alcohol, smoking, and their combination on pulmonary cytokines may help unravel mechanisms that predispose these individuals to pneumococcal pneumonia. We hypothesized that the combination of AUD and cigarette smoking would be associated with increased bronchoalveolar lavage (BAL) proinflammatory cytokines and diminished anti-inflammatory cytokines, compared with either AUDs or cigarette smoking alone. Acellular BAL fluid was obtained from 20 subjects with AUDs, who were identified using a validated questionnaire, and 19 control subjects, matched on the basis of age, sex, and smoking history. Half were current cigarette smokers; baseline pulmonary function tests and chest radiographs were normal. A positive relationship between regulated and normal T cell expressed and secreted (RANTES) with increasing severity of alcohol dependence was observed, independent of cigarette smoking (P = 0.0001). Cigarette smoking duration was associated with higher IL-1β (P = 0.0009) but lower VEGF (P = 0.0007); cigarette smoking intensity was characterized by higher IL-1β and lower VEGF and diminished IL-12 (P = 0.0004). No synergistic effects of AUDs and cigarette smoking were observed. Collectively, our work suggests that AUDs and cigarette smoking each contribute to a proinflammatory pulmonary milieu in human subjects through independent effects on BAL RANTES and IL-1β. Furthermore, cigarette smoking additionally influences BAL IL-12 and VEGF that may be relevant to the pulmonary immune response.

  4. Behavioral couples therapy (BCT) for alcohol and drug use disorders: a meta-analysis.

    Science.gov (United States)

    Powers, Mark B; Vedel, Ellen; Emmelkamp, Paul M G

    2008-07-01

    Narrative reviews conclude that behavioral couples therapy (BCT) produces better outcomes than individual-based treatment for alcoholism and drug abuse problems (e.g., [Epstein, E. E., & McCrady, B. S. (1998). Behavioral couples treatment of alcohol and drug use disorders: Current status and innovations. Clinical Psychology Review, 18(6), 689-711; O'Farrell, T. J., & Fals-Stewart, W. (2003). Alcohol abuse. Journal of Marital and Family Therapy, 29(1), 121-146]). However, the strength and consistency of this effect favoring BCT has not been examined because a meta-analysis of BCT studies has not been reported. This meta-analysis combines multiple well controlled studies to help clarify the overall impact of BCT in the treatment of substance use disorders. A comprehensive literature search produced 12 randomized controlled trials (n=754) that were included in the final analyses. There was a clear overall advantage of including BCT compared to individual-based treatments (Cohen's d=0.54). This was true across outcome domains (frequency of use d=0.36, consequences of use d=0.52, and relationship satisfaction d=0.57). However the pattern of results varied as a function of time. BCT was superior to control conditions only in relationship satisfaction at posttreatment (d=0.64). However, at follow-up BCT was superior on all three outcome domains (frequency of use d=0.45, consequences of use d=0.50, and relationship satisfaction d=0.51). In addition to other control conditions, BCT also outperformed individual cognitive behavioral therapy without couples therapy (d=0.42). Larger sample sizes were associated with higher effect sizes (p=0.02). However, treatment dose and publication year were not related to effect size. Overall, BCT shows better outcomes than more typical individual-based treatment for married or cohabiting individuals who seek help for alcohol dependence or drug dependence problems. The benefit for BCT with low severity problem drinkers has received little

  5. The ADH gene cluster SNP rs1789891 and temperamental dimensions in patients with alcohol dependence and affective disorders.

    Science.gov (United States)

    Oniszczenko, Włodzimierz; Rybakowski, Janusz K; Dragan, Wojciech Ł; Grzywacz, Anna; Samochowiec, Jerzy

    2015-08-01

    This study had three objectives: (1) to assess the relationship between the single nucleotide polymorphism (SNP) rs1789891 in the alcohol dehydrogenase gene cluster and alcohol dependence and affective disorders; (2) to assess the differences in the Regulative Theory of Temperament (RTT) traits between an alcohol dependent group, an affective disorders group, and a healthy group; and (3) to assess the relationship between rs1789891 and temperament traits in a healthy group, taking into account the interaction of genotype and sex. The SNP rs1789891 was genotyped in a group of 194 alcohol dependent men, aged 21 to 71 years; 137 patients with affective disorders, including 51 males and 86 females, aged 19 to 85 years; and a group of 207 healthy individuals, including 89 males and 118 females, aged 18 to 71 years. Temperament traits (briskness, perseveration, sensory sensitivity, emotional reactivity, endurance, and activity) were assessed in all groups using the Formal Characteristics of Behaviour-Temperament Inventory. The comparative analysis of genotypic frequencies showed no significant differences between patients with alcoholism or affective disorders and those in the control group. Alcohol dependent men and the affective disorder group were characterised by higher levels of emotional reactivity (p-value 1.4e-5 and 9.84e-7, respectively) and lower levels of briskness, sensory sensitivity, endurance, and activity (p-value from 3.76e-8 to 0.012) when compared to the healthy group. The rs1789891 polymorphism was associated with briskness (p = 0.02), sensory sensitivity (p = 0.036), and activity (p = 0.049). None of the results were statistically significant after Bonferroni correction.

  6. An Evolution of Virtual Reality Training Designs for Children With Autism and Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Strickland, Dorothy C; McAllister, David; Coles, Claire D; Osborne, Susan

    2007-07-01

    This article describes an evolution of training programs to use first-person interaction in virtual reality (VR) situations to teach safety skills to children with autism spectrum disorder (ASD) and fetal alcohol spectrum disorder (FASD). Multiple VR programs for children aged 2 to 9 were built and tested between 1992 and 2007. Based on these results, a learning design evolved that uses practice in virtual space with guidance and correction by an animated character, strategic limitations on allowed actions to force correct patterning, and customization of worlds and responses to simplify user controls. This article describes program evolution by comparing design details and results as variations in behavioral responses between disorders, differences in skill set complexity between different safety skills being taught, and improved technology required changes in the virtual training methodology. A series of research projects are summarized in which the VR programs proved effective for teaching children with ASD and FASD new skills in the virtual space and, where measured, most children generalized the actions to the real world.

  7. Alcohol Use Disorders, Research Findings | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Alcohol Use and Abuse Alcohol Use Research Findings Past Issues / Winter 2013 Table ... and adolescents years after they were exposed to alcohol in the womb. That is according to a ...

  8. Sociodemographic Correlates of Transitions from Alcohol Use to Disorders and Remission in the São Paulo Megacity Mental Health Survey, Brazil

    OpenAIRE

    Silveira, Camila Magalhães; Viana, Maria Carmen; Siu, Erica Rosanna; Guerra de Andrade, Arthur; Anthony, James C.; Andrade, Laura Helena

    2011-01-01

    Aims: To evaluate sociodemographic correlates associated with transitions from alcohol use to disorders and remission in a Brazilian population. Methods: Data are from a probabilistic, multi-stage clustered sample of adult household residents in the São Paulo Metropolitan Area. Alcohol use, regular use (at least 12 drinks/year), DSM-IV abuse and dependence and remission from alcohol use disorders (AUDs) were assessed with the World Mental Health version of the Composite International Diagnost...

  9. Adolescent-onset alcohol abuse exacerbates the influence of childhood conduct disorder on late adolescent and early adult antisocial behaviour

    OpenAIRE

    Howard, Richard; Finn, Peter; Jose, Paul; Gallagher, Jennifer

    2011-01-01

    This study tested the hypothesis that adolescent-onset alcohol abuse (AOAA) would both mediate and moderate the effect of childhood conduct disorder on antisocial behaviour in late adolescence and early adulthood. A sample comprising 504 young men and women strategically recruited from the community were grouped using the criteria of the Diagnostic and Statistical Manual (DSM-IV, American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washing...

  10. Emotional face recognition deficit in amnestic patients with mild cognitive impairment: behavioral and electrophysiological evidence

    OpenAIRE

    Yang L; Zhao X; Wang L; Yu L; Song M; Wang X.

    2015-01-01

    Linlin Yang, Xiaochuan Zhao, Lan Wang, Lulu Yu, Mei Song, Xueyi Wang Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, People’s Republic of China Abstract: Amnestic mild cognitive impairment (MCI) has been conceptualized as a transitional stage between healthy aging and Alzheimer’s disease. Thus, understanding emotional face recognition deficit in patients with amnestic...

  11. Impairment of social behaviour persists two years after embryonic alcohol exposure in zebrafish: A model of fetal alcohol spectrum disorders.

    Science.gov (United States)

    Fernandes, Yohaan; Rampersad, Mindy; Gerlai, Robert

    2015-10-01

    Zebrafish naturally form social groups called shoals. Previously, we have shown that submerging zebrafish eggs into low concentrations of alcohol (0.00, 0.25, 0.50, 0.75 and 1.00 vol/vol% external bath concentration) during development (24h post-fertilization) for two hours resulted in impaired shoaling response in seven month old young adult zebrafish. Here we investigate whether this embryonic alcohol exposure induced behavioural deficit persists to older age. Zebrafish embryos were exposed either to fresh system water (control) or to 1% alcohol for two hours, 24h after fertilization, and were raised in a high-density tank system. Social behaviour was tested by presenting the experimental fish with a computer animated group of zebrafish images, while automated tracking software measured their behaviour. Control fish were found to respond strongly to animated conspecific images by reducing their distanceand remaining close to the images during image presentation, embryonic alcohol treated fish did not. Our results suggest that the impaired shoaling response of the alcohol exposed fish was not due to altered motor function or visual perception, but likely to a central nervous system alteration affecting social behaviour itself. We found the effects of embryonic alcohol exposure on social behaviour not to diminish with age, a result that demonstrates the deleterious and potentially life-long consequences of exposure to even small amount of alcohol during embryonic development in vertebrates.

  12. Interaction between a functional MAOA locus and childhood sexual abuse predicts alcoholism and antisocial personality disorder in adult women.

    Science.gov (United States)

    Ducci, F; Enoch, M-A; Hodgkinson, C; Xu, K; Catena, M; Robin, R W; Goldman, D

    2008-03-01

    Women who have experienced childhood sexual abuse (CSA) have an increased risk of alcoholism and antisocial personality disorder (ASPD). Among male subjects, a functional polymorphism (MAOA-LPR, monoamine oxidase A linked polymorphic region) in the promoter region of the monoamine oxidase A gene (MAOA) appears to moderate the effect of childhood maltreatment on antisocial behavior. Our aim was to test whether MAOA-LPR influences the impact of CSA on alcoholism and ASPD in a sample of 291 women, 50% of whom have experienced CSA; we also tested whether haplotypes covering the region where both MAOA and monoamine oxidase B (MAOB) genes are located predict risk of alcoholism and ASPD better than the MAOA-LPR locus alone. Participants included 168 alcoholics (39 with ASPD (antisocial alcoholics) and 123 controls (no alcoholics, no ASPD). Antisocial behavior was also modeled as a continuous trait: ASPD symptoms count. The MAOA-LPR low activity allele was associated with alcoholism (P=0.005), particularly antisocial alcoholism (P=0.00009), only among sexually abused subjects. Sexually abused women who were homozygous for the low activity allele had higher rates of alcoholism and ASPD, and more ASPD symptoms, than abused women homozygous for the high activity allele. Heterozygous women displayed an intermediate risk pattern. In contrast, there was no relationship between alcoholism/antisocial behavior and MAOA-LPR genotype among non-abused women. The MAOA-LPR low activity allele was found on three different haplotypes. The most abundant MAOA haplotype containing the MAOA-LPR low activity allele was found in excess among alcoholics (P=0.008) and antisocial alcoholics (P=0.001). Finally, a MAOB haplotype, which we termed haplotype C, was significantly associated with alcoholism (P=0.006), and to a lesser extent with antisocial alcoholism (P=0.03). In conclusions, MAOA seems to moderate the impact of childhood trauma on adult psychopathology in female subjects in the same way

  13. Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials

    Science.gov (United States)

    Barrio, Pablo; Gual, Antoni

    2016-01-01

    Issues Patient-centered care (PCC) is increasingly accepted as an integral component of good health care, including addiction medicine. However, its implementation has been controversial in people with alcohol use disorders. Approach A systematic search strategy was devised to find completed randomized controlled trials enrolling adults (>18 years) with alcohol use disorders. Studies had to use a PCC approach such that they should have been individualized, respectful to the patients’ own goals, and empowering. Studies until September 2015 were searched using PubMed, Scopus, the Cochrane Library, PsychINFO, and Web of Knowledge. Key findings In total, 40 studies enrolling 16,020 patients met the inclusion criteria. Assessment revealed two main categories of study: psychosocial (n=35 based on motivational interviewing) and pharmacological (n=5 based on an as needed dosing regimen). Psychosocial interventions were further classified according to the presence or absence of an active comparator. When no active comparator was present, studies were classified according to the number of sessions (≥1). Results from single sessions of motivational interviewing showed no clear benefit on alcohol consumption outcomes, with few studies indicating benefit of PCC versus control. Although the results for studies of multiple sessions of counseling were also mixed, many did show a significant benefit of the PCC intervention. By contrast, studies consistently demonstrated a benefit of pharmacologically supported PCC interventions, with most of the differences reaching statistical significance. Implications PCC-based interventions may be beneficial for reducing alcohol consumption in people with alcohol use disorders. PMID:27695301

  14. Exploring the complexity of intellectual disability in fetal alcohol spectrum disorders

    Directory of Open Access Journals (Sweden)

    Aniruddho eChokroborty-Hoque

    2014-08-01

    Full Text Available Brain development in mammals is long lasting. It begins early during embryonic growth and is finalized in early adulthood. This progression represents a delicate choreography of molecular, cellular and physiological processes initiated and directed by the fetal genotype in close interaction with environment. Not surprisingly, most aberrations in brain functioning including mental retardation are attributed to either gene(s, or environment or the interaction of the two. The ensuing complexity has made the assessment of this choreography, ever challenging. A model to assess this complexity has used a mouse model (C57BL/6J or B6 that is subjected to prenatal alcohol exposure. The resulting pups show learning and memory deficits similar to patients with fetal alcohol spectrum disorder (FASD, which is associated with life-long changes in gene expression. Interestingly, this change in gene expression underlies epigenetic processes including DNA methylation and miRNAs. This paradigm is applicable to ethanol exposure at different developmental times (binge at trimesters 1, 2 and 3 as well as continuous preference drinking (70% of 10% alcohol by B6 females during pregnancy. The exposure leads to life-long changes in neural epigenetic marks, gene expression, and a variety of defects in neurodevelopment and CNS function. We argue that this cascade may be reversed postnatally via drugs, chemicals and environment including maternal care. Such conclusions are supported by two sets of results. First, antipsychotic drugs that are used to treat mental disability including psychosis function via changes in DNA methylation, a major epigenetic mark. Second, post-natal environment may improve (with enriched environments or worsen (with negative and maternal separation stress the cognitive ability of pups that were prenatally exposed to ethanol as well as their matched controls. In this review, we will discuss operational epigenetic mechanisms involved in the

  15. Costs of Fetal Alcohol Spectrum Disorder in the Canadian Criminal Justice System.

    Science.gov (United States)

    Thanh, Nguyen Xuan; Jonsson, Egon

    2015-01-01

    We reviewed literature to estimate the costs of Fetal Alcohol Spectrum Disorder (FASD) in the Canadian Criminal Justice System (CJS), and to update the total costs of FASD in Canada. The results suggest FASD is costlier than previous estimates. The costs of FASD associated with the CJS are estimated at $3.9 billion a year, with $1.2 billion for police, $0.4 billion for court, $0.5 billion for correctional services, $1.6 billion for victims, and $0.2 billion for third-party. The updated total costs of FASD in Canada are $9.7 billion a year, of which CJS accounts for 40%, healthcare 21%, education 17%, social services 13%, and others 9%.

  16. Seizures and electroencephalography findings in 61 patients with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Boronat, S; Vicente, M; Lainez, E; Sánchez-Montañez, A; Vázquez, E; Mangado, L; Martínez-Ribot, L; Del Campo, M

    2017-01-01

    Fetal alcohol spectrum disorders (FASD) cause neurodevelopmental abnormalities. However, publications about epilepsy and electroencephalographic features are scarce. In this study, we prospectively performed electroencephalography (EEG) and brain magnetic resonance (MR) imaging in 61 patients with diagnosis of FASD. One patient had multiple febrile seizures with normal EEGs. Fourteen children showed EEG anomalies, including slow background activity and interictal epileptiform discharges, focal and/or generalized, and 3 of them had epilepsy. In one patient, seizures were first detected during the EEG recording and one case had an encephalopathy with electrical status epilepticus during slow sleep (ESES). Focal interictal discharges in our patients did not imply the presence of underlying visible focal brain lesions in the neuroimaging studies, such as cortical dysplasia or polymicrogyria. However, they had nonspecific brain MR abnormalities, including corpus callosum hypoplasia, vermis hypoplasia or cavum septum pellucidum. The latter was significantly more frequent in the group with EEG abnormal findings (p < 0.01).

  17. Cost attributable to Fetal Alcohol Spectrum Disorder in the Canadian correctional system.

    Science.gov (United States)

    Popova, Svetlana; Lange, Shannon; Burd, Larry; Rehm, Jürgen

    2015-01-01

    Prenatal alcohol exposure is the leading identifiable cause of intellectual disability in the Western world and may result in Fetal Alcohol Spectrum Disorder (FASD). Individuals with FASD have a higher risk of being involved in the legal system, either as offenders or as victims. Therefore, the aim of the current study was to estimate the direct cost for youths (12-17 years old) and adults (18+ years old) with FASD to the Canadian correctional system in 2011/2012. The prevalence of FASD in the Canadian correctional system, obtained from the current epidemiological literature, was applied to the average number of youths and adults in the correctional system in 2011/2012. The average daily cost for corrections was then applied to the estimated number of youths and adults with FASD in custody. The cost of corrections among youths with FASD in Canada in 2011/2012 was calculated to be approximately $17.5M Canadian dollars (CND; $13.6M CND for males and $3.8M CND for females) and among adults with FASD was estimated to be about $356.2M CND ($140M CND for provincial and territorial custody and $216.2M CND for federal custody). The study findings emphasize the need to raise awareness regarding the prevalence of FASD in the correctional system. It is crucial to incorporate FASD screening and intervention strategies as early as possible in the criminal justice process.

  18. Fetal alcohol spectrum disorders: a population based study of premature mortality rates in the mothers.

    Science.gov (United States)

    Li, Qing; Fisher, Wayne W; Peng, Chun-Zi; Williams, Andrew D; Burd, Larry

    2012-08-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers' death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44-7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09-0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment.

  19. Fetal Alcohol Spectrum Disorders: A Population Based Study of Premature Mortality Rates in the Mothers

    Science.gov (United States)

    Li, Qing; Fisher, Wayne W.; Peng, Chun-Zi; Williams, Andrew D.

    2017-01-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers’ death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44–7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09–0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment. PMID:21710184

  20. Variability in Classroom Social Communication: Performance of Children with Fetal Alcohol Spectrum Disorders and Typically Developing Peers

    Science.gov (United States)

    Kjellmer, Liselotte; Olswang, Lesley B.

    2013-01-01

    Purpose: In this study, the authors examined how variability in classroom social communication performance differed between children with fetal alcohol spectrum disorders (FASD) and pair-matched, typically developing peers. Method: Twelve pairs of children were observed in their classrooms, 40 min per day (20 min per child) for 4 days over a…

  1. Examination of genetic variation in GABRA2 with conduct disorder and alcohol abuse and dependence in a longitudinal study

    Science.gov (United States)

    Melroy, Whitney E.; Stephens, Sarah H.; Sakai, Joseph T.; Kamens, Helen M.; McQueen, Matthew B.; Corley, Robin P.; Stallings, Michael C.; Hopfer, Christian J.; Krauter, Kenneth S.; Brown, Sandra A.; Hewitt, John K.; Ehringer, Marissa A.

    2014-01-01

    Previous studies have shown associations between SNPs in GABRA2 and adolescent conduct disorder (CD) and alcohol dependence in adulthood, but not adolescent alcohol dependence. The present study was intended as a replication and extension of this work, focusing on adolescent CD, adolescent alcohol abuse and dependence (AAD), and adult AAD. Family based association tests were run using Hispanics and non-Hispanic European American subjects from two independent longitudinal samples. Although the analysis provided nominal support for an association with rs9291283 and AAD in adulthood and CD in adolescence, the current study failed to replicate previous associations between two well replicated GABRA2 NPs and CD and alcohol dependence. Overall, these results emphasize the utility of including an independent replication sample in the study design, so that the results from an individual sample can be weighted in the context of its reproducibility. PMID:24687270

  2. Psychometric Properties of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) in Public First Responders.

    Science.gov (United States)

    Jeong, Hyeonseok S; Park, Shinwon; Lim, Soo Mee; Ma, Jiyoung; Kang, Ilhyang; Kim, Jungyoon; Kim, Eui-Jung; Choi, Yejee J; Lim, Jae-Ho; Chung, Yong-An; Lyoo, In Kyoon; Yoon, Sujung; Kim, Jieun E

    2017-03-21

    Problematic alcohol consumption is prevalent among first responders because alcohol is commonly used to cope with occupational stress and frequent exposure to traumatic incidents, making them an at-risk population for alcohol use disorders (AUD). This study investigated the psychometric properties of the Korean version of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among public first responders. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (SCID), AUDIT-C, AUDIT, and CAGE were administered to 222 public first responders, who were recruited by convenience sampling. One-week test-retest reliability was evaluated in a subsample (n = 24). Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic accuracy and estimate the optimal cut-off scores for any AUD and alcohol dependence. Three different analytic criteria were utilized to calculate the cut-off scores. The AUDIT-C demonstrated good test-retest reliability (intraclass correlation coefficient for test-retest reliability = 0.91) and satisfactory convergent validity. The areas under the ROC curves for any AUD and alcohol dependence of the AUDIT-C were 0.87 and 0.93, respectively. For any AUD, all three criteria suggested a cut-off score of 7.5 (sensitivity = 81.8%, specificity = 79.8%), whereas for alcohol dependence, a cut-off score of 8.5 (sensitivity = 85.7%, specificity = 86.1%) was derived from two criteria. In conclusion, the AUDIT-C demonstrated good reliability and validity and proved to be a brief and effective screening test for AUD among first responders.

  3. Parent and child psychopathology and suicide attempts among children of parents with alcohol use disorder.

    Science.gov (United States)

    Conner, Kenneth R; Bossarte, Robert M; Lu, Naiji; Kaukeinen, Kimberly; Chan, Grace; Wyman, Peter; Tu, Xin M; Goldston, David B; Houston, Rebecca J; Bucholz, Kathleen K; Hesselbrock, Victor M

    2014-01-01

    Parents with psychopathology such as alcohol use disorder (AUD) that confers risk for suicide attempt (SA) may have children who are more likely to develop such psychopathology and to attempt suicide, suggesting that risk may be "transmitted" from parents to children. We examined this phenomenon during the transition from childhood to adolescence, when risk for SA increases dramatically. A cohort of 418 children were examined at average age 9.4 (range 7-14) years at enrollment (Time 1, childhood) and approximately 5 years later, prior to reaching age 18 (Time 2, adolescence). One or both biological parents, oversampled for AUD, were also interviewed. Structural equation models (SEM) examined father-child, mother-child, and either/both parent-child associations. The primary outcome was SA over follow-up among offspring, assessed at Time 2. As hypothesized, parental antisocial personality disorder predicted conduct disorder symptoms in offspring both during childhood and adolescence (parent-child model, father-child model) and maternal AUD predicted conduct disorder symptoms during childhood (mother-child model). However, we did not find evidence to support transmission of depression from parents to offspring either during childhood or adolescence, and parent psychopathology did not show statistically significant associations with SA during adolescence. In conclusion, we conducted a rare study of parent-to-child "transmission" of risk for SA that used a prospective research design, included diagnostic interviews with both parents and offspring, and examined the transition from childhood to adolescence, and the first such study in children of parents with AUD. Results provided mixed support for hypothesized parent-child associations.

  4. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders.

    Science.gov (United States)

    Armstrong, M L; LaPlante, A M; Altice, F L; Copenhaver, M; Molina, P E

    2015-01-01

    Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol's impact on ART and HIV disease progression. These data were used to design the adapted EBI.

  5. Quality of life and risk of psychiatric disorders among regular users of alcohol, nicotine, and cannabis: An analysis of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC).

    Science.gov (United States)

    Cougle, Jesse R; Hakes, Jahn K; Macatee, Richard J; Chavarria, Jesus; Zvolensky, Michael J

    2015-01-01

    Research is limited on the effects of regular substance use on mental health-related outcomes. We used a large nationally representative survey to examine current and future quality of life and risk of psychiatric disorders among past-year regular (weekly) users of alcohol, nicotine, and cannabis. Data on psychiatric disorders and quality of life from two waves (Wave 1 N = 43,093, Wave 2 N = 34,653) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were used to test study aims. In cross-sectional analyses, regular nicotine and cannabis use were associated with higher rates of psychiatric disorder, though regular alcohol use was associated with lower rates of disorders. Prospective analyses found that regular nicotine use predicted onset of anxiety, depressive, and bipolar disorders. Regular alcohol use predicted lower risk of these disorders. Regular cannabis use uniquely predicted the development of bipolar disorder, panic disorder with agoraphobia, and social phobia. Lastly, regular alcohol use predicted improvements in physical and mental health-related quality of life, whereas nicotine predicted deterioration in these outcomes. Regular cannabis use predicted declines in mental, but not physical health. These data add to the literature on the relations between substance use and mental and physical health and suggest increased risk of mental health problems among regular nicotine and cannabis users and better mental and physical health among regular alcohol users. Examination of mechanisms underlying these relationships is needed.

  6. Repetitive Transcranial Magnetic Stimulation (rTMS) in the Management of Alcohol Dependence and other Substance Abuse Disorders – Emerging Data and Clinical Relevance

    Science.gov (United States)

    Sousa, Avinash De

    2013-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been used widely in various psychiatric disorders like depression and schizophrenia. There have been some reports of its usefulness in alcohol dependence and substance use disorders. The present paper reviews the studies done using rTMS in substance use disorders including alcohol and nicotine dependence. Various studies done have been reviewed including the proposed mechanisms of action are outlined with the future research needs and need for further clinical data PMID:25337357

  7. Facial emotion recognition in alcohol and substance use disorders: A meta-analysis.

    Science.gov (United States)

    Castellano, Filippo; Bartoli, Francesco; Crocamo, Cristina; Gamba, Giulia; Tremolada, Martina; Santambrogio, Jacopo; Clerici, Massimo; Carrà, Giuseppe

    2015-12-01

    People with alcohol and substance use disorders (AUDs/SUDs) show worse facial emotion recognition (FER) than controls, though magnitude and potential moderators remain unknown. The aim of this meta-analysis was to estimate the association between AUDs, SUDs and FER impairment. Electronic databases were searched through April 2015. Pooled analyses were based on standardized mean differences between index and control groups with 95% confidence intervals, weighting each study with random effects inverse variance models. Risk of publication bias and role of potential moderators, including task type, were explored. Nineteen of 70 studies assessed for eligibility met the inclusion criteria, comprising 1352 individuals, of whom 714 (53%) had AUDs or SUDs. The association between substance related disorders and FER performance showed an effect size of -0.67 (-0.95, -0.39), and -0.65 (-0.93, -0.37) for AUDs and SUDs, respectively. There was no publication bias and subgroup and sensitivity analyses based on potential moderators confirmed core results. Future longitudinal research should confirm these findings, clarifying the role of specific clinical issues of AUDs and SUDs.

  8. Personality disorder, emotional intelligence, and locus of control of patients with alcohol dependence

    Directory of Open Access Journals (Sweden)

    Om Prakash

    2015-01-01

    Full Text Available Aim: To assess personality disorder (PD, emotional intelligence (EI, and locus of control of alcohol dependent (AD patients and its comparison with normal controls. Materials and Methods: Based on purposive sampling technique, 33 AD patients were selected from the De-Addiction Ward of Ranchi Institute of Neuro-Psychiatry and Allied Sciences (RINPAS and 33 matched normal subjects were selected from Ranchi and nearby places. Both the groups were matched on various sociodemographic parameters, that is, age, gender, and socioeconomic level. All participants were assessed with Millon Clinical Multiaxial Inventory-III, Mangal EI Inventory, and Locus of Control scale. Obtained responses were scored by using standard scoring procedures and subsequently statistically analyzed by using Chi-square test. Results: AD patients have more comorbid pathological personality traits and disorders in comparison to their normal counterparts. Depressive, narcissistic, and paranoid PDs were prominent among AD group; followed by schizotypal, antisocial, negativistic, dependent, schizoid, sadistic, masochistic, and borderline PD. In comparison to normal participants, AD patients were significantly deficient in almost all the areas of EI and their locus of control was externally oriented. Conclusion: Patients with AD have significantly higher PDs, low EI, and an external orientation on the locus of control. Identification and management of these comorbid conditions are likely to improve the management and outcome of AD.

  9. Young adult social development as a mediator of alcohol use disorder symptoms from age 21 to 30.

    Science.gov (United States)

    Kosterman, Rick; Hill, Karl G; Lee, Jungeun Olivia; Meacham, Meredith C; Abbott, Robert D; Catalano, Richard F; Hawkins, J David

    2014-06-01

    Little research has examined social development in the young adult years relative to childhood and adolescence. This study tested the hypothesized pathways of the social development model (SDM) in young adulthood for predicting symptoms of alcohol use disorder (AUD) and positive functioning at age 30. A longitudinal panel study originally drawn from Seattle, Washington, elementary schools was examined. The sample included 808 participants with high retention and was gender balanced and ethnically diverse. Analyses focused on ages 21, 27, and 30. SDM constructs were assessed with self-reports of past-year behavior and combined multiple life domains. AUD symptoms corresponding to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994) criteria were assessed using the Diagnostic Interview Schedule. Positive functioning combined measures of constructive engagement in work and school, civic engagement, physical exercise, and lack of depressive symptoms. The study found that AUD symptoms were moderately stable from age 21 to 30; however, developmental pathways hypothesized by the SDM at age 27 played a significant role in partially mediating this association. Alcohol-specific factors were key mediating mechanisms, whereas prosocial factors played little role. Conversely, prosocial factors had an important role in predicting positive functioning at age 30, whereas there were no significant pathways involving alcohol-specific factors. Findings suggest that age 27 is not too late for interventions targeting adult social development to help diminish alcohol use disorder symptoms by age 30. Alcohol-specific factors such as reducing perceived opportunities or rewards for heavy alcohol use or challenging beliefs accepting of drunkenness are likely to be key ingredients of effective adult interventions.

  10. Out of sight, out of mind? A national survey of paediatricians in Ireland regarding Fetal Alcohol Spectrum Disorders

    LENUS (Irish Health Repository)

    Gill, I

    2017-03-01

    Fetal Alcohol Spectrum Disorders (FASDs) are one of the major causes of preventable developmental delay. There is no register of children with FASDs in Ireland. Up to 81% of Irish women report drinking alcohol during the periconceptual period or pregnancy. We aimed to evaluate self-reported knowledge and practice of doctors working in paediatrics in Ireland with regards to FASDs and alcohol consumption during pregnancy. We circulated a survey to all paediatric doctors in Ireland, either enrolled in specialist training or registered as trainers. Fifty-six respondents (31.3%) were unaware of the existence of FASDs. Sixty-two (34.6%) believed most patients with FASDs have dysmorphic features. Seventy-three respondents (40.8%) routinely ask about maternal alcohol consumption during pregnancy in the context of developmental delay. Thirty-one respondents (17.3%) stated that mild alcohol intake in the third trimester of pregnancy is safe. Our survey suggests prenatal alcohol exposure may not be routinely considered in the evaluation of children with developmental delay by paediatric doctors in Ireland.

  11. An animal model of fetal alcohol spectrum disorder: Trace conditioning as a window to inform memory deficits and intervention tactics.

    Science.gov (United States)

    Hunt, Pamela S; Barnet, Robert C

    2015-09-01

    Animal models of Fetal Alcohol Spectrum Disorders (FASD) afford the unique capacity to precisely control timing of alcohol exposure and alcohol exposure amounts in the developing animal. These models have powerfully informed neurophysiological alterations associated with fetal and perinatal alcohol. In two experiments presented here we expand use of the Pavlovian Trace Conditioning procedure to examine cognitive deficits and intervention strategies in a rat model of FASD. Rat pups were exposed to 5g/kg/day ethanol on postnatal days (PD) 4-9, simulating alcohol exposure in the third trimester in humans. During early adolescence, approximately PD 30, the rats were trained in the trace conditioning task in which a light conditioned stimulus (CS) and shock unconditioned stimulus (US) were paired but separated by a 10-s stimulus free trace interval. Learning was assessed in freezing behavior during shock-free tests. Experiment 1 revealed that neonatal ethanol exposure significantly impaired hippocampus-dependent trace conditioning relative to controls. In Experiment 2 a serial compound conditioning procedure known as 'gap filling' completely reversed the ethanol-induced deficit in trace conditioning. We also discuss prior data regarding the beneficial effects of supplemental choline and novel preliminary data regarding the pharmacological cognitive enhancer physostigmine, both of which mitigate the alcohol-induced cognitive deficit otherwise seen in trace conditioning controls. We suggest trace conditioning as a useful tool for characterizing some of the core cognitive deficits seen in FASD, and as a model for developing effective environmental as well as nutritional and pharmacological interventions.

  12. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    M. L. Armstrong

    2015-01-01

    Full Text Available Alcohol use disorders (AUDs are highly prevalent among people living with HIV/AIDS (PLWHA and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI, the Holistic Health Recovery Program (HHRP+, that focuses on secondary HIV prevention and antiretroviral therapy (ART adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1 negative mood states contribute to heavy alcohol consumption in PLWHA; (2 high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3 local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4 healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5 misperceptions about the relationships between alcohol and HIV are common; (6 PLWHA are interested in learning about alcohol’s impact on ART and HIV disease progression. These data were used to design the adapted EBI.

  13. Disruption of circulation by ethanol promotes fetal alcohol spectrum disorder (FASD) in medaka (Oryzias latipes) embryogenesis.

    Science.gov (United States)

    Hu, Yuhui; Khan, Ikhlas A; Dasmahapatra, Asok K

    2008-09-01

    Japanese medaka (Oryzias latipes) embryos exposed to ethanol have developed craniofacial, cardiovascular and skeletal defects which can be compared with the phenotypic features of fetal alcohol spectrum disorder (FASD) observed in human. The present experiment was designed to show that the disruption in circulation by ethanol during embryogenesis is a potential cause of FASD. Fertilized eggs were exposed to ethanol (0, 100 and/or 400 mM) for 24 or 48 h at various developmental stages (Iwamatsu stages 4-30) and were analyzed at 6 day post fertilization (dpf). It was observed that controls and the embryos exposed to 100 mM ethanol were in circulating state; however, a significant number of embryos of stages 4-24 exposed to 400 mM ethanol had disrupted circulation. Compared to controls, protein and RNA contents were significantly reduced in non-circulating embryos. Lipid peroxidation (LPO) analysis was made at 3, 6, 24, 48, 96 and 144 hour post fertilization (hpf). LPO was increased with the advancement of morphogenesis; however, ethanol or the circulation status had no effect. We further analyzed alcohol dehydrogenase (Adh 5 and adh8) and aldehyde dehydrogenase (Aldh9A and Aldh1A2) enzyme mRNAs in the embryos exposed to 400 mM ethanol for 24 h. A developmental stage-specific reduction in these enzyme mRNAs by ethanol was observed. We conclude that ethanol-induced disruption in circulation during embryogenesis is a potential cause of the development of FASD features in medaka.

  14. A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia

    Directory of Open Access Journals (Sweden)

    Watkins Rochelle E

    2013-01-01

    Full Text Available Abstract Background There is little reliable information on the prevalence of fetal alcohol spectrum disorders (FASD in Australia and no coordinated national approach to facilitate case detection. The aim of this study was to identify health professionals’ perceptions about screening for FASD in Australia. Method A modified Delphi process was used to assess perceptions of the need for, and the process of, screening for FASD in Australia. We recruited a panel of 130 Australian health professionals with experience or expertise in FASD screening or diagnosis. A systematic review of the literature was used to develop Likert statements on screening coverage, components and assessment methods which were administered using an online survey over two survey rounds. Results Of the panel members surveyed, 95 (73% responded to the questions on screening in the first survey round and, of these, 81 (85% responded to the second round. Following two rounds there was consensus agreement on the need for targeted screening at birth (76% and in childhood (84%. Participants did not reach consensus agreement on the need for universal screening at birth (55% or in childhood (40%. Support for targeted screening was linked to perceived constraints on service provision and the need to examine the performance, costs and benefits of screening. For targeted screening of high risk groups, we found highest agreement for siblings of known cases of FASD (96% and children of mothers attending alcohol treatment services (93%. Participants agreed that screening for FASD primarily requires assessment of prenatal alcohol exposure at birth (86% and in childhood (88%, and that a checklist is needed to identify the components of screening and criteria for referral at birth (84% and in childhood (90%. Conclusions There is an agreed need for targeted but not universal screening for FASD in Australia, and sufficient consensus among health professionals to warrant development and

  15. Differentially co-expressed genes in postmortem prefrontal cortex of individuals with alcohol use disorders: Influence on alcohol metabolism-related pathways

    Science.gov (United States)

    Zhang, Huiping; Wang, Fan; Xu, Hongqin; Liu, Yawen; Liu, Jin; Zhao, Hongyu; Gelernter, Joel

    2014-01-01

    Chronic alcohol consumption may induce gene expression alterations in brain reward regions such as the prefrontal cortex (PFC), modulating the risk of alcohol use disorders (AUDs). Transcriptome profiles of 23 AUD cases and 23 matched controls (16 pairs of males and 7 pairs of females) in postmortem PFC were generated using Illumina’s HumanHT-12 v4 Expression BeadChip. Probe-level differentially expressed genes and gene modules in AUD subjects were identified using multiple linear regression and weighted gene co-expression network analyses. The enrichment of differentially co-expressed genes in alcohol dependence-associated genes identified by genome-wide association studies (GWAS) was examined using gene set enrichment analysis. Biological pathways overrepresented by differentially co-expressed genes were uncovered using DAVID bioinformatics resources. Three AUD-associated gene modules in males [Module 1 (561 probes mapping to 505 genes): r=0.42, Pcorrelation=0.020; Module 2 (815 probes mapping to 713 genes): r=0.41, Pcorrelation=0.020; Module 3 (1,446 probes mapping to 1,305 genes): r=−0.38, Pcorrelation=0.030] and one AUD-associated gene module in females [Module 4 (683 probes mapping to 652 genes): r=0.64, Pcorrelation=0.010] were identified. Differentially expressed genes mapped by significant expression probes (Pnominal≤0.05) clustered in Modules 1 and 2 were enriched in GWAS-identified alcohol dependence-associated genes [Module 1 (134 genes): P=0.028; Module 2 (243 genes): P=0.004]. These differentially expressed genes, including ALDH2, ALDH7A1, and ALDH9A1, are involved in cellular functions such as aldehyde detoxification, mitochondrial function, and fatty acid metabolism. Our study revealed differentially co-expressed genes in postmortem PFC of AUD subjects and demonstrated that some of these differentially co-expressed genes participate in alcohol metabolism. PMID:25073604

  16. Are childhood externalizing disorders the harbinger of early-onset alcohol dependence?

    Directory of Open Access Journals (Sweden)

    Abhishek Ghosh

    2016-01-01

    Interpretation & conclusions: Our study showed more EDs in alcohol dependent individuals compared to controls. Further, the association observed between EDs and EO alcohol dependence points towards a developmental continuum between these two conditions.

  17. Primary anxiety disorders and the development of subsequent alcohol use disorder: a 4-year community study of adolescents and young adults

    OpenAIRE

    Zimmermann, Petra; Wittchen, Hans-Ulrich; Höfler, Michael; Pfister, Hildegard; Kessler, Ronald C.; Lieb, Roselind

    2013-01-01

    Background. Cross-sectional findings in community surveys of adults suggest that adolescent anxiety disorders are strong predictors of the subsequent onset of alcohol use, abuse and dependence. However, prospective data that follow a sample of adolescents into adulthood are needed to confirm these associations. Method. Baseline and 4-year follow-up data from the EDSP-Study, a prospective community survey of 3021 (2548 at follow-up) adolescents and young adults aged 14 to 24 years at baseli...

  18. The Effect of Bilingualism on Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Bialystok, Ellen; Craik, Fergus I. M.; Murphy, Kelly J.; Troyer, Angela K.

    2013-01-01

    Objectives. Previous reports have found that lifelong bilingualism is associated with a delay in the onset of dementia, including Dementia of the Alzheimer’s Type (DAT). Because amnestic mild cognitive impairment (aMCI) is often a transition stage between normal aging and DAT, our aim in this paper was to establish whether this delay in symptom onset for bilinguals would also be seen in the onset of symptoms of aMCI and whether this delay would be consistent in different subtypes of aMCI. Method. We examined the effect of bilingualism on the age of diagnosis in individuals with single- or multiple-domain aMCI who were administered a battery of neuropsychological tests and questionnaires about their language and social background. Results. Our results showed an interaction between aMCI type and language history. Only individuals diagnosed with single-domain aMCI demonstrated a later age of diagnosis for bilinguals (M = 79.4 years) than monolinguals (M = 74.9 years). Discussion. This preliminary evidence suggests that the early protective advantage of bilingualism may be specific to single-domain aMCI, which is the type of aMCI most specifically associated with progression to DAT. PMID:22454387

  19. Comparative utilization of pharmacotherapy for alcohol use disorder and other psychiatric disorders among U.S. Veterans Health Administration patients with dual diagnoses.

    Science.gov (United States)

    Rubinsky, Anna D; Chen, Cheng; Batki, Steven L; Williams, Emily C; Harris, Alex H S

    2015-10-01

    Patients with alcohol use disorder (AUD) and another co-occurring psychiatric disorder are a vulnerable population with high symptom severity. Such patients may benefit from a full arsenal of treatment options including pharmacotherapy. Receipt of AUD pharmacotherapy is generally very low despite recommendations that it be made available to every patient with AUD, including those with co-occurring disorders. Little is known about pharmacotherapy rates for AUD compared to other psychiatric disorders among patients with dual diagnoses. This study compared rates of pharmacotherapy for AUD to those for non-substance use psychiatric disorders and tobacco use disorder among patients with dual diagnoses in the U.S. Veterans Affairs (VA) healthcare system. VA data were used to identify patients with AUD and another psychiatric disorder in fiscal year 2012, and to estimate the proportion receiving pharmacotherapy for AUD and for each comorbid condition. Among subsets of patients with AUD and co-occurring schizophrenic, bipolar, posttraumatic stress or major depressive disorder, receipt of medications for AUD ranged from 7% to 11%, whereas receipt of medications for the comorbid disorder ranged from 69% to 82%. Among patients with AUD and co-occurring tobacco use disorder, 6% received medication for their AUD and 34% for their tobacco use disorder. Among patients with dual diagnoses, rates of pharmacotherapy for AUD were far lower than those for the comorbid disorders and contrary to evidence that medications for AUD are effective. Additional system-wide implementation efforts to identify and address patient- and provider-level barriers are needed to increase AUD pharmacotherapy in this high-need population.

  20. Genetic and neurophysiological correlates of the age of onset of alcohol use disorders in adolescents and young adults.

    Science.gov (United States)

    Chorlian, David B; Rangaswamy, Madhavi; Manz, Niklas; Wang, Jen-Chyong; Dick, Danielle; Almasy, Laura; Bauer, Lance; Bucholz, Kathleen; Foroud, Tatiana; Hesselbrock, Victor; Kang, Sun J; Kramer, John; Kuperman, Sam; Nurnberger, John; Rice, John; Schuckit, Marc; Tischfield, Jay; Edenberg, Howard J; Goate, Alison; Bierut, Laura; Porjesz, Bernice

    2013-09-01

    Discrete time survival analysis was used to assess the age-specific association of event-related oscillations (EROs) and CHRM2 gene variants on the onset of regular alcohol use and alcohol dependence. The subjects were 2,938 adolescents and young adults ages 12-25. Results showed that the CHRM2 gene variants and ERO risk factors had hazards which varied considerably with age. The bulk of the significant age-specific associations occurred in those whose age of onset was under 16. These associations were concentrated in those subjects who at some time took an illicit drug. These results are consistent with studies which associate greater rates of alcohol dependence among those who begin drinking at an early age. The age specificity of the genetic and neurophysiological factors is consistent with recent studies of adolescent brain development, which locate an interval of heightened vulnerability to substance use disorders in the early to mid teens.

  1. Targeting central melanocortin receptors: a promising novel approach for treating alcohol abuse disorders

    Directory of Open Access Journals (Sweden)

    Jeffrey eOlney

    2014-06-01

    Full Text Available The melanocortin (MC peptides are produced centrally by propiomelanocortin (POMC neurons within the arcuate nucleus of the hypothalamus and act through five seven-transmembrane G-protein coupled melanocortin receptor (MCR subtypes. The MC3R and MC4R subtypes, the most abundant central MCRs, are widely expressed in brain regions known to modulate neurobiological responses to ethanol, including regions of the hypothalamus and extended amygdala. Agouti-related protein (AgRP, also produced in the arcuate nucleus, is secreted in terminals expressing MCRs and functions as an endogenous MCR antagonist. This review highlights recent genetic and pharmacological findings that have implicated roles for the MC and AgRP systems in modulating ethanol consumption. Ethanol consumption is associated with significant alterations in the expression levels of various MC peptides/protein, which suggests that ethanol-induced perturbations of MC/AgRP signaling may modulate excessive ethanol intake. Consistently, MCR agonists decrease, and AgRP increases, ethanol consumption in mice. MCR agonists fail to blunt ethanol intake in mutant mice lacking the MC4R, suggesting that the protective effects of MCR agonists are modulated by the MC4R. Interestingly, recent evidence reveals that MCR agonists are more effective at blunting binge-like ethanol intake in mutant mice lacking the MC3R, suggesting that the MC3R has opposing effects on the MC4R. Finally, mutant mice lacking AgRP exhibit blunted voluntary and binge-like ethanol drinking, consistent with pharmacological studies. Collectively, these preclinical observations provide compelling evidence that compounds that target the MC system may provide therapeutic value for treating alcohol abuse disorders and that the utilization of currently available MC-targeting compounds- such as those being used to treat eating disorders- may be used as effective treatments to this end.

  2. Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Barrio P

    2016-09-01

    Full Text Available Pablo Barrio, Antoni Gual Neurosciences Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain Issues: Patient-centered care (PCC is increasingly accepted as an integral component of good health care, including addiction medicine. However, its implementation has been controversial in people with alcohol use disorders. Approach: A systematic search strategy was devised to find completed randomized controlled trials enrolling adults (>18 years with alcohol use disorders. Studies had to use a PCC approach such that they should have been individualized, respectful to the patients’ own goals, and empowering. Studies until September 2015 were searched using PubMed, Scopus, the Cochrane Library, PsychINFO, and Web of Knowledge. Key findings: In total, 40 studies enrolling 16,020 patients met the inclusion criteria. Assessment revealed two main categories of study: psychosocial (n=35 based on motivational interviewing and pharmacological (n=5 based on an as needed dosing regimen. Psychosocial interventions were further classified according to the presence or absence of an active comparator. When no active comparator was present, studies were classified according to the number of sessions (≥1. Results from single sessions of motivational interviewing showed no clear benefit on alcohol consumption outcomes, with few studies indicating benefit of PCC versus control. Although the results for studies of multiple sessions of counseling were also mixed, many did show a significant benefit of the PCC intervention. By contrast, studies consistently demonstrated a benefit of pharmacologically supported PCC interventions, with most of the differences reaching statistical significance. Implications: PCC-based interventions may be beneficial for reducing alcohol consumption in people with alcohol use disorders. Keywords: psychosocial intervention, pharmacological intervention, motivational interviewing, as-needed

  3. Prevalence and determinants of personality disorders in a clinical sample of alcohol-, drug-, and dual-dependent patients.

    Science.gov (United States)

    Colpaert, Kathy; Vanderplasschen, Wouter; De Maeyer, Jessica; Broekaert, Eric; De Fruyt, Filip

    2012-05-01

    The present study compares the prevalence rates of 12 personality disorders (PDs) among patients with alcohol, drug, and dual dependence through chi-square tests and analyses of variance. It further investigates possible predictors of these PDs through multiple linear regression analyses. Data were gathered in 2007-2008 among 274 patients admitted to intensive, residential substance abuse treatment programs in Belgium, using the ADP-IV (Assessment of DSM-IV Personality Disorders), the EuropASI (European version of the Addiction Severity Index), and the MINI (Mini International Neuropsychiatric Interview). The analyses showed that drug- and dual-dependent patients have higher PD prevalence rates than alcohol-dependent patients. The severity, but not the nature of the dependence, appears as an important predictor for personality pathology.

  4. A Brief Up-Date of the Use of Sodium Oxybate for the Treatment of Alcohol Use Disorder

    Directory of Open Access Journals (Sweden)

    Fabio Caputo

    2016-03-01

    Full Text Available The treatment of alcohol use disorder (AUD with sodium oxybate (SMO or gamma-hydroxybutyric acid (GHB was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA, exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as “street drug”; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD.

  5. A Brief Up-Date of the Use of Sodium Oxybate for the Treatment of Alcohol Use Disorder.

    Science.gov (United States)

    Caputo, Fabio; Vignoli, Teo; Tarli, Claudia; Domenicali, Marco; Zoli, Giorgio; Bernardi, Mauro; Addolorato, Giovanni

    2016-03-05

    The treatment of alcohol use disorder (AUD) with sodium oxybate (SMO) or gamma-hydroxybutyric acid (GHB) was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS) and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA), exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as "street drug"; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD.

  6. Fishing for Fetal Alcohol Spectrum Disorders: Zebrafish as a Model for Ethanol Teratogenesis.

    Science.gov (United States)

    Lovely, Charles Ben; Fernandes, Yohaan; Eberhart, Johann K

    2016-10-01

    Fetal Alcohol Spectrum Disorders (FASD) describes a wide array of ethanol-induced developmental defects, including craniofacial dysmorphology and cognitive impairments. It affects ∼1 in 100 children born in the United States each year. Due to the pleiotropic effects of ethanol, animal models have proven critical in characterizing the mechanisms of ethanol teratogenesis. In this review, we focus on the utility of zebrafish in characterizing ethanol-induced developmental defects. A growing number of laboratories have focused on using zebrafish to examine ethanol-induced defects in craniofacial, cardiac, ocular, and neural development, as well as cognitive and behavioral impairments. Growing evidence supports that genetic predisposition plays a role in these ethanol-induced defects, yet little is understood about these gene-ethanol interactions. With a high degree of genetic amenability, zebrafish is at the forefront of identifying and characterizing the gene-ethanol interactions that underlie FASD. Because of the conservation of gene function between zebrafish and humans, these studies will directly translate to studies of candidate genes in human populations and allow for better diagnosis and treatment of FASD.

  7. Should DSM-V include dimensional diagnostic criteria for alcohol use disorders?

    Science.gov (United States)

    Helzer, John E; Bucholz, Kathleen K; Bierut, Laura Jean; Regier, Darrel A; Schuckit, Marc A; Guth, Sarah E

    2006-02-01

    This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

  8. Suicidal ideation among adolescents with alcohol use disorders during treatment and aftercare.

    Science.gov (United States)

    Kaminer, Yifrah; Burleson, Joseph A; Goldston, David B; Burke, Rebecca H

    2006-01-01

    The objectives of this study are to assess the magnitude and course of suicidal ideation during outpatient treatment and aftercare for adolescents with alcohol use disorders (AUD). One hundred seventy-seven adolescents meeting eligibility criteria, including no past 30-day suicidal behavior, participated in 9 weeks of outpatient cognitive-behavioral group therapy. Treatment completers were randomized into: (1) No-Active, (2) In-Person, or (3) Telephone aftercare conditions for a period of 12 weeks. No specific intervention for suicidal behavior was provided during the study. The Suicide Ideation Questionnaire (SIQ-JR, Reynolds, 1988) was administered at baseline, end of treatment, and end of aftercare. The results are as follows, a higher baseline suicidal ideation was associated with higher retention at the end of treatment and through aftercare. The In-Person Aftercare condition showed a significant decrease in suicidal ideation, relative to the No-Active Aftercare condition. There was a trend for similarly reduced severity of suicidal ideation in the Telephone Aftercare condition. In conclusion, the type of aftercare and resulting decrease in AUD may play a role in the reduction in suicidal ideation. The mechanism of change by which suicidal ideation is reduced in adolescents in treatment for AUD needs to be further explored.

  9. Role of central nervous system insulin resistance in fetal alcohol spectrum disorders.

    Science.gov (United States)

    de la Monte, Suzanne M; Wands, Jack R

    2010-01-01

    Fetal alcohol spectrum disorder (FASD) is the most common preventable cause of mental retardation in the USA. Ethanol impairs neuronal survival and function by two major mechanisms: 1) it inhibits insulin signaling required for viability, metabolism, synapse formation, and acetylcholine production; and 2) it functions as a neurotoxicant, causing oxidative stress, DNA damage and mitochondrial dysfunction. Ethanol inhibition of insulin signaling is mediated at the insulin receptor (IR) level and caused by both impaired receptor binding and increased activation of phosphatases that reverse IR tyrosine kinase activity. As a result, insulin activation of PI3K-Akt, which mediates neuronal survival, motility, energy metabolism, and plasticity, is impaired. The neurotoxicant effects of ethanol promote DNA damage, which could contribute to mitochondrial dysfunction and oxidative stress. Therefore, chronic in utero ethanol exposure produces a dual state of CNS insulin resistance and oxidative stress, which we postulate plays a major role in ethanol neurobehavioral teratogenesis. We propose that many of the prominent adverse effects of chronic prenatal exposure to ethanol on CNS development and function may be prevented or reduced by treatment with peroxisome-proliferated activated receptor (PPAR) agonists which enhance insulin sensitivity by increasing expression and function of insulin-responsive genes, and reducing cellular oxidative stress.

  10. The Plausibility of Maternal Nutritional Status Being a Contributing Factor to the Risk for Fetal Alcohol Spectrum Disorders: The Potential Influence of Zinc Status as an Example

    OpenAIRE

    Keen, Carl L; Uriu-Adams, Janet Y.; Skalny, Anatoly; Grabeklis, Andrei; Grabeklis, Sevil; Green, Kerri; Yevtushok, Lyubov; Wertelecki, W. W.; Chambers, Christina D.

    2010-01-01

    There is increasing evidence that human pregnancy outcome can be significantly compromised by suboptimal maternal nutritional status. Poor diet results in a maternal-fetal environment in which the teratogenicity of other insults such as alcohol might be amplified. As an example, there is evidence that zinc (Zn) can interact with maternal alcohol exposure to influence the risk for fetal alcohol spectrum disorders (FASD). Studies with experimental animals have shown that the teratogenicity of a...

  11. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

    OpenAIRE

    2015-01-01

    Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) w...

  12. The relationship of alcohol-use disorders and depressive symptoms to tryptophan metabolism: cross-sectional data from a Nepalese alcohol treatment sample

    Science.gov (United States)

    Neupane, Sudan Prasad; Lien, Lars; Martinez, Priscilla; Hestad, Knut; Bramness, Jørgen G.

    2015-01-01

    Background Activation of the kynurenine pathway of tryptophan metabolism results in increased production of potentially depressogenic tryptophan catabolites and a reduction in tryptophan availability for serotonin synthesis. Since alcohol consumption affects tryptophan metabolism and disposition, we determined serum levels of kynurenine, tryptophan and the kynurenine/tryptophan ratio (KT ratio) in alcohol-use disorder (AUD) patients and compared their levels considering abstinence duration, AUD severity and comorbid depression. Methods The study sample included 169 AUD inpatients from eight alcohol treatment facilities in Kathmandu, Nepal. The Composite International Diagnostic Interview was administered to generate the AUD diagnosis. The Alcohol Use Disorder Identification Test (AUDIT) captured AUD severity and patterns of alcohol use. The Hopkins Symptom Checklist-25 was used to reveal current depressive symptoms. Serum kynurenine and tryptophan levels were determined by high-performance liquid chromatography and tryptophan degradation was measured by KT ratio (kynurenine/tryptophan × 103). Results Patients with above average AUDIT scores had higher mean serum levels of kynurenine (2.1μM±0.7 vs 1.8 μM ±0.6, p= 0.006) and KT ratios (48.6±17.6 vs 40.4±14.3, p=0.002) than those with below average scores. Patients with current depressive symptoms had higher mean tryptophan concentrations (49.9 μM ±13 vs 45.7 μM±14.1, p= 0.047) and lower KT ratios (41.4 μM ±14 vs 47.5 μM ±17.6, p=0.028) compared to patients whose reported depressive symptoms were below the standard cut-off. Higher tryptophan levels and lower KT ratios in the depressed group was specific to patients with longer abstinence and higher AUD severity. Conclusions Depression-related deregulation in tryptophan metabolism was found to depend on length of abstinence and on AUD severity. Together, results suggest that in AUD populations, peripheral tryptophan metabolism is subject to interactions

  13. Effect of alcohol use on the course of bipolar disorder : one-year follow-up study using the daily prospective Life Chart method

    NARCIS (Netherlands)

    van Zaane, Jan; van de Ven, Peter M.; Draisma, Stasja; Smit, Johannes H.; Nolen, Willem A.; van den Brink, Wim

    2014-01-01

    Objectives Relatively little is known about the temporal relationship between alcohol use and subsequent mood changes in patients with bipolar disorder, and the available findings are inconsistent. The present study was a fine-grained analysis of the temporal relationship between alcohol use and sho

  14. Prenatal alcohol exposure and autistic spectrum disorders--a population-based prospective study of 80,552 children and their mothers

    DEFF Research Database (Denmark)

    Eliasen, Marie; Tolstrup, Janne S; Nybo Andersen, Anne-Marie;

    2010-01-01

    To examine whether maternal alcohol intake, including binge drinking (intake > or =5 drinks, equivalent to 60 g pure ethanol on a single occasion), is associated with autistic spectrum disorders (ASD) and infantile autism.......To examine whether maternal alcohol intake, including binge drinking (intake > or =5 drinks, equivalent to 60 g pure ethanol on a single occasion), is associated with autistic spectrum disorders (ASD) and infantile autism....

  15. Principal component analysis of FDG PET in amnestic MCI

    Energy Technology Data Exchange (ETDEWEB)

    Nobili, Flavio; Girtler, Nicola; Brugnolo, Andrea; Dessi, Barbara; Rodriguez, Guido [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Medical Sciences, Genoa (Italy); S. Martino Hospital, Alzheimer Evaluation Unit, Genoa (Italy); S. Martino Hospital, Head-Neck Department, Genoa (Italy); Salmaso, Dario [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); CNR, Institute of Cognitive Sciences and Technologies, Padua (Italy); Morbelli, Silvia [University of Genoa, Nuclear Medicine Unit, Department of Internal Medicine, Genoa (Italy); Piccardo, Arnoldo [Galliera Hospital, Nuclear Medicine Unit, Department of Imaging Diagnostics, Genoa (Italy); Larsson, Stig A. [Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Pagani, Marco [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); CNR, Institute of Cognitive Sciences and Technologies, Padua (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden)

    2008-12-15

    The purpose of the study is to evaluate the combined accuracy of episodic memory performance and {sup 18}F-FDG PET in identifying patients with amnestic mild cognitive impairment (aMCI) converting to Alzheimer's disease (AD), aMCI non-converters, and controls. Thirty-three patients with aMCI and 15 controls (CTR) were followed up for a mean of 21 months. Eleven patients developed AD (MCI/AD) and 22 remained with aMCI (MCI/MCI). {sup 18}F-FDG PET volumetric regions of interest underwent principal component analysis (PCA) that identified 12 principal components (PC), expressed by coarse component scores (CCS). Discriminant analysis was performed using the significant PCs and episodic memory scores. PCA highlighted relative hypometabolism in PC5, including bilateral posterior cingulate and left temporal pole, and in PC7, including the bilateral orbitofrontal cortex, both in MCI/MCI and MCI/AD vs CTR. PC5 itself plus PC12, including the left lateral frontal cortex (LFC: BAs 44, 45, 46, 47), were significantly different between MCI/AD and MCI/MCI. By a three-group discriminant analysis, CTR were more accurately identified by PET-CCS + delayed recall score (100%), MCI/MCI by PET-CCS + either immediate or delayed recall scores (91%), while MCI/AD was identified by PET-CCS alone (82%). PET increased by 25% the correct allocations achieved by memory scores, while memory scores increased by 15% the correct allocations achieved by PET. Combining memory performance and {sup 18}F-FDG PET yielded a higher accuracy than each single tool in identifying CTR and MCI/MCI. The PC containing bilateral posterior cingulate and left temporal pole was the hallmark of MCI/MCI patients, while the PC including the left LFC was the hallmark of conversion to AD. (orig.)

  16. Mental disorders in alcoholic liver disease%酒精性肝病与精神障碍

    Institute of Scientific and Technical Information of China (English)

    胡伟(综述); 韩涛; 刘华(审校)

    2014-01-01

    酒精性肝病是由于长期大量饮酒所导致的慢性肝脏疾病。酗酒会导致机体多系统受损,其中包括神经损害和精神障碍。临床上,酒精所致的神经精神损害表现复杂多样,常导致诊断困难甚至出现误诊。本文将对酒精所致的精神障碍的机制、5种常见的酒精性精神障碍疾病的识别要点及酒精性相关精神障碍的治疗进行综述。多学科有效协作、社会和家庭各方面相互合作对此类疾病的诊治和预防具有重要意义。%Alcoholic liver disease is caused by long-term heavy alcohol drinking. Alcoholism may lead to the multiple systems injury of human body,including neuropsychiatric injury. The manifestations of neuropsychiatric injury caused by alco-holism are complex and varied,which often make clinical diagnosis difficult. In this paper,we will review the mechanisms of alco-hol-induced mental disorders,the clinical features and treatment of five kinds of common alcoholic mental disorders. Effective multi-disciplinary collaboration and the help of society and family members are great significance for diagnosis,treatment and pre-vention of these diseases.

  17. [Trans-Cultural Prevention of Alcohol-Related Disorders in Elderly Immigrants].

    Science.gov (United States)

    Bermejo, I; Frank, F

    2015-09-01

    In migrants alcohol-related problems increase with increasing age. This group, in particular, is hardly reached by alcohol-specific care offers. Thus our project aimed at the identification of target group-specific barriers to health-care use by means of a cross-sectional study (n=435). Based on these results a trans-cultural concept for alcohol prevention among elderly migrants was developed and evaluated in a cluster-randomised controlled trial (n=176).

  18. Long-term genomic and epigenomic dysregulation as a consequence of prenatal alcohol exposure: a model for fetal alcohol spectrum disorders

    Directory of Open Access Journals (Sweden)

    Morgan L Kleiber

    2014-06-01

    Full Text Available There is abundant evidence that prenatal alcohol exposure leads to a range of behavioural and cognitive impairments, categorized under the term fetal alcohol spectrum disorders (FASDs. These disorders are pervasive in Western cultures and represent the most common preventable source of neurodevelopmental disabilities. The genetic and epigenetic etiology of these phenotypes, including those factors that may maintain these phenotypes throughout the lifetime of an affected individual, has become a recent topic of investigation. This review integrates recent data that has progressed our understanding FASD as a continuum of molecular events, beginning with cellular stress response and ending with a long-term ‘footprint’ of epigenetic dysregulation across the genome. It reports on data from multiple ethanol-treatment paradigms in mouse models that identify changes in gene expression that occur with respect to neurodevelopmental timing of exposure and ethanol dose. These studies have identified patterns of genomic alteration that are dependent on the biological processes occurring at the time of ethanol exposure. This review also adds to evidence that epigenetic processes such as DNA methylation, histone modifications, and non-coding RNA regulation may underlie long-term changes to gene expression patterns. These may be initiated by ethanol-induced alterations to DNA and histone methylation, particularly in imprinted regions of the genome, affecting transcription which is further fine-tuned by altered microRNA expression. These processes are likely complex, genome-wide, and interrelated. The proposed model suggests a potential for intervention, given that epigenetic changes are malleable and may be altered by postnatal environment. This review accentuates the value of mouse models in deciphering the molecular etiology of FASD, including those processes that may provide a target for the ammelioration of this common yet entirely preventable disorder.

  19. Randomized controlled trial of a mobile phone intervention for improving adherence to naltrexone for alcohol use disorders.

    Directory of Open Access Journals (Sweden)

    Susan A Stoner

    Full Text Available Naltrexone is a front-line treatment for alcohol use disorders, but its efficacy is limited by poor medication adherence. This randomized controlled trial evaluated whether a mobile health intervention could improve naltrexone adherence.Treatment-seeking participants with an alcohol use disorder (N = 76 were randomized to intervention and control conditions. All participants received naltrexone (50 mg/day with a medication event monitoring system (MEMS and a prepaid smartphone, and received a daily text message querying medication side effects, alcohol use, and craving. Those in the intervention arm received additional medication reminders and adherence assessment via text message.The primary outcome, proportion of participants with adequate adherence (defined as ≥80% of prescribed doses taken through Week 8, did not differ between groups in intent-to-treat analyses (p = .34. Mean adherence at study midpoint (Week 4 was 83% in the intervention condition and 77% in the control condition (p = .35. Survival analysis found that the intervention group sustained adequate adherence significantly longer (M = 19 days [95% CI = 0.0-44.0] than those in the control group (M = 3 days [95% CI = 0.0-8.1] during the first month of treatment (p = .04. Medication adherence did not predict drinking outcomes.These results suggest that in the context of daily monitoring and assessment via cell phone, additional text message reminders do not further improve medication adherence. Although this initial trial does not provide support for the efficacy of text messaging to improve adherence to pharmacotherapy for alcohol use disorders, additional trials with larger samples and alternate designs are warranted.ClinicalTrials.gov: NCT01349985.

  20. Inadequate intake of nutrients essential for neurodevelopment in children with fetal alcohol spectrum disorders (FASD).

    Science.gov (United States)

    Fuglestad, Anita J; Fink, Birgit A; Eckerle, Judith K; Boys, Christopher J; Hoecker, Heather L; Kroupina, Maria G; Zeisel, Steven H; Georgieff, Michael K; Wozniak, Jeffrey R

    2013-01-01

    This study evaluated dietary intake in children with fetal alcohol spectrum disorders (FASD). Pre-clinical research suggests that nutrient supplementation may attenuate cognitive and behavioral deficits in FASD. Currently, the dietary adequacy of essential nutrients in children with FASD is unknown. Dietary data were collected as part of a randomized, double-blind controlled trial of choline supplementation in FASD. Participants included 31 children with FASD, ages 2.5-4.9 years at enrollment. Dietary intake data was collected three times during the nine-month study via interview-administered 24-hour recalls with the Automated Self-Administered 24-hour Recall. Dietary intake of macronutrients and 17 vitamins/minerals from food was averaged across three data collection points. Observed nutrient intakes were compared to national dietary intake data of children ages 2-5 years (What we Eat in America, NHANES 2007-2008) and to the Dietary Reference Intakes. Compared to the dietary intakes of children in the NHANES sample, children with FASD had lower intakes of saturated fat, vitamin D, and calcium. The majority (>50%) of children with FASD did not meet the Recommended Dietary Allowance (RDA) or Adequate Intake (AI) for fiber, n-3 fatty acids, vitamin D, vitamin E, vitamin K, choline, and calcium. This pattern of dietary intake in children with FASD suggests that there may be opportunities to benefit from nutritional intervention. Supplementation with several nutrients, including choline, vitamin D, and n-3 fatty acids, has been shown in animal models to attenuate the cognitive deficits of FASD. These results highlight the potential of nutritional clinical trials in FASD.

  1. Preclinical development of moxidectin as a novel therapeutic for alcohol use disorder.

    Science.gov (United States)

    Huynh, Nhat; Arabian, Natalie; Naito, Anna; Louie, Stan; Jakowec, Michael W; Asatryan, Liana; Davies, Daryl L

    2017-02-01

    Current pharmacotherapies for alcohol used disorder (AUD) are few and relatively ineffective illustrating the need for the development of new, effective medications. Using a translational approach, our laboratory reported that ivermectin, an FDA-approved, human and animal anti-parasitic agent, can significantly reduce ethanol intake in male and female mice across different drinking paradigms. Extending this line of investigation, the current paper investigated the utility of moxidectin (MOX), an analogue of ivermectin, to reduce ethanol intake. Notably, MOX is widely held to have lower neurotoxicity potential and improved margin of safety compared to ivermectin. Using a 24-h-two-bottle choice paradigm, MOX significantly reduced ethanol intake in a dose dependent manner in both male and female C57BL/6J mice, respectively (1.25-7.5 mg/kg) and (1.25-10 mg/kg). Further, multi-day administration of MOX (2.5 mg/kg; intraperitoneal injection) for 5 consecutive days significantly reduced ethanol intake in both the 24-h-two-bottle choice and Drinking-in-the-Dark paradigms in female mice. No overt signs of behavioral toxicity were observed. Notably in both male and female mice, MOX significantly reduced ethanol intake starting approximately 4 h post-injection. Using a Xenopus oocyte expression system, we found that MOX significantly potentiated P2X4 receptor (P2X4R) function and antagonized the inhibitory effects of ethanol on ATP-gated currents in P2X4Rs. This latter finding represents the first report of MOX having activity on P2X4Rs. In addition, MOX potentiated GABAA receptors, but to a lesser degree as compared to ivermectin supporting the hypothesis that MOX would be advantageous (compared to ivermectin) with respect to reducing contraindications. Overall, the results illustrate the potential for development of MOX as a novel pharmacotherapy for the treatment of AUD.

  2. Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Bower Carol

    2009-05-01

    Full Text Available Abstract Background Children with Fetal Alcohol Spectrum Disorders (FASD may have significant neurobehavioural problems persisting into adulthood. Early diagnosis may decrease the risk of adverse life outcomes. However, little is known about effective interventions for children with FASD. Our aim is to conduct a systematic review of the literature to identify and evaluate the evidence for pharmacological and non-pharmacological interventions for children with FASD. Methods We did an electronic search of the Cochrane Library, MEDLINE, EMBASE, PsychINFO, CINAHL and ERIC for clinical studies (Randomized controlled trials (RCT, quasi RCT, controlled trials and pre- and post-intervention studies which evaluated pharmacological, behavioural, speech therapy, occupational therapy, physiotherapy, psychosocial and educational interventions and early intervention programs. Participants were aged under 18 years with a diagnosis of a FASD. Selection of studies for inclusion and assessment of study quality was undertaken independently by two reviewers. Meta-analysis was not possible due to diversity in the interventions and outcome measures. Results Twelve studies met the inclusion criteria. Methodological weaknesses were common, including small sample sizes; inadequate study design and short term follow up. Pharmacological interventions, evaluated in two studies (both RCT showed some benefit from stimulant medications. Educational and learning strategies (three RCT were evaluated in seven studies. There was some evidence to suggest that virtual reality training, cognitive control therapy, language and literacy therapy, mathematics intervention and rehearsal training for memory may be beneficial strategies. Three studies evaluating social communication and behavioural strategies (two RCT suggested that social skills training may improve social skills and behaviour at home and Attention Process Training may improve attention. Conclusion There is limited good

  3. Latent Class Analysis of DSM-5 Alcohol Use Disorder Criteria Among Heavy-Drinking College Students.

    Science.gov (United States)

    Rinker, Dipali Venkataraman; Neighbors, Clayton

    2015-10-01

    The DSM-5 has created significant changes in the definition of alcohol use disorders (AUDs). Limited work has considered the impact of these changes in specific populations, such as heavy-drinking college students. Latent class analysis (LCA) is a person-centered approach that divides a population into mutually exclusive and exhaustive latent classes, based on observable indicator variables. The present research was designed to examine whether there were distinct classes of heavy-drinking college students who met DSM-5 criteria for an AUD and whether gender, perceived social norms, use of protective behavioral strategies (PBS), drinking refusal self-efficacy (DRSE), self-perceptions of drinking identity, psychological distress, and membership in a fraternity/sorority would be associated with class membership. Three-hundred and ninety-four college students who met DSM-5 criteria for an AUD were recruited from three different universities. Two distinct classes emerged: Less Severe (86%), the majority of whom endorsed both drinking more than intended and tolerance, as well as met criteria for a mild AUD; and More Severe (14%), the majority of whom endorsed at least half of the DSM-5 AUD criteria and met criteria for a severe AUD. Relative to the Less Severe class, membership in the More Severe class was negatively associated with DRSE and positively associated with self-identification as a drinker. There is a distinct class of heavy-drinking college students with a more severe AUD and for whom intervention content needs to be more focused and tailored. Clinical implications are discussed.

  4. Plasma Chemokines in Patients with Alcohol Use Disorders: Association of CCL11 (Eotaxin-1) with Psychiatric Comorbidity

    Science.gov (United States)

    García-Marchena, Nuria; Araos, Pedro Fernando; Barrios, Vicente; Sánchez-Marín, Laura; Chowen, Julie A.; Pedraz, María; Castilla-Ortega, Estela; Romero-Sanchiz, Pablo; Ponce, Guillermo; Gavito, Ana L.; Decara, Juan; Silva, Daniel; Torrens, Marta; Argente, Jesús; Rubio, Gabriel; Serrano, Antonia; de Fonseca, Fernando Rodríguez; Pavón, Francisco Javier

    2017-01-01

    Recent studies have linked changes in peripheral chemokine concentrations to the presence of both addictive behaviors and psychiatric disorders. The present study further explore this link by analyzing the potential association of psychiatry comorbidity with alterations in the concentrations of circulating plasma chemokine in patients of both sexes diagnosed with alcohol use disorders (AUD). To this end, 85 abstinent subjects with AUD from an outpatient setting and 55 healthy subjects were evaluated for substance and mental disorders. Plasma samples were obtained to quantify chemokine concentrations [C–C motif (CC), C–X–C motif (CXC), and C–X3–C motif (CX3C) chemokines]. Abstinent AUD patients displayed a high prevalence of comorbid mental disorders (72%) and other substance use disorders (45%). Plasma concentrations of chemokines CXCL12/stromal cell-derived factor-1 (p < 0.001) and CX3CL1/fractalkine (p < 0.05) were lower in AUD patients compared to controls, whereas CCL11/eotaxin-1 concentrations were strongly decreased in female AUD patients (p < 0.001). In the alcohol group, CXCL8 concentrations were increased in patients with liver and pancreas diseases and there was a significant correlation to aspartate transaminase (r = +0.456, p < 0.001) and gamma-glutamyltransferase (r = +0.647, p < 0.001). Focusing on comorbid psychiatric disorders, we distinguish between patients with additional mental disorders (N = 61) and other substance use disorders (N = 38). Only CCL11 concentrations were found to be altered in AUD patients diagnosed with mental disorders (p < 0.01) with a strong main effect of sex. Thus, patients with mood disorders (N = 42) and/or anxiety (N = 16) had lower CCL11 concentrations than non-comorbid patients being more evident in women. The alcohol-induced alterations in circulating chemokines were also explored in preclinical models of alcohol use with male Wistar rats. Rats exposed to

  5. Drinking patterns and alcohol use disorders in Sao Paulo, Brazil: the role of neighborhood social deprivation and socioeconomic status.

    Directory of Open Access Journals (Sweden)

    Camila Magalhães Silveira

    Full Text Available BACKGROUND: Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD, however, associations between area-level neighborhood social deprivation (NSD and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations. METHODS: A multi-stage area probability sample of adult household residents in the São Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI (n = 5,037. Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF, heavy drinking of higher frequency (HDHF, abuse, dependence, and DMS-5 AUD] among regular users (RU; odds ratio (OR were obtained. RESULTS: Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD. CONCLUSIONS: Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to

  6. Boarding and Public Schools: Navajo Educational Attainment, Conduct Disorder, and Alcohol Dependency.

    Science.gov (United States)

    Henderson, Eric; Kunitz, Stephen J.; Gabriel, K. Ruben; McCright, Aaron; Levy, Jerrold E.

    1998-01-01

    Interviews with over 1,000 Navajos aged 21-67 in 1992-95 found that alcohol dependency was less common among high school graduates than dropouts but was also disproportionately low among older men with no schooling. Despite abusive conditions that prevailed in some Indian boarding schools, alcohol dependency rates did not differ by type of school…

  7. Intervention for Individuals with Fetal Alcohol Spectrum Disorders: Treatment Approaches and Case Management

    Science.gov (United States)

    Paley, Blair; O'Connor, Mary J.

    2009-01-01

    Exposure to alcohol in utero is considered to be the leading cause of developmental disabilities of known etiology. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of characteristic facial anomalies, growth retardation, and central nervous system (CNS) dysfunction. Some…

  8. Prescription Stimulant Misuse, Alcohol Abuse, and Disordered Eating among College Students

    Science.gov (United States)

    Ward, Rose Marie; Oswald, Barbara B.; Galante, Marina

    2016-01-01

    The misuse of prescription stimulants (MPS), risky drinking, and drunkorexia are current public health concerns. The present study assessed the prevalence of MPS and drunkorexia using an online survey. Specifically, we examined alcohol consumption, the Rutgers Alcohol Problem Index, Compensatory Eating and Behaviors in Response to Alcohol…

  9. Evaluation of the alcohol use disorders identification test and the drug use disorders identification test among patients at a Norwegian psychiatric emergency ward.

    Science.gov (United States)

    Gundersen, Oystein Hoel; Mordal, Jon; Berman, Anne H; Bramness, Jørgen G

    2013-01-01

    High rates of substance use disorders (SUD) among psychiatric patients are well documented. This study explores the usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) in identifying SUD in emergency psychiatric patients. Of 287 patients admitted consecutively, 256 participants (89%) were included, and 61-64% completed the questionnaires and the Mini-International Neuropsychiatric Interview (MINI), used as the reference standard. Both AUDIT and DUDIT were valid (area under the curve above 0.92) and reliable (Cronbach's alpha above 0.89) in psychotic and nonpsychotic men and women. The suitable cutoff scores for AUDIT were higher among the psychotic than nonpsychotic patients, with 12 versus 10 in men and 8 versus 5 in women. The suitable cutoff scores for DUDIT were 1 in both psychotic and nonpsychotic women, and 5 versus 1 in psychotic and nonpsychotic men, respectively. This study shows that AUDIT and DUDIT may provide precise information about emergency psychiatric patients' problematic alcohol and drug use.

  10. A new treatment for cognitive disorders related to in utero exposure to alcohol

    Institute of Scientific and Technical Information of China (English)

    Shuang Li; Yan Zhang; Feng Zhu; Bin Zhang; Jianying Lin; Chunyang Xu; Wancai Yang; Wei Hao; Ruiling Zhang

    2013-01-01

    Maternal alcohol consumption during pregnancy has detrimental effects on fetal central nervous system development. Maternal alcohol consumption prior to and during pregnancy significantly affects cognitive functions in offspring, which may be related to changes in cyclin-dependent kinase 5 because it is associated with modulation of synaptic plasticity and impaired learning and memory. In this study, we examined adult offspring in a maternal alcohol consumption model in rats. Y-maze test results showed that in utero exposure to alcohol impairs learning and memory capacities. Cyclin-dependent kinase 5 mRNA and protein expressions in the hippocampus of the offspring were significantly elevated, as assayed by quantitative real-time PCR and reverse transcription-PCR, immunofluorescence, and immuno-precipitation. Our experimental findings strongly suggest that altered cyclin-dependent kinase 5 may mediate impaired learning and memory in adult rats that were exposed to alcohol by maternal consumption while in utero.

  11. Reexposure to the Amnestic Agent Alleviates Cycloheximide-Induced Retrograde Amnesia for Reactivated and Extinction Memories

    Science.gov (United States)

    Briggs, James F.; Olson, Brian P.

    2013-01-01

    We investigated whether reexposure to an amnestic agent would reverse amnesia for extinction of learned fear similar to that of a reactivated memory. When cycloheximide (CHX) was administered immediately after a brief cue-induced memory reactivation (15 sec) and an extended extinction session (12 min) rats showed retrograde amnesia for both…

  12. Prevalence of smoking, alcohol and substance use among adolescents with attention-deficit/hyperactivity disorder in Denmark compared with the general population

    DEFF Research Database (Denmark)

    Madsen, Anders G.; Dalsgaard, Søren

    2014-01-01

    Background: Studies have shown that adolescents with attention-deficit/hyperactivity disorder (ADHD) have an increased risk of alcohol and substance abuse in adulthood. An unequivocal reason for this association has not yet been identified but it has been shown that pharmacological treatment...... is likely to reduce this risk. Aims: To test whether adolescents with ADHD in pharmacological treatment have a higher prevalence of smoking and use of alcohol and drugs than a matched control group from the general population. The study will also analyse associations between smoking, alcohol and drug use......, drugs and alcohol and the self-report version of the Strengths and Difficulties Questionnaire (SDQ). Results: 21% of ADHD probands vs. 16% controls were daily smokers (P = 0.326). Among alcohol users, 52% of ADHD probands vs. 70% controls confirmed monthly alcohol intake (P = 0.014); 4% of cases...

  13. An open-label pilot study of quetiapine plus mirtazapine for heavy drinkers with alcohol use disorder.

    Science.gov (United States)

    Brunette, Mary F; Akerman, Sarah C; Dawson, Ree; O'Keefe, Christopher D; Green, Alan I

    2016-06-01

    Animal research suggests that medications that produce a weak dopamine D2 receptor blockade and potentiate noradrenergic activity may decrease alcohol drinking. In an open-label pilot study of subjects with alcohol dependence, we tested whether the combination of quetiapine, a weak dopamine D2 receptor antagonist, whose primary metabolite, desalkylquetiapine, is a norepinephrine reuptake inhibitor, and mirtazapine, a potent α2 norepinephrine receptor antagonist, would decrease alcohol drinking and craving. Twenty very heavy drinkers with alcohol dependence entered a trial of 8 weeks of treatment with quetiapine followed by 8 weeks of treatment with a combination of quetiapine plus mirtazapine. Alcohol use was assessed weekly with a Timeline Follow-Back interview and craving with the Penn Alcohol Craving Scale. Among the 11 completers, subjects reported improved outcomes in the quetiapine plus mirtazapine period compared to the quetiapine alone period: fewer very heavy drinking days per week (1.3 [SD = 2.4] vs. 2.1 [SD = 2.8]; t = 2.3, df = 10, p = 0.04); fewer total number of drinks per week (39.7 [SD = 61.6] vs. 53.4 [SD = 65.0]; t = 2.8, df = 10, p = 0.02); and lower craving scores (2.5 [SD = 1.4] vs. 3.2 [SD = 1.2]; t = 2.4, df = 10, p = 0.04). All subjects reported at least one adverse event; 72.7% reported somnolence. In this open-label pilot study, treatment with quetiapine plus mirtazapine was associated with a decrease in alcohol drinking and craving. These findings are consistent with our previous work in animal models of alcohol use disorders and suggest that further study of medications or combinations of medications with this pharmacologic profile is warranted.

  14. Use of the social competence interview and the anger transcendence challenge in individuals with alcohol use disorder.

    Science.gov (United States)

    Maisto, Stephen A; Ewart, Craig K; Connors, Gerard J; Funderburk, Jennifer S; Krenek, Marketa

    2009-06-01

    Interpersonal stress is a significant determinant of relapse following treatment for Alcohol Use Disorders (AUDs), but there remains little specific information about the mechanisms underlying the relationship between interpersonal stress and AUD relapse. Application of Social Action Theory provides one new approach to advancing knowledge about the interpersonal stress-relapse relationship. Especially relevant are the Social Action Theory construct of social-emotional competence, with its accompanying measurement procedures of the Social Competence Interview and the Anger Transcendence Challenge. This study evaluated the use of the Social Competence Interview and Anger Transcendence Challenge in a sample of 63 men and women in AUD intensive outpatient treatment. The results support the use of the Social Competence Interview and the Anger Transcendence Challenge with an adult AUD clinical sample, so that these measures may help to advance knowledge about the relationship between interpersonal stress and alcohol relapse.

  15. Prevalence and correlates of alcohol and other substance use disorders in young adulthood: A population-based study

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    Korhonen Tellervo

    2009-11-01

    Full Text Available Abstract Background Several risk factors for alcohol and other substance use disorders (SUDs have been identified, but it is not well understood whether their associations with SUD are independent of each other. In particular, it is not well known, whether the associations between behavioral and affective factors and SUDs are independent of other risk factors. The incidence of SUDs peaks by young adulthood making epidemiological studies of SUDs in young adults informative. Methods In a comprehensive population-based survey of mental health in Finnish young adults (aged 21-35 years, n = 605, structured clinical interview (SCID-I complemented by medical record data from all lifetime hospital and outpatient treatments were used to diagnose SUDs. We estimated the prevalences of lifetime DSM-IV SUDs, and investigated their associations with correlates from four domains representing: (1 behavioral and affective factors, (2 parental factors, (3 early initiation of substance use, and (4 educational factors. Independence of the association of behavioral and affective factors with SUD was investigated. Results Lifetime prevalences of abuse or dependence of any substance, alcohol, and any illicit substance were 14.2%, 13.1%, and 4.4%, respectively. Correlates from all four domains were associated with SUD. The associations between behavioral and affective factors (attention or behavior problems at school, aggression, anxiousness and SUD were largely independent of other correlates, whereas only daily smoking and low education associated with SUD after adjustment for behavioral and affective factors. Conclusion Alcohol use disorders are common in Finnish young adults, whereas other SUDs are less common than in many other developed countries. Our cross-sectional analyses suggested that the association between behavioral and affective factors and SUD was only partly accounted for by other correlates, such as early initiation of substance use and parental

  16. Discovery, Development, and Adoption of Medications to Treat Alcohol Use Disorder: Goals for the Phases of Medications Development.

    Science.gov (United States)

    Litten, Raye Z; Falk, Daniel E; Ryan, Megan L; Fertig, Joanne B

    2016-07-01

    For more than 25 years, advances have been made in developing medications to treat alcohol use disorder (AUD), highlighted by the U.S. Food and Drug Administration's approval of naltrexone (oral and long-acting) and acamprosate. Despite this progress, more work remains to be done in this area because these medications, although effective for some people, do not work for everyone. A high priority for the National Institute on Alcohol Abuse and Alcohol is to put into place a solid infrastructure to aid in the development of medications that are more effective than those currently available and with few side effects. Medication development, especially for a disorder as complex as AUD, is challenging and involves multiple phases, including discovery of "druggable" targets, preclinical studies, human clinical trials, and the adoption and implementation of the new medication into mainstream medicine. A successful medications development program requires clearly established goals for each phase to ensure that a candidate compound is not trapped in one particular phase, a condition known as "the valley of death." In this article, the phases of medication development are described as they apply to AUD, and specific goals of each phase are identified for the next decade. In addition, several important crosscutting themes are outlined for each phase, all of which are essential for advancing medications development. These include identifying and validating screening models and druggable targets, making use of precision medicine, and establishing partnerships among key stakeholders. Our goal in writing this article is to provide a guide on medications development that will aid the alcohol research community in planning, testing, and developing medications for AUD.

  17. The relationship between childhood conduct disorder and adult antisocial behavior is partially mediated by early-onset alcohol abuse.

    Science.gov (United States)

    Khalifa, Najat; Duggan, Conor; Howard, Rick; Lumsden, John

    2012-10-01

    Early-onset alcohol abuse (EOAA) was previously found to both mediate and moderate the effect of childhood conduct disorder (CD) on adult antisocial behavior (ASB) in an American community sample of young adults (Howard, R., Finn, P. R., Gallagher, J., & Jose, P. (2011). Adolescent-onset alcohol abuse exacerbates the influence of childhood conduct disorder on late adolescent and early adult antisocial behavior. Journal of Forensic Psychiatry and Psychology. Advance online publication. doi:10.1080/14789949.2011.641996). This study tested whether this result would generalize to a British forensic sample comprising 100 male forensic patients with confirmed personality disorder. Results confirmed that those in whom EOAA co-occurred with CD showed the highest level of personality pathology, particularly Cluster B traits and antisocial/borderline comorbidity. Those with co-occurring CD with EOAA, compared with those showing only CD, showed more violence in their criminal history and greater recreational drug use. Regression analysis showed that both EOAA and CD predicted adult ASB when covariates were controlled. Further analysis showed that EOAA significantly mediated but did not moderate the effect of CD on ASB. The failure to demonstrate an exacerbating effect of EOAA on the relationship between CD and ASB likely reflects the high prevalence of CD in this forensic sample. Some implications of these findings are discussed.

  18. The glucagon-like peptide-1 receptor as a potential treatment target in alcohol use disorder: evidence from human genetic association studies and a mouse model of alcohol dependence.

    Science.gov (United States)

    Suchankova, P; Yan, J; Schwandt, M L; Stangl, B L; Caparelli, E C; Momenan, R; Jerlhag, E; Engel, J A; Hodgkinson, C A; Egli, M; Lopez, M F; Becker, H C; Goldman, D; Heilig, M; Ramchandani, V A; Leggio, L

    2015-06-16

    The hormone glucagon-like peptide-1 (GLP-1) regulates appetite and food intake. GLP-1 receptor (GLP-1R) activation also attenuates the reinforcing properties of alcohol in rodents. The present translational study is based on four human genetic association studies and one preclinical study providing data that support the hypothesis that GLP-1R may have a role in the pathophysiology of alcohol use disorder (AUD). Case-control analysis (N = 908) was performed on a sample of individuals enrolled in the National Institute on Alcohol Abuse and Alcoholism (NIAAA) intramural research program. The Study of Addiction: Genetics and Environment (SAGE) sample (N = 3803) was used for confirmation purposes. Post hoc analyses were carried out on data from a human laboratory study of intravenous alcohol self-administration (IV-ASA; N = 81) in social drinkers and from a functional magnetic resonance imaging study in alcohol-dependent individuals (N = 22) subjected to a Monetary Incentive Delay task. In the preclinical study, a GLP-1R agonist was evaluated in a mouse model of alcohol dependence to demonstrate the role of GLP-1R for alcohol consumption. The previously reported functional allele 168Ser (rs6923761) was nominally associated with AUD (P = 0.004) in the NIAAA sample, which was partially replicated in males of the SAGE sample (P = 0.033). The 168 Ser/Ser genotype was further associated with increased alcohol administration and breath alcohol measures in the IV-ASA experiment and with higher BOLD response in the right globus pallidus when receiving notification of outcome for high monetary reward. Finally, GLP-1R agonism significantly reduced alcohol consumption in a mouse model of alcohol dependence. These convergent findings suggest that the GLP-1R may be an attractive target for personalized pharmacotherapy treatment of AUD.

  19. Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality

    Directory of Open Access Journals (Sweden)

    Lindberg Nina

    2007-07-01

    Full Text Available Abstract Background The validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology. Methods The temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ and were diagnosed with DSM-III-R criteria. Results The typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder. Conclusion Results indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R. Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis.

  20. The Risk of Offspring Developing Substance Use Disorders when Exposed to One versus Two Parent(s) with Alcohol Use Disorder

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Brink, Maria; Andersen, Lene;

    2016-01-01

    Aim: Few population-based, family studies have examined associations between exposure to one vs. two parent(s) with alcohol use disorder (AUD) and the risk of offspring developing substance use disorder (SUD). Moreover, these studies have focused solely on the development of AUD, and not SUD......, in offspring. The purpose of this study was to investigate whether exposure to one vs. two parent(s) with AUD increases the risk of offspring developing SUD. Methods: A population-based, cohort study was conducted in which offspring born in Denmark between 1983 and 1989 were followed through national...... registries until 2011. Register-based data were obtained from the: Psychiatric Central Research Register, National Patient Registry, Civil Registration System, Fertility Database, and Cause of Death Register. Adjusted hazard ratios were calculated using multivariate Cox-regression models. Findings: A total...

  1. The Risk of Offspring Developing Substance Use Disorders when Exposed to One versus Two Parents with Alcohol Use Disorder: A Register-based Prospective Cohort Study

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Brink, M; Bjerregaard, Lene Berit Skov;

    2014-01-01

    Background: Few population-based studies have investigated associations between having one or two parents with alcohol use disorder (AUD) and the risk of substance use disorders (SUD) in the offspring. Moreover, these studies have solely focused on AUD in the offspring and not SUD in general....... The aim of this study was to investigate the risk of SUD in offspring when exposed to one versus two parents with AUD. Methods: A population-based, prospective cohort study with 398,881 offspring’s born in Denmark within 1983-1989 was followed until 2011. Register-data was obtained from the following data......-bases: the Civil Registration System, the Psychiatric Central Research Register, the National Patient Registry, the National Prescription Registry, the Fertility Database, and the Cause of Death Register. Adjusted hazard ratios (AHR) were calculated using multivariate Cox-regression models. Results: In all, 10...

  2. Alcohol Use Disorder Identification Test (AUDIT: explorando seus parâmetros psicométricos

    Directory of Open Access Journals (Sweden)

    Walberto Silva dos Santos

    2012-01-01

    Full Text Available OBJETIVO: O presente estudo teve como objetivo conhecer evidências de validade e precisão do Alcohol Use Disorder Identification Test (AUDIT. MÉTODOS: Contou-se com uma amostra de conveniência (não probabilística de 547 estudantes universitários de Fortaleza (CE, com idade média de 21,6 anos (dp = 4,86; amplitude de 18 a 53, a maioria do sexo masculino (51,5%, solteira (91,4% e católica (62,5%. Os participantes responderam ao AUDIT e a perguntas demográficas. Procurando conhecer a estrutura fatorial, além de estatísticas descritivas, realizou-se uma Análise de Componentes Principais. Adicionalmente, a fim de avaliar a precisão do instrumento, efetuaram-se cálculos de alfa de Cronbach (consistência interna, correlações de r de Pearson e coeficiente de correlação intraclasse - ICC (precisão teste-reteste. RESULTADOS: De acordo com a análise de componentes principais com rotação oblimin, a estrutura bifatorial do AUDIT mostrou-se coerente, com todos os itens apresentando saturações satisfatórias, superior a |0,40|, tendo o Fator 1 explicado 47,5% da variância total com alfa de 0,84 e o Fator 2 explicado 11,6% da variância total com alfa de 0,69. Os resultados do teste-reteste indicaram correlação forte entre os dados obtidos na primeira (t1 e segunda (t2 aplicação (r tt = 0,94, p 0,05, com ICC satisfatório (0,96. CONCLUSÕES: Os achados apoiaram a adequação psicométrica do AUDIT, com as análises fatoriais exploratórias apontando como mais satisfatória a estrutura com dois fatores, bem como atestaram sua boa estabilidade temporal.

  3. Fetal alcohol spectrum disorders and childhood cancer: a concise review of case reports and future research considerations.

    Science.gov (United States)

    Burd, Larry; Peterson, Leah; Kobrinsky, Nathan

    2014-05-01

    We reviewed the published literature on the relationship between childhood cancer and fetal alcohol spectrum disorders (FASD). A Pub Med search identified 12 subjects with the co-occurrence of FASD and cancer. We included an additional case from the author's institution. Neuroblastomas comprised 6 of the 13 (46%) case reports, yet neuroblastomas comprise only about 10% of childhood cancers (z = 4.1; P cancer was reported more than once. Few cases of childhood cancer associated with FASD were identified likely due to under ascertainment of FASD.

  4. Diagnoses of alcohol abuse and other neuropsychiatric disorders among house painters compared with house carpenters.

    OpenAIRE

    Lundberg, I; Gustavsson, A; Högberg, M; Nise, G

    1992-01-01

    The incidence of alcoholism and the incidence of other neuropsychiatric diagnoses were compared between the 767 house painters and the 1212 house carpenters, born in 1925 or later, who were members of the Stockholm branches of their respective trade unions in 1965 and who had been members for at least 10 years before 1970. Four different outcome registers were used: (1) the alcohol crime register, which contained all persons who had broken any law regulating the handling and consumption of al...

  5. Application of the stressor vulnerability model to understanding posttraumatic stress disorder (PTSD) and alcohol-related problems in an undergraduate population.

    Science.gov (United States)

    Hruska, Bryce; Delahanty, Douglas L

    2012-12-01

    Research examining the comorbidity of posttraumatic stress disorder (PTSD) and alcohol-use disorder (AUD) suggests that individuals experiencing PTSD symptoms (PTSS) often drink alcohol as a means to self-medicate their trauma symptoms; however, little attention has been given to moderating variables that may make this association more likely. The stressor vulnerability model proposes that being male, relying on maladaptive forms of coping, and holding positive alcohol-outcome expectancies predispose individuals to engage in alcohol use when experiencing psychological distress. In the current study, sex, avoidance coping (AVC), tension-reduction expectancies (TRE), and emotional-relief drinking-refusal self-efficacy (ERDRSE) were examined as moderators of the relationship between PTSS and alcohol-related problems in a sample of 144 undergraduates. Results indicated that males reporting high levels of TRE exhibited a stronger positive relationship between PTSS and alcohol-related problems than was present for males reporting low levels of TRE and for females reporting either high or low levels of TRE. In addition, a significant positive relationship between PTSS and alcohol-related problems was observed for individuals reporting high levels of TRE and low levels of ERDRSE, but not for individuals reporting high levels of TRE and high levels of ERDRSE, low TRE-low ERDRSE, or low TRE-high ERDRSE. Assessment of these vulnerability factors in traumatized youth and young adults may serve as a useful means of identifying individuals at risk for the development of alcohol-related problems.

  6. How Fetal Alcohol Spectrum Disorders Co-Occur with Mental Illness

    Science.gov (United States)

    ... noted in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) 4 , such as: • Educational ... Psychiatric Association.2000. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Text Revision. DSM-IV-TR. Arlington, ...

  7. Relationship of Social Network to Protective Factors in Suicide and Alcohol Use Disorder Intervention for Rural Yup’ik Alaska Native Youth

    Directory of Open Access Journals (Sweden)

    Jacques Philip

    2016-04-01

    Full Text Available Suicide and alcohol use disorders are significant Alaska Native health disparities, yet there is limited understanding of protection and no studies about social network factors in protection in this or other populations. The Qungasvik intervention enhances protective factors from suicide and alcohol use disorders through activities grounded in Yupik cultural practices and values. Identification of social network factors associated with protection within the cultural context of these tight, close knit, and high density rural Yupik Alaska Native communities in southwest Alaska can help identify effective prevention strategies for suicide and alcohol use disorder risk. Using data from ego-centered social network and protective factors from suicide and alcohol use disorders surveys with 50 Yupik adolescents, we provide descriptive data on structural and network composition variables, identify key network variables that explain major proportions of the variance in a four principal component structure of these network variables, and demonstrate the utility of these key network variables as predictors of family and community protective factors from suicide and alcohol use disorder risk. Connections to adults and connections to elders, but not peer connections, emerged as predictors of family and community level protection, suggesting these network factors as important intervention targets for intervention.

  8. Evaluation of guanfacine as a potential medication for alcohol use disorder in long-term drinking rats: behavioral and electrophysiological findings.

    Science.gov (United States)

    Fredriksson, Ida; Jayaram-Lindström, Nitya; Wirf, Malin; Nylander, Erik; Nyström, Erica; Jardemark, Kent; Steensland, Pia

    2015-03-13

    One of the main treatment challenges in alcohol use disorder (AUD) is the high rate of craving in combination with decreased cognitive functioning including impaired decision making and impulse control that often lead to relapse. Recent studies show that guanfacine, an α-2-adrenoceptor agonist and FDA-approved ADHD medication, attenuates stress-induced relapse of several drugs of abuse including alcohol. Here we evaluated guanfacine's effects on voluntary alcohol intake, the alcohol deprivation effect (ADE), alcohol seeking behavior, and cue/priming-induced reinstatement in Wistar rats that had voluntarily consumed alcohol for at least 2 months before treatment. In addition, guanfacine's ability to regulate glutamatergic neurotransmission was evaluated through electrophysiological recordings in medial prefrontal cortex (mPFC) slices prepared from long-term drinking rats (and alcohol-naive controls) that had received three daily guanfacine (0.6 mg/kg/day) or vehicle injections in vivo. Guanfacine decreased alcohol intake in high, but not low, alcohol-consuming rats and the effects were generally more long lasting than that of the AUD medication naltrexone. Repeated guanfacine treatment induced a long-lasting decrease in alcohol intake, persistent up to five drinking sessions after the last injection. In addition, guanfacine attenuated the ADE as well as alcohol seeking and cue/priming-induced reinstatement of alcohol seeking. Finally, subchronic guanfacine treatment normalized an alcohol-induced dysregulated glutamatergic neurotransmission in the mPFC. These results support previous studies showing that guanfacine has the ability to improve prefrontal connectivity through modulation of the glutamatergic system. Together with the fact that guanfacine appears to be clinically safe, these results merit evaluation of guanfacine's clinical efficacy in AUD individuals.

  9. Decision-making deficits in alcohol-dependent patients with and without comorbid personality disorder

    NARCIS (Netherlands)

    G. Dom; B. de Wilde; W. Hulstijn; W. van den Brink; B. Sabbe

    2006-01-01

    Background: Impairments in decision making are a consistent finding in substance use disorder (SUD) populations. However, decision-making deficits are not specific for SUDs and are also reported in the context of other psychiatric disorders such as antisocial and borderline personality disorders (PD

  10. Genetic and environmental factors underlying comorbid bulimic behaviours and alcohol use disorders: a moderating role for the dysregulated personality cluster?

    Science.gov (United States)

    Slane, Jennifer D; Klump, Kelly L; McGue, Matthew; Iacono, G

    2014-05-01

    Women with bulimia nervosa (BN) frequently have co-occurring alcohol use disorders (AUDs). Studies of shared genetic transmission of these disorders have been mixed. Personality heterogeneity among individuals with BN may explain discrepant findings. Cluster analysis has characterized women with BN in groups on the basis of personality profiles. One group, the Dysregulated cluster, characterized largely by behavioural disinhibition and emotional dysregulation may be more closely linked etiologically to AUDs. This study examined whether genetic associations between BN and AUDs are the strongest among the Dysregulated cluster. Symptoms of BN and AUDs were assessed in female twins at ages 17 and 25 years from the Minnesota Twin Family Study. Personality clusters were defined using the Multidimensional Personality Questionnaire. Twin moderation models suggested small-to-moderate common genetic transmission between BN and AUDs. However, shared genetic effects did not differ by personality cluster. Findings suggest that personality clusters are unlikely to account for inconsistent findings regarding their shared aetiology.

  11. Plasma Levels of Monocyte Chemotactic Protein 3 and Beta-Nerve Growth Factor Increase with Amnestic Mild Cognitive Impairment

    Institute of Scientific and Technical Information of China (English)

    Kang Soo Lee; Ji Hyung Chung; Kyung Hye Lee; Min-Jeong Shin; Byoung Hoon Oh; Soo Hyung Lee; Chang Hyung Hong

    2009-01-01

    A number of studies have investigated peripheral inflammatory indices, including plasma cytokines and related molecules according to subtypes of dementia, but not in mild cognitive impairment (MCI). In this study, we used multiplex cytokine assay to assess the plasma levels of 22 cytokines in patients with MCI subtyped as amnestic and non-amnestic, according to cognitive features. When comparing the levels of plasma growth factors, chemokines and cytokines, plasma levels of monocyte chemotactic protein 3 (MCP-3), and beta-nerve growth factor (β-NGF) in these two groups, they were found to be significantly higher in amnestic MCI patients than in non-amnestic MCI patients, after adjusting for age and gender. This suggests that plasma MCP-3 and β-NGF may be useful in differentiating subtypes of MCI. Cellular & Molecular Immunology.

  12. Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: results from the Mental Disorder, Substance Abuse and Crime study.

    Science.gov (United States)

    Durbeej, Natalie; Berman, Anne H; Gumpert, Clara H; Palmstierna, Tom; Kristiansson, Marianne; Alm, Charlotte

    2010-12-01

    Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings.

  13. Change over time in adolescent and friend alcohol use: Differential associations for youth with and without childhood attention-deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Belendiuk, Katherine A; Pedersen, Sarah L; King, Kevin M; Pelham, William E; Molina, Brooke S G

    2016-02-01

    Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for experiencing alcohol-related problems by adulthood. However, few studies have examined contextual factors that may contribute to this risk. The current study examined 1 widely investigated social-contextual risk factor, friend alcohol use, in a sample of adolescents with and without a history of ADHD. One hundred and 59 adolescents (14-17 years old) with childhood ADHD and 117 demographically similar youth without ADHD were interviewed annually in the Pittsburgh ADHD Longitudinal Study. Adolescents reported the frequency of their own alcohol use in the prior 12 months and the number of friends who used alcohol regularly or occasionally (perceived friend alcohol use). Multiple-group parallel process models indicated that increases in friend alcohol use were more strongly associated with increases in adolescent alcohol use over time for individuals with ADHD (r = .15, SE = 0.04; 95% confidence interval [CI] = [0.08, 0.22]) than for those without ADHD (r = .06, SE = 0.03; 95% CI [0.00, 0.11]). These results suggest that social factors are an important part of escalating alcohol use among adolescents with ADHD histories, and they highlight the possibility that interventions focused on the peer context could be important for these at-risk youth. Additional social network research on adolescent alcohol use within the larger context of other relationships (e.g., family and romantic relationships) is indicated.

  14. Prevalence of Children with Severe Fetal Alcohol Spectrum Disorders in Communities Near Rome, Italy: New Estimated Rates Are Higher than Previous Estimates

    Directory of Open Access Journals (Sweden)

    Mauro Ceccanti

    2011-06-01

    Full Text Available Objective: To determine the population-based epidemiology of fetal alcohol syndrome (FAS and other fetal alcohol spectrum disorders (FASD in towns representative of the general population of central Italy. Methods: Slightly revised U.S. Institute of Medicine diagnostic methods were used among children in randomly-selected schools near Rome. Consented first grade children (n = 976 were screened in Tier I for height, weight, or head circumference and all children

  15. A cross-sectional study to assess disability and its correlates among treatment seeking individuals with alcohol use disorders

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    Yatan Pal Singh Balhara

    2017-01-01

    Full Text Available Background and Objectives: Alcohol use is a major risk factor for global disease burden, and excessive use leads to disability in the individual. This study aimed to assess the disability and its correlates among individuals with alcohol use disorders (AUDs. In addition, it assessed the quality of life measures in this population group. Methodology: A cross-sectional study on a sample (N = 62 from among treatment seekers for alcohol dependence. Diagnostic and Statistical Manual, Fifth Edition (DSM-5 criteria were used to assess disorder severity. The WHO Disability Assessment Schedule (WHODAS 2.0 and World Health Organization Quality of Life-BREF were used to assess disability and quality of life, respectively. Descriptive statistics, correlation analysis, and linear regression analysis were used for comparative assessments. The level of statistical significance was kept at P < 0.05 for all the tests. Results: DSM-5 diagnosis of the individuals suggested a high severity of substance use disorder as an average of 8.8 (±1.8 criteria were fulfilled. WHODAS 2.0 revealed maximum disability in the domains of “participation in the society,” “household and work-related activities” and “cognitive functioning.” The quality of life measures indicate poor physical health, reduced work capacity, and cognitive dysfunction. A negative correlation was seen between the social dimensions of disability (getting along and quality of life measures of psychological health (P = 0.026 and social relationships (P = 0.046, work domain of disability schedule and physical health score on quality of life evaluation (P = 0.001. Older age had greater impairment in the work domain (P = 0.040, and unemployment was associated with higher disability (P = 0.001. Unemployment and duration of alcohol use were the independent predictors of greater disability. Conclusions: Disability assessment using WHODAS 2.0 shows significant impairment in individuals with AUDs that is

  16. A case-control study on alcohol and psychiatric disorders as risk factors for drug abuse pattern

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    Claudia S. Lopes

    2002-12-01

    Full Text Available We evaluated alcohol and psychiatric disorders as risk factors for the pattern of drug abuse/dependence in a matched case-control study (370 adults. Cases (drug abusers and controls were selected in the community using the snowball technique and matched by sex, age, and friendship. Information was gathered using the "Composite International Diagnostic Interview" (CIDI. Three patterns of drug abuse/dependence were evaluated: any drug abuse/dependence, only cannabis, and cocaine and other drugs. Logistic conditional regression showed that alcohol dependence was strongly associated with pattern of drug abuse/dependence. Thus, compared to the "no drug abuse group", the odds ratio for association with diagnosis of abuse/dependence on cocaine and other drugs was 10.2 (95% CI: 4.9-21.2, whereas for abuse/dependence on cannabis only, the odds ratio was 1.0. For affective disorders, the odds ratio was 2.0 (95% CI: 1.10-3.64 for the group that received a diagnosis of abuse/dependence on cocaine and other drugs, whereas no association was found for those with abuse/dependence on cannabis only. In conclusion, there is not a homogeneous group of "drug users", and the role of risk factors depends on the drug use pattern.

  17. A case-control study on alcohol and psychiatric disorders as risk factors for drug abuse pattern

    Directory of Open Access Journals (Sweden)

    Lopes Claudia S.

    2002-01-01

    Full Text Available We evaluated alcohol and psychiatric disorders as risk factors for the pattern of drug abuse/dependence in a matched case-control study (370 adults. Cases (drug abusers and controls were selected in the community using the snowball technique and matched by sex, age, and friendship. Information was gathered using the "Composite International Diagnostic Interview" (CIDI. Three patterns of drug abuse/dependence were evaluated: any drug abuse/dependence, only cannabis, and cocaine and other drugs. Logistic conditional regression showed that alcohol dependence was strongly associated with pattern of drug abuse/dependence. Thus, compared to the "no drug abuse group", the odds ratio for association with diagnosis of abuse/dependence on cocaine and other drugs was 10.2 (95% CI: 4.9-21.2, whereas for abuse/dependence on cannabis only, the odds ratio was 1.0. For affective disorders, the odds ratio was 2.0 (95% CI: 1.10-3.64 for the group that received a diagnosis of abuse/dependence on cocaine and other drugs, whereas no association was found for those with abuse/dependence on cannabis only. In conclusion, there is not a homogeneous group of "drug users", and the role of risk factors depends on the drug use pattern.

  18. Prevalence and impact of alcohol and other drug use disorders on sedation and mechanical ventilation: a retrospective study

    Directory of Open Access Journals (Sweden)

    Jenvey Wendy I

    2007-03-01

    Full Text Available Abstract Background Experience suggests that patients with alcohol and other drug use disorders (AOD are commonly cared for in our intensive care units (ICU's and require more sedation. We sought to determine the impact of AOD on sedation requirement and mechanical ventilation (MV duration. Methods Retrospective review of randomly selected records of adult patients undergoing MV in the medical ICU. Diagnoses of AOD were identified using strict criteria in Diagnostic and Statistical Manual of Mental Disorders, and through review of medical records and toxicology results. Results Of the 70 MV patients reviewed, 27 had AOD (39%. Implicated substances were alcohol in 22 patients, cocaine in 5, heroin in 2, opioids in 2, marijuana in 2. There was no difference between AOD and non-AOD patients in age, race, or reason for MV, but patients with AOD were more likely to be male (21 versus 15, p Conclusion The prevalence of AOD among medical ICU patients undergoing MV is high. Patients with AOD receive higher doses of sedation than their non-AOD counterparts to achieve similar RASS scores but do not undergo longer duration of MV.

  19. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome.

    Science.gov (United States)

    Dickerson, Justin B

    2011-02-22

    Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (β=0.31, P=0.001), referral to a hospital by a physician (β=0.35, P=0.014), and increasing age (β= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  20. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome

    Directory of Open Access Journals (Sweden)

    Justin B. Dickerson

    2011-02-01

    Full Text Available Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358. Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (b=0.31, P=0.001, referral to a hospital by a physician (b=0.35, P=0.014, and increasing age (b= 0.01, P=0.001 were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62. Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  1. Modulation of Craving Related Brain Responses Using Real-Time fMRI in Patients with Alcohol Use Disorder.

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    Susanne Karch

    Full Text Available One prominent symptom in addiction disorders is the strong desire to consume a particular substance or to display a certain behaviour (craving. Especially the strong association between craving and the probability of relapse emphasises the importance of craving in the therapeutic process. Neuroimaging studies have shown that craving is associated with increased responses, predominantly in fronto-striatal areas.The aim of the present study is the modification of craving-related neuronal responses in patients with alcohol addiction using fMRI real-time neurofeedback. For that purpose, patients with alcohol use disorder and healthy controls participated once in neurofeedback training; during the sessions neuronal activity within an individualized cortical region of interest (ROI (anterior cingulate cortex, insula, dorsolateral prefrontal cortex was evaluated. In addition, variations regarding the connectivity between brain regions were assessed in the resting state.The results showed a significant reduction of neuronal activity in patients at the end of the training compared to the beginning, especially in the anterior cingulate cortex, the insula, the inferior temporal gyrus and the medial frontal gyrus. Furthermore, the results show that patients were able to regulate their neuronal activities in the ROI, whereas healthy subjects achieved no significant reduction. However, there was a wide variability regarding the effects of the training within the group of patients. After the neurofeedback-sessions, individual craving was slightly reduced compared to baseline. The results demonstrate that it seems feasible for patients with alcohol dependency to reduce their neuronal activity using rtfMRI neurofeedback. In addition, there is some evidence that craving can be influenced with the help of this technique.In future, real-time fMRI might be a complementary neurophysiological-based strategy for the psychotherapy of patients with psychiatric or

  2. Genetics and alcoholism

    OpenAIRE

    Edenberg, Howard J; Foroud, Tatiana

    2013-01-01

    Alcohol is widely consumed, but excessive use creates serious physical, psychological and social problems and contributes to many diseases. Alcoholism (alcohol dependence, alcohol use disorders) is a maladaptive pattern of excessive drinking leading to serious problems. Abundant evidence indicates that alcoholism is a complex genetic disease, with variations in a large number of genes affecting risk. Some of these genes have been identified, including two genes of alcohol me...

  3. The plausibility of maternal nutritional status being a contributing factor to the risk for fetal alcohol spectrum disorders: the potential influence of zinc status as an example.

    Science.gov (United States)

    Keen, Carl L; Uriu-Adams, Janet Y; Skalny, Anatoly; Grabeklis, Andrei; Grabeklis, Sevil; Green, Kerri; Yevtushok, Lyubov; Wertelecki, Wladimir W; Chambers, Christina D

    2010-01-01

    There is increasing evidence that human pregnancy outcome can be significantly compromised by suboptimal maternal nutritional status. Poor diet results in a maternal-fetal environment in which the teratogenicity of other insults such as alcohol might be amplified. As an example, there is evidence that zinc (Zn) can interact with maternal alcohol exposure to influence the risk for fetal alcohol spectrum disorders (FASD). Studies with experimental animals have shown that the teratogenicity of alcohol is increased under conditions of Zn deficiency, whereas its teratogenicity is lessened when animals are given Zn-supplemented diets or Zn injections before the alcohol exposure. Alcohol can precipitate an acute-phase response, resulting in a subsequent increase in maternal liver metallothionein, which can sequester Zn and lead to decreased Zn transfer to the fetus. Importantly, the teratogenicity of acute alcohol exposure is reduced in metallothionein knockout mice, which can have improved Zn transfer to the conceptus relative to wild-type mice. Consistent with the above, Zn status has been reported to be low in alcoholic women at delivery. Preliminary data from two basic science and clinical nutritional studies that are ongoing as part of the international Collaborative Initiative on Fetal Alcohol Spectrum Disorders support the potential role of Zn, among other nutritional factors, relative to risk for FASD. Importantly, the nutrient levels being examined in these studies are relevant to general clinical populations and represent suboptimal levels rather than severe deficiencies. These data suggest that moderate deficiencies in single nutrients can act as permissive factors for FASD, and that adequate nutritional status or intervention through supplementation may provide protection from some of the adverse effects of prenatal alcohol exposure.

  4. Alcoholism and Alcohol Abuse

    Science.gov (United States)

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism

  5. Disrupted functional brain connectivity and its association to structural connectivity in amnestic mild cognitive impairment and Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Yu Sun

    Full Text Available Although anomalies in the topological architecture of whole-brain connectivity have been found to be associated with Alzheimer's disease (AD, our understanding about the progression of AD in a functional connectivity (FC perspective is still rudimentary and few study has explored the function-structure relations in brain networks of AD patients. By using resting-state functional MRI (fMRI, this study firstly investigated organizational alternations in FC networks in 12 AD patients, 15 amnestic mild cognitive impairment (aMCI patients, and 14 age-matched healthy aging subjects and found that all three groups exhibit economical small-world network properties. Nonetheless, we found a decline of the optimal architecture in the progression of AD, represented by a more localized modular organization with less efficient local information transfer. Our results also show that aMCI forms a boundary between normal aging and AD and represents a functional continuum between healthy aging and the earliest signs of dementia. Moreover, we revealed a dissociated relationship between the overall FC and structural connectivity (SC in AD patients. In this study, diffusion tensor imaging tractography was used to map the structural network of the same individuals. The decreased FC-SC coupling may be indicative of more stringent and less dynamic brain function in AD patients. Our findings provided insightful implications for understanding the pathophysiological mechanisms of brain dysfunctions in aMCI and AD patients and demonstrated that functional disorders can be characterized by multimodal neuroimaging-based metrics.

  6. Fetal Alcohol Spectrum Disorders: When Science, Medicine, Public Policy, and Laws Collide

    Science.gov (United States)

    Warren, Kenneth R.; Hewitt, Brenda G.

    2009-01-01

    Historically, alcohol has been used for different purposes including as a part of religious observances, as a food, at times as a medicine and its well-known use as a beverage. Until relatively recently these purposes have not changed and have at times been at odds with one another, resulting in collisions among policies and practices in science,…

  7. Physiological and endocrine reactions to psychosocial stress in alcohol use disorders: duration of abstinence matters

    NARCIS (Netherlands)

    Starcke, K.; Holst, R.J. van; Brink, W. van den; Veltman, D.J.; Goudriaan, A.E.

    2013-01-01

    BACKGROUND: Recent research findings suggest that heavy alcohol use is associated with alterations of the hypothalamic-pituitary-adrenal axis and autonomic nervous system function and that early abstinence is associated with blunted stress responsiveness. METHODS: This study investigated abstinent a

  8. Concordance between gambling disorder diagnoses in the DSM-IV and DSM-5: Results from the National Epidemiological Survey of Alcohol and Related Disorders.

    Science.gov (United States)

    Petry, Nancy M; Blanco, Carlos; Jin, Chelsea; Grant, Bridget F

    2014-06-01

    The fifth edition of the Diagnostic and Statistic Manual for Mental Disorders (DSM-5) eliminates the committing illegal acts criterion and reduces the threshold for a diagnosis of gambling disorder to 4 of 9 criteria. This study compared the DSM-5 "4 of 9" classification system to the "5 of 10" DSM-IV system, as well as other permutations (i.e., just lowing the threshold to 4 criteria or just eliminating the illegal acts criterion) in 43,093 respondents to the National Epidemiological Survey of Alcohol and Related Conditions. Subgroups were analyzed to ascertain whether changes will impact differentially diagnoses based on gender, age, or race/ethnicity. In the full sample and each subpopulation, prevalence rates were higher when the DSM-5 classification system was employed relative to the DSM-IV system, but the hit rate between the two systems ranged from 99.80% to 99.96%. Across all gender, age, and racial/ethnic subgroups, specificity was greater than 99% when the DSM-5 system was employed relative to the DSM-IV system, and sensitivity was 100%. Results from this study suggest that eliminating the illegal acts criterion has little impact on diagnosis of gambling disorder, but lowering the threshold for diagnosis does increase the base rate in the general population and each subgroup, even though overall rates remain low and sensitivity and specificity are high.

  9. The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial

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    Shepherd Jonathan P

    2010-10-01

    Full Text Available Abstract Background Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. Objective To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. Design A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. Results The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. Conclusion The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police

  10. Comorbidade: uso de álcool e outros transtornos psiquiátricos Comorbidity: alcohol use and other psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Hamer Alves

    2004-05-01

    Full Text Available Os transtornos relacionados ao consumo de álcool freqüentemente coexistem com outras doenças psiquiátricas e sua incidência parece estar aumentando nas últimas décadas. Estudos demonstram que pacientes com comorbidade, principalmente aqueles com transtornos psiquiátricos graves, apresentam maiores taxas de suicídio, recaídas, gastos com tratamento, falta de moradia e utilizam mais os serviços médicos. A avaliação deve ser minuciosa, pois o diagnóstico diferencial torna-se complicado sem um longo período de abstinência do álcool. Esses pacientes costumam ter um prognóstico pior, além de serem de difícil tratamento. A maioria dos estudos nesse campo tem indicado que integração de técnicas psicossociais e farmacológicas é mais efetiva. O tratamento de longo prazo deve focar-se na minimização dos sintomas, melhora do funcionamento social e familiar, treinamento de habilidades e prevenção de recaída.Alcohol related disorders often coexist with other psychiatric disorders and its incidence is increasing in last decades. Studies show that patients with comorbidity, specially those with severe psychiatric disorders, have higher rates of suicide, relapse, money spent in treatment, homeless and they use more medical service. Their evaluation must be meticulous because the differencial diagnosis become complicated without a long period of alcohol withdrawal. These patients have a worse prognostic and their treatment is more difficult. Most of studies in this area have indicated that the integration of psychosocial and pharmacological techniques is more effective. The long term treatment must focus in the reduction of symptoms, improvement of social and familiar funcioning, coping skills and relapse prevention.

  11. Similar Verbal Fluency Patterns in Amnestic Mild Cognitive Impairment and Alzheimer's Disease

    Science.gov (United States)

    Teng, Edmond; Leone-Friedman, Judith; Lee, Grace J.; Woo, Stephanie; Apostolova, Liana G.; Harrell, Shelly; Ringman, John M.; Lu, Po H.

    2013-01-01

    Disproportionately greater deficits in semantic relative to phonemic verbal fluency are seen in Alzheimer's disease (AD) and have been attributed to neurodegenerative changes in the temporal lobe. Amnestic (AMN) mild cognitive impairment (MCI), which often represents incipient AD, is also characterized by early temporal lobe neuropathology, but previous comparisons of verbal fluency between AD and AMN MCI have yielded mixed results. We examined semantic and phonemic verbal fluency performance in 399 individuals (78 AD, 138 AMN MCI, 72 non-amnestic MCI, and 111 cognitively normal controls). Similar verbal fluency patterns were seen in AMN MCI and AD; both groups exhibited disproportionately poorer performance on semantic verbal fluency relative to normal controls. However, relative verbal fluency indices performed more poorly than individual semantic or phonemic verbal fluency indices for discriminating AMN MCI or AD participants from normal controls, suggesting that they are unlikely to provide additional utility for predicting progression from MCI to AD. PMID:23752677

  12. Drinking patterns of adolescents who develop alcohol use disorders: results from the Victorian Adolescent Health Cohort Study

    Science.gov (United States)

    Olsson, Craig A; Romaniuk, Helena; Salinger, Jodi; Staiger, Petra K; Bonomo, Yvonne; Hulbert, Carol; Patton, George C

    2016-01-01

    Objective We identify drinking styles that place teens at greatest risk of later alcohol use disorders (AUD). Design Population-based cohort study. Setting Victoria, Australia. Participants A representative sample of 1943 adolescents living in Victoria in 1992. Outcome measures Teen drinking was assessed at 6 monthly intervals (5 waves) between mean ages 14.9 and 17.4 years and summarised across waves as none, one, or two or more waves of: (1) frequent drinking (3+ days in the past week), (2) loss of control over drinking (difficulty stopping, amnesia), (3) binge drinking (5+ standard drinks in a day) and (4) heavy binge drinking (20+ and 11+ standard drinks in a day for males and females, respectively). Young Adult Alcohol Use Disorder (AUD) was assessed at 3 yearly intervals (3 waves) across the 20s (mean ages 20.7 through 29.1 years). Results We show that patterns of teen drinking characterised by loss of control increase risk for AUD across young adulthood: loss of control over drinking (one wave OR 1.4, 95% CI 1.1 to 1.8; two or more waves OR 1.9, CI 1.4 to 2.7); binge drinking (one wave OR 1.7, CI 1.3 to 2.3; two or more waves OR 2.0, CI 1.5 to 2.6), and heavy binge drinking (one wave OR 2.0, CI 1.4 to 2.8; two or more waves OR 2.3, CI 1.6 to 3.4). This is not so for frequent drinking, which was unrelated to later AUD. Although drinking was more common in males, there was no evidence of sex differences in risk relationships. Conclusions Our results extend previous work by showing that patterns of drinking that represent loss of control over alcohol consumption (however expressed) are important targets for intervention. In addition to current policies that may reduce overall consumption, emphasising prevention of more extreme teenage bouts of alcohol consumption appears warranted. PMID:26868948

  13. Neurophysiological Measures and Alcohol Use Disorder (AUD): Hypothesizing Links between Clinical Severity Index and Molecular Neurobiological Patterns

    Science.gov (United States)

    Vitali, Mario; Napolitano, Carmen; Berman, Marlene Oscar; Minuto, Simona Flamminii; Battagliese, Gemma; Attilia, Maria Luisa; Braverman, Eric R; Romeo, Marina; Blum, Kenneth; Ceccanti, Mauro

    2016-01-01

    Background In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics. Materials and Methods 191 alcoholics were recruited in a Day Hospital (DH) setting at the Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome. After 7 days detoxification treatment a psychodiagnostic protocol was administered, including TCI, VAS-C, ASI and SADQ. All patients signed an Institutional Review Board (IRB) approved informed consent. Results Principally, we detected a significant positive correlation between HA-scale scores and the VAS scale: increasing in HA-scale corresponds to an increase in craving perception for both intensity (r=0.310; p ≤ 0.001) and frequency (r=0.246; p ≤ 0.001). Moreover, perception of dependence severity, measured with SADQ was also found to be significantly associated positively to both HA-scale (r=0.246; p ≤ 0.001) and NS-scale (r=0.224; p ≤ 0.01). While, for character scales, Persistence (r=−0.195; p=.008) and Self-directedness (r=−0.294; p ≤ 0.001) was negatively associated with ASI linked to alcohol problems. Self-directedness was also negatively correlated with ASI linked to family and social problems (r=−0.349; p ≤ 0.001), employment and support problems (r=−0.220; p=0.003) and psychiatric problems (r=−0.358; p ≤ 0.001). Cooperativeness was a negative correlate with Legal Problems (r=−0.173; p=0.019). and Self

  14. Treatment of alcohol dependence in patients with co-morbid major depressive disorder – predictors for the outcomes with memantine and escitalopram medication

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    Lönnqvist Jouko

    2008-10-01

    Full Text Available Abstract Background Alcohol dependence comorbid with major depressive disorder poses a major challenge in the clinical setting. The results in the treatment with selective serotonin re-uptake inhibitors have been conflicting. Thus, we compared in alcohol-dependent patients with co-morbid major depressive disorder the selective serotonin re-uptake inhibitor escitalopram to a compound that acts on different transporter system and may reduce craving, the glutamate receptor antagonist memantine. Methods Eighty alcohol-dependent patients comorbid with major depressive disorder in municipal alcohol clinics were randomized 1:1 to receive memantine 20 mg or escitalopram 20 mg in a double-blind manner. During the 26-week study period patients continued their routine treatment at the clinics. Abstinence was not required but encouraged. The patients attended visits weekly during the first month, and then at 3 and at 6 months. Outcome measures were Alcohol Use Disorders Identification Test (AUDIT, Obsessive Compulsive Drinking Scale (OCDS and Drinking Diary. Results The completion rate was high in both groups, especially among the patients who had been abstinent at the beginning of the study. However, among those patients who were not abstinent at baseline, 47% in both groups discontinued the study. Numbers of abstinent days were high in both groups throughout the study. Alcohol consumption measured by the AUDIT QF (quantity-frequency score was significantly reduced in both groups, as was the craving for alcohol measured by the OCDS. Early age at first alcohol intoxication predicted poor treatment outcomes in patients treated with escitalopram, and the same was seen with the early onset of the first depressive episode. The same predictive effects were not found in patients treated with memantine. Conclusion Our results indicate that both memantine and escitalopram are useful adjunct medications for the treatment of alcohol dependence co-morbid with major

  15. Sex-related differences in auditory processing in adolescents with fetal alcohol spectrum disorder: A magnetoencephalographic study

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    Claudia D. Tesche

    2015-01-01

    Full Text Available Children exposed to substantial amounts of alcohol in utero display a broad range of morphological and behavioral outcomes, which are collectively referred to as fetal alcohol spectrum disorders (FASDs. Common to all children on the spectrum are cognitive and behavioral problems that reflect central nervous system dysfunction. Little is known, however, about the potential effects of variables such as sex on alcohol-induced brain damage. The goal of the current research was to utilize magnetoencephalography (MEG to examine the effect of sex on brain dynamics in adolescents and young adults with FASD during the performance of an auditory oddball task. The stimuli were short trains of 1 kHz “standard” tone bursts (80% randomly interleaved with 1.5 kHz “target” tone bursts (10% and “novel” digital sounds (10%. Participants made motor responses to the target tones. Results are reported for 44 individuals (18 males and 26 females ages 12 through 22 years. Nine males and 13 females had a diagnosis of FASD and the remainder were typically-developing age- and sex-matched controls. The main finding was widespread sex-specific differential activation of the frontal, medial and temporal cortex in adolescents with FASD compared to typically developing controls. Significant differences in evoked-response and time–frequency measures of brain dynamics were observed for all stimulus types in the auditory cortex, inferior frontal sulcus and hippocampus. These results underscore the importance of considering the influence of sex when analyzing neurophysiological data in children with FASD.

  16. Andel av Befolkningen i Norge Med et Risikofylt Alkoholkonsum Målt Gjennom Alcohol Use Disorders Identification Test (AUDIT

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    Halkjelsvik Torleif

    2015-03-01

    Full Text Available AIMS - To estimate the proportion of the Norwegian population that according to the World Health Organization (WHO guidelines should be followed up by primary health care, based on three levels of risk drinking. We also investigated the relationship between risky drinking and demographic variables (gender, age and education. MATERIALS & METHODS - In 2012 and 2013 Statistics Norway conducted 4048 telephone interviews on a random sample of the population aged 16-79 (55.3% response rate. The Alcohol Use Disorders Identification Test (AUDIT, a screening instrument for primary health care, was used to identify potential problem drinking. We used descriptive statistics and linear regression analysis. RESULTS - Approximately 17% of the sample scored within the WHO-recommended limits for simple advice and/or further monitoring. Of these, 2% scored above the limit for the two most serious risk categories. Risky drinking was most prevalent among men, especially those aged 16-50. Among women, there was most risky drinking in the 16-30 age group. The regression analysis showed that age, gender and education predicted AUDIT sum scores. CONCLUSION - A large proportion scored within the least serious risk group, where simple advice to cut down on alcohol is the recommended measure. This group mostly consisted of younger respondents (16-30 years, and a large majority were men (age categories 20 and older. These are individuals who do not necessarily have an alcohol problem, but are at increased risk for negative consequences such as injury during intoxication, and/or developing misuse or dependence over time.

  17. Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Grant, B F; Goldstein, R B; Chou, S P; Huang, B; Stinson, F S; Dawson, D A; Saha, T D; Smith, S M; Pulay, A J; Pickering, R P; Ruan, W J; Compton, W M

    2009-11-01

    The objective of this study was to present nationally representative findings on sociodemographic and psychopathologic predictors of first incidence of Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) substance, mood and anxiety disorders using the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. One-year incidence rates of DSM-IV substance, mood and anxiety disorders were highest for alcohol abuse (1.02), alcohol dependence (1.70), major depressive disorder (MDD; 1.51) and generalized anxiety disorder (GAD; 1.12). Incidence rates were significantly greater (Pdisorders and greater among women for mood and anxiety disorders except bipolar disorders and social phobia. Age was inversely related to all disorders. Black individuals were at decreased risk of incident alcohol abuse and Hispanic individuals were at decreased risk of GAD. Anxiety disorders at baseline more often predicted incidence of other anxiety disorders than mood disorders. Reciprocal temporal relationships were found between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. Borderline and schizotypal personality disorders predicted most incident disorders. Incidence rates of substance, mood and anxiety disorders were comparable to or greater than rates of lung cancer, stroke and cardiovascular disease. The greater incidence of all disorders in the youngest cohort underscores the need for increased vigilance in identifying and treating these disorders among young adults. Strong common factors and unique factors appear to underlie associations between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. The major results of this study are discussed with regard to prevention and treatment implications.

  18. A Comparison of the Alcohol Use Disorder Identification Test (AUDIT) in General Population Surveys in nine European Countries

    DEFF Research Database (Denmark)

    Bloomfield, Kim; Knibbe, Ronald; Derickx, Mieke

    2006-01-01

    Aims: This study explored the suitability of the Alcohol Use Disorder Identification Test (AUDIT) for cross-national comparable estimates of problem drinking in general populations. On the item level the focus is on responsiveness to cross-national and gender differences. For the set of items...... the focus is on intercorrelations between items, indicating to what extent the AUDIT constitutes a scale. Methods: General population surveys from nine European countries were included. Cross-tabulations were used to analyse cross-national and gender differences in scores on the items. Reliability analysis......'. The reliability analysis shows that in eight of the nine countries frequency of drinking lowers the alpha. Injury and concern of others lead to a lower internal consistency in three countries. Conclusions: There was sufficient variation between countries in the pattern of responses and variation in gender...

  19. Sensory processing, school performance, and adaptive behavior of young school-age children with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Jirikowic, Tracy; Olson, Heather Carmichael; Kartin, Deborah

    2008-05-01

    This study described sensory processing behaviors and sensory-motor abilities in children with fetal alcohol spectrum disorders (FASD) and explored their relationship to home and school function. A clinic-referred sample of 25 children with FASD, ages 5 to 8 years, was compared with 26 children with typical development, balanced for age, gender, and race/ethnicity, on standardized tests examining sensory processing, sensory-motor performance, school performance, and adaptive behavior. Children with FASD scored significantly more poorly on sensory processing, sensory-motor, adaptive, and academic achievement measures, and demonstrated more problem behaviors at home and school. Correlations were significant between measures of sensory processing and sensory-motor performance, adaptive behavior, and some aspects of academic performance. Sensory processing and related foundational sensory-motor impairments should be considered when determining the developmental needs of children with FASD. These impairments may co-occur with and contribute, at least in part, to decreased adaptive and school function.

  20. Feasibility, Acceptability, and Impact of a Web-based Gratitude Exercise among Individuals in Outpatient Treatment for Alcohol Use Disorder

    Science.gov (United States)

    Krentzman, Amy R.; Mannella, Kristin A.; Hassett, Afton L.; Barnett, Nancy P.; Cranford, James A.; Brower, Kirk J.; Higgins, Margaret M.; Meyer, Piper S.

    2015-01-01

    This mixed-methods pilot study examined the feasibility, acceptability, and impact of a web-based gratitude exercise (the ‘Three Good Things’ exercise (TGT)) among 23 adults in outpatient treatment for alcohol use disorder (AUD). Participants were randomized to TGT or a placebo condition. The intervention was feasible with high rates of completion. Participants found TGT acceptable and welcomed the structure of daily emails; however, they found it difficult at times and discontinued TGT when the study ended. Participants associated TGT with gratitude, although there were no observed changes in grateful disposition over time. TGT had a significant effect on decreasing negative affect and increasing unactivated (e.g., feeling calm, at ease) positive affect, although there were no differences between groups at the 8 week follow up. Qualitative results converged on quantitative findings that TGT was convenient, feasible, and acceptable, and additionally suggested that TGT was beneficial for engendering positive cognitions and reinforcing recovery. PMID:27076837

  1. A multinational deployment of 3D laser scanning to study craniofacial dysmorphology in fetal alcohol spectrum disorders

    Science.gov (United States)

    Rogers, Jeff; Wernert, Eric; Moore, Elizabeth; Ward, Richard; Wetherill, Leah F.; Foroud, Tatiana

    2007-01-01

    Craniofacial anthropometry (the measurement and analysis of head and face dimensions) has been used to assess and describe abnormal craniofacial variation (dysmorphology) and the facial phenotype in many medical syndromes. Traditionally, anthropometry measurements have been collected by the direct application of calipers and tape measures to the subject's head and face, and can suffer from inaccuracies due to restless subjects, erroneous landmark identification, clinician variability, and other forms of human error. Three-dimensional imaging technologies promise a more effective alternative that separates the acquisition and measurement phases to reduce these variabilities while also enabling novel measurements and longitudinal analysis of subjects. Indiana University (IU) is part of an international consortium of researchers studying fetal alcohol spectrum disorders (FASD). Fetal alcohol exposure results in predictable craniofacial dysmorphologies, and anthropometry has been proven to be an effective diagnosis tool for the condition. IU is leading a project to study the use of 3D surface scanning to acquire anthropometry data in order to more accurately diagnose FASD, especially in its milder forms. This paper describes our experiences in selecting, verifying, supporting, and coordinating a set of 3D scanning systems for use in collecting facial scans and anthropometric data from around the world.

  2. Clinical improvements in adopted children with fetal alcohol spectrum disorders through neurodevelopmentally informed clinical intervention: A pilot study.

    Science.gov (United States)

    Zarnegar, Zohreh; Hambrick, Erin P; Perry, Bruce D; Azen, Stanley P; Peterson, Cassandra

    2016-10-01

    Research on early intervention for young children (infants and toddlers) with fetal alcohol spectrum disorders (FASD), particularly children with comorbid maltreatment experiences, is limited. Existing research has primarily focused on structuring environments to be responsive to the needs experienced by children with FASD rather than improving their functioning. The purpose of this study is to present outcomes from an early psychosocial intervention with 10 adopted, maltreated young children diagnosed with FASD, aged 10-53 months (M = 35 months), and their adoptive parents. The potential for early, targeted interventions to improve developmental outcomes for children with prenatal alcohol exposure was examined, as well as improving the skills of and reducing stress experienced by their adoptive parents. Based on the outcomes of a neurodevelopmentally informed assessment protocol, the 10 children whose data are presented were recommended to receive a range of regulatory, somatosensory, relational, and cognitive enrichments. As part of their treatment, children and caregivers received Child-Parent Psychotherapy (CPP), and caregivers (here, adoptive parents) also received Mindful Parenting Education (MPE). Related-samples Wilcoxon signed-rank tests indicated that scores of several measures of child developmental functioning improved from pre- to post-intervention and that parents' caregiving skills improved while their caregiving stress decreased. Reliable change analyses indicated that change observed from pre- to post-intervention was reliable. The promise of using neurodevelopmentally informed assessment strategies to sequence interventions for young children with diverse neurodevelopmental insults is discussed.

  3. Enhancing Learning Environments for Students Affected by Fetal Alcohol Spectrum Disorders: An Exploratory Study of Canadian Pre-Service Teacher Knowledge and Conceptions

    Science.gov (United States)

    Pei, Jacqueline; Job, Jenelle; Poth, Cheryl; O'Brien-Langer, Anna; Tang, Wei

    2015-01-01

    There is a pressing need for enhancing the learning environment for students affected by Fetal Alcohol Spectrum Disorders (FASDs). To develop relevant professional learning opportunities for teachers, a logical initial step is to explore the extent to which pre-service teachers accurately understand the unique neuropsychological functioning…

  4. Integrating Case Topics in Medical School Curriculum to Enhance Multiple Skill Learning: Using Fetal Alcohol Spectrum Disorders as an Exemplary Case

    Science.gov (United States)

    Paley, Blair; O'Connor, Mary J.; Baillie, Susan J.; Guiton, Gretchen; Stuber, Margaret L.

    2009-01-01

    Objectives: This article describes the use of fetal alcohol spectrum disorders (FASDs) as a theme to connect the learning of basic neurosciences with clinical applications across the age span within a systems-based, integrated curricular structure that emphasizes problem-based learning. Methods: In collaboration with the Centers for Disease…

  5. Cue-Elicited Affect and Craving: Advancement of the Conceptualization of Craving in Co-Occurring Posttraumatic Stress Disorder and Alcohol Dependence

    Science.gov (United States)

    Nosen, Elizabeth; Nillni, Yael I.; Berenz, Erin C.; Schumacher, Julie A.; Stasiewicz, Paul R.; Coffey, Scott F.

    2012-01-01

    Posttraumatic stress disorder (PTSD) commonly co-occurs with alcohol dependence (AD) and negatively affects treatment outcomes. Trauma-related negative affect enhances substance craving in laboratory cue-reactivity studies of AD individuals, but the role of positive affect has not been established. In this study, 108 AD treatment-seeking adults…

  6. The three year course of alcohol use disorders in the general population: DSM-IV, ICD-10 and the Craving Withdrawal Model

    NARCIS (Netherlands)

    C. de Bruijn; W. van den Brink; R. de Graaf; W.A.M. Vollebergh

    2006-01-01

    To determine the course of alcohol use disorders (AUD) in a prospective general population study using three different classification systems: Diagnostic and Statistical Manual version IV (DSM-IV), International Classification of Diseases version 10 (ICD-10) and the craving withdrawal model (CWM). T

  7. Socioeconomic Status, Psychological Distress, and Other Maternal Risk Factors for Fetal Alcohol Spectrum Disorders among American Indians of the Northern Plains

    Science.gov (United States)

    Lewis, Phyllis Trujillo; Shipman, Virginia C.; May, Philip A.

    2011-01-01

    The relationship of selected demographic, socioeconomic status (SES), and psychological characteristics was examined in interviews with 176 Northern Plains American Indian mothers whose children were referred to diagnostic clinics for evaluation of developmental disabilities, including fetal alcohol spectrum disorders (FASD). Thirty-nine mothers…

  8. A cross-sectional study of personality traits in women previously treated or untreated for alcohol use disorders

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    Sundh Valter

    2007-08-01

    Full Text Available Abstract Background A better understanding of the relationship between treatment-seeking for alcohol problems and personality traits could give useful insight in factors promoting or hindering treatment for alcohol use disorders (AUD. The aim of this study was to analyze the associations between treatment-seeking for AUD, personality traits, and psychiatric co-morbidity in women. The study was based on pooled cross-sectional data from three population based samples and one clinical sample (n = 1,339. Comparisons were made between treated and untreated women with AUD, and between those with resolved and unresolved AUD. Results A stepwise logistic regression model showed that treatment-seeking for AUD was not associated with personality traits. Among women with lifetime AUD (n = 217, those who had been treated (n = 42 had significantly higher scores than untreated women (n = 175 on three personality traits of the Karolinska Scales of Personality (KSP; somatic anxiety, muscular tension, and guilt. Women with resolved AUD, who had received treatment (n = 23 had significantly higher scores on scales measuring somatic anxiety, psychic anxiety, muscular tension, irritability, and guilt than untreated women with resolved AUD. The latter group resembled women without AUD on most personality traits. There were no differences in occurrence of lifetime psychiatric disorders between the treated and the untreated women, whereas treated women with current AUD had increased risk of lifetime anxiety (OR: 3.1, 95% CI: 1.1–8.7. Conclusion Treatment-seeking was not associated with personality traits in this study. Still, it can be concluded that women with resolved AUD who had received treatment had high scores on the KSP-scales measuring psychic and somatic anxiety, tension, irritability, and feelings of guilt. This suggests that personality assessment might be a useful tool in tailoring individual treatment programs for women with AUD. Future studies need to

  9. How many people have alcohol use disorders?: using the harmful dysfunction analysis to reconcile prevalence estimates in two community surveys

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    Jerome C Wakefield

    2014-02-01

    Full Text Available Community prevalence rates of alcohol use disorders (AUDs provided by epidemiological studies using DSM-based diagnostic criteria pose several challenges: the rates appear implausibly high to many epidemiologists; they do not converge across similar studies; and, due to low service utilization by those diagnosed as disordered, they yield estimates of unmet need for services so high that credibility for planning purposes is jeopardized. For example, two early community studies using DSM diagnostic criteria, the Epidemiologic Catchment Area Study (ECA and the National Comorbidity Survey (NCS, yielded lifetime AUD prevalence rates of 14% and 24%, respectively, with NCS unmet need for services 19% of the entire population. Attempts to address these challenges by adding clinical significance requirements to diagnostic criteria have proven unsuccessful. Hypothesizing that these challenges are due to high rates of false positive diagnoses of problem drinking as AUDs, we test an alternative approach. We use the harmful dysfunction (HD analysis of the concept of mental disorder as a guide to construct more valid criteria within the framework of the standard out-of-control model of AUD. The proposed HD criteria require harm and dysfunction, where harm can be any negative social, personal, or physical outcome, and dysfunction requires either withdrawal symptoms or inability to stop drinking. Using HD criteria, ECA and NCS lifetime prevalences converge to much-reduced rates of 6% and 6.8%, respectively. Due to higher service utilization rates, NCS lifetime unmet need is reduced to 3.4%. Service-use and duration comparisons suggest increased diagnostic validity. Moreover, HD criteria eliminate 90% of transient teenage drinking from disorder status. The HD version of the out-of-control model thus potentially resolves the three classic prevalence challenges while offering a more rigorous approach to distinguishing AUDs from problematic drinking.

  10. How Many People have Alcohol Use Disorders? Using the Harmful Dysfunction Analysis to Reconcile Prevalence Estimates in Two Community Surveys

    Science.gov (United States)

    Wakefield, Jerome C.; Schmitz, Mark F.

    2014-01-01

    Community prevalence rates of alcohol use disorders (AUDs) provided by epidemiological studies using DSM-based diagnostic criteria pose several challenges: the rates appear implausibly high to many epidemiologists; they do not converge across similar studies; and, due to low service utilization by those diagnosed as disordered, they yield estimates of unmet need for services so high that credibility for planning purposes is jeopardized. For example, two early community studies using DSM diagnostic criteria, the Epidemiologic Catchment Area Study (ECA) and the National Comorbidity Survey (NCS), yielded lifetime AUD prevalence rates of 14 and 24%, respectively, with NCS unmet need for services 19% of the entire population. Attempts to address these challenges by adding clinical significance requirements to diagnostic criteria have proven unsuccessful. Hypothesizing that these challenges are due to high rates of false-positive diagnoses of problem drinking as AUDs, we test an alternative approach. We use the harmful dysfunction (HD) analysis of the concept of mental disorder as a guide to construct more valid criteria within the framework of the standard out-of-control model of AUD. The proposed HD criteria require harm and dysfunction, where harm can be any negative social, personal, or physical outcome, and dysfunction requires either withdrawal symptoms or inability to stop drinking. Using HD criteria, ECA and NCS lifetime prevalences converge to much-reduced rates of 6 and 6.8%, respectively. Due to higher service utilization rates, NCS lifetime unmet need is reduced to 3.4%. Service use and duration comparisons suggest that HD criteria possess increased diagnostic validity. Moreover, HD criteria eliminate 90% of transient teenage drinking from disorder status. The HD version of the out-of-control model thus potentially resolves the three classic prevalence challenges while offering a more rigorous approach to distinguishing AUDs from problematic drinking. PMID

  11. Growth and weight status in treatment-naïve 12-16 year old adolescents with Alcohol Use Disorders in Cape Town, South Africa

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    Laubscher Ria

    2011-08-01

    Full Text Available Abstract Background Heavy alcohol consumption during adolescence has many known harmful health and social consequences and is strongly associated with numerous health risk behaviours. The consequences of heavy alcohol use during adolescence on nutritional status, specifically growth and weight status are largely unknown at this time. Methods Substance use, anthropometric indices of growth and weight, dietary energy intake and physical activity in heavy drinking adolescents (meeting DSM-IV criteria for alcohol use disorders and matched light/non-drinking control adolescents were assessed. Results Lifetime alcohol dose, measured in standard drinks of alcohol, was orders of magnitude higher in adolescents with alcohol use disorders (AUDs compared to controls. The AUDs group was selected to represent relatively 'pure' AUDs, with minimal other drug use and no psychiatric diagnoses. The growth and weight status of adolescents with AUDs were generally comparable to that of controls, and is in line with the growth and weight status of the South African adolescent population. A greater proportion of overweight/obese females was found in both groups, with this percentage tending to be greater, although not significantly so, in the AUDs group. Adolescent females with AUDs had increased odds of being overweight/obese compared to controls, after adjustment for smoking, physical activity and energy intake. Conclusion Anthropometric indices of growth and weight status of participants in the Control and AUD groups were generally comparable. Female adolescents with AUDs may have an increased risk of being overweight/obese compared to adolescent females without AUDs. The presence of an AUD in our adolescent sample was associated with higher energy intake. Longitudinal studies are needed to elucidate the effects of heavy alcohol use on energy balance, growth and weight status in adolescents as they age. Nonetheless, the current study contributes to our

  12. Predictive Capacity of Cloninger's temperament and character inventory (TCI-R) in alcohol use disorder outcomes.

    Science.gov (United States)

    Ávila Escribano, José Juan; Sánchez Barba, Mercedes; Álvarez Pedrero, Aida; López Villarreal, Ana; Recio Pérez, Joaquina; Rodríguez Rodilla, Manuela; Fraile García, Eulalia

    2016-06-14

    Objetivo: se pretende investigar la capacidad de predicción del inventario de temperamento y carácter de Cloninger (TCI-R) en la evolución de los trastornos por uso de alcohol. Metodología: Es un estudio longitudinal de 237 pacientes con trastornos por uso de alcohol, en tratamiento ambulatorio y seguimiento durante seis meses, cuya personalidad fue estudiada mediante el inventario TCI-R. Se analizó la puntuación de cada una de las dimensiones del inventario TCI-R en función de su situación (retención o abandono) al final del estudio. Resultados: La muestra presentaba puntuaciones  elevadas en búsqueda de novedad (BN) y evitación del daño (ED) y baja en autodirección (AD), definidas, estas últimas, como prominentes. El grupo que abandonó presentaba una puntuación significativamente (p= .004) más elevada en búsqueda de novedad (BN) que el grupo en seguimiento; además cuando la puntuación era superior al percentil 67 la probabilidad de abandonar era 1,07 veces superior. Conclusiones: El inventario de temperamento y carácter de Cloninger (TCI-R) es un buen instrumento para predecir la evolución de los pacientes con trastorno por uso de alcohol y la dimensión búsqueda de novedad (BN) está fuertemente relacionada con el abandono terapéutico.

  13. The appropriateness of the treatment setting for the inpatient post-acute treatment of alcohol dependence disorders in Switzerland

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    Odenwald Michael

    2009-07-01

    Full Text Available Abstract Background In Switzerland, a total of 1'000 patients a year are treated for alcohol-dependence in specialized institutions. Though the current literature suggests favoring outpatient treatment, whether outpatient or inpatient treatment is more efficient cannot be answered generally. For Germany, "AWMF"-treatment guidelines were formulated in order to treat patients with substance use disorders in the appropriate treatment settings. The aim of the present study was to test the hypothesis that the majority of patients treated in the largest specialized institution for alcohol abuse treatment in Switzerland were treated in the appropriate setting. Methods All completed treatments conducted in the Forel-Hospital – the largest clinic of its kind in Switzerland – between the 1st of January 2004 and the 20th of December 2006 were included in the investigation (n = 915. Patient and treatment characteristics were gathered using the information from the PSYREC and act-info questionnaire. The AWMF criteria were operationalized on the basis of the questionnaire. Results Applying the AWMF criteria resulted in the emergence of three groups: 73.7% of the study sample could clearly be assigned to the inpatient treatment group, and for 7.5% there was evidence supporting the allocation to an outpatient treatment setting. In 18.8% of the cases, however, the AWMF criteria did not allow an assignment to either of the treatment settings. Of the total sample, 18.5% of all patients apparently did not profit from the inpatient treatment setting, whereas for the vast majority (81.5%, a therapeutic progress was documented. In those patients who, according to the AWMF guidelines, did not need an inpatient setting, a larger proportion improved than in the group of the patients who needed an inpatient treatment in a specialized hospital. Furthermore, the logistic regression analyses revealed that the less severe the clinical state of a patient upon admittance

  14. Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients

    Science.gov (United States)

    Fleming, M. F.; Krupitsky, E.; Tsoy, M.; Zvartau, E.; Brazhenko, N.; Jakubowiak, W.; E. McCaul, M.

    2006-01-01

    SUMMARY SETTING: Alcohol use, tuberculosis (TB) drug resistance and human immunodeficiency virus (HIV) risk behavior are of increasing concern in Russian TB patients. DESIGN: A prevalence study of alcohol use and HIV risk behavior was conducted in a sample of 200 adult men and women admitted to TB hospitals in St Petersburg and Ivanovo, Russia. RESULTS: Of the subjects, 72% were men. The mean age was 41. Active TB was diagnosed using a combination of chest X-ray, sputum smears and sputum cultures. Sixty-two per cent met DSM-IV criteria for current alcohol abuse or dependence. Drug use was uncommon, with only two patients reporting recent intravenous heroin use. There was one case of HIV infection. The mean total risk assessment battery score was 3.4. Depression was present in 60% of the sample, with 17% severely depressed. Alcohol abuse/dependence was associated with an eight-fold increase in drug resistance (OR 8.58; 95% CI 2.09-35.32). Patients with relapsing or chronic TB were more likely to meet the criteria for alcohol abuse/dependence (OR 2.56; 95% CI 1.0-6.54). CONCLUSION: Alcohol use disorders are common in patients being treated for active TB, and are associated with significant morbidity. Additional surveys are needed to examine the relationship between alcohol use disorders and anti-tuberculosis drug resistance. CONTEXTE: Chezles patients tuberculeux russes, l’utilisation d’alcool, la résistance aux médicaments antituberculeux et un comportement à risque pour le virus de l’immunodéficience humaine (VIH) sont des sujets croissants d’inquiétude. SCHÉMA: Une étude: de prévalence de l’utilisation d’alcool et du comportement à risque pour le VIH a été menée sur un échantillon de 200 hommes et femmes adultes, admis dans des hôpitaux pour la tuberculose (TB) de Saint-Pétersbourg et d’Ivanovo en Russie. RÉSULTATS: Il y avait 72% d’hommes dans l’échantillon. L’âge moyen est de 41 ans. On a diagnostiqué la TB active par l

  15. Longitudinal course of panic disorder with and without agoraphobia using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

    Science.gov (United States)

    Nay, William; Brown, Ruth; Roberson-Nay, Roxann

    2013-06-30

    Few naturalistic, longitudinal studies of panic disorder with and without agoraphobia (PD/PDA) exist, limiting our knowledge of the temporal rates of incidence, relapse, and chronicity, or the factors that predict category transition. Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave 1 (n=43,093) and wave 2 (n=34,653) were utilized to determine transitional rates, and predictors of category transitions, over a 3-year period. Analyses revealed very high 3-year remission rates for PD and PDA (75% and 67%, respectively), although relapse also was relatively frequent (PD=12%; PDA=21%). Logistic regression revealed previous history of panic attacks, generalized anxiety disorder/major depression (GAD/MDD), nicotine dependence, female sex, younger age, and major financial crises to be reliable predictors of incidence and relapse. The direction and magnitude of association of many predictor variables were similar for PD and PDA, with notable exceptions for social anxiety and romantic relationship factors. Clinicians should be aware of the relapsing-remitting nature of PD and PDA and, thus, take caution to not reduce or eliminate effective treatments prematurely. Similarly, the current study suggests clinicians pay particular attention to concurrent factors relevant to relapse in PD/PDA that may also be clinically addressed (e.g., co-morbid MDD/GAD and nicotine dependence).

  16. Alcohol Use Disorders and Risk Factor Interactions for Adolescent Suicidal Ideation and Attempts.

    Science.gov (United States)

    Kelly, Thomas M.; Lynch, Kevin G.; Donovan, John E.; Clark, Duncan B.

    2001-01-01

    Adolescents diagnosed with at least one mental disorder were studied to determine predictors of suicidal ideation and suicide attempts. Major depression was predictive of suicidal ideation and attempts for both genders. Chronic stress was found predictive of male suicidal ideations, while low self esteem and family dysfunction were predictive in…

  17. Treating Inpatients with Comorbid Depression and Alcohol Use Disorders: A Comparison of Acceptance and Commitment Therapy

    Science.gov (United States)

    Petersen, Connie L.; Zettle, Robert D.

    2009-01-01

    Inpatients involuntarily committed to a chemical dependency unit and exhibiting a co-occurring depressive disorder received either individual sessions of acceptance and commitment therapy (ACT) or treatment as usual (TAU) within the context of an ongoing 12-step program. Results indicated significant, but equivalent, reductions in levels of…

  18. The NSW brain tissue resource centre: Banking for alcohol and major neuropsychiatric disorders research.

    Science.gov (United States)

    Sutherland, G T; Sheedy, D; Stevens, J; McCrossin, T; Smith, C C; van Roijen, M; Kril, J J

    2016-05-01

    The New South Wales Brain Tissue Resource Centre (NSWBTRC) at the University of Sydney (Australia) is an established human brain bank providing tissue to the neuroscience research community for investigations on alcohol-related brain damage and major psychiatric illnesses such as schizophrenia. The NSWBTRC relies on wide community engagement to encourage those with and without neuropsychiatric illness to consent to donation through its allied research programs. The subsequent provision of high-quality samples relies on standardized operational protocols, associated clinical data, quality control measures, integrated information systems, robust infrastructure, and governance. These processes are continually augmented to complement the changes in internal and external governance as well as the complexity and diversity of advanced investigation techniques. This report provides an overview of the dynamic process of brain banking and discusses the challenges of meeting the future needs of researchers, including synchronicity with other disease-focus collections.

  19. Cross-sectional study of sleep quantity and quality and amnestic and non-amnestic cognitive function in an ageing population: the English Longitudinal Study of Ageing (ELSA.

    Directory of Open Access Journals (Sweden)

    Michelle A Miller

    Full Text Available BACKGROUND: The aim was to investigate the association between sleep disturbances and cognitive function in younger and older individuals from an ageing population. METHODS: 3,968 male and 4,821 female white participants, aged 50 years and over, from the English Longitudinal Study of Ageing (ELSA were studied. Information on sleep quality and quantity as well as both amnestic (memory, ACF and non-amnestic (non-memory, nACF function was available at Wave 4 (2008. Analysis of covariance was used to evaluate the relationship between sleep and cognitive function. RESULTS: After adjustment for multiple confounders in the younger group (50-64 years duration of sleep explained 15.2% of the variance in ACF (p = 0.003 and 20.6% of nACF (p = 0.010. In the older group (65+ years the estimates were 21.3% (p<0.001 and 25.6% (p<0.001, respectively. For sleep quality, there was a statistically significant association between sleep quality and both ACF (p<0.001 and nACF (p<0.001 in the older age group, but not in the younger age group (p = 0.586 and p = 0.373, respectively; interaction between age and sleep quality in the study sample including both age groups: p<0.001 for ACF and p = 0.018 for nACF. Sleep quality explained between 15.1% and 25.5% of the variance in cognition. The interaction with age was independent of duration of sleep. At any level of sleep duration there was a steeper association between sleep quality and ACF in the older than the younger group. CONCLUSIONS: The associations between sleep disturbances and cognitive function vary between younger and older adults. Prospective studies will determine the temporal relationships between sleep disturbances and changes in cognition in different age groups.

  20. Avermectins differentially affect ethanol intake and receptor function: implications for developing new therapeutics for alcohol use disorders.

    Science.gov (United States)

    Asatryan, Liana; Yardley, Megan M; Khoja, Sheraz; Trudell, James R; Hyunh, Nhat; Louie, Stan G; Petasis, Nicos A; Alkana, Ronald L; Davies, Daryl L

    2014-06-01

    Our laboratory is investigating ivermectin (IVM) and other members of the avermectin family as new pharmaco-therapeutics to prevent and/or treat alcohol use disorders (AUDs). Earlier work found that IVM significantly reduced ethanol intake in mice and that this effect likely reflects IVM's ability to modulate ligand-gated ion channels. We hypothesized that structural modifications that enhance IVM's effects on key receptors and/or increase its brain concentration should improve its anti-alcohol efficacy. We tested this hypothesis by comparing the abilities of IVM and two other avermectins, abamectin (ABM) and selamectin (SEL), to reduce ethanol intake in mice, to alter modulation of GABAARs and P2X4Rs expressed in Xenopus oocytes and to increase their ability to penetrate the brain. IVM and ABM significantly reduced ethanol intake and antagonized the inhibitory effects of ethanol on P2X4R function. In contrast, SEL did not affect either measure, despite achieving higher brain concentrations than IVM and ABM. All three potentiated GABAAR function. These findings suggest that chemical structure and effects on receptor function play key roles in the ability of avermectins to reduce ethanol intake and that these factors are more important than brain penetration alone. The direct relationship between the effect of these avermectins on P2X4R function and ethanol intake suggest that the ability to antagonize ethanol-mediated inhibition of P2X4R function may be a good predictor of the potential of an avermectin to reduce ethanol intake and support the use of avermectins as a platform for developing novel drugs to prevent and/or treat AUDs.

  1. Medindo consumo de álcool: análise fatorial confirmatória do Alcohol Use Disorder Identification Test (AUDIT Midiendo consumo de alcohol: análisis factorial confirmatorio del Alcohol Use Disorder Identification Test (AUDIT Measuring alcohol consumption: confirmatory factor analysis of The Alcohol Use Disorder Identification Test (AUDIT

    Directory of Open Access Journals (Sweden)

    Walberto Silva dos Santos

    2013-04-01

    Full Text Available O presente estudo buscou verificar a adequação dos modelos uni e multifatoriais do AUDIT, bem como verificar sua validade convergente e de critério. Participaram da pesquisa 386 pessoas da população geral com idade média de 27,7 anos (dp=10,5. Além do AUDIT, os participantes responderam a dois instrumentos correlatos e a perguntas biossociodemográficas. As análises indicaram a adequação do modelo de três fatores, com índices de qualidade de ajuste (χ²/gl=63,29, CFI=0,98, AGFI=0,98 e RMSEA=0,05 estatisticamente superiores às estruturas uni e bifatoriais. Finalmente, por meio de correlações r de Pearson e da comparação de médias foram atestadas a validade convergente e de critério do AUDIT, assegurando sua proposta de medir o consumo de álcool e demonstrando sua aplicabilidade na triagem de bebedores-problema.Este estudio buscó verificar la adecuación de los modelos uni y multi-factoriales del AUDIT y verificar su validez convergente y de criterio. Participaron de la investigación 386 personas de la población general, con un promedio de edad de 27,7 años (DT=10,5. Además del AUDIT, los participantes respondieron a dos instrumentos correlativos y a cuestiones sociodemográficas. Los análisis indicaron la adecuación del modelo de tres factores, con los índices calidad de ajuste (χ ²/gl=63,29, CFI=0,98, AGFI=0,98 y RMSEA=0,05 estadísticamente superiores a las estructuras uni y bifactoriales. Finalmente, por medio de correlaciones r de Pearson y de comparación de las medias se comprobó la validez convergente y de criterio del AUDIT, asegurando su propuesta para medir el consumo de alcohol y demostrando su aplicabilidad en la detección de bebedores problema.This study aims to evaluate the adequacy of uni and multi-factorial models of AUDIT, as well as to verify its convergent and criterion validity. Participants consisted in 386 people from the general population with average age of 27.7 years (SD=10.5. In addition

  2. Aberrant development of post-movement beta rebound in adolescents and young adults with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Vakhtin, Andrei A; Kodituwakku, Piyadasa W; Garcia, Christopher M; Tesche, Claudia D

    2015-01-01

    Dependent on maternal (e.g. genetic, age) and exposure (frequency, quantity, and timing) variables, the effects of prenatal alcohol exposure on the developing fetus are known to vary widely, producing a broad range of morphological anomalies and neurocognitive deficits in offspring, referred to as fetal alcohol spectrum disorders (FASD). Maternal drinking during pregnancy remains a leading risk factor for the development of intellectual disabilities in the US. While few functional findings exist today that shed light on the mechanisms responsible for the observed impairments in individuals with FASD, animal models consistently report deleterious effects of early alcohol exposure on GABA-ergic inhibitory pathways. The post-motor beta rebound (PMBR), a transient increase of 15-30 Hz beta power in the motor cortex that follows the termination of movement, has been implicated as a neural signature of GABA-ergic inhibitory activity. Further, PMBR has been shown to be a reliable predictor of age in adolescents. The present study sought to investigate any differences in the development of PMBR between FASD and control groups. Beta event-related de-synchronization (ERD) and movement-related gamma synchronization (MRGS), although not clearly linked to brain maturation, were also examined. Twenty-two participants with FASD and 22 age and sex-matched controls (12-22 years old) underwent magnetoencephalography scans while performing an auditory oddball task, which required a button press in response to select target stimuli. The data surrounding the button presses were localized to the participants' motor cortices, and the time courses from the locations of the maximally evoked PMBR were subjected to wavelet analyses. The subsequent analysis of PMBR, ERD, and MRGS revealed a significant interaction between group and age in their effects on PMBR. While age had a significant effect on PMBR in the controls, no simple effects of age were detected in the FASD group. The FASD group

  3. Temporal associations between physical illnesses and mental disorders--results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

    Science.gov (United States)

    Chou, S Patricia; Huang, Boji; Goldstein, Risë; Grant, Bridget F

    2013-08-01

    Clinical and epidemiologic evidence has documented the significant associations between medical illnesses and psychiatric disorders. However, extensive research has focused on the comorbidity of medical conditions and depression, and most were cross sectional, focused on clinical samples, and grounded in DSM-III or DSM-III-R diagnostic criteria. The current prospective investigation examined associations among medical conditions at baseline and incident psychiatric disorders over a 3-year follow-up, using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Overall, the 3-year incidence rates of DSM-IV substance use, mood and anxiety disorders ranged from 0.65% (bipolar II) to 5.2% (alcohol abuse). Multiple regression analysis was conducted to examine the prospective physical-mental associations, while controlling for sociodemographic characteristics, psychological stress and health-related risk factors, and comorbid physical and psychiatric disorders. The present study represents, to our knowledge the largest population-based prospective study examining the physical-mental associations. Our results showed distinctly different patterns of comorbidity of medical illnesses with substance use, mood, and anxiety disorders. Stomach ulcer/gastritis, hypertension and arthritis emerged to be significant predictors of incident psychiatric disorders.

  4. Carbon-based building blocks for alcohol dehydration membranes with disorder-enhanced water permeability

    DEFF Research Database (Denmark)

    Boffa, Vittorio; Etmimi, H.; Mallon, P.E.

    2017-01-01

    separation membranes. In this work, a humic acid-like biopolymer (HAL), extracted from organic compost with a yield of ~ 20%, was used to fabricate composite GO-HAL membranes. The HAL brings a high degree of disorder to the membrane structure, with the benefit of an increased water permeation rate. Upon...... concerns about their stability at basic pH and under cross-flow conditions. The stabilization of graphene oxide can be achieved by thermal or chemical reduction; but stacked layers of reduced GO tend to form ordered and compact graphite-like structures, thus preventing their application as molecular...

  5. In their own words: Content analysis of pathways to recovery among individuals with the lived experience of homelessness and alcohol use disorders

    Science.gov (United States)

    Collins, Susan E.; Jones, Connor B.; Hoffmann, Gail; Nelson, Lonnie A.; Hawes, Starlyn M.; Grazioli, Véronique S.; Mackelprang, Jessica L.; Holttum, Jessica; Kaese, Greta; Lenert, James; Herndon, Patrick; Clifasefi, Seema L.

    2015-01-01

    Background Alcohol use disorders (AUDs) are more prevalent among homeless individuals than in the general population, and homeless individuals are disproportionately affected by alcohol-related morbidity and mortality. Unfortunately, abstinence-based approaches are neither desirable to nor highly effective for most members of this population. Recent research has indicated that homeless people aspire to clinically significant recovery goals beyond alcohol abstinence, including alcohol harm reduction and quality-of-life improvement. However, no research has documented this population’s preferred pathways toward self-defined recovery. Considering principles of patient-centred care, a richer understanding of this population’s desired pathways to recovery may help providers better engage and support them. Methods Participants (N = 50) had lived experience of homelessness and AUDs and participated in semi-structured interviews regarding histories of homelessness, alcohol use, and abstinence-based treatment as well as suggestions for improving alcohol treatment. Conventional content analysis was used to ascertain participants’ perceptions of abstinence-based treatment and mutual-help modalities, while it additionally revealed alternative pathways to recovery. Results Most participants reported involvement in abstinence-based modalities for reasons other than the goal of achieving long-term abstinence from alcohol (e.g., having shelter in winter months, “taking a break” from alcohol use, being among “like-minded people”). In contrast, most participants preferred alternative pathways to recovery, including fulfilling basic needs (e.g., obtaining housing), using harm reduction approaches (e.g., switching from higher to lower alcohol content beverages), engaging in meaningful activities (e.g., art, outings, spiritual/cultural activities), and making positive social connections. Conclusions Most people with the lived experience of homelessness and AUDs we

  6. Longitudinal MRI reveals altered trajectory of brain development during childhood and adolescence in fetal alcohol spectrum disorders.

    Science.gov (United States)

    Treit, Sarah; Lebel, Catherine; Baugh, Lauren; Rasmussen, Carmen; Andrew, Gail; Beaulieu, Christian

    2013-06-12

    Diffusion tensor imaging (DTI) of brain development in fetal alcohol spectrum disorders (FASD) has revealed structural abnormalities, but studies have been limited by the use of cross-sectional designs. Longitudinal scans can provide key insights into trajectories of neurodevelopment within individuals with this common developmental disorder. Here we evaluate serial DTI and T1-weighted volumetric MRI in a human sample of 17 participants with FASD and 27 controls aged 5-15 years who underwent 2-3 scans each, ∼2-4 years apart (92 scans total). Increases of fractional anisotropy and decreases of mean diffusivity (MD) were observed between scans for both groups, in keeping with changes expected of typical development, but mixed-models analysis revealed significant age-by-group interactions for three major white matter tracts: superior longitudinal fasciculus and superior and inferior fronto-occipital fasciculus. These findings indicate altered developmental progression in these frontal-association tracts, with the FASD group notably showing greater reduction of MD between scans. ΔMD is shown to correlate with reading and receptive vocabulary in the FASD group, with steeper decreases of MD in the superior fronto-occipital fasciculus and superior longitudinal fasciculus between scans correlating with greater improvement in language scores. Volumetric analysis revealed reduced total brain, white, cortical gray, and deep gray matter volumes and fewer significant age-related volume increases in the FASD group, although age-by-group interactions were not significant. Longitudinal DTI indicates delayed white matter development during childhood and adolescence in FASD, which may underlie persistent or worsening behavioral and cognitive deficits during this critical period.

  7. Transcranial magnetic stimulation:potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders

    Institute of Scientific and Technical Information of China (English)

    Amy AHerrold; Sandra LKletzel; Brett CHarton; R.Andrew Chambers; Neil Jordan; Teresa Louise-Bender Pape

    2014-01-01

    Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress dis-order (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, relfective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimu-lation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI +PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological ifndings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identiifed by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review arti-cles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.

  8. Alcohol disorder in 15 cases of clinical analysis%酒精性精神障碍15例临床分析

    Institute of Scientific and Technical Information of China (English)

    谭正强; 黎明

    2014-01-01

    目的:报道15例酒精性精神障碍患者的综合治疗体会。方法应用药物与心理治疗结合,治疗15例酒精性精神障碍患者。结果显效12例,好转3例,总有效率100%。结论综合治疗药物副作用小,疗效稳定。%objective to report of comprehensive treatment of 15 patients with alcohol disorder experience combination of medication and psychotherapy method application, the treatment of 15 patients with alcohol disorder results 12 cases were markedly effective, improvement in 3 cases, total effective rate 100% conclusion comprehensive treatment of drug side effects, efficacy and stability.

  9. Smoking, consumption of alcohol and sedentary life style in population grouping and their relationships with lipemic disorders

    Directory of Open Access Journals (Sweden)

    Salas Martins Ignez

    1995-01-01

    Full Text Available The study, part of the project "Atherosclerotic cardiovascular diseases, lipemic disorders, hypertension, obesity and diabetis mellitus in a population of the metropolitan area of the southeastern region of Brazil", had the following objectives: a the characterization and distribution among typical human socio-economic groupings, of the prevalence of some particular habits which constitute aspects of life-style-the use of tobacco, the use of alcohol and sedentary activity; b the establishment of the interrelation between the above-mentioned habits and some lipemic disorders. The prevalence of the habits cited behaved in the following manner: the use of tobacco predominated among men, distributed uniformly throughout the social strata; among the women the average percentage of smokers was 18,9%, a significant difference occurring among the highest socio-economic class, where the average was of 40.2%. The sedentary style of life presented high prevalence, among both men and women with exception of the women of the highest socio-economic level and of the skilled working class. The use of alcohol, as one would expect, is a habit basically practised by the men, without any statistically significant differences between classes. For the purpose of establishing associations between these risk fictors and lipemic conditions four situations were chosen, of the following characteristics: 1- total cholesterol > or = 220 mg/dl and triglycerides > or = 150 mg/dl; 2- HDL cholesterol or = 150 mg/dl; 3- HDL cholesterol or = 150 mg/dl, and the following independent variables: age, use of tobacco and the interactions between obesity and smoking, age and sedentary lifestyle, sex and obesity (R2=22%; the standardized B coefficient showed that the variables with the greatest weight in the forecasting of the variation in the levels of cholesterol were smoking and the interaction between obesity and smoking. The hypercholesterolemia accompanied by triglycerides levels

  10. The Diffusion of Acamprosate for the Treatment of Alcohol Use Disorder: Results from a National Longitudinal Study

    Science.gov (United States)

    Knudsen, Hannah K.; Roman, Paul M.

    2015-01-01

    To consider how the Affordable Care Act may impact the diffusion of acamprosate, an evidence-based treatment for alcohol use disorder (AUD), the present study estimated the associations between acamprosate availability, Medicaid revenues, and private insurance revenues. Data were collected from organizational leaders of national samples of 307 specialty treatment centers in 2009-2012 and 372 treatment centers in 2011-2013. Notably, there was not a significant change in the percentage of organizations offering acamprosate over the study period. However, greater reliance on Medicaid and private insurance as sources of revenue was positively associated with the availability of acamprosate. In addition, acamprosate availability was positively associated with access to physicians and the presence of on-site primary medical care, while centers that placed greater emphasis on confrontational group therapy were significantly less likely to offer acamprosate for AUD treatment. To the extent that the ACA is expanding the number of insured individuals enrolled in Medicaid and commercial insurance sold through health insurance exchanges, this study suggests that the ACA may hold promise for expanding the availability of this EBP for AUD treatment. Future research is needed to measure whether this potential impact actually occurs within the specialty treatment system over time. PMID:26689318

  11. Prenatal and childhood growth, and hospitalization for alcohol use disorders in adulthood: the Helsinki birth cohort study.

    Directory of Open Access Journals (Sweden)

    Jari Lahti

    Full Text Available BACKGROUND: Small birth size - an indicator of a sub-optimal prenatal environment - and variation in growth after birth have been associated with non-communicable diseases in later life. We tested whether birth size or growth in childhood associated with the risk of hospital admission for alcohol use disorders (AUDs from early to late adulthood. METHODS: The sample comprised 6544 men and 6050 women born between 1934 and 1944 in Helsinki, Finland. Data on anthropometric measures were extracted from medical records and diagnoses of AUD from the Finnish Hospital Discharge Register and Causes of Death Register covering a 40-year period from 1969 to 2008. RESULTS: Altogether 171 women (2.8% and 657 men (10.0% were diagnosed at a hospital with AUD. After adjusting for major confounders, shorter length at birth, shorter height up to two years of age, and lower weight at two years associated with hospitalization for AUD in women. In men, slower growth in height, particularly from 2 to 7 years, and slower weight gain from 7 to 11 years as well as shorter height and lower weight at 7 and 11 years associated with a diagnosis of AUD in men. CONCLUSIONS: Pre- and postnatal growth associates with the risk for AUD later in life differently in women than in men: the fetal period and infancy seem to be the sensitive periods for women, whereas those for men the occur from toddlerhood onwards.

  12. Pedofilia, transtorno bipolar e dependência de álcool e opioides Paedophilia, bipolar disorder and alcohol and opioid dependence

    Directory of Open Access Journals (Sweden)

    Vanessa Fabiane Machado Gomes Marsden

    2009-01-01

    Full Text Available Diversos estudos investigaram a relação entre psicopatologia e parafilias, especialmente pedofilia. Transtornos de humor e ansiedade, seguidos de transtornos relacionados ao uso de substâncias, são as comorbidades mais prevalentes em pacientes com parafilias. Apresentou- se o caso de um paciente em tratamento para dependência de substâncias (álcool e heroína, transtorno bipolar e pedofilia. É importante frisar que poucos casos relatando comorbidades como essas foram descritos na literatura.Many studies have investigated the relationship between psychopathology and paraphilias, specifically paedophilia. Mood disorders, anxiety disorders, followed by substance use were the most prevalent disorders comorbid in these patients. We present the case of a patient in treatment for substance misuse (alcohol and heroin, bipolar disorder and paedophilia. To our knowledge few cases were reported describing cases of comorbidity such as this.

  13. Applicability of the Rivermead Behavioural Memory Test – Third Edition (RBMT-3 in Korsakoff's syndrome and chronic alcoholics

    Directory of Open Access Journals (Sweden)

    Wester AJ

    2013-06-01

    planning and adjustment in patients with alcohol-related cognitive impairments. Keywords: ecological validity, neuropsychological assessment, Korsakoff's syndrome, alcohol-induced persisting amnestic disorder, episodic memory, treatment outcome

  14. The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review : Alcohol and the HIV Continuum of Care.

    Science.gov (United States)

    Vagenas, Panagiotis; Azar, Marwan M; Copenhaver, Michael M; Springer, Sandra A; Molina, Patricia E; Altice, Frederick L

    2015-12-01

    Alcohol use is highly prevalent globally with numerous negative consequences to human health, including HIV progression, in people living with HIV (PLH). The HIV continuum of care, or treatment cascade, represents a sequence of targets for intervention that can result in viral suppression, which ultimately benefits individuals and society. The extent to which alcohol impacts each step in the cascade, however, has not been systematically examined. International targets for HIV treatment as prevention aim for 90 % of PLH to be diagnosed, 90 % of them to be prescribed with antiretroviral therapy (ART), and 90 % to achieve viral suppression; currently, only 20 % of PLH are virally suppressed. This systematic review, from 2010 through May 2015, found 53 clinical research papers examining the impact of alcohol use on each step of the HIV treatment cascade. These studies were mostly cross-sectional or cohort studies and from all income settings. Most (77 %) found a negative association between alcohol consumption on one or more stages of the treatment cascade. Lack of consistency in measurement, however, reduced the ability to draw consistent conclusions. Nonetheless, the strong negative correlations suggest that problematic alcohol consumption should be targeted, preferably using evidence-based behavioral and pharmacological interventions, to indirectly increase the proportion of PLH achieving viral suppression, to achieve treatment as prevention mandates, and to reduce HIV transmission.

  15. Is Alcohol Use Disorder Identification Test (AUDIT or its shorter versions more useful to identify risky drinkers in a Chinese population? A diagnostic study.

    Directory of Open Access Journals (Sweden)

    Benjamin H K Yip

    Full Text Available To examine the diagnostic performance of shorter versions of Alcohol Use Disorder Identification Test (AUDIT, including Alcohol Consumption (AUDIT-C, in identifying risky drinkers in primary care settings using conventional performance measures, supplemented by decision curve analysis and reclassification table.A cross-sectional study of adult males in general outpatient clinics in Hong Kong. The study included only patients who reported at least sometimes drinking alcoholic beverages. Timeline follow back alcohol consumption assessment method was used as the reference standard. A Chinese translated and validated 10-item AUDIT (Ch-AUDIT was used as a screening tool of risky drinking.Of the participants, 21.7% were classified as risky drinkers. AUDIT-C has the best overall performance among the shorter versions of Ch-AUDIT. The AUC of AUDIT-C was comparable to Ch-AUDIT (0.898 vs 0.901, p-value = 0.959. Decision curve analysis revealed that when the threshold probability ranged from 15-30%, the AUDIT-C had a higher net-benefit than all other screens. AUDIT-C improved the reclassification of risky drinking when compared to Ch-AUDIT (net reclassification improvement = 0.167. The optimal cut-off of AUDIT-C was at ≥5.Given the rising levels of alcohol consumption in the Chinese regions, this Chinese translated 3-item instrument provides convenient and time-efficient risky drinking screening and may become an increasingly useful tool.

  16. Treatment of Anxiety Disorders and Comorbid Alcohol Abuse with Buspirone in a Patient with Antidepressant-Induced Platelet Dysfunction: A Case Report

    Directory of Open Access Journals (Sweden)

    Mir Mazhar

    2013-01-01

    Full Text Available The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient’s underlying qualitative platelet dysfunction. Treatment with venlafaxine, citalopram, escitalopram, and clomipramine resulted in improvement and anxiety symptoms, as well as reduction in alcohol use, but pharmacological treatment has to be discontinued because of bruising and hematomas. In view of an active substance use disorder, benzodiazepines were avoided as a treatment option. The patient’s anxiety symptoms and comorbid alcohol abuse responded well to pharmacological treatment with buspirone which gradually titrated up to a dose of 30 mg BID. Patient was followed for around a six-month period while she was on buspirone before being discharged to family doctor’s care. Buspirone is unlikely to have a significant effect on platelet serotonin transponder and could be an effective alternative for pharmacological treatment of anxiety in patients with a bleeding diathesis.

  17. False Recognition Helps to Distinguish Patients with Alzheimer's Disease and Amnestic MCI from Patients with Other Kinds of Dementia

    NARCIS (Netherlands)

    Hildebrandt, H.; Haldenwanger, A.; Eling, P.A.T.M.

    2009-01-01

    Two recent reviews on neuropsychological assessment argue that Alzheimer's disease (AD) is characterized by deficits in delayed recall and that this allows differentiating AD from other types of dementia. We attempted to differentiate patients with AD and amnestic mild cognitive impairment (MCI) fro

  18. Impacto del trastorno por consumo de alcohol en la mortalidad: ¿hay diferencias según la edad y el sexo? Impact of alcohol use disorder on mortality: are there age and gender differences?

    Directory of Open Access Journals (Sweden)

    Anna M. Guitart

    2011-10-01

    Full Text Available Objetivos: Estimar el exceso de mortalidad en pacientes con trastorno por consumo de alcohol y calcular el impacto poblacional que puede atribuirse a dicho trastorno, haciendo especial énfasis en las diferencias según sexo y edad. Métodos: Estudio longitudinal de cohorte dinámica de tipo retrospectivo. Se reclutaron 7109 pacientes (76,5% hombres de 18 a 64 años de edad que iniciaron tratamiento ambulatorio durante el periodo 1997-2006. El seguimiento de las defunciones se realizó mediante el registro de mortalidad del Instituto Nacional de Estadística. Se estimó la razón de mortalidad estandarizada (SMR según la edad y el sexo, y el riesgo atribuible poblacional (RAP por grupo de edad. Resultados: Murieron 557 personas (83% hombres. El exceso de mortalidad total fue ocho veces mayor respecto a la población general de 18-64 años de edad, y especialmente en el grupo de 25-34 años (SMR: 11,2 [intervalo de confianza del 95% (IC95%: 7,8-16,0] en hombres y 24 [IC95%: 11,5-50,4] en mujeres. Se observaron diferencias significativas según el sexo en todas las variables analizadas. En Barcelona ciudad, se estimó que el trastorno por consumo de alcohol ocasionaba 73 muertes al año; el 3,3% del total de defunciones de la ciudad en esta franja de edad. Este porcentaje era notablemente más alto en el grupo de 25-34 años (RAP: 19,4% [IC95%: 19,2-19,6] y en el de 18-24 años (RAP: 11,1% [IC95%: 10,7-11,4]. Conclusiones: Los jóvenes y las mujeres con trastorno por consumo de alcohol tienen un riesgo elevado de mortalidad prematura. Para prevenirla debería mejorarse la detección del consumo problemático de alcohol y reforzar los programas de prevención selectiva e indicada.Objectives: To estimate excess mortality in patients with an alcohol use disorder and to calculate the population-based impact attributable to this disorder, with emphasis on differences according to gender and age. Methods: We carried out a longitudinal study of a

  19. Differences in childhood physical abuse reporting and the association between CPA and alcohol use disorder in European American and African American women.

    Science.gov (United States)

    Werner, Kimberly B; Grant, Julia D; McCutcheon, Vivia V; Madden, Pamela A F; Heath, Andrew C; Bucholz, Kathleen K; Sartor, Carolyn E

    2016-06-01

    The goal of the current study was to examine whether the magnitude of the association between childhood physical abuse (CPA) and alcohol use disorder (AUD) varies by type of CPA assessment and race of the respondents. Data are from the Missouri adolescent female twins study and the Missouri family study (N = 4508) where 21.2% identified as African American (AA) and 78.8% as European American (EA); mean age = 23.8. Data were collected using a structured comprehensive interview which assessed CPA experiences using behavioral questions about specific abusive behaviors and trauma checklist items. Cox proportional hazards regression analyses were conducted, adjusting for additional risk factors associated with AUD, including co-occurring psychiatric disorders (defined as time-varying) and parental alcohol misuse. Overall, CPA reporting patterns were highly correlated (tetrachoric ρ = 0.73); although, only 25.8% of women who endorsed behaviorally defined CPA also endorsed checklist items whereas 72.2% of women who endorsed checklist items also endorsed behavioral questions. Racial disparities were evident, with behaviorally defined CPA increasing the hazard for AUD in EA but not AA women. Additional racial disparities in the risk for AUD were observed: increased hazard for AUD were associated with major depressive disorder in AA, and cannabis dependence and paternal alcohol problems in EA, women. Results demonstrate the relevance of the type of CPA measure in assessing CPA in studies of alcohol-related problems-behavioral items may be more inclusive of CPA exposure and more predictive of AUD- and highlight racial distinctions of AUD etiology in women. (PsycINFO Database Record

  20. Relations between common and specific factors of anxiety sensitivity and distress tolerance and fear, distress, and alcohol and substance use disorders.

    Science.gov (United States)

    Allan, Nicholas P; Macatee, Richard J; Norr, Aaron M; Raines, Amanda M; Schmidt, Norman B

    2015-06-01

    Whereas it has been speculated that the psychopathology risk factors anxiety sensitivity (AS) and distress tolerance (DT) are highly overlapping, no studies have examined whether a core affect sensitivity construct explains this relation. It was hypothesized that, in a sample of 808 treatment-seeking individuals (M(age) = 35.11, SD = 14.94), the best-fitting confirmatory factor analysis model of AS and DT would comprise a common underlying affect sensitivity factor orthogonal to DT and lower-order AS factors (physical, cognitive, and social concerns). It was also hypothesized that specific relations between the factors and fear, distress, and alcohol/substance use disorders would emerge. The best-fitting model comprised a common affect sensitivity factor orthogonal to DT and lower-order AS factors. Whereas the affect sensitivity and DT factors were associated with fear, distress, and alcohol/substance use disorders, AS cognitive concerns was only related to distress disorders and AS social concerns was only related to fear disorders.

  1. Selective reduction of cerebral cortex GABA neurons in a late gestation model of fetal alcohol spectrum disorder.

    Science.gov (United States)

    Smiley, John F; Saito, Mariko; Bleiwas, Cynthia; Masiello, Kurt; Ardekani, Babak; Guilfoyle, David N; Gerum, Scott; Wilson, Donald A; Vadasz, Csaba

    2015-09-01

    Fetal alcohol spectrum disorders (FASD) are associated with cognitive and behavioral deficits, and decreased volume of the whole brain and cerebral cortex. Rodent models have shown that early postnatal treatments, which mimic ethanol toxicity in the third trimester of human pregnancy, acutely induce widespread apoptotic neuronal degeneration and permanent behavioral deficits. However, the lasting cellular and anatomical effects of early ethanol treatments are still incompletely understood. This study examined changes in neocortex volume, thickness, and cellular organization that persist in adult mice after postnatal day 7 (P7) ethanol treatment. Post mortem brain volumes, measured by both MRI within the skull and by fluid displacement of isolated brains, were reduced 10-13% by ethanol treatment. The cerebral cortex showed a similar reduction (12%) caused mainly by lower surface area (9%). In spite of these large changes, several features of cortical organization showed little evidence of change, including cortical thickness, overall neuron size, and laminar organization. Estimates of total neuron number showed a trend level reduction of about 8%, due mainly to reduced cortical volume but unchanged neuron density. However, counts of calretinin (CR) and parvalbumin (PV) subtypes of GABAergic neurons showed a striking >30% reduction of neuron number. Similar ethanol effects were found in male and female mice, and in C57BL/6By and BALB/cJ mouse strains. Our findings indicate that the cortex has substantial capacity to develop normal cytoarchitectonic organization after early postnatal ethanol toxicity, but there is a selective and persistent reduction of GABA cells that may contribute to the lasting cognitive and behavioral deficits in FASD.

  2. Neuroendocrinology of a Male-Specific Pattern for Depression Linked to Alcohol Use Disorder and Suicidal Behavior

    Science.gov (United States)

    Walther, Andreas; Rice, Timothy; Kufert, Yael; Ehlert, Ulrike

    2017-01-01

    Epidemiological studies show low rates of diagnosed depression in men compared to women. At the same time, high rates of alcohol use disorders (AUDs) and completed suicide are found among men. These data suggest that a male-specific pattern for depression may exist that is linked to AUDs and suicidal behavior. To date, no underlying neuroendocrine model for this specific pattern of male depression has been suggested. In this paper, we integrate findings related to this specific pattern of depression with underlying steroid secretion patterns, polymorphisms, and methylation profiles of key genes in order to detail an original neuroendocrine model of male-specific depression. Low circulating levels of sex steroids seem to increase the vulnerability for male depression, while concomitant high levels of glucocorticoids further intensify this vulnerability. Interactions of hypothalamus–pituitary–gonadal (HPG) and hypothalamus–pituitary–adrenocortical (HPA) axis-related hormones seem to be highly relevant for a male-specific pattern of depression linked to AUDs and suicidal behavior. Moreover, genetic variants and the epigenetic profiles of the androgen receptor gene, well-known depression related genes, and HPA axis-related genes were shown to further interact with men’s steroid secretion and thus may further contribute to the proposed male-specific pattern for depression. This mini-review points out the multilevel interactions between the HPG and HPA axis for a male-specific pattern of depression linked to AUDs and suicidal behavior. An integration of multilevel interactions within the three-hit concept of vulnerability and resilience concludes the review. PMID:28096796

  3. Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women

    Science.gov (United States)

    Sartor, C. E.; McCutcheon, V. V.; Pommer, N. E.; Nelson, E. C.; Grant, J. D.; Duncan, A. E.; Waldron, M.; Bucholz, K. K.; Madden, P. A. F.; Heath, A. C.

    2012-01-01

    Background The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females. Method Data were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure. Results Additive genetic influences (A) accounted for 72 % of the variance in PTSD ; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71 %. The genetic correlation between PTSD and AD was 0.54. Conclusions The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited. PMID:21054919

  4. Dissociable patterns in the control of emotional interference in adults with attention-deficit/hyperactivity disorder (ADHD and in adults with alcohol dependence.

    Directory of Open Access Journals (Sweden)

    Ivo Marx

    Full Text Available OBJECTIVES: To effectively manage current task demands, attention must be focused on task-relevant information while task-irrelevant information is rejected. However, in everyday life, people must cope with emotions, which may interfere with actual task demands and may challenge functional attention allocation. Control of interfering emotions has been associated with the proper functioning of the dorsolateral prefrontal cortex (DLPFC. As DLPFC dysfunction is evident in subjects with ADHD and in subjects with alcohol dependence, the current study sought to examine the bottom-up effect of emotional distraction on task performance in both disorders. METHODS: Male adults with ADHD (n = 22, male adults with alcohol dependence (n = 16, and healthy controls (n = 30 performed an emotional working memory task (n-back task. In the background of the task, we presented neutral and negative stimuli that varied in emotional saliency. RESULTS: In both clinical groups, a working memory deficit was evident. Moreover, both clinical groups displayed deficient emotional interference control. The n-back performance of the controls was not affected by the emotional distractors, whereas that of subjects with ADHD deteriorated in the presence of low salient distractors, and that of alcoholics did not deteriorate until high salient distractors were presented. Subsequent to task performance, subjects with ADHD accurately recognized more distractors than did alcoholics and controls. In alcoholics, picture recognition accuracy was negatively associated with n-back performance, suggesting a functional association between the ability to suppress emotional distractors and successful task performance. In subjects with ADHD, performance accuracy was negatively associated with ADHD inattentive symptoms, suggesting that inattention contributes to the performance deficit. CONCLUSIONS: Subjects with ADHD and alcoholics both display an emotional interference control

  5. Emotion recognition deficits exist in mild cognitive impairment, but only in the amnestic subtype.

    Science.gov (United States)

    McCade, Donna; Savage, Greg; Guastella, Adam; Lewis, Simon J G; Naismith, Sharon L

    2013-09-01

    Emotion recognition is impaired in dementia and there is some initial evidence to suggest that milder deficits may be present in Mild Cognitive Impairment (MCI) patients, an "at risk" population for transition to dementia. In this study, we investigated the emotion recognition profile of MCI subgroups. Results show emotion recognition deficits exist for the amnestic subtype with impairment in multiple domains, with an emotion-specific deficit for anger recognition. Impaired emotion recognition in aMCI was independent of patient mood and cognitive deficits. The study is the first to examine the nonamnestic subtype. No emotion recognition deficits were found. This finding is surprising given the association between the nonamnestic subtype and frontal systems dysfunction. Impaired emotion recognition could be related to the selective pathophysiology in neural pathways, particularly the temporal lobe and connected limbic and prefrontal regions, implicated in both aMCI and emotion processing. These findings may have implications for early diagnosis, prognosis, and clinical management.

  6. Movements Execution in Amnestic Mild Cognitive Impairment and Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Rosolino Camarda

    2007-01-01

    Full Text Available We evaluated the relationship between motor and neuropsychological deficits in subjects affected by amnestic Mild Cognitive Impairment (aMCI and early Alzheimer’s Disease (AD. Kinematics of goal-directed movement of aMCI and AD subjects were compared to those of age-matched control subjects. AD showed a slowing down of motor performance compared to aMCI and controls. No relationships were found between motor and cognitive performances in both AD and aMCI. Our results suggest that the different motor behaviour between AD and aMCI cannot be related to memory deficits, probably reflecting the initial degeneration of parietal-frontal circuits for movement planning. The onset of motor dysfunction in early AD could represent the transition from aMCI to AD.

  7. Deficits in episodic memory retrieval reveal impaired default mode network connectivity in amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Cameron J. Dunn

    2014-01-01

    Full Text Available Amnestic mild cognitive impairment (aMCI is believed to represent a transitional stage between normal healthy ageing and the development of dementia. In particular, aMCI patients have been shown to have higher annual transition rates to Alzheimer's Disease (AD than individuals without cognitive impairment. Despite intensifying interest investigating the neuroanatomical basis of this transition, there remain a number of questions regarding the pathophysiological process underlying aMCI itself. A number of recent studies in aMCI have shown specific impairments in connectivity within the default mode network (DMN, which is a group of regions strongly related to episodic memory capacities. However to date, no study has investigated the integrity of the DMN between patients with aMCI and those with a non-amnestic pattern of MCI (naMCI, who have cognitive impairment, but intact memory storage systems. In this study, we contrasted the DMN connectivity in 24 aMCI and 33 naMCI patients using seed-based resting state fMRI. The two groups showed no statistical difference in their DMN intra-connectivity. However when connectivity was analysed according to performance on measures of episodic memory retrieval, the two groups were separable, with aMCI patients demonstrating impaired functional connectivity between the hippocampal formation and the posterior cingulate cortex. We provide evidence that this lack of connectivity is driven by impaired communication from the posterior cingulate hub and does not simply represent hippocampal atrophy, suggesting that posterior cingulate degeneration is the driving force behind impaired DMN connectivity in aMCI.

  8. Deficits in episodic memory retrieval reveal impaired default mode network connectivity in amnestic mild cognitive impairment

    Science.gov (United States)

    Dunn, Cameron J.; Duffy, Shantel L; Hickie, Ian B; Lagopoulos, Jim; Lewis, Simon J.G.; Naismith, Sharon L.; Shine, James M.

    2014-01-01

    Amnestic mild cognitive impairment (aMCI) is believed to represent a transitional stage between normal healthy ageing and the development of dementia. In particular, aMCI patients have been shown to have higher annual transition rates to Alzheimer's Disease (AD) than individuals without cognitive impairment. Despite intensifying interest investigating the neuroanatomical basis of this transition, there remain a number of questions regarding the pathophysiological process underlying aMCI itself. A number of recent studies in aMCI have shown specific impairments in connectivity within the default mode network (DMN), which is a group of regions strongly related to episodic memory capacities. However to date, no study has investigated the integrity of the DMN between patients with aMCI and those with a non-amnestic pattern of MCI (naMCI), who have cognitive impairment, but intact memory storage systems. In this study, we contrasted the DMN connectivity in 24 aMCI and 33 naMCI patients using seed-based resting state fMRI. The two groups showed no statistical difference in their DMN intra-connectivity. However when connectivity was analysed according to performance on measures of episodic memory retrieval, the two groups were separable, with aMCI patients demonstrating impaired functional connectivity between the hippocampal formation and the posterior cingulate cortex. We provide evidence that this lack of connectivity is driven by impaired communication from the posterior cingulate hub and does not simply represent hippocampal atrophy, suggesting that posterior cingulate degeneration is the driving force behind impaired DMN connectivity in aMCI. PMID:24634833

  9. Everyday episodic memory in amnestic Mild Cognitive Impairment: a preliminary investigation

    LENUS (Irish Health Repository)

    Irish, Muireann

    2011-08-04

    Abstract Background Decline in episodic memory is one of the hallmark features of Alzheimer\\'s disease (AD) and is also a defining feature of amnestic Mild Cognitive Impairment (MCI), which is posited as a potential prodrome of AD. While deficits in episodic memory are well documented in MCI, the nature of this impairment remains relatively under-researched, particularly for those domains with direct relevance and meaning for the patient\\'s daily life. In order to fully explore the impact of disruption to the episodic memory system on everyday memory in MCI, we examined participants\\' episodic memory capacity using a battery of experimental tasks with real-world relevance. We investigated episodic acquisition and delayed recall (story-memory), associative memory (face-name pairings), spatial memory (route learning and recall), and memory for everyday mundane events in 16 amnestic MCI and 18 control participants. Furthermore, we followed MCI participants longitudinally to gain preliminary evidence regarding the possible predictive efficacy of these real-world episodic memory tasks for subsequent conversion to AD. Results The most discriminating tests at baseline were measures of acquisition, delayed recall, and associative memory, followed by everyday memory, and spatial memory tasks, with MCI patients scoring significantly lower than controls. At follow-up (mean time elapsed: 22.4 months), 6 MCI cases had progressed to clinically probable AD. Exploratory logistic regression analyses revealed that delayed associative memory performance at baseline was a potential predictor of subsequent conversion to AD. Conclusions As a preliminary study, our findings suggest that simple associative memory paradigms with real-world relevance represent an important line of enquiry in future longitudinal studies charting MCI progression over time.

  10. Tobacco and alcohol use, sexual behavior and common mental disorders among military students at the Police Academy, São Paulo, Brazil. A cross-sectional study

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    Arlene de Maria Perez

    Full Text Available CONTEXT AND OBJECTIVE: The lifestyle of military personnel has been little studied in Brazil. This study evaluated the frequencies of tobacco and alcohol use, sexual behavior and mental health among military students.DESIGN AND SETTING: Cross-sectional study at the Police Academy, in São Paulo.METHODS: Students answered a questionnaire about tobacco use, alcohol consumption, sexual behavior and common mental disorders (CMDs. To analyze associations among the frequencies of smoking and alcohol use, sexually transmitted diseases (STDs and CMDs during the undergraduate years, we built a multinomial logistic regression model adjusted for age and sex.RESULTS: All 473 students were invited to participate and 430 (90.9% agreed (10.5% were women. Most were white (76.6%, aged < 30 years, from the upper middle class (78.1%. The frequency of smoking was 6.5%, alcohol consumption 69.3%, STDs 14% and CMDs 15.6%. The use of condoms was low. Fourth-year students presented a lower odds ratio (OR for STDs than the first-year students: 0.44 (95% confidence interval: 0.22-0.90. Third-year students presented a lower OR for CMDs than the first-year students.CONCLUSION: The frequencies of smoking and CMDs were low, while the frequency of alcohol consumption was similar to that of the Brazilian population. The use of condoms was low, in comparison with previous studies with similar samples. The results suggest that there was a certain degree of protection against CMDs and STDs during the undergraduate years.

  11. Health professionals’ perceptions about the adoption of existing guidelines for the diagnosis of fetal alcohol spectrum disorders in Australia

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    Watkins Rochelle E

    2012-06-01

    Full Text Available Abstract Background Despite the availability of five guidelines for the diagnosis of fetal alcohol spectrum disorders (FASD, there is no national endorsement for their use in diagnosis in Australia. In this study we aimed to describe health professionals’ perceptions about the adoption of existing guidelines for the diagnosis of FASD in Australia and identify implications for the development of national guidelines. Methods We surveyed 130 Australian and 9 international health professionals with expertise or involvement in the screening or diagnosis of FASD. An online questionnaire was used to evaluate participants’ familiarity with and use of five existing diagnostic guidelines for FASD, and to assess their perceptions about the adoption of these guidelines in Australia. Results Of the 139 participants surveyed, 84 Australian and 8 international health professionals (66.2% responded to the questions on existing diagnostic guidelines. Participants most frequently reported using the University of Washington 4-Digit Diagnostic Code (27.2% and the Canadian guidelines (18.5% for diagnosis. These two guidelines were also most frequently recommended for adoption in Australia: 32.5% of the 40 participants who were familiar with the University of Washington 4-Digit Diagnostic Code recommended adoption of this guideline in Australia, and 30.8% of the 26 participants who were familiar with the Canadian guidelines recommended adoption of this guideline in Australia. However, for the majority of guidelines examined, most participants were unsure whether they should be adopted in Australia. The adoption of existing guidelines in Australia was perceived to be limited by: their lack of evidence base, including the appropriateness of established reference standards for the Australian population; their complexity; the need for training and support to use the guidelines; and the lack of an interdisciplinary and interagency model to support service delivery in

  12. Lifetime suicide attempt history, quality of life, and objective functioning among HIV/AIDS patients with alcohol and illicit substance use disorders.

    Science.gov (United States)

    Walter, Kimberly N; Petry, Nancy M

    2016-05-01

    This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. All patients met the diagnostic criteria for past-year cocaine or opioid use disorders and 27% of patients also had co-occurring alcohol use disorders. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps quality-of-life scores. Lifetime suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning.

  13. Interactive Voice Response for Relapse Prevention Following Cognitive-Behavioral Therapy for Alcohol Use Disorders: A Pilot Study

    OpenAIRE

    Rose, Gail L.; Skelly, Joan M.; Gary J Badger; Magdalena R. Naylor; HELZER, JOHN E.

    2012-01-01

    Relapse after alcoholism treatment is high. Alcohol Therapeutic Interactive Voice Response (ATIVR) is an automated telephone program for posttreatment self-monitoring, skills practice, and feedback. This pilot study examined feasibility of ATIVR. Participants (n = 21; 57% male) had access to ATIVR for 90 days following outpatient group cognitive-behavioral therapy (CBT) to make daily reports of mood, confidence in sobriety, urges to use substances, and actual use. Reports of relapse or risk w...

  14. Affect regulation training (ART) for alcohol use disorders: development of a novel intervention for negative affect drinkers.

    Science.gov (United States)

    Stasiewicz, Paul R; Bradizza, Clara M; Schlauch, Robert C; Coffey, Scott F; Gulliver, Suzy B; Gudleski, Gregory D; Bole, Christopher W

    2013-01-01

    Although negative affect is a common precipitant of alcohol relapse, there are few interventions for alcohol dependence that specifically target negative affect. In this stage 1a/1b treatment development study, several affect regulation strategies (e.g., mindfulness, prolonged exposure, distress tolerance) were combined to create a new treatment supplement called affect regulation training (ART), which could be added to enhance cognitive-behavioral therapy (CBT) for alcohol dependence. A draft therapy manual was given to therapists and treatment experts before being administered to several patients who also provided input. After two rounds of manual development (stage 1a), a pilot randomized clinical trial (N=77) of alcohol-dependent outpatients who reported drinking often in negative affect situations was conducted (stage 1b). Participants received 12-weekly, 90-minute sessions of either CBT for alcohol dependence plus ART (CBT+ART) or CBT plus a healthy lifestyles control condition (CBT+HLS). Baseline, end-of-treatment, and 3- and 6-month posttreatment interviews were conducted. For both treatment conditions, participant ratings of treatment satisfaction were high, with CBT+ART rated significantly higher. Drinking outcome results indicated greater reductions in alcohol use for CBT+ART when compared to CBT+HLS, with moderate effect sizes for percent days abstinent, drinks per day, drinks per drinking day, and percent heavy drinking days. Overall, findings support further research on affect regulation interventions for negative affect drinkers.

  15. CHRM2 gene predisposes to alcohol dependence, drug dependence and affective disorders: results from an extended case-control structured association study.

    Science.gov (United States)

    Luo, Xingguang; Kranzler, Henry R; Zuo, Lingjun; Wang, Shuang; Blumberg, Hilary P; Gelernter, Joel

    2005-08-15

    Cholinergic muscarinic 2 receptor (CHRM2) is implicated in memory and cognition, functions impaired in many neuropsychiatric disorders. Wang et al. [Wang, J.C., Hinrichs, A.L., Stock, H., Budde, J., Allen, R., Bertelsen, S., Kwon, J.M., Wu, W., Dick, D.M., Rice, J. et al. (2004) Evidence of common and specific genetic effects: association of the muscarinic acetylcholine receptor M2 (CHRM2) gene with alcohol dependence and major depressive syndrome. Hum. Mol. Genet., 13, 1903-1911] reported that variation in CHRM2 gene predisposed to alcohol dependence (AD) and major depressive syndrome. We examined the relationships between variation in CHRM2 and AD, drug dependence (DD) and affective disorders, using a novel extended case-control structured association (SA) method. Six markers at CHRM2 and 38 ancestry-informative markers (AIMs) were genotyped in a sample of 871 subjects, including 333 healthy controls [287 European-Americans (EAs) and 46 African-Americans (AAs)] and 538 AD and/or DD subjects (415 with AD and 346 with DD and 382 EAs and 156 AAs). The same CHRM2 markers were genotyped in a sample of 137 EA subjects with affective disorders. All of the six markers were in Hardy-Weinberg equilibrium in controls, but SNP3 (rs1824024) was in Hardy-Weinberg disequilibrium in the AD and DD groups. Using conventional case-control comparisons, some markers were nominally significantly or suggestively associated with phenotypes before or after controlling for population stratification and admixture effects, but these associations were not significant after multiple test correction. However, regression analysis identified specific alleles, genotypes, haplotypes and diplotypes that were significantly associated with risk for each disorder. We conclude that variation in CHRM2 predisposes to AD, DD and affective disorders. One haplotype block within the 5'-UTR of CHRM2 may be more important for the development of these disorders than other regions. Interaction between two

  16. Smoking, consumption of alcohol and sedentary life style in population grouping and their relationships with lipemic disorders

    Directory of Open Access Journals (Sweden)

    Ignez Salas Martins

    1995-02-01

    Full Text Available The study, part of the project "Atherosclerotic cardiovascular diseases, lipemic disorders, hypertension, obesity and diabetis mellitus in a population of the metropolitan area of the southeastern region of Brazil", had the following objectives: a the characterization and distribution among typical human socio-economic groupings, of the prevalence of some particular habits which constitute aspects of life-style-the use of tobacco, the use of alcohol and sedentary activity; b the establishment of the interrelation between the above-mentioned habits and some lipemic disorders. The prevalence of the habits cited behaved in the following manner: the use of tobacco predominated among men, distributed uniformly throughout the social strata; among the women the average percentage of smokers was 18,9%, a significant difference occurring among the highest socio-economic class, where the average was of 40.2%. The sedentary style of life presented high prevalence, among both men and women with exception of the women of the highest socio-economic level and of the skilled working class. The use of alcohol, as one would expect, is a habit basically practised by the men, without any statistically significant differences between classes. For the purpose of establishing associations between these risk fictors and lipemic conditions four situations were chosen, of the following characteristics: 1- total cholesterol > or = 220 mg/dl and triglycerides > or = 150 mg/dl; 2- HDL cholesterol or = 150 mg/dl; 3- HDL cholesterol or = 150 mg/dl, and the following independent variables: age, use of tobacco and the interactions between obesity and smoking, age and sedentary lifestyle, sex and obesity (R2=22%; the standardized B coefficient showed that the variables with the greatest weight in the forecasting of the variation in the levels of cholesterol were smoking and the interaction between obesity and smoking. The hypercholesterolemia accompanied by triglycerides levels

  17. An exploratory evaluation of Take Control: A novel computer-delivered behavioral platform for placebo-controlled pharmacotherapy trials for alcohol use disorder.

    Science.gov (United States)

    Devine, Eric G; Ryan, Megan L; Falk, Daniel E; Fertig, Joanne B; Litten, Raye Z

    2016-09-01

    Placebo-controlled pharmacotherapy trials for alcohol use disorder (AUD) require an active behavioral platform to avoid putting participants at risk for untreated AUD and to better assess the effectiveness of the medication. Therapist-delivered platforms (TDP) can be costly and present a risk to study design because of the variability in therapist fidelity. Take Control is a novel computer-delivered behavioral platform developed for use in pharmacotherapy trials sponsored by the National Institute on Alcohol Abuse and Alcoholism Clinical Investigations Group (NCIG). This behavioral platform was developed with the goal of reducing trial implementation costs and limiting potential bias introduced by therapists providing TDP. This exploratory study is the first to compare Take Control with TDP on measures related to placebo response rate, medication adherence, and participant retention. Data were drawn from the placebo arms of four multisite, double-blind, randomized controlled trials (RCT) for AUD conducted by NCIG from 2007 to 2015. Data were compared from subjects receiving TDP (n=156) in two RCTs and Take Control (n=155) in another two RCTs. Placebo response rate, as represented by weekly percentage of heavy drinking days, was similar between groups. Subjects who received Take Control had a higher rate of medication adherence than those who received TDP. Subject retention was not significantly different between groups. The findings suggest that Take Control is comparable to TDP on measures of retention, medication adherence, and placebo response. Additional research is needed to evaluate Take Control directly against TDPs in a randomized trial.

  18. Pathways to Care of Alcohol -Dependent Patients: An Exploratory Study From a Tertiary Care Substance Use Disorder Treatment Center

    Directory of Open Access Journals (Sweden)

    Pal Singh Balhara

    2016-02-01

    Full Text Available Background No study from India has examined pathways to care in alcohol using population systematically. Objectives The present study aimed to understand the pathways to care among alcohol-dependent individuals seeking help at a tertiary care center. Patients and Methods It was a cross-sectional, observational study. A total of 58 subjects diagnosed with alcohol- dependence syndrome as per DSM-IV-TR were included in the study. Pathways to care were assessed using the world health organization encounter form. Results For 56.9% of the subjects, first point of contact was with a tertiary care addiction psychiatrist. Traditional healers were consulted by about 5.2% of the patients seeking help for the first time. The mean duration of main problems due to alcohol use was 5.82 ± 4.95 years. The first contact tended to be at place nearer to the patient’s residence while further contacts tended to be farther away. Family, friends and neighbours together constituted the single largest group suggesting patients to seek care. Conclusions There is a long time lag between the onset of alcohol use related problems and the first help seeking attempt. Of those who do decide to seek help, the proportion of those obtaining specialist help is higher than commonly believed.

  19. The Clinical Characteristics Analysis of Patients with Mental Disorders Due to Use of Alcohol%酒精所致精神障碍的临床分析

    Institute of Scientific and Technical Information of China (English)

    初阳

    2013-01-01

    Objective To explore the clinical characteristics of patients with mental disorders due to use of alcohol. Methods The clinical datas of 196 patients with mental disorders due to use of alcohol, treated from October 2011 to September 2012 in the mental hospital, were retrospectively analyzed. Results Long-term alcohol abuse could damage the nervous system. Patients with mental disorders could appear instability symptoms, such as different degrees of illusions, visual hallucination, delusion, depression, mood, excited agitation. The cultural level of patients was generally low, and heavy physical labor men were in the majority. The total effective rate of the control group was higher than that of the conventional group (χ2=4.6296, P<4.6296). Conclusion Alcohol can cause mental and physical damage. Early treatment can improve symptoms. A small amount of antidepressant drugs and abstinence and other comprehensive treatment can effectively improve the patients ' disease status. It is worthy of clinical promotion and use.%目的:探讨酒精所致精神障碍患者的临床特点。方法回顾分析精神专科医院2011年10月至2012年9月收治的196例酒精所致精神障碍患者临床资料。结果长期饮酒对神经系统损害较大,精神障碍患者可出现不同程度的幻觉、幻视、妄想、抑郁、情绪高涨、兴奋躁动等不稳定症状,有些患者出现人格障碍及记忆障碍。患病率中文化水平低、体力劳动重的男性居多。对照组总有效率高于常规组(χ2=4.6296,P<0.05)。结论酒精可致精神和躯体损害,早期治疗能改善症状,少量抗精神药物及戒酒等综合性治疗可有效改善患者病情,值得在临床推广应用。

  20. Alcohol Alert

    Science.gov (United States)

    ... main content National Institute on Alcohol Abuse and Alcoholism (NIAAA) Main Menu Search Search form Search Alcohol & ... on a single aspect of alcohol abuse and alcoholism. Please click on the desired publication for full ...

  1. Developmental regulation of neuroligin genes in Japanese ricefish (Oryzias latipes) embryogenesis maintains the rhythm during ethanol-induced fetal alcohol spectrum disorder.

    Science.gov (United States)

    Haron, Mona H; Khan, Ikhlas A; Dasmahapatra, Asok K

    2014-01-01

    Although prenatal alcohol exposure is the potential cause of fetal alcohol spectrum disorder (FASD) in humans, the molecular mechanism(s) of FASD is yet unknown. We have used Japanese ricefish (Oryzias latipes) embryogenesis as an animal model of FASD and reported that this model has effectively generated several phenotypic features in the cardiovasculature and neurocranial cartilages by developmental ethanol exposure which is analogous to human FASD phenotypes. As FASD is a neurobehavioral disorder, we are searching for a molecular target of ethanol that alters neurological functions. In this communication, we have focused on neuroligin genes (nlgn) which are known to be active at the postsynaptic side of both excitatory and inhibitory synapses of the central nervous system. There are six human NLGN homologs of Japanese ricefish reported in public data bases. We have partially cloned these genes and analyzed their expression pattern during normal development and also after exposing the embryos to ethanol. Our data indicate that the expression of all six nlgn genes in Japanese ricefish embryos is developmentally regulated. Although ethanol is able to induce developmental abnormalities in Japanese ricefish embryogenesis comparable to the FASD phenotypes, quantitative real-time PCR (qPCR) analysis of nlgn mRNAs indicate unresponsiveness of these genes to ethanol. We conclude that the disruption of the developmental rhythm of Japanese ricefish embryogenesis by ethanol that leads to FASD may not affect the nlgn gene expression at the message level.

  2. 动机增强治疗在酒精使用障碍中的应用%Motivational enhancement therapy for alcohol use disorders

    Institute of Scientific and Technical Information of China (English)

    王姗姗; 郝伟; 赵敏

    2015-01-01

    本文介绍了动机增强治疗在酒精使用障碍中应用情况,对动机增强治疗理论基础、原则及技术要点进行了系统介绍,并举例说明其实施步骤,还对针对不同酒精使用障碍者的康复提出了不同的治疗策略,希望对读者掌握动机强化治疗有所帮助。%This article introduced the implementation of motivational enhancement therapy(MET)for alcohol use disorders. The theoretical basis,principles and technical skills was explained. An example on how the MET was used step by step when work with pa-tients with alcohol use disorder. Strategies used in difference stage of changes were introduced. We hope this article will be helpful for clinical use.

  3. Molecular changes during neurodevelopment following second-trimester binge ethanol exposure in a mouse model of fetal alcohol spectrum disorder: from immediate effects to long-term adaptation.

    Science.gov (United States)

    Mantha, Katarzyna; Laufer, Benjamin I; Singh, Shiva M

    2014-01-01

    Fetal alcohol spectrum disorder (FASD) is an umbrella term that refers to a wide range of behavioral and cognitive deficits resulting from prenatal alcohol exposure. It involves changes in brain gene expression that underlie lifelong FASD symptoms. How these changes are achieved from immediate to long-term effects, and how they are maintained, is unknown. We have used the C57BL/6J mouse to assess the dynamics of genomic alterations following binge alcohol exposure. Ethanol-exposed fetal (short-term effect) and adult (long-term effect) brains were assessed for gene expression and microRNA (miRNA) changes using Affymetrix mouse arrays. We identified 48 and 68 differentially expressed genes in short- and long-term groups, respectively. No gene was common between the 2 groups. Short-term (immediate) genes were involved in cellular compromise and apoptosis, which represent ethanol's toxic effects. Long-term genes were involved in various cellular functions, including epigenetics. Using quantitative RT-PCR, we confirmed the downregulation of long-term genes: Camk1g, Ccdc6, Egr3, Hspa5, and Xbp1. miRNA arrays identified 20 differentially expressed miRNAs, one of which (miR-302c) was confirmed. miR-302c was involved in an inverse relationship with Ccdc6. A network-based model involving altered genes illustrates the importance of cellular redox, stress and inflammation in FASD. Our results also support a critical role of apoptosis in FASD, and the potential involvement of miRNAs in the adaptation of gene expression following prenatal ethanol exposure. The ultimate molecular footprint involves inflammatory disease, neurological disease and skeletal and muscular disorders as major alterations in FASD. At the cellular level, these processes represent abnormalities in redox, stress and inflammation, with potential underpinnings to anxiety.

  4. Oral delivery of ivermectin using a fast dissolving oral film: Implications for repurposing ivermectin as a pharmacotherapy for alcohol use disorder.

    Science.gov (United States)

    Yardley, Megan M; Huynh, Nhat; Rodgers, Kathleen E; Alkana, Ronald L; Davies, Daryl L

    2015-09-01

    Individuals suffering from an alcohol-use disorder (AUD) constitute a major health concern. Preclinical studies in our laboratory show that acute and chronic intraperitoneal (i.p.) administration of ivermectin (IVM) reduces alcohol intake and preference in mice. To enable clinical investigation to use IVM for the treatment of an AUD, development of an oral formulation that can be used in animals as well as long-term preclinical toxicology studies are required. The present work explores the use of a promising alternative dosage form of IVM, fast-dissolving oral films (Cure Pharmaceutical®), to test the efficacy and safety of oral IVM in conjunction with alcohol exposure. We tested the effect of IVM (0.21 mg) using a fast-dissolving oral film delivery method on reducing 10% v/v alcohol (10E) intake in female C57BL/6 mice using a 24-h access two-bottle choice paradigm for 6 weeks (5 days per week). Differences in ethanol intake, preference for ethanol, water intake, fluid intake, food intake, changes in mouse and organ weights, as well as histological changes to kidney, liver, and brain were analyzed. The IVM group drank significantly less ethanol over the 30-day period compared to the placebo (blank strip) and the no-treatment groups. Organ weights did not differ between the groups. Histological evaluation showed no differences in the brain and kidney between groups. In the liver, there was a slight increase in the incidence of microvesicular fatty and degenerative changes of the animals receiving the thin strips. No overt hepatocellular necrosis or perivascular inflammation was noted. Overall, these data support the use of this novel method of oral drug delivery for longer-term studies and should facilitate FDA required preclinical testing that is necessary to repurpose IVM for treatment of an AUD.

  5. Sleep-disordered breathing, sleep quality, and mild cognitive impairment in the general population.

    Science.gov (United States)

    Dlugaj, Martha; Weinreich, Gerhard; Weimar, Christian; Stang, Andreas; Dragano, Nico; Wessendorf, Thomas E; Teschler, Helmut; Winkler, Angela; Wege, Natalia; Moebus, Susanne; Möhlenkamp, Stefan; Erbel, Raimund; Jöckel, Karl-Heinz

    2014-01-01

    There is increasing evidence that sleep disorders are associated with cognitive decline. We, therefore, examined the cross-sectional association of sleep-disordered breathing (SDB), sleep quality, and three types of sleep complaints (difficulties initiating sleep, difficulties maintaining sleep, and early morning awakening) with mild cognitive impairment (MCI) and its subtypes. A group of 1,793 participants (51% men; 63.8 ± 7.5 years) of the population-based Heinz Nixdorf Recall study (total sample n = 4,157) received a screening for SDB and self-report measures of sleep complaints. Group comparisons were used to compare performances among five cognitive subtests. Multivariate logistic regression models were calculated to determine the association of MCI (n = 230) and MCI subtypes (amnestic MCI, n = 120; non-amnestic MCI, n = 110) with SDB severity levels, poor sleep quality, and sleep complaints. Severe SDB (apnea-hypopnea index ≥30/h, n = 143) was not associated with MCI, amnestic MCI, or non-amnestic MCI. Poor sleep quality was associated with MCI (Odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.02-2.03; fully adjusted) as well as frequently reported difficulties initiating sleep (OR = 1.94, 1.20-3.14), difficulties maintaining sleep (OR = 2.23, 1.27-4.63), and early morning awakening (OR = 2.30, 1.32-4.00). Severe difficulties initiating sleep (OR = 2.23, 1.21-4.13) and early morning awakening (OR = 2.88, 1.45-5.73) were solely associated with the amnestic MCI subtype, whereas, severe difficulties maintaining sleep (OR = 3.84, 1.13-13.08) were associated with non-amnestic MCI. Our results suggest that poor sleep quality, rather than SDB, is associated with MCI. The selective association of difficulties initiating sleep and early morning awakening with amnestic MCI and of difficulties maintaining sleep with non-amnestic MCI might serve as a marker to improve diagnostic accuracy in the earliest stages of cognitive impairment and will be further

  6. Nursing of emotional disorder in patients with alcohol dependence%乙醇依赖患者情绪障碍的护理

    Institute of Scientific and Technical Information of China (English)

    童芳; 易元平

    2011-01-01

    Objective To analyze the nursing effect of emotional disorder in patients with alcohol dependence.Methods From January 2009 to February 2010,81 patients in our hospital with emotional disorder of alcohol dependence were randomly divided into the observation group (41 cases)and the control group (40 cases).The control group was given routine nursing care,and the observation group was given enhanced care for emotional disorders on the basis of routine nursing care,the clinical results of two groups were compared.Results In the observation group,the re-drinking rate and readmission rate were19.5 % and 7.3%,significantly lower than 40.0% and 27.5% of the control group,the time interval of re-drinking of the observation group was significantly longer than the control group,the anxiety and depression scores were significantly better than the control group.Conclusions To give enhanced care on the basis of routine nursing care for patients with emotional disorders because of alcohol dependence has better clinical effect,it contributes to the patients′ rehabilitation.%目的 分析乙醇依赖患者情绪障碍的护理效果.方法 将我院2009年1月至2010年2月收治的乙醇依赖患者81例,随机分为观察组41例和对照组40例.对照组给予常规护理,而观察组在对照组的基础上加强对情绪障碍的护理,比较2组的护理效果.结果 观察组的复饮率、再住院率分别为19.5%、7.3%,明显低于对照组的40.0%、27.5%,且观察组的复饮间隔时间明显长于对照组;观察组护理后的焦虑、抑郁评分均明显优于对照组.结论 对乙醇依赖患者在常规护理的基础上加强情绪障碍护理可以取得更好的临床效果,有利于患者的康复.

  7. An Exploration of Quality of Life and Its Predictors in Patients with Addictive Disorders: Gambling, Alcohol and Drugs

    Science.gov (United States)

    Manning, Victoria; Gomez, Brenda; Guo, Song; Low, Yee Deng; Koh, Puay Kee; Wong, Kim Eng

    2012-01-01

    The study set out to examine Quality of Life (QoL), specifically subjective well being in three different addiction populations (260 alcohol-dependent, 282 drug-dependent, and 132 pathological gambling outpatients) at their first visit to treatment, using the Personal Well being Index (PWI). The mean PWI score for all patients was significantly…

  8. Development of children adopted from Poland : The role of early life risk factors, fetal alcohol spectrum disorders and parenting

    NARCIS (Netherlands)

    Knuiman, S.

    2015-01-01

    Annually, 300 to 400 Polish children are adopted internationally. Prior to adoption, most of these children were exposed to circumstances that could harm their development, for example, neglect or prenatal exposure to alcohol. Our study was initiated because the Dutch adoption agency that placed the

  9. Neurological soft signs in persons with amnestic mild cognitive impairment and the relationships to neuropsychological functions

    Directory of Open Access Journals (Sweden)

    Li Hui-jie

    2012-06-01

    Full Text Available Abstract Background Neurological abnormalities have been reported in people with amnestic mild cognitive impairment (aMCI. The current study aimed to examine the prevalence of neurological soft signs (NSS in this clinical group and to examine the relationship of NSS to other neuropsychological performances. Methods Twenty-nine people with aMCI and 28 cognitively healthy elderly people were recruited for the present study. The NSS subscales (motor coordination, sensory integration, and disinhibition of the Cambridge Neurological Inventory and a set of neuropsychological tests were administered to all the participants. Results People with aMCI exhibited significantly more motor coordination signs, disinhibition signs, and total NSS than normal controls. Correlation analysis showed that the motor coordination subscale score and total score of NSS were significantly inversely correlated with the combined Z-score of neuropsychological tests in aMCI group. Conclusions These preliminary findings suggested that people with aMCI demonstrated a higher prevalence of NSS compared to healthy elderly people. Moreover, NSS was found to be inversely correlated with the neuropsychological performances in persons with aMCI. When taken together, these findings suggested that NSS may play a potential important role and serve as a tool to assist in the early detection of aMCI.

  10. Intraindividual variability in performance on associative memory tasks is elevated in amnestic mild cognitive impairment.

    Science.gov (United States)

    Troyer, Angela K; Vandermorris, Susan; Murphy, Kelly J

    2016-09-01

    Elevations in intraindividual variability (IIV) are an indicator of neurocognitive compromise and are seen on reaction time tasks in individuals with mild cognitive impairment (MCI). We examined IIV on memory tasks known to be sensitive to early cognitive change in a group of 24 individuals with amnestic MCI and 21 matched controls. Traditional measures of accuracy and speed, as well as indices of IIV statistically purified for systematic between-group and trial effects, were derived from performance on two computer-based associative recognition tests of word-word and face-name pairs. Accuracy and speed were reduced and IIV was elevated in the MCI group compared to controls on both tasks. Logistic regression analyses demonstrated that IIV, but not speed, was a unique predictor of group membership, over and above performance accuracy. Observed elevations in IIV in MCI are congruent with the notion that IIV may reflect disturbance in distributed neural networks, including medial temporal regions, in addition to frontal systems dysfunction. Present findings have diagnostic implications for accurate identification of individuals with MCI and add to the growing literature on IIV as an early indicator of cognitive decline in older adults.

  11. Item and associative memory in amnestic mild cognitive impairment: performance on standardized memory tests.

    Science.gov (United States)

    Troyer, Angela K; Murphy, Kelly J; Anderson, Nicole D; Hayman-Abello, Brent A; Craik, Fergus I M; Moscovitch, Morris

    2008-01-01

    The earliest neuroanatomical changes in amnestic mild cognitive impairment (aMCI) involve the hippocampus and entorhinal cortex, structures implicated in the integration and learning of associative information. The authors hypothesized that individuals with aMCI would have impairments in associative memory above and beyond the known impairments in item memory. A group of 29 individuals with aMCI and 30 matched control participants were administered standardized tests of object-location recall and symbol-symbol recall, from which both item and associative recall scores were derived. As expected, item recall was impaired in the aMCI group relative to controls. Associative recall in the aMCI group was even more impaired than was item recall. The best group discriminators were measures of associative recall, with which the sensitivity and specificity for detecting aMCI were 76% and 90% for symbol-symbol recall and were 86% and 97% for object-location recall. Associative recall may be particularly sensitive to early cognitive change in aMCI, because this ability relies heavily on the medial temporal lobe structures that are affected earliest in aMCI. Incorporating measures of associative recall into clinical evaluations of individuals with memory change may be useful for detecting aMCI.

  12. Biased recognition of positive faces in aging and amnestic mild cognitive impairment.

    Science.gov (United States)

    Werheid, Katja; Gruno, Maria; Kathmann, Norbert; Fischer, Håkan; Almkvist, Ove; Winblad, Bengt

    2010-03-01

    We investigated age differences in biased recognition of happy, neutral, or angry faces in 4 experiments. Experiment 1 revealed increased true and false recognition for happy faces in older adults, which persisted even when changing each face's emotional expression from study to test in Experiment 2. In Experiment 3, we examined the influence of reduced memory capacity on the positivity-induced recognition bias, which showed the absence of emotion-induced memory enhancement but a preserved recognition bias for positive faces in patients with amnestic mild cognitive impairment compared with older adults with normal memory performance. In Experiment 4, we used semantic differentials to measure the connotations of happy and angry faces. Younger and older participants regarded happy faces as more familiar than angry faces, but the older group showed a larger recognition bias for happy faces. This finding indicates that older adults use a gist-based memory strategy based on a semantic association between positive emotion and familiarity. Moreover, older adults' judgments of valence were more positive for both angry and happy faces, supporting the hypothesis of socioemotional selectivity. We propose that the positivity-induced recognition bias might be based on fluency, which in turn is based on both positivity-oriented emotional goals and on preexisting semantic associations.

  13. Abnormal salience network in normal aging and in amnestic mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    He, Xiaoxi; Qin, Wen; Liu, Yong; Zhang, Xinqing; Duan, Yunyun; Song, Jinyu; Li, Kuncheng; Jiang, Tianzi; Yu, Chunshui

    2014-07-01

    The salience network (SN) serves to identify salient stimuli and to switch between the central executive network (CEN) and the default-mode network (DMN), both of which are impaired in Alzheimer's disease (AD)/amnestic mild cognitive impairment (aMCI). We hypothesized that both the structural and functional organization of the SN and functional interactions between the SN and CEN/DMN are altered in normal aging and in AD/aMCI. Gray matter volume (GMV) and resting-state functional connectivity (FC) were analyzed from healthy younger (HYC) to older controls (HOC) and from HOC to aMCI and AD patients. All the SN components showed significant differences in the GMV, intranetwork FC, and internetwork FC between the HYC and HOC. Most of the SN components showed differences in the GMV between the HOC and AD and between the aMCI and AD. Compared with the HOC, AD patients exhibited significant differences in intra- and internetwork FCs of the SN, whereas aMCI patients demonstrated differences in internetwork FC of the SN. Most of the GMVs and internetwork FCs of the SN and part of the intranetwork FC of the SN were correlated with cognitive differences in older subjects. Our findings suggested that structural and functional impairments of the SN may occur as early as in normal aging and that functional disconnection between the SN and CEN/ DMN may also be associated with both normal aging and disease progression.

  14. Changes in Parahippocampal White Matter Integrity in Amnestic Mild Cognitive Impairment: A Diffusion Tensor Imaging Study

    Directory of Open Access Journals (Sweden)

    E. J. Rogalski

    2009-01-01

    Full Text Available In the present study, changes in the parahippocampal white matter (PWM, in the region that includes the perforant path, were investigated, in vivo, in 14 individuals with amnestic mild cognitive impairment (aMCI compared to 14 elderly controls with no cognitive impairment (NCI. For this purpose, (1 volumetry; (2 diffusion tensor imaging (DTI derived measures of mean diffusivity (MD and fractional anisotropy (FA; and (3 tractography were used. In addition, regression models were utilized to examine the association of PWM measurements with memory decline. The results from this study confirm previous findings in our laboratory and others, showing that compared to controls, individuals with aMCI have PWM volume loss. In addition to volume reduction, participants with aMCI demonstrated a significant increase in MD, but no difference in FA, both in the PWM region and in fibers modeled to pass through the PWM region. Further, the DTI metric of MD was associated with declarative memory performance, suggesting it may be a sensitive marker for memory dysfunction. These results indicate that there is general tissue loss and degradation (decreased volume; increased MD in individuals with aMCI compared to older people with normal cognitive function. However, the microstructural organization of remaining fibers, as determined by measures of anisotropic diffusion, is not significantly different from that of controls.

  15. Weighted-Permutation Entropy Analysis of Resting State EEG from Diabetics with Amnestic Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Zhijie Bian

    2016-08-01

    Full Text Available Diabetes is a significant public health issue as it increases the risk for dementia and Alzheimer’s disease (AD. In this study, we aim to investigate whether weighted-permutation entropy (WPE and permutation entropy (PE of resting-state EEG (rsEEG could be applied as potential objective biomarkers to distinguish type 2 diabetes patients with amnestic mild cognitive impairment (aMCI from those with normal cognitive function. rsEEG series were acquired from 28 patients with type 2 diabetes (16 aMCI patients and 12 controls, and neuropsychological assessments were performed. The rsEEG signals were analysed using WPE and PE methods. The correlations between the PE or WPE of the rsEEG and the neuropsychological assessments were analysed as well. The WPE in the right temporal (RT region of the aMCI diabetics was lower than the controls, and the WPE was significantly positively correlated to the scores of the Auditory Verbal Learning Test (AVLT (AVLT-Immediate recall, AVLT-Delayed recall, AVLT-Delayed recognition and the Wechsler Adult Intelligence Scale Digit Span Test (WAIS-DST. These findings were not obtained with PE. We concluded that the WPE of rsEEG recordings could distinguish aMCI diabetics from normal cognitive function diabetic controls among the current sample of diabetic patients. Thus, the WPE could be a potential index for assisting diagnosis of aMCI in type 2 diabetes.

  16. Short-Term Memory Depends on Dissociable Medial Temporal Lobe Regions in Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Das, Sandhitsu R; Mancuso, Lauren; Olson, Ingrid R; Arnold, Steven E; Wolk, David A

    2016-05-01

    Short-term memory (STM) has generally been thought to be independent of the medial temporal lobe (MTL) in contrast to long-term memory (LTM). Prodromal Alzheimer's disease (AD) is a condition in which the MTL is a major early focus of pathology and LTM is thought disproportionately affected relative to STM. However, recent studies have suggested a role for the MTL in STM, particularly hippocampus, when binding of different elements is required. Other work has suggested involvement of extrahippocampal MTL structures, particularly in STM tasks that involve item-level memory. We examined STM for individual objects, locations, and object-location conjunctions in amnestic mild cognitive impairment (MCI), often associated with prodromal AD. Relative to age-matched, cognitively normal controls, MCI patients not only displayed impairment on object-location conjunctions but were similarly impaired for non-bound objects and locations. Moreover, across all participants, these conditions displayed dissociable correlations of cortical thinning along the long axis of the MTL and associated cortical nodes of anterior and posterior MTL networks. These findings support the role of the MTL in visual STM tasks and the division of labor of MTL in support of different types of memory representations, overlapping with findings in LTM.

  17. Influence of Perceived Stress on Incident Amnestic Mild Cognitive Impairment: Results From the Einstein Aging Study.

    Science.gov (United States)

    Katz, Mindy J; Derby, Carol A; Wang, Cuiling; Sliwinski, Martin J; Ezzati, Ali; Zimmerman, Molly E; Zwerling, Jessica L; Lipton, Richard B

    2016-01-01

    Stress is a potentially remediable risk factor for amnestic mild cognitive impairment (aMCI). Our objective is to determine whether perceived stress predicts incident aMCI and to determine if the influence of stress on aMCI is independent of known aMCI risk factors, particularly demographic variables, depression, and apolipoprotein genotype. The Einstein Aging Study is a longitudinal community-based study of older adults. The Perceived Stress Scale (PSS) was administered annually in the Einstein Aging Study to participants (N=507; 71 developed incident aMCI; mean follow-up time=3.6 y, SD=2.0) who were aged 70 years and older, free of aMCI and dementia at baseline PSS administration, and had at least 1 subsequent annual follow-up. Cox hazard models were used to examine time to aMCI onset adjusting for covariates. High levels of perceived stress are associated with a 30% greater risk of incident aMCI (per 5-point increase in PSS: hazard ratio=1.30; 95% confidence interval, 1.08-1.58) independent of covariates. The consistency of results after covariate adjustment and the lack of evidence for reverse causation in longitudinal analyses suggest that these findings are robust. Understanding of the effect of perceived stress on cognition may lead to intervention strategies that prevent the onset of aMCI and Alzheimer dementia.

  18. Memory complaints in subjective cognitive impairment, amnestic mild cognitive impairment and mild Alzheimer's disease.

    Science.gov (United States)

    Ryu, Seon Young; Lee, Sang Bong; Kim, Tae Woo; Lee, Taek Jun

    2016-12-01

    Memory complaints are a frequent phenomenon in elderly individuals and can lead to opportunistic help-seeking behavior. The aim of this study was to compare different aspects of memory complaints (i.e., prospective versus retrospective complaints) in individuals with subjective cognitive impairment (SCI), amnestic mild cognitive impairment (aMCI), and mild Alzheimer's disease (AD). The study included a total of 115 participants (mean age: 68.82 ± 8.83 years) with SCI (n = 34), aMCI (n = 46), and mild AD (n = 35). Memory complaints were assessed using the Prospective and Retrospective Memory Questionnaire (PRMQ), which consists of 16 items that describe everyday memory failure of both prospective memory (PM) and retrospective memory (RM). For aMCI and AD subjects, informants also completed an informant-rating of the PRMQ. All participants completed detailed neuropsychological tests. Results show that PM complaints were equivalent among the three groups. However, RM complaints differed. Specifically, RM complaints in aMCI were higher than SCI, but similar to AD. Informant-reported memory complaints were higher for AD than aMCI. Our study suggests that RM complaints of memory complaints may be helpful in discriminating between SCI and aMCI, but both PM and RM complaints are of limited value in differentiating aMCI from AD.

  19. Executive dysfunction and gray matter atrophy in amnestic mild cognitive impairment.

    Science.gov (United States)

    Zheng, Dongming; Sun, Hongzan; Dong, Xiaoyu; Liu, Baiwei; Xu, Yongchuan; Chen, Sipan; Song, Lichun; Zhang, Hong; Wang, Xiaoming

    2014-03-01

    Recent studies have shown that impairment in executive function (EF) is common in patients with amnestic mild cognitive impairment (aMCI). However, the neuroanatomic basis of executive impairment in patients with aMCI remains unclear. In this study, multiple regression voxel-based morphometry analyses were used to examine the relationship between regional gray matter volumes and EF performance in 50 patients with aMCI and 48 healthy age-matched controls. The core EF components (response inhibition, working memory and task switching, based on the EF model of Miyake et al) were accessed with computerized tasks. Atrophic brain areas related to decreases in the three EF components in patients with aMCI were located in the frontal and temporal cortices. Within the frontal cortex, the brain region related to response inhibition was identified in the right inferior frontal gyrus. Brain regions related to working memory were located in the left anterior cingulate gyrus, left premotor cortex, and right inferior frontal gyrus, and brain regions related to task shifting were distributed in the bilateral frontal cortex. Atrophy in the right inferior frontal gyrus was most closely associated with a decrease in all three EF components in patients with aMCI. Our data, from the perspective of brain morphology, contribute to a better understanding of the role of these brain areas in the neural network of EF.

  20. Structural Neuroimaging of Concomitant Depressive Symptoms in Amnestic Mild Cognitive Impairment: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jean-François Morin

    2012-11-01

    Full Text Available Late-life depression (LLD and amnestic mild cognitive impairment (aMCI can both denote prodromal Alzheimer’s disease. While the two concepts share common clinical features, differential diagnosis between them is crucial. The objective of this pilot study was to explore differences in terms of the hippocampal (HC and entorhinal cortex (EC volume reduction between LLD and aMCI patients with (aMCI/D+ group or without (aMCI group depressive symptoms. Six LLD, 6 aMCI, and 6 aMCI/D+ participants were assessed using a structural magnetic resonance imaging protocol. Manual segmentation of HC and EC was carried out. The results of volumetric comparisons suggest that the HC was larger in aMCI/D+ and LLD subjects compared to aMCI participants. The left EC mean volume was slightly lower in aMCI/D+ subjects. Power analyses revealed that 36 participants per group would suffice to confirm these findings. Overall, these pilot findings suggest that aMCI can be distinguished from LLD based on cerebral atrophy measures, and that HC and EC atrophy in aMCI varies according to the presence or absence of depressive symptoms.

  1. Naturalistic Action Performance Distinguishes Amnestic Mild Cognitive Impairment from Healthy Aging.

    Science.gov (United States)

    Gold, David A; Park, Norman W; Murphy, Kelly J; Troyer, Angela K

    2015-07-01

    Individuals with amnestic mild cognitive impairment (aMCI) show minor decrements in their instrumental activities of daily living (IADL). Sensitive measures of IADL performance are needed to capture the mild difficulties observed in aMCI groups. Routine naturalistic actions (NAs) are familiar IADL-type activities that require individuals to enact everyday tasks such as preparing coffee. In the current study we examined the extent to which NAs could be used to help facilitate differential diagnosis of aMCI relative to composite measures of episodic memory, semantic knowledge, and executive function. Healthy older adults (n=24) and individuals with aMCI (n=24) enacted two highly familiar NAs and completed tests of episodic memory, semantic knowledge, and executive function. Binary logistic regression was used to predict group membership (aMCI vs. control participants). The regression analyses indicated that NA performance could reliably predict group membership, over and above measures of cognitive functioning. These findings indicated that NA performance can be used to help facilitate differential diagnosis of healthy aging and aMCI and used as an outcome measure in intervention studies.

  2. Plasma fatty acid lipidomics in amnestic mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Iuliano, Luigi; Pacelli, Antonio; Ciacciarelli, Marco; Zerbinati, Chiara; Fagioli, Sabrina; Piras, Fabrizio; Orfei, Maria Donata; Bossù, Paola; Pazzelli, Floriana; Serviddio, Gaetano; Caltagirone, Carlo; Spalletta, Gianfranco

    2013-01-01

    Polyunsaturated fatty acids (PUFA) of the n-3 series have been linked to brain physiology and cognitive decline, but little is known about the other components of the complex fatty acids category. Here, we compared 30 molecular species pertaining to saturated, monounsaturated, polyunsaturated, and trans fatty acids, measured in plasma by gas chromatography, in 14 patients with a diagnosis of amnestic single domain mild cognitive impairment (aMCI), 30 patients with mild Alzheimer's disease (AD), and 30 healthy controls (HC). As no participants showed neuroimaging evidence of cerebrovascular disease, patients could be considered as purely neurodegenerative. We found differences in specific components of almost all fatty acid classes except n-3-polyunsaturated fatty acids. Compared with HC, aMCI and AD patients had higher levels of arachidic (C20:0), erucic (C22:1, n-9), and vaccenic acid (C18:1, n-9) and lower levels of cerotic (C26:0) and linoleic acid (C18:2, n-6). In particular, level of linoleic acid decreased and level of mead acid increased progressively from HC to aMCI to AD patients, and they were also inversely correlated in AD and aMCI patients. In conclusion, we found a previously unrecognized linoleic acid deficiency in the early phase of neurodegeneration that was strongly supported by an increased, compensatory mead acid level. These findings suggest the importance of creating new dietary manipulation strategies to counteract disease progression.

  3. Intimate Partner Violence and Alcohol, Drug, and Mental Disorders among American Indian Women from Southwest Tribes in Primary Care

    Science.gov (United States)

    Duran, Bonnie; Oetzel, John; Parker, Tassy; Malcoe, Lorraine Halinka; Lucero, Julie; Jiang, Yizhou

    2009-01-01

    The relationship of intimate partner violence (IPV) with mental disorders was investigated among 234 American Indian/Alaska Native female primary care patients. Results indicated that unadjusted prevalence ratios for severe physical or sexual abuse (relative to no IPV) were significant for anxiety, PTSD, mood, and any mental disorder. Adjusted…

  4. Interaction between ALDH2*1*1 and DRD2/ANKK1 TaqI A1A1 genes may be associated with antisocial personality disorder not co-morbid with alcoholism.

    Science.gov (United States)

    Lu, Ru-Band; Lee, Jia-Fu; Huang, San-Yuan; Lee, Sheng-Yu; Chang, Yun-Hsuan; Kuo, Po-Hsiu; Chen, Shiou-Lan; Chen, Shih-Heng; Chu, Chun-Hsien; Lin, Wei-Wen; Wu, Pei-Lin; Ko, Huei-Chen

    2012-09-01

    Previous studies on acetaldehyde dehydrogenase 2 (ALDH2) focused on drinking behavior or alcoholism because the ALDH2*2 allele protects against the risk of developing alcoholism. The mechanism provides that the ALDH2 gene's protective effect is also involved in dopamine metabolism. The interaction of the ALDH2 gene with neurotransmitters, such as dopamine, is suggested to be related to alcoholism. Because alcoholism is often co-morbid with antisocial personality disorder (ASPD), previous association studies on antisocial alcoholism cannot differentiate whether those genes relate to ASPD with alcoholism or ASPD only. This study examined the influence of the interaction effect of the ALDH2*1*1, *1*2 or *2*2 polymorphisms with the dopamine 2 receptor (DRD2) Taq I polymorphism on ASPD. Our 541 Han Chinese male participants were classified into three groups: antisocial alcoholism (ASPD co-morbid with alcohol dependence, antisocial ALC; n = 133), ASPD without alcoholism (ASPD not co-morbid with alcohol dependence, antisocial non-ALC; n = 164) and community controls (healthy volunteers from the community; n = 244). Compared with healthy controls, individuals with the DRD2 A1/A1 and the ALDH2*1/*1 genotypes were at a 5.39 times greater risk for antisocial non-ALC than were those with other genotypes. Our results suggest that the DRD2/ANKK1 and ALDH2 genes interacted in the antisocial non-ALC group; a connection neglected in previous studies caused by not separating antisocial ALC from ASPD. Our study made this distinction and showed that these two genes may be associated ASPD without co-morbid alcoholism.

  5. P2X4 receptors (P2X4Rs represent a novel target for the development of drugs to prevent and/or treat alcohol use disorders

    Directory of Open Access Journals (Sweden)

    Kelle M. Franklin

    2014-06-01

    Full Text Available Alcohol use disorders (AUDs have a staggering socioeconomic impact. Few therapeutic options are available, and they are largely inadequate. These shortcomings highlight the urgent need to develop effective medications to prevent and/or treat AUDs. A critical barrier is the lack of information regarding the molecular target(s by which ethanol (EtOH exerts its pharmacological activity. This review highlights findings implicating P2X4 receptors (P2X4Rs as a target for the development of therapeutics to treat AUDs and discusses the use of ivermectin (IVM as a potential clinical tool for treatment of AUDs. P2XRs are a family of ligand-gated ion channels activated by extracellular ATP. Of the P2XR subtypes, P2X4Rs are expressed the most abundantly in the CNS. Converging evidence suggests that P2X4Rs are involved in the development and progression of AUDs. First, in vitro studies report that pharmacologically relevant EtOH concentrations can negatively modulate ATP-activated currents. Second, P2X4Rs in the mesocorticolimbic dopamine system are thought to play a role in synaptic plasticity and are located ideally to modulate brain reward systems. Third, alcohol-preferring (P rats have lower functional expression of the p2rx4 gene than alcohol-non-preferring (NP rats suggesting an inverse relationship between alcohol intake and P2X4R expression. Similarly, whole brain p2rx4 expression has been shown to relate inversely to innate 24 hr alcohol preference across 28 strains of rats. Fourth, mice lacking the p2rx4 gene drink more EtOH than wildtype controls. Fifth, IVM, a positive modulator of P2X4Rs, antagonizes EtOH-mediated inhibition of P2X4Rs in vitro and reduces EtOH intake and preference in vivo. These findings suggest that P2X4Rs contribute to EtOH intake. The present review summarizes recent findings focusing on the P2X4R as a molecular target of EtOH action, its role in EtOH drinking behavior and modulation of its activity by IVM as a potential

  6. Uncovering genes for cognitive (dys)function and predisposition for alcoholism spectrum disorders: a review of human brain oscillations as effective endophenotypes.

    Science.gov (United States)

    Rangaswamy, Madhavi; Porjesz, Bernice

    2008-10-15

    Brain oscillations provide a rich source of potentially useful endophenotypes (intermediate phenotypes) for psychiatric genetics, as they represent important correlates of human information processing and are associated with fundamental processes from perception to cognition. These oscillations are highly heritable, are modulated by genes controlling neurotransmitters in the brain, and provide links to associative and integrative brain functions. These endophenotypes represent traits that are less complex and more proximal to gene function than either diagnostic labels or traditional cognitive measures, providing a powerful strategy in searching for genes in psychiatric disorders. These intermediate phenotypes identify both affected and unaffected members of an affected family, including offspring at risk, providing a more direct connection with underlying biological vulnerability. Our group has utilized heritable neurophysiological features (i.e., brain oscillations) as endophenotypes, making it possible to identify susceptibility genes that may be difficult to detect with diagnosis alone. We have discussed our findings of significant linkage and association between brain oscillations and genes in GABAergic, cholinergic and glutamatergic systems (GABRA2, CHRM2, and GRM8). We have also shown that some oscillatory indices from both resting and active cognitive states have revealed a common subset of genetic foci that are shared with the diagnosis of alcoholism and related disorders. Implications of our findings have been discussed in the context of physiological and pharmacological studies on receptor function. These findings underscore the utility of quantitative neurophysiological endophenotypes in the study of the genetics of brain function and the genetic diathesis underlying complex psychiatric disorders.

  7. Alcohol Dependence and Alcoholic Liver Disease

    Directory of Open Access Journals (Sweden)

    Karl Mann

    2015-01-01

    Full Text Available Alcohol dependence is a disabling condition that has a high prevalence, but in Europe only a small fraction of the people diagnosed with alcohol abuse and dependence are treated, representing the widest treatment gap, as compared with other mental disorders. Early diagnosis and monitoring of alcoholic liver disease (ALD is still insufficiently solved. Although ALD is the most common cause for liver disease in the Western world, it largely remains underestimated and underdiagnosed for many reasons. The recent introduction of non-invasive elastographic techniques such as transient elastography (TE has significantly improved the early diagnosis of alcoholic liver cirrhosis (ALC. As demonstrated in the literature, inflammation-associated liver stiffness (LS rapidly decreases during alcohol detoxification, and is also directly correlated to change in LS in both abstinent and relapsing patients. Newly published data show that LS could be used to monitor and validate hepatoprotective effects during nalmefene usage. Nalmefene is an opioid system modulator that diminishes the reinforcing effects of alcohol, helping the patient to reduce drinking. Three randomised, multicentre, double-blind, placebo-controlled, parallelgroup Phase III studies were designed to assess the efficacy and safety of nalmefene in reducing alcohol consumption. Patients with a high or very high drinking risk level (DRL at baseline and randomisation show a clinically significant effect from nalmefene treatment, which is generally well tolerated. Moreover, reduced alcohol consumption supported by nalmefene in combination with psychosocial support may indeed help to reduce the alcohol-related burden and the large treatment gap.

  8. Perspectives on the neuroscience of alcohol from the National Institute on Alcohol Abuse and Alcoholism.

    Science.gov (United States)

    Reilly, Matthew T; Noronha, Antonio; Warren, Kenneth

    2014-01-01

    Mounting evidence over the last 40 years clearly indicates that alcoholism (alcohol dependence) is a disorder of the brain. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has taken significant steps to advance research into the neuroscience of alcohol. The Division of Neuroscience and Behavior (DNB) was formed within NIAAA in 2002 to oversee, fund, and direct all research areas that examine the effects of alcohol on the brain, the genetic underpinnings of alcohol dependence, the neuroadaptations resulting from excessive alcohol consumption, advanced behavioral models of the various stages of the addiction cycle, and preclinical medications development. This research portfolio has produced important discoveries in the etiology, treatment, and prevention of alcohol abuse and dependence. Several of these salient discoveries are highlighted and future areas of neuroscience research on alcohol are presented.

  9. Developing a Group Motivational Interviewing Intervention for Adolescents At-Risk for Developing an Alcohol or Drug use Disorder

    OpenAIRE

    D’Amico, Elizabeth J.; Osilla, Karen Chan; Hunter, Sarah B.

    2010-01-01

    This study examined how teens who had committed a first-time alcohol or other drug (AOD) offense responded to a motivational interviewing (MI) group intervention. Participants were 101 first-time AOD adolescent offenders (M=15.88; 63% male, 54% Hispanic). We developed and tested a six-session curriculum called Free Talk and solicited feedback from different teens after each session. Groups were recorded and transcribed. Feedback was categorized using the Motivational Interviewing Treatment In...

  10. The Risks Associated With Alcohol Use and Alcoholism

    OpenAIRE

    Rehm, Jürgen

    2011-01-01

    Alcohol consumption, particularly heavier drinking, is an important risk factor for many health problems and, thus, is a major contributor to the global burden of disease. In fact, alcohol is a necessary underlying cause for more than 30 conditions and a contributing factor to many more. The most common disease categories that are entirely or partly caused by alcohol consumption include infectious diseases, cancer, diabetes, neuropsychiatric diseases (including alcohol use disorders), cardiov...

  11. Interactive voice response for relapse prevention following cognitive-behavioral therapy for alcohol use disorders: a pilot study.

    Science.gov (United States)

    Rose, Gail L; Skelly, Joan M; Badger, Gary J; Naylor, Magdalena R; Helzer, John E

    2012-05-01

    Relapse after alcoholism treatment is high. Alcohol Therapeutic Interactive Voice Response (ATIVR) is an automated telephone program for posttreatment self-monitoring, skills practice, and feedback. This pilot study examined feasibility of ATIVR. Participants (n = 21; 57% male) had access to ATIVR for 90 days following outpatient group cognitive-behavioral therapy (CBT) to make daily reports of mood, confidence in sobriety, urges to use substances, and actual use. Reports of relapse or risk were followed with additional questions. Participants received personalized therapist feedback based on responses, and could access recorded CBT skill reviews. Pre-post assessments included: alcohol consumption (Timeline Follow-Back), self-efficacy (Situational Confidence Questionnaire), and perceived coping ability (Effectiveness of Coping Behaviors Inventory). Participants called on 59% of scheduled days and continued making calls for an average of 84 days. Following ATIVR, participants gave feedback that ATIVR was easy to use and increased self-awareness. Participants particularly liked the therapist feedback component. Abstinence rate increased significantly during ATIVR (p = .03), and both self-efficacy and coping significantly improved from pre-CBT to post-ATIVR (p efficacy should be evaluated in a randomized controlled trial.

  12. 78 cases of patients with mental disorders due to alcohol ECG analysis%78例酒精所致精神障碍病人的心电图分析

    Institute of Scientific and Technical Information of China (English)

    余利英

    2013-01-01

    Objective:To understand the impact of alcohol on the ECG changes and cardiac function relationships. Methods :Meet CCMD-3 diagnostic criteria for mental disorders caused by alcohol 78 cases of patients with mental disorders due to alcohol ECG analysis. Results:Patients with mental disorders due to alcohol ECG changes are: sinus tachycardia, sinus arrhythmia, limb leads low voltage, high voltage left ventricular and left ventricular hypertrophy, ST-T changes. Conclusions:Excessive alcohol consumption on electrocardiogram influential with cardiovascular damage related.%目的:了解酒精对心电图变化的影响与心功能之间的关系。方法:对符合CCMD-3酒精所致精神障碍诊断标准的78例酒精所致精神障碍患者进行心电图检查分析。结果:酒精所致精神障碍患者的心电图改变为:窦性心动过速,窦性心律不齐,肢体导联低电压,左心室高电压及左心室肥厚,ST-T改变。结论:过度饮酒对心电图有影响并与心血管损害有关。

  13. Genetics and alcoholism.

    Science.gov (United States)

    Edenberg, Howard J; Foroud, Tatiana

    2013-08-01

    Alcohol is widely consumed; however, excessive use creates serious physical, psychological and social problems and contributes to the pathogenesis of many diseases. Alcohol use disorders (that is, alcohol dependence and alcohol abuse) are maladaptive patterns of excessive drinking that lead to serious problems. Abundant evidence indicates that alcohol dependence (alcoholism) is a complex genetic disease, with variations in a large number of genes affecting a person's risk of alcoholism. Some of these genes have been identified, including two genes involved in the metabolism of alcohol (ADH1B and ALDH2) that have the strongest known affects on the risk of alcoholism. Studies continue to reveal other genes in which variants affect the risk of alcoholism or related traits, including GABRA2, CHRM2, KCNJ6 and AUTS2. As more variants are analysed and studies are combined for meta-analysis to achieve increased sample sizes, an improved picture of the many genes and pathways that affect the risk of alcoholism will be possible.

  14. The Effectiveness of Visual Short-Time Neurofeedback on Brain Activity and Clinical Characteristics in Alcohol Use Disorders: Practical Issues and Results.

    Science.gov (United States)

    Lackner, Nina; Unterrainer, Human F; Skliris, Dimitris; Wood, Guilherme; Wallner-Liebmann, Sandra J; Neuper, Christa; Gruzelier, John H

    2016-07-01

    The present study was carried out to examine the efficacy of alpha/theta neurofeedback (NF) with a new visual paradigm in a cohort of alcohol use disordered (AUD) patients (n = 25) treated in an Austrian therapeutic community center. The experimental study design focused on changes in absolute and relative resting EEG band power as well as in clinical variables, including depression (Beck Depresion Inventory [BDI-V]), psychiatric symptoms (Brief Symptom Inventory [BSI], coping (Freiburg Questionnaire on Coping with Illness [FKV-lis]), psychotherapy motivation (Therapy Motivation Questionnaire [FPTM-23]), sense of coherence (Sense of Coherence Scale [SOC-13]), posttraumatic growth (Posttraumatic Growth Inventory [PPR]), and alcohol cravings (Alcohol Craving Questionnaire [ACQ]). For measuring training effects, participants were randomly allocated to 2 groups: an experimental group (EG, n = 13) and a control group (CG, n = 12). Patients in EG received 12 sessions of visual NF training over a period of 6 weeks to enhance alpha (8-12 Hz) and theta (4-7 Hz) frequency band power in addition to the standard treatment program of the rehabilitation center. Participants in CG received no additional NF intervention. The multivariate analysis of covariance (MANCOVA) showed a change by trend in absolute alpha and theta power in the EG. Even though no MANCOVA effects were found in the clinical scales, AUD patients reported increasing control of their brain activity during the course of NF. However, changes in several clinical scales (BDI-V, BSI, FKV-lis, PPR) from pre- to posttest were observed only in the EG contrary to the CG. The findings of this pilot study provide first evidence for the practicality and effectiveness of visual short-term NF as an additive intervention in the therapeutic community.

  15. Transtorno de estresse pós-traumático em dependente do álcool Post-traumatic stress disorder and alcoholism

    Directory of Open Access Journals (Sweden)

    Gilda Pulcherio

    2008-01-01

    promover o tratamento adequado.BACKGROUND: Psychiatric comorbidity is common among addicted patients. Post-traumatic stress disorder (PTSD is a highly symptomatic anxiety disorder of acute onset after a major distressing life-event. OBJECTIVES: In clinical practice, patients suffering from drug addiction invariably report the occurrence of psychologically stressful episodes, with frequencies of PTSD ranging from 30% to 60%. Among patients suffering from alcohol dependence, the prevalence of PTSD is estimated to range between 10% and 40%. METHODS: We report the case of a 40-year old alcoholic man presenting with comorbid bipolar disorder and long-lasting symptoms of PTSD. The subject was an outpatient at the Institute for Prevention and Research on Alcohol and Other Addictions (Instituto de Prevenção e Pesquisa em Álcool e Outras Dependências - IPPAD, being assessed for the occurrence of PTSD with the aid of several psychometric instruments. RESULTS: Data derived from clinical sessions and research interviews include the Davidson Trauma Scale (DTS, which was administered at baseline and after one year of follow-up, yielding scores of 75 and 40 respectively. Global response to treatment was achieved after the recognition and appropriate treatment of the latter condition, along with the combined approach to other comorbid disorders. DISCUSSION: The investigation of traumatic events should be encouraged in the clinical management of alcoholic patients.

  16. What once was sick is now bad: The shift from victim to deviant identity for those diagnosed with fetal alcohol spectrum disorder

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    Erin Dej

    2011-01-01

    Full Text Available Fetal alcohol spectrum disorder (FASD is constituted by different networks and institutions. I demonstrate that while the symptoms associated with FASD do not differ from childhood to adulthood, their conceptualization and thus societal and governmental responses to individuals with FASD change dramatically. This research is theoretically grounded in Rose’s work on psy-identities andHacking’s concept of a looping effect. To unpack the reconstitution of the FASD identity from childhood to adulthood I have identified two linked but distinctive loops — that of the promising child and the deviant adult. These two loops conceptualize the different institutions, stakeholders, and knowledges that take interest in the “FASD child” and those that constitute the “FASD adult” identitywithin the criminal justice system.

  17. Disrupted white matter integrity is associated with cognitive deficits in patients with amnestic mild cognitive impairment: An atlas-based study

    Directory of Open Access Journals (Sweden)

    Duan Liu

    2016-06-01

    Full Text Available Objective: This study investigated white matter integrity in patients with amnestic mild cognitive impairment by diffusion tensor imaging. Methods: A total of 83 patients with amnestic mild cognitive impairment and 85 elderly healthy controls underwent neuropsychological testing and a diffusion tensor imaging scan. Whole-brain white matter data were parcellated into 50 regions based on the anatomical ICBM-DTI-81 atlas, and regional diffusion metrics consisting of fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity were calculated for each region. Diffusion tensor imaging indices were compared between groups, and it was determined that between-group differences were significantly correlated with neurocognitive performance. Results: Relative to the healthy controls group, the amnestic mild cognitive impairment group exhibited poorer cognitive performance in all neuropsychological tests except the complex figure test (p = 0.083 and showed decreased mean fractional anisotropy in the fornix, increased mean diffusivity in the fornix and bilateral uncinate fasciculus, elevated axial diffusivity in the fornix and genu of corpus callosum, and elevated radial diffusivity in the fornix and bilateral uncinate fasciculus (p < 0.05. Behaviorally, integrity of the bilateral uncinate fasciculus was correlated positively with episodic memory function, while left uncinate fasciculus integrity was positively associated with language function in the amnestic mild cognitive impairment group (p < 0.05. Conclusion: White matter abnormalities in neural pathways associated with memory were correlated with neurocognitive deficiencies in amnestic mild cognitive impairment. Given that amnestic mild cognitive impairment is putatively a prodromal syndrome for Alzheimer’s disease, this study furthers our understanding of the white matter changes associated with Alzheimer’s disease pathogenesis in the predementia stage.

  18. Alcohol Intolerance

    Science.gov (United States)

    ... beer-alcohol.aspx. Accessed Jan. 16, 2015. Alcohol angioedema and uticaria. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/ask-the-expert/alcohol-angioedema-urticaria.aspx. Accessed Jan. 16, 2015. Alcohol and ...

  19. Gene-specific of endocannabinoid receptor 1 (cnr1a) by ethanol probably leads to the development of fetal alcohol spectrum disorder (FASD) phenotypes in Japanese rice fish (Oryzias latipes) embryogenesis

    Science.gov (United States)

    Developmental ethanol exposure is able to induce Fetal Alcohol Spectrum Disorder (FASD) phenotypes in Japanese rice fish (Oryzias latipes). This study investigated possible differential expression of cannabinoid receptor (cnr) mRNAs during Japanese rice fish embryogenesis and variability to ethanol-...

  20. Cardiovascular disease risks in adult Native and Mexican Americans with a history of alcohol use disorders: association with cardiovascular autonomic control.

    Science.gov (United States)

    Criado, José R; Gilder, David A; Kalafut, Mary A; Ehlers, Cindy L

    2016-04-01

    Hypertension and obesity are serious health problems that have been associated with an increased risk of cardiovascular disease (CVD). We recently showed a relationship between hypertension, obesity and cardiovagal control in a sample of Native and Mexican Americans at high risk of alcohol use disorders (AUD). While studies have shown that Native and Mexican Americans exhibit high rates of AUD, the consequences of AUD on CVD risk factors and their relationship with cardiovascular autonomic control is not well understood in these ethnic groups. This study investigated whether an association could be demonstrated between cardiovascular autonomic control and several CVD risk factors in Native and Mexican American men and women (n = 228) who are literate in English and are residing legally in San Diego County. Participants with lifetime history of AUD showed higher rates of systolic and diastolic hypertension and obesity than participants without lifetime AUD. Lifetime AUD was significantly associated with reduced HR response to deep breathing (HRDB) measure of cardiovagal control, higher current drinking quantity, and obesity. Reduced HRDB was also associated with increased systolic pre-hypertension or hypertension (pre-/hypertension) and with higher diastolic blood pressure in a linear regression model that included several diagnostic and demographic variables. HRDB and time- and frequency-domain measures of cardiovagal control were significantly reduced in participants with diastolic pre-/hypertension. These data suggest that lower cardiovagal control may play a role in the prevalence of systolic and diastolic pre-/hypertension in a community sample with a history of alcohol and substance use disorders.

  1. Steep Decrease of Gender Difference in DSM-IV Alcohol Use Disorder: A Comparison of Two Nation-wide Surveys Conducted 10 Years Apart in Korea.

    Science.gov (United States)

    Seong, Su Jeong; Hong, Jin Pyo; Hahm, Bong-Jin; Jeon, Hong Jin; Sohn, Jee Hoon; Lee, Jun Young; Cho, Maeng Je

    2015-11-01

    While decreasing trend in gender differences in alcohol use disorders was reported in Western countries, the change in Asian countries is unknown. This study aims to explore the shifts in gender difference in alcohol abuse (AA) and dependence (AD) in Korea. We compared the data from two nation-wide community surveys to evaluate gender differences in lifetime AA and AD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Face-to-face interviews using the Composite International Diagnostic Interview (CIDI) were applied to all subjects in 2001 (n=6,220) and 2011 (n=6,022). Male-to-female ratio of odds was decreased from 6.41 (95% CI, 4.81-8.54) to 4.37 (95% CI, 3.35-5.71) for AA and from 3.75 (95% CI, 2.96-4.75) to 2.40 (95% CI, 1.80-3.19) for AD. Among those aged 18-29, gender gap even became statistically insignificant for AA (OR, 1.59; 95% CI, 0.97-2.63) and AD (OR, 1.18; 95% CI, 0.80-2.41) in 2011. Men generally showed decreased odds for AD (0.55; 95% CI, 0.45-0.67) and women aged 30-39 showed increased odds for AA (2.13; 95% CI 1.18-3.84) in 2011 compared to 2001. Decreased AD in men and increased AA in women seem to contribute to the decrease of gender gap. Increased risk for AA in young women suggests needs for interventions.

  2. Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial.

    Science.gov (United States)

    Luchsinger, José A; Perez, Thania; Chang, Helena; Mehta, Pankaj; Steffener, Jason; Pradabhan, Gnanavalli; Ichise, Masanori; Manly, Jennifer; Devanand, Davangere P; Bagiella, Emilia

    2016-01-01

    Diabetes and hyperinsulinemia may be risk factors for Alzheimer's disease (AD). We conducted a pilot study of metformin, a medication efficacious in treating and preventing diabetes while reducing hyperinsulinemia, among persons with amnestic mild cognitive impairment (aMCI) with the goal of collecting preliminary data on feasibility, safety, and efficacy. Participants were 80 men and women aged 55 to 90 years with aMCI, overweight or obese, without treated diabetes. We randomized participants to metformin 1000 mg twice a day or matching placebo for 12 months. The co-primary clinical outcomes were changes from baseline to 12 months in total recall of the Selective Reminding Test (SRT) and the score of the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog). The secondary outcome was change in relative glucose uptake in the posterior cingulate-precuneus in brain fluorodeoxyglucose positron emission tomography. Change in plasma Aβ42 was an exploratory outcome. The mean age of participants was 65 years. Fifty percent of participants were women. The only baseline variable that was different between the arms was the ADAS-Cog. Metformin could not be tolerated by 7.5% of participants; 15% tolerated 500 mg/day, 35% tolerated 1000 mg/day, 32.5% tolerated 1500 mg/day, and only 10% tolerated the maximum dose. There were no serious adverse events related to metformin. The 7.5% of persons who did not tolerate metformin reported gastrointestinal symptoms. After adjusting for baseline ADAS-cog, changes in total recall of the SRT favored the metformin group (9.7±8.5 versus 5.3±8.5; p = 0.02). Differences for other outcomes were not significant. A larger trial seems warranted to evaluate the efficacy and cognitive safety of metformin in prodromal AD.

  3. White Matter Abnormalities in Two Different Subtypes of Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Liu, Jianghong; Liang, Peipeng; Yin, Linlin; Shu, Ni; Zhao, Tengda; Xing, Yi; Li, Fangyu; Zhao, Zhilian; Li, Kuncheng; Han, Ying

    2017-01-01

    White matter (WM) degeneration has been found during the course of cognitive decline in both Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI), however, it is unclear whether there are different WM microstructural abnormalities between two subtypes of aMCI, including single domain aMCI (aMCI-s) and multiple domain aMCI (aMCI-m). Thirty-two patients of aMCI single-domain (aMCI-s), twenty-three patients of aMCI multiple-domain (aMCI-m) and twenty-three healthy normal controls (NC) participated in this study. Neuropsychological measures and diffusion tensor imaging (DTI) data were acquired from each subject and tract-based spatial statistics (TBSS) was implemented. It was found that both aMCI groups showed significantly reduced fractional anisotropy (FA) in the right superior longitudinal fasciculus (SLF) than NC. It was also identified that, as compared to aMCI-m, aMCI-s showed significantly decreased FA in the left SLF, left uncinate fasciculus (UF) and left inferior longitudinal fasciculus (ILF), while significantly increased FA in the left anterior thalamic radiation (ATR). The correlation analysis showed that FA values in the regions with group difference were significantly correlated with cognitive functions as measured by Boston naming test and trail making test. These results suggested that the variations of aMCI may be differentiated by FA indexes and DTI may help to understand why specific signs and symptoms occur in patients. PMID:28107493

  4. Fast, but not slow, familiarity is preserved in patients with amnestic mild cognitive impairment.

    Science.gov (United States)

    Besson, Gabriel; Ceccaldi, Mathieu; Tramoni, Eve; Felician, Olivier; Didic, Mira; Barbeau, Emmanuel J

    2015-04-01

    Recognition memory--affected early in the course of Alzheimer Disease (AD)--is supposed to rely on two processes: recollection (i.e., retrieval of details from the encoding episode) and familiarity (i.e., acontextual sense of prior exposure). Recollection has repeatedly been shown to be impaired in patients with amnestic Mild Cognitive Impairment (aMCI)--known to be at high risk for AD. However, studies that evaluated familiarity in these patients have reported conflicting results. Here, we assessed familiarity in single-domain aMCI patients (n = 19) and healthy matched controls (n = 22). All participants underwent a classic yes/no recognition memory paradigm with confidence judgements, allowing an estimation of familiarity and recollection similar to the approach used in previous studies. In addition, they underwent a novel speeded recognition memory task, the Speed and Accuracy Boosting procedure, based on the idea that familiarity is fast and hence that fast answers rely on familiarity. On the classic yes/no task, aMCI patients were found to have impaired performance, reaction times, recollection and familiarity. However, performance and reaction times of aMCI patients did not differ from that of controls in the speeded task. This is noteworthy since this task was comparatively difficult for control subjects. This dissociation within familiarity suggests that a very basic component of declarative memory, probably at the interface between implicit and explicit memory, may be preserved, or possibly released, in patients with aMCI. It is suggested that early subprocesses (e.g., fluency based familiarity) could be preserved in aMCI patients, while delayed ones (e.g., conceptual fluency, post-retrieval monitoring, confidence assessment, or even access to awareness) may be impaired. These findings may provide support for recent suggestions that familiarity may result from the combination of a set of subprocesses, each with its specific temporal signature.

  5. Microstructural white matter changes, not hippocampal atrophy, detect early amnestic mild cognitive impairment.

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    Lin Zhuang

    Full Text Available BACKGROUND: Alzheimer's disease (AD is generally considered to be characterized by pathology in gray matter of the brain, but convergent evidence suggests that white matter degradation also plays a vital role in its pathogenesis. The evolution of white matter deterioration and its relationship with gray matter atrophy remains elusive in amnestic mild cognitive impairment (aMCI, a prodromal stage of AD. METHODS: We studied 155 cognitively normal (CN and 27 'late' aMCI individuals with stable diagnosis over 2 years, and 39 'early' aMCI individuals who had converted from CN to aMCI at 2-year follow up. Diffusion tensor imaging (DTI tractography was used to reconstruct six white matter tracts three limbic tracts critical for episodic memory function - the fornix, the parahippocampal cingulum, and the uncinate fasciculus; two cortico-cortical association fiber tracts - superior longitudinal fasciculus and inferior longitudinal fasciculus; and one projection fiber tract - corticospinal tract. Microstructural integrity as measured by fractional anisotropy (FA, mean diffusivity (MD, radial diffusivity (RD and axial diffusivity (AxD was assessed for these tracts. RESULTS: Compared with CN, late aMCI had lower white matter integrity in the fornix, the parahippocampal cingulum, and the uncinate fasciculus, while early aMCI showed white matter damage in the fornix. In addition, fornical measures were correlated with hippocampal atrophy in late aMCI, whereas abnormality of the fornix in early aMCI occurred in the absence of hippocampal atrophy and did not correlate with hippocampal volumes. CONCLUSIONS: Limbic white matter tracts are preferentially affected in the early stages of cognitive dysfunction. Microstructural degradation of the fornix preceding hippocampal atrophy may serve as a novel imaging marker for aMCI at an early stage.

  6. Regional cingulum disruption, not gray matter atrophy, detects cognitive changes in amnestic mild cognitive impairment subtypes.

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    Chang, Yu-Ling; Chen, Ta-Fu; Shih, Yao-Chia; Chiu, Ming-Jang; Yan, Sui-Hing; Tseng, Wen-Yih Isaac

    2015-01-01

    Amnestic mild cognitive impairment (aMCI), which has a high risk of progression to Alzheimer's disease (AD), can be classified into single domain (S-aMCI) and multiple domain (M-aMCI) subtypes. We investigated the integrity of regional gray matter and segments of the cingulum bundle with diffusion spectrum imaging tract-specific analysis, and their relationships to neuropsychological functioning, in 46 individuals with aMCI (S-aMCI n = 24; M-aMCI n = 22) and 36 healthy controls (HC). Results demonstrated that although both aMCI groups were impaired on all memory measures relative to HCs, the M-aMCI group demonstrated worse performance on paired association memory and on selective executive function relative to the S-aMCI group. The two aMCI groups did not show significant atrophy in regional gray matter indices as compared to the HC group, but the M-aMCI group showed significant disruption in white matter of the left anterior and inferior cingulum bundles relative to the S-aMCI and HC groups. Furthermore, disruption in the inferior cingulum bundles was significantly associated with executive function and attention/processing speed in all aMCI participants above and beyond the contribution of bilateral hippocampal volumes. Overall, these results indicate that the degeneration of cingulum fibers did not appear to arise from degeneration of the corresponding cerebral cortex. It also suggests relatively greater sensitivity of a white matter biomarker and comprehensive neuropsychological evaluation over gray matter biomarkers in early detection of AD.

  7. Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment

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    Malek-Ahmadi Michael

    2012-02-01

    Full Text Available Abstract Background Differentiating amnestic mild cognitive impairment (aMCI from normal cognition is difficult in clinical settings. Self-reported and informant-reported memory complaints occur often in both clinical groups, which then necessitates the use of a comprehensive neuropsychological examination to make a differential diagnosis. However, the ability to identify cognitive symptoms that are predictive of aMCI through informant-based information may provide some clinical utility in accurately identifying individuals who are at risk for developing Alzheimer's disease (AD. Methods The current study utilized a case-control design using data from an ongoing validation study of the Alzheimer's Questionnaire (AQ, an informant-based dementia assessment. Data from 51 cognitively normal (CN individuals participating in a brain donation program and 47 aMCI individuals seen in a neurology practice at the same institute were analyzed to determine which AQ items differentiated aMCI from CN individuals. Results Forward stepwise multiple logistic regression analysis which controlled for age and education showed that 4 AQ items were strong indicators of aMCI which included: repetition of statements and/or questions [OR 13.20 (3.02, 57.66]; trouble knowing the day, date, month, year, and time [OR 17.97 (2.63, 122.77]; difficulty managing finances [OR 11.60 (2.10, 63.99]; and decreased sense of direction [OR 5.84 (1.09, 31.30]. Conclusions Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with aMCI from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power.

  8. Perspective taking abilities in amnestic mild cognitive impairment and Alzheimer's disease.

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    Marková, Hana; Laczó, Jan; Andel, Ross; Hort, Jakub; Vlček, Kamil

    2015-03-15

    Perspective taking is the ability to imagine what a scene looks like from a different viewpoint, which has been reported to be impaired in Alzheimer's disease (AD). This study compared overhead and first-person view perspective taking abilities in patients with mild cognitive impairment (MCI) and AD. A newly developed Arena Perspective Taking Task (APTT), using an environment of a circular arena, was used to compare 23 AD patients and 38 amnestic MCI patients with 18 healthy controls. The results were contrasted with a published perspective taking test (Standardized Road-Map Test of Direction Sense, RMTDS). The AD group was impaired in both overhead and first-person view APTT versions, but the impairment in the overhead view version applied specifically to women. Patients with aMCI were impaired in the first-person view but not in the overhead view version. Substantial sexual differences were found in the overhead but not in the first-person view APTT version. The RMTDS resembled both APTT versions: patients with aMCI were impaired in this test and also women in both patient groups were less accurate than men. Using the receiver operating characteristic analysis, the highest predictive power for MCI and AD patients diagnosis versus controls was observed for their success rate in the first-person view version. The results suggest distinction between overhead and first-person view perspective taking in the impairment of aMCI patients and the sex differences. The first-person view perspective taking is a potentially important candidate psychological marker for AD.

  9. [Thiamine metabolism disorders in the rat brain in experimental alcoholism and a possibility of their correction by vitamin E].

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    Parkhomenko, Iu M; Pilipchuk, S Iu; Sidorova, A A; Stepanenko, S P; Chekhovskaia, L I; Donchenko, G V

    2008-01-01

    The influence of the chronic consumption of alcohol on biochemical reactions of thiamine metabolism in the rat brain is investigated. It is shown that the content of thiamine diphosphate (ThDP) in the brain tissue does not change at these conditions, though there is an essential decrease in the thiamine-kinase activity. The ability of the isolated nerve terminals (synaptosomes) to absorb labelled thiamine also decreases under this condition. The specified disturbances are probably the reason for deceleration of exchange of free (uncombined with proteins) thiamine and its phosphates in nervous cells, that results in the observed reduction in activity of pyruvate dehydrogenase complex (PDC) due to inactivation by phosphorylation. Thiamine-binding and thiaminetriphosphatase activities of thiamine-binding protein (ThBP) in the structure of synaptic plasma membranes (SPM), isolated from the rat brain in various experimental groups, have been investigated. The increase, with respect to control, in the both enzymes activity in SPM, isolated from the brain of rats with chronic alcoholism has been shown. Kinetic researches testify to an increase of affinity of SPM (ThBP) for thiamine and thiaminetriphosphate in these conditions. When vitamin E was given to animals with a model of chronic alcoholism the normalization of PDC activity in nervous cells was observed, that can testify to the transient character of these changes. Inability of vitamin E to normalize biological activities of ThBP in PMS, that has been analyzed, can testify to more deep disturbances in the structure of SPM or thiamine binding protein in their structure.

  10. Alcohol use disorder with and without stimulant use: brain morphometry and its associations with cigarette smoking, cognition, and inhibitory control.

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    David L Pennington

    Full Text Available Little is known about the effects of polysubstance use and cigarette smoking on brain morphometry. This study examined neocortical brain morphometric differences between abstinent polysubstance dependent and alcohol-only dependent treatment seekers (ALC as well as light drinking controls (CON, the associations of cigarette smoking in these polysubstance users (PSU, and morphometric relationships to cognition and inhibitory control.All participants completed extensive neuropsychological assessments and 4 Tesla brain magnetic resonance imaging. PSU and ALC were abstinent for one month at the time of study. Parcellated morphological data (volume, surface area, thickness were obtained with FreeSurfer methodology for the following bilateral components: dorso-prefrontal cortex (DPFC, anterior cingulate cortex (ACC, orbitofrontal cortex (OFC, and insula. Regional group differences were examined and structural data correlated with domains of cognition and inhibitory control.PSU had significantly smaller left OFC volume and surface area and trends to smaller right DPFC volume and surface area compared to CON; PSU did not differ significantly from ALC on these measures. PSU, however, had significantly thinner right ACC than ALC. Smoking PSU had significantly larger right OFC surface area than non-smoking PSU. No significant relationships between morphometry and quantity/frequency of substance use, alcohol use, or age of onset of heavy drinking were observed. PSU exhibited distinct relationships between brain structure and processing speed, cognitive efficiency, working memory and inhibitory control that were not observed in ALC or CON.Polysubstance users have unique morphometric abnormalities and structure-function relationships when compared to individuals dependent only on alcohol and light drinking controls. Chronic cigarette smoking is associated with structural brain irregularities in polysubstance users. Further elucidation of these distinctive

  11. Alcohol disrupts sleep homeostasis.

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    Thakkar, Mahesh M; Sharma, Rishi; Sahota, Pradeep

    2015-06-01

    Alcohol is a potent somnogen and one of the most commonly used "over the counter" sleep aids. In healthy non-alcoholics, acute alcohol decreases sleep latency, consolidates and increases the quality (delta power) and quantity of NREM sleep during the first half of the night. However, sleep is disrupted during the second half. Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceeds $18 billion. Thus, although alcohol-associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, we have described our attempts to unravel the mechanism of alcohol-induced sleep disruptions. We have conducted a series of experiments using two different species, rats and mice, as animal models. We performed microdialysis, immunohistochemical, pharmacological, sleep deprivation and lesion studies which suggest that the sleep-promoting effects of alcohol may be mediated via alcohol's action on the mediators of sleep homeostasis: adenosine (AD) and the wake-promoting cholinergic neurons of the basal forebrain (BF). Alcohol, via its action on AD uptake, increases extracellular AD resulting in the inhibition of BF wake-promoting neurons. Since binge alcohol consumption is a highly prevalent pattern of alcohol consumption and disrupts sleep, we examined the effects of binge drinking on sleep-wakefulness. Our results suggest that disrupted sleep homeostasis may be the primary cause of sleep disruption observed following binge drinking. Finally, we have also shown that sleep disruptions observed during acute withdrawal, are caused due to impaired

  12. Psychiatric Disorder

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008566 Research on regional cerebral blood flow in patients of amnestic mild cognitive impairment and vascular cognitive impairment-no dementia. YUAN Jing(袁晶),et al. Dept Neurol,Huashan Hosp,Fudan Univ,Shanghai 200040. Chin J Neurol 2008;41(10):678-682. Objective To investigate the regional cerebral blood flow(rCBF)in amnestic mild cognitive impairment(aMCI)and vascular cognitive impairment-no dementia(VCI-ND)sub

  13. Population heterogeneity of trait anger and differential associations of trait anger facets with borderline personality features, neuroticism, depression, Attention Deficit Hyperactivity Disorder (ADHD), and alcohol problems.

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    Lubke, Gitta H; Ouwens, Klaasjan G; de Moor, Marleen H M; Trull, Timothy J; Boomsma, Dorret I

    2015-12-15

    Anger is an emotion consisting of feelings of variable intensity ranging from mild irritation to intense fury. High levels of trait anger are associated with a range of psychiatric, interpersonal, and health problems. The objectives of this study were to explore heterogeneity of anger as measured by the Spielberger Trait Anger Scale (STAS), and to assess the association of the different anger facets with a selection of psychiatric disorders covering externalizing and internalizing problems, personality disorders, and substance use. Factor mixture models differentiated between a high and low scoring class (28% vs. 72%), and between three factors (anger-temperament, anger-reaction, and immediacy of an anger response). Whereas all psychiatric scales correlated significantly with the STAS total score, regressing the three STAS factors on psychiatric behaviors model showed a more detailed pattern. Only borderline affect instability and depression were significantly associated with all three factors in both classes whereas other problem behaviors were associated only with 1 or 2 of the factors. Alcohol problems were associated with immediacy only in the high scoring class, indicating a non-linear relation in the total sample. Taking into account these more specific associations is likely to be beneficial when investigating differential treatment strategies.

  14. Validation of brief screening tools for depressive and alcohol use disorders among TB and HIV patients in primary care in Zambia

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    Patel Vikram

    2011-05-01

    Full Text Available Abstract Background This study was conducted to evaluate the diagnostic accuracy and determine the optimum cut-off scores for clinical use of the Center for Epidemiological Studies Depression scale (CES-D and Alcohol Use Disorders Identification Test (AUDIT against a reference psychiatric diagnostic interview, in TB and anti-retroviral therapy (ART patients in primary care in Zambia. Methods This was a cross-sectional study in 16 primary level care clinics. Consecutive sampling was used to select 649 participants who started TB treatment or ART in the preceding month. Participants were first interviewed using the CES-D and AUDIT, and subsequently with a psychiatric diagnostic interview for current major depressive disorder (MDD and alcohol use disorders (AUDs using the Mini-International Neuropsychiatric Interview (MINI. The diagnostic accuracy was calculated using the Area Under the Receiver Operating Characteristic curve (AUROC. The optimum cut-off scores for clinical use were calculated using sensitivity and positive predictive value (PPV. Results The CES-D and AUDIT had high internal consistency (Cronbach's alpha = 0.84; 0.98 respectively. Confirmatory factor analysis showed that the four-factor CES-D model was not a good fit for the data (Tucker-Lewis Fit Index (TLI = 0.86; standardized root-mean square residual (SRMR = 0.06 while the two-factor AUDIT model fitted the data well (TFI = 0.99; SRMR = 0.04. Both the CES-D and AUDIT demonstrated good discriminatory ability in detecting MINI-defined current MDDs and AUDs (AUROC for CES-D = 0.78; AUDIT = 0.98 for women and 0.75 for men. The optimum CES-D cut-off score in screening for current MDD was 22 (sensitivity 73%, PPV 76% while that of the AUDIT in screening for AUD was 24 for women (sensitivity 60%, PPV 60%, and 20 for men (sensitivity 55%, PPV 50%. Conclusions The CES-D and AUDIT showed high discriminatory ability in measuring MINI-defined current MDD and AUD respectively. They are

  15. Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense herbal remedy and alcohol: a case report

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    Martínez-Salcedo Eduardo

    2011-03-01

    Full Text Available Abstract Introduction Autism is a complex neurodevelopmental disorder in which the interactions of genetic, epigenetic and environmental influences are thought to play a causal role. In humans, throughout embryonic and fetal life, brain development is exquisitely susceptible to injury caused by exposure to toxic chemicals present in the environment. Although the use of herbal supplements during pregnancy is relatively common, little information is available on their association with fetal neurodevelopment. This is, to the best of our knowledge, the first report in the literature to associate a new plausible mechanism of neurodevelopmental toxicity with a case of autism spectrum disorder through a vitamin deficiency potentiated by concomitant use of herbal supplements and ethanol exposure. Case presentation We describe the pediatric environmental history of a three-year-old Caucasian girl with an autism spectrum disorder. We utilized her pediatric environmental history to evaluate constitutional, genetic, and environmental factors pertinent to manifestation of neurodevelopment disorders. Both parents reported prenatal exposure to several risk factors of interest. A year prior to conception the mother began a weight loss diet and ingested 1200 mg/day of 'horsetail' (Equisetum arvense herbal remedies containing thiaminase, an enzyme that with long-term use can lead to vitamin deficiency. The mother reported a significant weight loss during the pregnancy and a deficiency of B-complex vitamins. Thiamine (vitamin B1 deficiency could have been potentiated by the horsetail's thiaminase activity and ethanol exposure during pregnancy. No other risk factors were identified. Conclusions A detailed and careful pediatric environmental history, which includes daily intake, herbal remedies and ethanol exposure, should be obtained from all patients with autism spectrum disorder. Maternal consumption of ethanol and of herbal supplements with suspected or

  16. Alcohol and Public Health: Frequently Asked Questions

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    ... drowning, burns and firearm injuries. Violence, such as child maltreatment, homicide, and suicide. Harm to a developing fetus if a woman drinks while pregnant, such as fetal alcohol spectrum disorders . Sudden infant death syndrome (SIDS). Alcohol ...

  17. Main mental disorders in crack-cocaine users treated at Psychosocial Care Centers for Alcohol and Drugs in the city of Recife, Brazil

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    Antonio Gomes de Castro Neto

    Full Text Available Abstract Introduction: Brazil's Northeast region has the highest crack-cocaine consumption in the country. Crack-cocaine has more intense effects than cocaine powder and can cause greater chemical dependence. Psychosocial Care Centers for Alcohol and Drugs (CAPSad are public health services that provide treatment for drug dependence. It is common for drug users, and particularly crack-cocaine users, to develop mental disorders. Objective: To evaluate the most common mental disorders in crack-cocaine dependents in treatment at CAPSad in the city of Recife, Brazil. Methods: The research database "Between rocks and shots: user profiles, consumption strategies, and social impact of crack cocaine" (CEP/CCS/UFPE no. 206/11 was consulted to establish the areas of crack cocaine consumption in the city of Recife. Results: There were 885 patients in treatment for crack-cocaine use, with a mean age of 29.8±9.4 years. The mean duration of drug use was 6.1±4.6 years. Most of the patients were males (80.3%, had left school at some point between the 1st and 9th grades (45.6%, were unemployed and/or seeking employment (52% and used drugs daily (56.4%. Cocaine chemical dependence was more significant when correlated with use of crack-cocaine and other drugs such as medications and hallucinogens (p = 0.01. Conclusions: Data from this study showed strong associations between crack-cocaine uses and development of mental disorders, particularly when abuse of multiple substances occurs. Based on these data, there is a clear need for coordination of related public policies for support and social reintegration to provide these people with comprehensive care.

  18. An item response theory analysis of DSM-IV diagnostic criteria for personality