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Sample records for alcohol amnestic disorder

  1. Amnestic Disorders

    NARCIS (Netherlands)

    Kessels, R.P.C.; Savage, G.; Cautin, R.L.; Lilienfeld, S.O.

    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:

  2. Alcohol use disorder

    Science.gov (United States)

    ... have problems with alcohol if you: Are a young adult under peer pressure Have depression, bipolar disorder , anxiety disorders , or schizophrenia Can easily obtain alcohol Have low self-esteem Have problems with relationships Live a stressful lifestyle ...

  3. Combining SPECT and Quantitative EEG Analysis for the Automated Differential Diagnosis of Disorders with Amnestic Symptoms

    Directory of Open Access Journals (Sweden)

    Yvonne Höller

    2017-09-01

    Full Text Available Single photon emission computed tomography (SPECT and Electroencephalography (EEG have become established tools in routine diagnostics of dementia. We aimed to increase the diagnostic power by combining quantitative markers from SPECT and EEG for differential diagnosis of disorders with amnestic symptoms. We hypothesize that the combination of SPECT with measures of interaction (connectivity in the EEG yields higher diagnostic accuracy than the single modalities. We examined 39 patients with Alzheimer's dementia (AD, 69 patients with depressive cognitive impairment (DCI, 71 patients with amnestic mild cognitive impairment (aMCI, and 41 patients with amnestic subjective cognitive complaints (aSCC. We calculated 14 measures of interaction from a standard clinical EEG-recording and derived graph-theoretic network measures. From regional brain perfusion measured by 99mTc-hexamethyl-propylene-aminoxime (HMPAO-SPECT in 46 regions, we calculated relative cerebral perfusion in these patients. Patient groups were classified pairwise with a linear support vector machine. Classification was conducted separately for each biomarker, and then again for each EEG- biomarker combined with SPECT. Combination of SPECT with EEG-biomarkers outperformed single use of SPECT or EEG when classifying aSCC vs. AD (90%, aMCI vs. AD (70%, and AD vs. DCI (100%, while a selection of EEG measures performed best when classifying aSCC vs. aMCI (82% and aMCI vs. DCI (90%. Only the contrast between aSCC and DCI did not result in above-chance classification accuracy (60%. In general, accuracies were higher when measures of interaction (i.e., connectivity measures were applied directly than when graph-theoretical measures were derived. We suggest that quantitative analysis of EEG and machine-learning techniques can support differentiating AD, aMCI, aSCC, and DCC, especially when being combined with imaging methods such as SPECT. Quantitative analysis of EEG connectivity could become

  4. Blockade of alcohol's amnestic activity in humans by an alpha5 subtype benzodiazepine receptor inverse agonist.

    Science.gov (United States)

    Nutt, David J; Besson, Marie; Wilson, Susan J; Dawson, Gerard R; Lingford-Hughes, Anne R

    2007-12-01

    Alcohol produces many subjective and objective effects in man including pleasure, sedation, anxiolysis, plus impaired eye movements and memory. In human volunteers we have used a newly available GABA-A/benzodiazepine receptor inverse agonist that is selective for the alpha5 subtype (a5IA) to evaluate the role of this subtype in mediating these effects of alcohol on the brain. After pre-treatment with a5IA, we found almost complete blockade of the marked impairment caused by alcohol (mean breath concentration 150mg/100ml) of word list learning and partial but non-significant reversal of subjective sedation without effects on other measures such as intoxication, liking, and slowing of eye movements. This action was not due to alterations in alcohol kinetics and so provides the first proof of concept that selectively decreasing GABA-A receptor function at a specific receptor subtype can offset some actions of alcohol in humans. It also supports growing evidence for a key role of the alpha5 subtype in memory. Inverse agonists at other GABA-A receptor subtypes may prove able to reverse other actions of alcohol, and so offer a new approach to understanding the actions of alcohol in the human brain and in the treatment of alcohol related disorders in humans.

  5. Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Alcohol can harm your baby at any stage during a pregnancy. That includes the earliest stages, before ... can cause a group of conditions called fetal alcohol spectrum disorders (FASDs). Children who are born with ...

  6. Alcohol Use Disorders

    Science.gov (United States)

    ... alcohol use disorder” or AUD. AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using. ...

  7. Alcohol use disorders in pregnancy.

    Science.gov (United States)

    DeVido, Jeffrey; Bogunovic, Olivera; Weiss, Roger D

    2015-01-01

    Alcohol use disorders (AUDs) are less prevalent in pregnant women than in nonpregnant women, but these disorders can create a host of clinical challenges when encountered. Unfortunately, little evidence is available to guide clinical decision making in this population. Drinking alcohol during pregnancy can have negative consequences on both fetus and mother, but it remains controversial as to the volume of alcohol consumption that correlates with these consequences. Likewise, little evidence is available to support the use of particular pharmacologic interventions for AUDs during pregnancy or to guide the management of alcohol detoxification in pregnant women. The use of benzodiazepines (the mainstay of most alcohol detoxification protocols) in pregnant women is controversial. Nevertheless, despite the lack of robust data to guide management of AUDs in pregnancy, clinicians need to make management decisions when confronted with these challenging situations. In that context, this article reviews the epidemiology of AUDs in pregnancy and the pharmacologic management of both AUDs and alcohol withdrawal in pregnant women, with the goal of informing clinicians about what is known about managing these co-occurring conditions.

  8. Bipolar Disorder and Alcoholism: Are They Related?

    Science.gov (United States)

    ... Are they related? 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 ...

  9. Alcohol Abuse and Other Psychiatric Disorders

    Science.gov (United States)

    ... Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current Diagnostic and Statistical Manual ... and other substance use disorders are defined as psychiatric disorders. Many individuals who misuse alcohol also abuse ...

  10. Alcohol use disorders among Nigerian University students ...

    African Journals Online (AJOL)

    environments and encounter new social and institutional factors that may foster heavy alcohol use. Little is known about alcohol use disorders in non-western cultures. Aims This study aimed to estimate the prevalence and examine the socio-demographic correlates of alcohol use disorders among students in Nigerian ...

  11. 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.

  12. 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...

  13. 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

  14. Alcohol Use Disorder (AUD) Treatment

    Science.gov (United States)

    ... and/or stressed when you are not drinking Types of AUDs include alcoholism (also called alcohol dependence), and ... enhancement therapy helps you build and strengthen the motivation to change ... over a short period of time. The therapy starts with identifying the pros ...

  15. Fetal Alcohol Spectrum Disorders (FASDs)

    Science.gov (United States)

    ... Articles & Key Findings Materials & Multimedia Fact Sheets & Brochures Posters & Print Ads Infographics 5 Steps for Alcohol Screening ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

  16. Construct validation of the scale of attitudes toward alcohol, alcoholism and individuals with alcohol use disorders

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    Divane de Vargas

    2014-08-01

    Full Text Available Background : The attitudes toward issues related to alcohol and alcoholism have been noted as important predictors of the quantity and quality of care provided to individuals who have problems related to alcohol use. The Scale of Attitudes toward Alcohol, Alcoholism and Alcoholics (EAFAAA (Escala de Atitudes Frente ao Álcool, ao Alcoolismo e à pessoa com transtornos relacionados ao uso do álcool – EAFAAA has been widely used among students in health-related fields. However, the psychometric properties of this instrument have not been tested among professionals. Objective : The goal of this study was to determine the construct validity of the EAFAAA for use among health professionals. Methods : A preliminary version of the EAFAAA was distributed to a sample of health care professionals (n = 1,025. For the construct validation of the scale, the data were subjected to a factorial analysis, and the internal consistency was examined; the cutoff score of the instrument was determined using a receiver operating characteristic (ROC curve. Results : The exploratory factor analysis and the refinement of the EAFAAA items resulted in a final version consisting of 50 items divided into four factors: (1 Work and interpersonal relationships with patients with alcohol use disorders, (2 The individual with an alcohol use disorder, (3 Etiology of alcoholism and (4 Alcoholic beverages and their use. The internal consistency of the scale was considered adequate (Cronbach’s α > 0.80, and the instrument cutoff score was set at 3.15. Discussion : The results suggest that the instrument is valid for identifying attitudes towards alcohol, alcoholism and individuals with alcohol use disorders among health professionals.

  17. Fetal Alcohol Spectrum Disorders (FASDs): Alcohol Use Quiz

    Science.gov (United States)

    ... Links to Other Websites About Us More CDC Alcohol Topics CDC Alcohol Portal Excessive Alcohol Use Binge ... of alcohol screening and counseling for all women Alcohol Use Quiz Recommend on Facebook Tweet Share Compartir ...

  18. The pharmacogenetics of alcohol use disorder.

    Science.gov (United States)

    Jones, Jermaine D; Comer, Sandra D; Kranzler, Henry R

    2015-03-01

    Annually, the use and abuse of alcohol contributes to millions of deaths and billions of dollars in societal costs. To determine the impact of genetic variation on the susceptibility to the disorder and its response to treatment, studies have been conducted to assess the contribution of a variety of candidate genetic variants. These variants, which we review here, were chosen based upon their observed or hypothesized functional relevance to alcohol use disorder (AUD) risk or to the mechanism by which medications used to treat the disorder exert their effects. This qualitative review examines studies in which candidate polymorphisms were tested as moderator variables to identify pharmacogenetic effects on either the subjective response to alcohol or the outcomes of pharmacotherapy. Although findings from these studies provide evidence of a number of clinically relevant pharmacogenetic effects, the literature is limited and there are conflicting findings that require resolution. Pharmacogenetic studies of AUD treatment that use greater methodological rigor and better statistical controls, such as corrections for multiple testing, may help to resolve inconsistent findings. These procedures could also lead to the discovery of more robust and clinically meaningful moderator effects. As the field evolves through methodological standardization and the use of larger study samples, pharmacogenetic research has the potential to inform clinical care by enhancing therapeutic effects and personalizing treatments. These efforts may also provide insights into the mechanisms by which medications reduce heavy drinking or promote abstinence in patients with an AUD. Copyright © 2015 by the Research Society on Alcoholism.

  19. Association of body mass index with amnestic and non-amnestic mild cognitive impairment risk in elderly.

    Science.gov (United States)

    Wang, Feng; Zhao, Minghui; Han, Zhaoli; Li, Dai; Zhang, Shishuang; Zhang, Yongqiang; Kong, Xiaodong; Sun, Ning; Zhang, Qiang; Lei, Ping

    2017-09-15

    Previous studies focused on the relationship between body mass index and cognitive disorder and obtained many conflicting results. This study explored the potential effects of body mass index on the risk of mild cognitive impairment (amnestic and non-amnestic) in the elderly. The study enrolled 240 amnestic mild cognitive impairment patients, 240 non-amnestic mild cognitive impairment patients and 480 normal cognitive function controls. Data on admission and retrospective data at baseline (6 years ago) were collected from their medical records. Cognitive function was evaluated using Mini-Mental State Examination and Montreal Cognitive Assessment. Being underweight, overweight or obese at baseline was associated with an increased risk of amnestic mild cognitive impairment (OR: 2.30, 95%CI: 1.50 ~ 3.52; OR: 1.74, 95%CI: 1.36 ~ 2.20; OR: 1.71, 95%CI: 1.32 ~ 2.22, respectively). Being overweight or obese at baseline was also associated with an increased risk of non-amnestic mild cognitive impairment (OR: 1.51, 95%CI: 1.20 ~ 1.92; OR: 1.52, 95%CI: 1.21 ~ 1.97, respectively). In subjects with normal weights at baseline, an increased or decreased body mass index at follow-up was associated with an elevated risk of amnestic mild cognitive impairment (OR: 1.80, 95%CI: 1.10 ~ 3.05; OR: 3.96, 95%CI: 2.88 ~ 5.49, respectively), but only an increased body mass index was associated with an elevated risk of non-amnestic mild cognitive impairment (OR: 1.71, 95%CI: 1.16 ~ 2.59). Unhealthy body mass index levels at baseline and follow-up might impact the risk of both types of mild cognitive impairment (amnestic and non-amnestic).

  20. Personality disorder and treatment outcome in alcohol use disorder.

    Science.gov (United States)

    Newton-Howes, Giles; Foulds, James

    2018-01-01

    As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

  1. A Study of the Relationship Between Alcoholism and Character Disorder.

    Science.gov (United States)

    Wolfley, Virgil L.

    Studies have shown that sociopaths and alcoholics tend to come from similar social backgrounds and that they share several characteristics. To investigate the relationship between alcoholism and character disorder syndrome in adult males, 20 males who had a history of alcohol problems and displayed characteristics of character disorder were…

  2. Parental bonding in men with alcohol disorders: a relationship with conduct disorder.

    Science.gov (United States)

    Joyce, P R; Sellman, D; Wells, E; Frampton, C M; Bushnell, J A; Oakley-Browne, M; Hornblow, A R

    1994-09-01

    Men from a clinical treatment setting suffering from alcohol dependence, and randomly selected men from the community diagnosed as having alcohol abuse and/or dependence, completed the Parental Bonding Instrument. The men from the alcohol treatment setting perceived both parents as having been uncaring and overprotective. In the general population sample, an uncaring and overprotective parental style was strongly associated with childhood conduct disorder, but not with alcohol disorder symptoms. This discrepancy in perceived parenting highlights the difficulties in extrapolating findings about aetiological factors for alcohol disorders from clinical samples. It also suggests that childhood conduct disorder and adult antisocial behaviour could influence which men with alcohol disorders receive inpatient treatment.

  3. Fetal Alcohol Syndrome Disorder: diminished responsibility and mitigation of sentence.

    Science.gov (United States)

    Scott, Russ

    2018-02-01

    The objective of this study was to consider the implications of a recent Western Australia Court of Appeal decision in which an indigenous youth who had been sentenced for the manslaughter of his neonate child was later diagnosed with Fetal Alcohol Syndrome Disorder. The increased use of the 2016 Australian guide to the diagnosis of fetal alcohol spectrum disorder should be encouraged to enable clinicians to not only diagnose and manage Fetal Alcohol Syndrome Disorder, but also counsel families to prevent it.

  4. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B.W.J.H.; Wall, M.M.; Hasin, D.S.

    2012-01-01

    Background Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  5. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B. W. J. H.; Wall, M. M.; Hasin, D. S.

    2012-01-01

    Background. Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  6. Trauma, alexithymia, emotional regulation and dissociation in alcohol use disorder, substance use disorder and polysubstance disorder

    OpenAIRE

    Stark, Claire

    2017-01-01

    Background: Around 33-50% who attend treatment for substance use disorder (SUD) and alcohol use disorder (AUD) have a history of trauma. Experiencing trauma can lead to psychological disorders, difficulties with emotional regulation and dissociation. SUD and AUD can be chronic, relapsing disorders and understanding what individual factors affect addiction has important implications for treatment. Objective: The systematic review was interested in whether alexithymia affects ...

  7. Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Schneier, F R; Foose, T E; Hasin, D S; Heimberg, R G; Liu, S-M; Grant, B F; Blanco, C

    2010-06-01

    To assess the prevalence and clinical impact of co-morbid social anxiety disorder (SAD) and alcohol use disorders (AUD, i.e. alcohol abuse and alcohol dependence) in a nationally representative sample of adults in the United States. Data came from a large representative sample of the US population. Face-to-face interviews of 43093 adults residing in households were conducted during 2001-2002. Diagnoses of mood, anxiety, alcohol and drug use disorders and personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV version. Lifetime prevalence of co-morbid AUD and SAD in the general population was 2.4%. SAD was associated with significantly increased rates of alcohol dependence [odds ratio (OR) 2.8] and alcohol abuse (OR 1.2). Among respondents with alcohol dependence, SAD was associated with significantly more mood, anxiety, psychotic and personality disorders. Among respondents with SAD, alcohol dependence and abuse were most strongly associated with more substance use disorders, pathological gambling and antisocial personality disorders. SAD occurred before alcohol dependence in 79.7% of co-morbid cases, but co-morbidity status did not influence age of onset for either disorder. Co-morbid SAD was associated with increased severity of alcohol dependence and abuse. Respondents with co-morbid SAD and alcohol dependence or abuse reported low rates of treatment-seeking. Co-morbid lifetime AUD and SAD is a prevalent dual diagnosis, associated with substantial rates of additional co-morbidity, but remaining largely untreated. Future research should clarify the etiology of this co-morbid presentation to better identify effective means of intervention.

  8. Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

    Science.gov (United States)

    Leggio, Lorenzo; Lee, Mary R.

    2016-01-01

    Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral and/or pharmacological treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In addition to medications approved by the Food and Drug Administration (FDA) for alcohol use disorder (disulfiram, naltrexone and acamprosate), recent efforts to identify potential new treatments have yielded promising candidate pharmacotherapies. Finally, more efforts are needed to integrate treatments across disciplines toward patient-centered approaches in the management of patients with alcohol use disorder and alcoholic liver disease. PMID:27984008

  9. Practical outpatient pharmacotherapy for alcohol use disorder

    Science.gov (United States)

    Kim, Youngjung; Hack, Laura M; Ahn, Elizabeth S

    2018-01-01

    Alcohol use disorder (AUD) is commonly encountered in clinical practice. A combination of psychosocial intervention and pharmacotherapy is the cornerstone of AUD treatment. Despite their efficacy, safety and cost-effectiveness, clinicians are reluctant to prescribe medications to treat individuals with AUD. Given the high rate of relapse with psychosocial intervention alone, increasing patient access to this underutilized treatment has the potential to improve clinical outcome in this difficult-to-treat population. Herein, we provide practical pharmacotherapy strategies to improve treatment outcome for AUD. We review the efficacy and side effects of both on- and off-label agents with a particular focus on clinical applicability. Recommendations are supported by findings from randomized controlled trials (RCT) and meta-analyses selected to be representative, where possible, of current treatment guidelines. The goal of this paper is to help readers use pharmacotherapy with greater confidence when treating patients with AUD. PMID:29445407

  10. Practical outpatient pharmacotherapy for alcohol use disorder

    Directory of Open Access Journals (Sweden)

    Youngjung Kim

    2018-02-01

    Full Text Available Alcohol use disorder (AUD is commonly encountered in clinical practice. A combination of psychosocial intervention and pharmacotherapy is the cornerstone of AUD treatment. Despite their efficacy, safety and cost-effectiveness, clinicians are reluctant to prescribe medications to treat individuals with AUD. Given the high rate of relapse with psychosocial intervention alone, increasing patient access to this underutilized treatment has the potential to improve clinical outcome in this difficult-to-treat population. Herein, we provide practical pharmacotherapy strategies to improve treatment outcome for AUD. We review the efficacy and side effects of both on- and off-label agents with a particular focus on clinical applicability. Recommendations are supported by findings from randomized controlled trials (RCT and meta-analyses selected to be representative, where possible, of current treatment guidelines. The goal of this paper is to help readers use pharmacotherapy with greater confidence when treating patients with AUD.

  11. Epigenetic mechanisms of alcoholism and stress-related disorders.

    Science.gov (United States)

    Palmisano, Martina; Pandey, Subhash C

    2017-05-01

    Stress-related disorders, such as anxiety, early life stress, and posttraumatic stress disorder appear to be important factors in promoting alcoholism, as alcohol consumption can temporarily attenuate the negative affective symptoms of these disorders. Several molecules involved in signaling pathways may contribute to the neuroadaptation induced during alcohol dependence and stress disorders, and among these, brain-derived neurotrophic factor (BDNF), corticotropin releasing factor (CRF), neuropeptide Y (NPY) and opioid peptides (i.e., nociceptin and dynorphin) are involved in the interaction of stress and alcohol. In fact, alterations in the expression and function of these molecules have been associated with the pathophysiology of stress-related disorders and alcoholism. In recent years, various studies have focused on the epigenetic mechanisms that regulate chromatin architecture, thereby modifying gene expression. Interestingly, epigenetic modifications in specific brain regions have been shown to be associated with the neurobiology of psychiatric disorders, including alcoholism and stress. In particular, the enzymes responsible for chromatin remodeling (i.e., histone deacetylases and methyltransferases, DNA methyltransferases) have been identified as common molecular mechanisms for the interaction of stress and alcohol and have become promising therapeutic targets to treat or prevent alcoholism and associated emotional disorders. Published by Elsevier Inc.

  12. Hazardous alcohol use and alcohol use disorders in women : characteristics and vulnerability factors

    OpenAIRE

    Magnusson, Åsa

    2010-01-01

    The overall aim of this thesis was to study vulnerability factors associated with hazardous alcohol consumption during pregnancy and alcohol use disorders among Swedish women. Different risk-factors and characteristics were studied, and examined for their ability to discriminate or identify different subtypes (type I/late onset and type II/early onset) of alcohol dependence ( alcoholism ). In study I, an RCT at ANC in Stockholm (control, n = 156, intervention, n =147) we...

  13. Sub-clinical Alcohol Consumption and Gambling Disorder.

    Science.gov (United States)

    Harries, Michael D; Redden, Sarah A; Leppink, Eric W; Chamberlain, Samuel R; Grant, Jon E

    2017-06-01

    While it is well established that gambling disorder is associated with alcohol use disorder, less is known regarding whether sub-clinical alcohol consumption increases gambling behavior. This study examined the effects of varying levels of alcohol consumption on clinical and cognitive measures. The sample consisted of 572 non-treatment seeking gamblers age 18-29 who were divided into three groups: non-current drinkers, current drinkers who did not qualify for an alcohol use disorder, and those with an alcohol use disorder (AUD). All subjects were assessed on gambling pathology, severity and impulsivity using the Structured Clinical Interview for Gambling Disorder, Yale Brown Obsessive Compulsive Scale for Pathologic Gambling and the Barratt Impulsive Scale-11 and select cognitive tests. In all of the clinical measures, controlling for age, gender and education, the AUD group was significantly more likely than the non-current and current drinkers to be a pathologic gambler and to be impulsive, compulsive and depressed. On cognitive tasks, controlling for age, gender and education, the AUD group had significantly worse strategy use on a spatial working memory task than both other groups. This study suggests that the relationship between alcohol and gambling may only exist when pathology in both alcohol consumption and gambling behavior is present. Examining this relationship with alcohol consumption as a continuous variable would provide additional insight into the potential effects alcohol consumption has on gambling behavior.

  14. Relationship between Alcohol Purchasing Time and Alcohol Use Disorder in South Korea.

    Science.gov (United States)

    Amista, Narcie Faith; Chun, Sungsoo; Yun, Mieun

    2017-12-01

    Currently, time of alcohol purchase is not part of the policies to regulate alcohol consumption in South Korea. This study was conducted to determine the relationship between alcohol purchasing time and alcohol use disorder. The survey for this study was conducted in geographically diverse regions of South Korea in 2012. Respondents' purchasing behaviors for both on-licensed (i.e., allows for consumption within the premises) and off-licensed (i.e., where alcohol is consumed off the premises) outlets and time of alcohol consumption were collected. Alcohol consumption patterns were examined using the Rapid Alcohol Problem Screen 4 (RAPS4). Data were also analyzed by age, gender and purchasing time. Results showed that among the off-licensed premises, supermarkets appear to be the most popular venue while for on-licensed premises; alcohol was generally consumed inside hotels/pubs regardless of age and gender of the purchaser. Purchasing of alcohol was highest during the day and early evening period (9:00 a.m. to 9:59 p.m.). Females are most likely to abuse alcohol than males during the early morning period and is that period after 12:00 midnight. Analysis suggests that the survey instrument used in the International Alcohol Control Study is being used to collect data on alcohol purchasing time consumption; therefore, the potential is there to provide accurate results to contribute appropriate policy responses to reduce alcohol related-harm.

  15. Foetal Alcohol Spectrum Disorders and Alterations in Brain and Behaviour

    OpenAIRE

    Guerri, Consuelo; Bazinet, Alissa; Riley, Edward P.

    2009-01-01

    The term ‘Foetal Alcohol Spectrum Disorders (FASD)’ refers to the range of disabilities that may result from prenatal alcohol exposure. This article reviews the effects of ethanol on the developing brain and its long-term structural and neurobehavioural consequences. Brain imaging, neurobehavioural and experimental studies demonstrate the devastating consequences of prenatal alcohol exposure on the developing central nervous system (CNS), identifying specific brain regions affected, the range...

  16. Value-based decision making and alcohol use disorder

    OpenAIRE

    Nebe, Stephan

    2018-01-01

    Alcohol use disorder (AUD) is a widespread mental disease denoted by chronic alcohol use despite significant negative consequences for a person’s life. It affected more than 14 million persons in Europe alone and accounted for more than 5% of deaths worldwide in 2011-2012. Understanding the psychological and neurobiological mechanisms driving the development and maintenance of pathological alcohol use is key to conceptualizing new programs for prevention and therapy of AUD. There has been a v...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    in a prospective design. Methods: Information on social network and covariates was obtained from 9589 men and women aged 21–99 years in the Copenhagen City Heart Study, followed for registration of alcohol use disorder in the Danish National Patient Registry and the WINALCO database. Results: Men who lived alone......Objective: Social network has been linked to alcohol use disorder in several studies. However, since the majority of such findings are crosssectional, causal interpretation is difficult. The aim of the present study was to test if social network characteristics predict alcohol use disorder......, 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...

  18. Alcohol use disorder and tuberculosis treatment: A longitudinal ...

    African Journals Online (AJOL)

    Objective: The relationship between tuberculosis (TB) treatment and alcohol use disorders over time is under-researched. The aim of this investigation was to study alcohol use and TB medication adherence and its predictors among TB patients over a period of 6 months. Methods: A longitudinal investigation was carried out ...

  19. Prevalence of Alcohol use Disorders among Medical and Surgical in ...

    African Journals Online (AJOL)

    reasons include inadequate medical school and residency training in addictions and a lack of adequate faculty role models who intervene and diagnose alcohol dependence (30). The likelihood that a physician will detect and address alcohol use disorders in patients varies according to the physician's field of training (8).

  20. Difficult Temperament, Parental Relationships, and Adolescent Alcohol Use Disorder Symptoms.

    Science.gov (United States)

    Neighbors, Bryan D.; Clark, Duncan B.; Donovan, John E.; Brody, Gene H.

    2000-01-01

    Study tested the hypothesis that the quality of the parent-adolescent relationship mediates the association between difficult temperament and alcohol use disorder (AUD) symptoms. Results suggest that alcohol abuse prevention and treatment programs should consider the role of basic temperamental characteristics in pathological drinking, and the…

  1. 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…

  2. 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…

  3. The discriminant validity of alcohol use disorder in well-functioning men with hazardous alcohol use

    NARCIS (Netherlands)

    de Bruijn, H.; Korzec, A.; Arndt, T.; van den Brink, W.

    2003-01-01

    The purpose of this study was to establish the discriminant validity of alcohol use disorder (AUD) diagnoses within a population of well-functioning male heavy drinkers. A group of 57 subjects with a consumption of at least 28 alcoholic units (AU)/week was recruited from wine-tasting clubs. Within

  4. [Predictors of hospitalization for alcohol use disorder in Korean men].

    Science.gov (United States)

    Hong, Hae-Sook; Park, Jeong-Eun; Park, Wan-Ju

    2014-10-01

    This study was done to identify the patterns and significant predictors influencing hospitalization of Korean men for alcohol use disorder. A descriptive study design was utilized. Data were collected using self-report questionnaires from 143 inpatients who met the DSM-5 alcohol use disorder criteria and were receiving treatment and 157 social drinkers living in the community. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Alcohol Problems, Alcohol Expectancy Questionnaire (AEQ), Life Position, and The Korean version of the Children of Alcoholics Screening Test (CAST-K). Data were analyzed using descriptive statistics, t-test, χ²-test, F-test, Pearson correlation coefficients, and logistic regression with forward stepwise. AUDIT had significant correlations with alcohol problems, alcohol expectancy, and parents' alcoholism. In logistic regression, factors significantly affecting hospitalization were divorced (OR=4.18, 95% CI: 1.28-13.71), graduation from elementary school (OR=28.50, 95% CI: 8.07-100.69), middle school (OR=6.66, 95% CI: 2.21-20.09), high school (OR=6.31, 95% CI: 2.59-15.36), drinking alone (OR=9.07, 95% CI: 1.78-46.17), family history of alcoholism (OR=2.41, 95% CI: 1.11-5.25), interpersonal relationship problems (OR=1.28, 95% CI:1.17-1.41), and sexual enhancement of alcohol expectancy (OR=0.83, 95% CI: 0.72-0.94), which accounted for 53% of the variance. Results suggest that interpersonal relationship programs and customized cognitive programs for social drinkers in the community are needed to decreased alcohol related hospitalization in Korean men.

  5. The effect of comorbid alcoholism on recurrence in affective disorder

    DEFF Research Database (Denmark)

    Kessing, L V

    1999-01-01

    BACKGROUND: Studies of the effect of comorbid alcoholism on the risk of recurrence in affective disorder have given contradictory results. METHOD: Using survival analysis, the rate of recurrence was calculated in a case register study including all hospital admissions with primary affective...... an auxiliary diagnosis of alcoholism. Patients with a current auxiliary diagnosis of alcoholism had increased rate of recurrence following the first three affective episodes but not following subsequent episodes compared with patients without auxiliary diagnoses. The effect of alcoholism declined...... with the number of episodes. In contrast, no effect was found of other auxiliary diagnoses on the rate of recurrence. CONCLUSION: Rehospitalisation data suggest that concurrent alcoholism increases the risk of recurrence of affective episodes during the initial course of unipolar and bipolar disorder but has...

  6. Fetal alcohol spectrum disorders: experimental treatments and strategies for intervention.

    Science.gov (United States)

    Idrus, Nirelia M; Thomas, Jennifer D

    2011-01-01

    Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol's teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased. The insights gained to date from experimental models offer several candidates for attenuating the deficits associated with FASD.

  7. 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...... 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...... women or men. CONCLUSIONS: Individuals who include wine when they drink alcohol have lower risks of AUD, independent of the total amount of alcohol consumed. The most likely explanation of these results is that lifestyle factors and personal characteristics are associated with beverage preference....

  8. The Cycle of Schizoaffective Disorder, Cognitive Ability, Alcoholism, and Suicidality

    Science.gov (United States)

    Goldstein, Gerald; Haas, Gretchen L.; Pakrashi, Manish; Novero, Ada M.; Luther, James F.

    2006-01-01

    In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-IV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a…

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

    Science.gov (United States)

    Francis, Joel M; Weiss, Helen A; Mshana, Gerry; Baisley, Kathy; Grosskurth, Heiner; Kapiga, Saidi H

    2015-01-01

    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

  10. 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

  11. [Comorbidity in panic disorders and alcoholism (II). Alcoholism in a sample of 148 patients with panic disorders].

    Science.gov (United States)

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

    1995-01-01

    Among 148 patients presenting Panic Disorder (DSM-III-R), 18.9% have an alcohol disorder, 8.8% present abuse and 10.1% dependence. Mean age of onset of alcoholism was much earlier than panic disorder. Patients with alcoholism: a) are males more frequently (0.001); b) present more alcoholism in first grade relatives (0.05); c) use more often other drugs like: tobacco (0.01), coffee (p cannabis (p < 0.001), d) patients with alcoholism refer a greater severity of their panic attacks when drinking large amounts of alcohol (25%) than the group without these problems (2.5%) (x2:14.8) (p < 0.001) e) according to the GAS the overall level of performance is lower in alcoholics (p < 0.005); f) present more anxiety measured by the HARS (p < 0.01), and therefore have more comorbid anxiety disorders according to DSM-III-R (p < 0.01). The clinical significance of these findings is discussed.

  12. Alcohol dependence as a chronic pain disorder

    Science.gov (United States)

    Egli, Mark; Koob, George F.; Edwards, Scott

    2013-01-01

    Dysregulation of pain neurocircuitry and neurochemistry has been increasingly recognized as playing a critical role in a diverse spectrum of diseases including migraine, fibromyalgia, depression, and PTSD. Evidence presented here supports the hypothesis that alcohol dependence is among the pathologies arising from aberrant neurobiological substrates of pain. In this review, we explore the possible influence of alcohol analgesia and hyperalgesia in promoting alcohol misuse and dependence. We examine evidence that neuroanatomical sites involved in the negative emotional states of alcohol dependence also play an important role in pain transmission and may be functionally altered under chronic pain conditions. We also consider possible genetic links between pain transmission and alcohol dependence. We propose an allostatic load model in which episodes of alcohol intoxication and withdrawal, traumatic stressors, and injury are each capable of dysregulating an overlapping set of neural substrates to engender sensory and affective pain states that are integral to alcohol dependence and comorbid conditions such as anxiety, depression, and chronic pain. PMID:22975446

  13. Borderline personality disorder and regularly drinking alcohol before sex.

    Science.gov (United States)

    Thompson, Ronald G; Eaton, Nicholas R; Hu, Mei-Chen; Hasin, Deborah S

    2017-07-01

    Drinking alcohol before sex increases the likelihood of engaging in unprotected intercourse, having multiple sexual partners and becoming infected with sexually transmitted infections. Borderline personality disorder (BPD), a complex psychiatric disorder characterised by pervasive instability in emotional regulation, self-image, interpersonal relationships and impulse control, is associated with substance use disorders and sexual risk behaviours. However, no study has examined the relationship between BPD and drinking alcohol before sex in the USA. This study examined the association between BPD and regularly drinking before sex in a nationally representative adult sample. Participants were 17 491 sexually active drinkers from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models estimated effects of BPD diagnosis, specific borderline diagnostic criteria and BPD criterion count on the likelihood of regularly (mostly or always) drinking alcohol before sex, adjusted for controls. Borderline personality disorder diagnosis doubled the odds of regularly drinking before sex [adjusted odds ratio (AOR) = 2.26; confidence interval (CI) = 1.63, 3.14]. Of nine diagnostic criteria, impulsivity in areas that are self-damaging remained a significant predictor of regularly drinking before sex (AOR = 1.82; CI = 1.42, 2.35). The odds of regularly drinking before sex increased by 20% for each endorsed criterion (AOR = 1.20; CI = 1.14, 1.27) DISCUSSION AND CONCLUSIONS: This is the first study to examine the relationship between BPD and regularly drinking alcohol before sex in the USA. Substance misuse treatment should assess regularly drinking before sex, particularly among patients with BPD, and BPD treatment should assess risk at the intersection of impulsivity, sexual behaviour and substance use. [Thompson Jr RG, Eaton NR, Hu M-C, Hasin DS Borderline personality disorder and regularly drinking alcohol

  14. 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.

  15. Fetal Alcohol Spectrum Disorders (FASDs): Diagnosis

    Science.gov (United States)

    ... Articles & Key Findings Materials & Multimedia Fact Sheets & Brochures Posters & Print Ads Infographics 5 Steps for Alcohol Screening ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

  16. Facts About Fetal Alcohol Spectrum Disorders (FASDs)

    Science.gov (United States)

    ... behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control. Alcohol-Related Birth Defects (ARBD): People with ARBD might have problems ...

  17. Association of attention-deficit hyperkinetic disorder with alcohol use disorders in fishermen

    Directory of Open Access Journals (Sweden)

    Manoj Kumar

    2017-01-01

    Full Text Available Introduction: Alcohol use is a widely prevalent problem and poses hazard during work for certain groups such as fishermen. Disorders such as Attention-Deficit/Hyperkinetic Disorder (ADHD correlate with early onset and greater severity of alcohol use disorders. Aims: We planned to study the frequency of ADHD among fishermen in a fishing hamlet of southern India using adult ADHD self-reported scale (ASRS and correlated with the severity of alcohol use disorder as evidenced by age at initiation of alcohol use, presence of harmful use, or dependence use as defined by Alcohol Use Disorders Identification Test (AUDIT. Subjects and Methods: This was a community-based interview using AUDIT questionnaire for severity of alcohol use and the ASRS to detect ADHD. Results: The prevalence of adult ADHD among fishermen in this study was 25.7% using the critical items of the ASRS. ADHD was about twice as likely in participants with dependence as those without dependence (odds ratio = 2.10. ADHD was also more likely in participants with onset of use before 30 years of age than others (25.1% vs. 15.4% (P = 0.27. Discussion: We found a high frequency of alcohol use among fishermen (79.8%. However, only 9.9% had alcohol dependence which is higher than the general population (2.3% in the region. Fishermen with alcohol dependence were twice as likely to have ADHD as those without alcohol dependence. Conclusion: In a community-based survey of fishermen, the prevalence of alcohol dependence was about 10%. The presence of alcohol dependence predicted a two times higher likelihood of ADHD among fishermen than those without alcohol dependence.

  18. Social Anxiety Disorders and Alcohol Abuse

    Science.gov (United States)

    ... social anxiety disorder Follow Us Facebook Twitter RSS YouTube Advertisement Find A Therapist Search our directory of ADAA mental health professional members who specialize in anxiety, depression and co-occurring disorders. Understand the Facts Anxiety ...

  19. Why MDMA therapy for alcohol use disorder? And why now?

    Science.gov (United States)

    Sessa, Ben

    2017-11-07

    Alcohol use disorder represents a serious clinical, social and personal burden on its sufferers and a significant financial strain on society. Current treatments, both psychological and pharmacological are poor, with high rates of relapse after medical detoxification and dedicated treatment programs. The earliest historical roots of psychedelic drug-assisted psychotherapy in the 1950s were associated with Lysergic acid diethylamide (LSD)-assisted psychotherapy to treat what was then called, alcoholism. But results were varied and psychedelic therapy with LSD and other 'classical' psychedelics fell out of favour in the wake of socio-political pressures and cultural changes. A current revisiting of psychedelic clinical research is now targeting substance use disorders - and particularly alcohol use disorder - again. 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy has never been formally explored as a treatment for any form of substance use disorder. But in recent years MDMA has risen in prominence as an agent to treat posttraumatic stress disorder (PTSD). With its unique receptor profile and a relatively well-tolerated subjective experience of drug effects when used clinically, MDMA Therapy is ideally suited to allow a patient to explore and address painful memories without being overwhelmed by negative affect. Given that alcohol use disorder is so often associated with early traumatic experiences, the author is proposing in a current on-going UK-based study that patients with alcohol use disorder who have undergone a medical detoxification from alcohol might benefit from a course of MDMA-assisted psychotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Modification of automatic alcohol-approach tendencies in alcohol-dependent patients with mild or major neurocognitive disorder

    NARCIS (Netherlands)

    Loijen, A.; Rinck, M.; Walvoort, S.J.W.; Kessels, R.P.C.; Becker, E.S.; Egger, J.I.M.

    2018-01-01

    Background: To examine the applicability of an alcohol-avoidance training procedure in patients with alcohol dependence and alcohol-induced neurocognitive disorders, we trained two groups that differed in the degree of cognitive impairment: One group fulfilled the DSM-5 criteria for Alcohol-Induced

  1. Skeletal muscle and fetal alcohol spectrum disorder.

    Science.gov (United States)

    Myrie, Semone B; Pinder, Mark A

    2018-04-01

    Skeletal muscle is critical for mobility and many metabolic functions integral to survival and long-term health. Alcohol can affect skeletal muscle physiology and metabolism, which will have immediate and long-term consequences on health. While skeletal muscle abnormalities, including morphological, biochemical, and functional impairments, are well-documented in adults that excessively consume alcohol, there is a scarcity of information about the skeletal muscle in the offspring prenatally exposed to alcohol ("prenatal alcohol exposure"; PAE). This minireview examines the available studies addressing skeletal muscle abnormalities due to PAE. Growth restriction, fetal alcohol myopathy, and abnormalities in the neuromuscular system, which contribute to deficits in locomotion, are some direct, immediate consequences of PAE on skeletal muscle morphology and function. Long-term health consequences of PAE-related skeletal abnormalities include impaired glucose metabolism in the skeletal muscle, resulting in glucose intolerance and insulin resistance, leading to an increased risk of type 2 diabetes. In general, there is limited information on the morphological, biochemical, and functional features of skeletal abnormalities in PAE offspring. There is a need to understand how PAE affects muscle growth and function at the cellular level during early development to improve the immediate and long-term health of offspring suffering from PAE.

  2. Alcohol Alert

    Science.gov (United States)

    ... of Alcohol Consumption Alcohol's Effects on the Body Alcohol Use Disorder Fetal Alcohol Exposure Support & Treatment Alcohol Policy Special ... 466 KB] No. 81: Exploring Treatment Options for Alcohol Use Disorders [ PDF - 539K] No. 80: Alcohol and HIV/AIDS: ...

  3. [Epidemiologic warnings from studies on alcohol use disorders].

    Science.gov (United States)

    Limosin, F

    2014-04-01

    The highest consumption levels of alcohol are found in the developed world, mostly the Northern Hemisphere. After a slight decrease at the beginning of the 1990s, alcohol use in the European Region increased with an average adult per capita consumption amounting to 12.5 litres of pure alcohol per capita for the year 2009. In France, adult consumption was 12.7 litres of pure alcohol per capita for the year 2009, and it is estimated that 1.5 to 2 million of adults are alcohol-dependent (4-5% of the adult population) and 5 million are excessive drinkers. The harmful use of alcohol is one of the world's leading health risks. Alcohol is the direct cause of more than 30 diseases and a causal factor in more than 60 major types of diseases and injuries, resulting in approximately 2.5 million deaths each year. Approximately 4% of all deaths worldwide and 4.5% (7.4% for men and 1.4% for women) of the global burden of disease and injury are attributable to alcohol. In 2004 in the EU, 15.2% of all disability-adjusted life years (DALYs) in men and 3.9% of all DALYs in women were lost due to alcohol. While the impact of alcohol consumption and dependence on mortality and disease is substantial, there are also many psychosocial consequences, including violence, family problems, child neglect and abuse, absenteeism and lost productivity in the workplace. This means that alcohol consumption and dependence have sizable impacts on many people other than the drinker. These effects add up to a staggering number of alcohol-attributable social costs, which can be estimated at € 155.8 billion a year in Europe. Despite all these consequences, many individuals with alcohol use disorders remain untreated although effective treatments exist. From 37 community-based psychiatric epidemiology studies that used standardized diagnostic instruments and included data on the percentage of individuals receiving care for alcohol abuse or dependence, the median rate of untreated cases of these

  4. Physical Activity and Risk of Alcohol Use Disorders

    DEFF Research Database (Denmark)

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

    2015-01-01

    .5- to 2-fold 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......AIMS: To examine the effect of physical activity on risk of developing alcohol use disorders in a large prospective cohort study with focus on leisure-time physical activity. METHODS: Data came from the four examinations of the Copenhagen City Heart Study (CCHS), performed in 1976-1978, 1981......-1983, 1991-1994 and 2001-2003. Information on physical activity (classified as Moderate/high, low or sedentary) and covariates was obtained through self-administered questionnaires, and information on alcohol use disorders was obtained from the Danish Hospital Discharge Register, the Danish Psychiatric...

  5. [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.

  6. Fetal Alcohol Spectrum Disorders (FASDs): Treatments

    Science.gov (United States)

    ... the treatment plan that works best for your child. Behavior and Education Therapy NOFAS Brochure — Hope for Children Living with ... Curriculum Development Guide for Medical and Allied Health Education and Practice ... importance of alcohol screening and counseling for all women ...

  7. Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders.

    Science.gov (United States)

    May, Philip A; Hasken, Julie M; Blankenship, Jason; Marais, Anna-Susan; Joubert, Belinda; Cloete, Marise; de Vries, Marlene M; Barnard, Ronel; Botha, Isobel; Roux, Sumien; Doms, Cate; Gossage, J Phillip; Kalberg, Wendy O; Buckley, David; Robinson, Luther K; Adnams, Colleen M; Manning, Melanie A; Parry, Charles D H; Hoyme, H Eugene; Tabachnick, Barbara; Seedat, Soraya

    2016-08-01

    Determine any effects that maternal alcohol consumption during the breastfeeding period has on child outcomes. Population-based samples of children with fetal alcohol spectrum disorders (FASD), normally-developing children, and their mothers were analyzed for differences in child outcomes. Ninety percent (90%) of mothers breastfed for an average of 19.9 months. Of mothers who drank postpartum and breastfed (MDPB), 47% breastfed for 12 months or more. In case control analyses, children of MDPB were significantly lighter, had lower verbal IQ scores, and more anomalies in comparisons controlling for prenatal alcohol exposure and final FASD diagnosis. Utilizing a stepwise logistic regression model adjusting for nine confounders of prenatal drinking and other maternal risks, MDPB were 6.4 times more likely to have a child with FASD than breastfeeding mothers who abstained from alcohol while breastfeeding. Alcohol use during the period of breastfeeding was found to significantly compromise a child's development. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Delay to first treatment contact for alcohol use disorder.

    Science.gov (United States)

    Chapman, Cath; Slade, Tim; Hunt, Caroline; Teesson, Maree

    2015-02-01

    This study explored the patterns and correlates of time to first treatment contact among people with alcohol use disorder (AUD) in Australia. Specifically it examined the relationship between sex, birth cohort, onset of AUD symptoms, severity, comorbidity, symptom type and time to first treatment contact (treatment delay) among those with alcohol abuse and dependence in a large population sample. Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N=8841). A modified version of the World Health Organization's Composite International Diagnostic Interview was used to determine the presence and age of onset of DSM-IV AUD and other mental disorders and the age at which respondents first sought treatment for alcohol or other drug-related problems. Median time to first treatment contact for an AUD was 18 years (14 years dependence, 23 years abuse). Projected lifetime treatment rates were 78.1% for alcohol dependence and 27.5% for abuse. Those with earlier onset and from older cohorts reported longer delay and were less likely to ever seek treatment compared to those with later onset or from more recent cohorts. Those with comorbid anxiety but not mood disorder, or who reported alcohol-related role disruption or recurrent interpersonal problems were more likely to ever seek treatment and reported shorter delay compared to those who did not report these symptoms. Treatment delay for alcohol use disorder in Australia is substantial. Those with earlier onset and those with comorbid mood disorder should be a target for earlier treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. 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.

  10. Disentangling the role of astrocytes in alcohol use disorder

    Science.gov (United States)

    Adermark, Louise; Bowers, M. Scott

    2016-01-01

    Several laboratories recently identified that astrocytes are critical regulators of addiction machinery. It is now known that astrocyte pathology is a common feature of ethanol exposure in both humans and animal models, as even brief ethanol exposure is sufficient to elicit long-lasting perturbations in astrocyte gene expression, activity, and proliferation. Astrocytes were also recently shown to modulate the motivational properties of ethanol and other strongly reinforcing stimuli. Given the role of astrocytes in regulating glutamate homeostasis, a crucial component of alcohol use disorder, astrocytes might be an important target for the development of next generation alcoholism treatments. This review will outline some of the more prominent features displayed by astrocytes, how these properties are influenced by acute and long term ethanol exposure, and future directions that may help to disentangle astrocytic from neuronal functions in the etiology of alcohol use disorder. PMID:27476876

  11. 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…

  12. Reliability Generalization of the Alcohol Use Disorder Identification Test.

    Science.gov (United States)

    Shields, Alan L.; Caruso, John C.

    2002-01-01

    Evaluated the reliability of scores from the Alcohol Use Disorders Identification Test (AUDIT; J. Sounders and others, 1993) in a reliability generalization study based on 17 empirical journal articles. Results show AUDIT scores to be generally reliable for basic assessment. (SLD)

  13. Fetal Alcohol Spectrum Disorders: An Overview from the Glia Perspective.

    Science.gov (United States)

    Wilhelm, Clare J; Guizzetti, Marina

    2015-01-01

    Alcohol consumption during pregnancy can produce a variety of central nervous system (CNS) 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 abnormal brain

  14. Pharmacotherapy for anxiety and comorbid alcohol use disorders.

    Science.gov (United States)

    Ipser, Jonathan C; Wilson, Don; Akindipe, Taiwo O; Sager, Carli; Stein, Dan J

    2015-01-20

    Anxiety disorders are a potentially disabling group of disorders that frequently co-occur with alcohol use disorders. Comorbid anxiety and alcohol use disorders are associated with poorer outcomes, and are difficult to treat with standard psychosocial interventions. In addition, improved understanding of the biological basis of the conditions has contributed to a growing interest in the use of medications for the treatment of people with both diagnoses. To assess the effects of pharmacotherapy for treating anxiety in people with comorbid alcohol use disorders, specifically: to provide an estimate of the overall effects of medication in improving treatment response and reducing symptom severity in the treatment of anxiety disorders in people with comorbid alcohol use disorders; to determine whether specific medications are more effective and tolerable than other medications in the treatment of particular anxiety disorders; and to identify which factors (clinical, methodological) predict response to pharmacotherapy for anxiety disorders. Review authors searched the specialized registers of The Cochrane Collaboration Depression, Anxiety and Neurosis Review Group (CCDANCTR, to January 2014) and the Cochrane Drugs and Alcohol Group (CDAG, to March 2013) for eligible trials. These registers contain reports of relevant randomized controlled trials (RCT) from: the Cochrane Central Register of Controlled Trials (CENTRAL, all years), MEDLINE (1950 to date), EMBASE (1974 to date) and PsycINFO (1967 to date). Review authors ran complementary searches on EMBASE, PubMed, PsycINFO and the Alcohol and Alcohol Problems Science Database (ETOH) (to August 2013). We located unpublished trials through the National Institutes of Health (NIH) RePORTER service and the World Health Organization (WHO) International Clinical Trials Registry Platform (to August 2013). We screened reference lists of retrieved articles for additional studies. All true RCTs of pharmacotherapy for treating

  15. Neuropeptide Y in Alcohol Addiction and Affective Disorders

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    Annika Thorsell

    2017-07-01

    Full Text Available Neuropeptide Y (NPY, a neuropeptide highly conserved throughout evolution, is present at high levels in the central nervous system (CNS, as well as in peripheral tissues such as the gut and cardiovascular system. The peptide exerts its effects via multiple receptor subtypes, all belonging to the G-protein-coupled receptor superfamily. Of these subtypes, the Y1 and the Y2 are the most thoroughly characterized, followed by the Y5 subtype. NPY and its receptors have been shown to be of importance in central regulation of events underlying, for example, affective disorders, drug/alcohol use disorders, and energy homeostasis. Furthermore, within the CNS, NPY also affects sleep regulation and circadian rhythm, memory function, tissue growth, and plasticity. The potential roles of NPY in the etiology and pathophysiology of mood and anxiety disorders, as well as alcohol use disorders, have been extensively studied. This focus was prompted by early indications for an involvement of NPY in acute responses to stress, and, later, also data pointing to a role in alterations within the CNS during chronic, or repeated, exposure to adverse events. These functions of NPY, in addition to the peptide’s regulation of disease states, suggest that modulation of the activity of the NPY system via receptor agonists/antagonists may be a putative treatment mechanism in affective disorders as well as alcohol use disorders. In this review, we present an overview of findings with regard to the NPY system in relation to anxiety and stress, acute as well as chronic; furthermore we discuss post-traumatic stress disorder and, in part depression. In addition, we summarize findings on alcohol use disorders and related behaviors. Finally, we briefly touch upon genetic as well as epigenetic mechanisms that may be of importance for NPY function and regulation. In conclusion, we suggest that modulation of NPY-ergic activity within the CNS, via ligands aimed at different receptor

  16. Psychiatric morbidity in spouses of patients with alcohol related disorders

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    Aruna Dandu

    2017-01-01

    Full Text Available Context: Alcohol dependence is on rise world over, especially in developing countries such as India. According to the World Health Organization, about 30% of Indians consume alcohol, out of which 4%–13% are daily consumers and up to 50% of them, fall under the category of hazardous drinking. Another worrying trend from India is that the average age of initiation of alcohol use has reduced from 28 years during the 1980s to 17 years in 2007. In India, alcohol abuse also amounts to huge annual losses due to alcohol-related problems in workplaces. This was a cross-sectional, noninterventional study which was carried out at the Department of Psychiatry, Sri Venkateswara Ramnaraian Ruia Government General Hospital (SVRRGGH, Tirupati, Andhra Pradesh. Aim: The aim of this study was to determine the frequency and nature of psychiatric morbidity in spouses of patients with alcohol-related disorders (ARDs. Methods: Study design - Hospital-based cross-sectional study. Study setting - Psychiatry Department of SVRRGGH, Sri Venkateswara Medical College, Tirupati. Study period - October 1, 2014 to September 30, 2015. Study units - the spouses of adult patients attending the Department of Psychiatry, with a diagnosis of ARDs. After the ethical clearance from the Institutional Ethical Committee, the spouses of adult patients attending the Department of Psychiatry with a diagnosis of ARDs according to the International Classification of Diseases-10 classification of mental and behavioral disorders constitute the population for the investigation. After obtaining written informed consent from each of the concerned subjects, demographic details and history of psychiatric illness were noted as per the structured pro forma. Results: The age of the alcohol-dependent men and spouses of men with ADS ranged from 23 to 67 years (mean ± standard deviation [SD] 41.24 ± 10.101 and 21–60 years (mean ± SD 35.04 ± 8.98, respectively. Among the study population, 36.6% of

  17. Altering ethanol pharmacokinetics to treat alcohol use disorder: Can you teach an old dog new tricks?

    Science.gov (United States)

    Haass-Koffler, Carolina L; Akhlaghi, Fatemeh; Swift, Robert M; Leggio, Lorenzo

    2017-07-01

    Disulfiram was the first pharmacotherapy approved to treat alcohol use disorder in the 1950s. Disulfiram alters ethanol pharmacokinetics and causes uncomfortable reactions (e.g. headache, tachycardia, nausea, flushing and hypotension) when alcohol is consumed. Subsequently, a better understanding of the neurobiological pathways involved in alcohol use disorder led to the development of other medications (e.g. naltrexone and acamprosate). These neurobiological-based medications act on alcohol use disorder-related phenotypes including craving, stress, and/or withdrawal. The original approach to treat alcohol use disorder, by altering ethanol pharmacokinetics has been much less investigated. Recent research on ethanol pharmacokinetics has shed light on the mechanisms of action underlying alcohol use disorder and how some medications that alter ethanol pharmacokinetics may be helpful in treating alcohol use disorder. This review summarizes and discusses the complex pharmacokinetics of ethanol, and proposes that altering ethanol pharmacokinetics via novel pharmacological approaches may be a viable approach to treat alcohol use disorder.

  18. Genetics Home Reference: alcohol use disorder

    Science.gov (United States)

    ... use disorder can cause major health, social, and economic problems, and can endanger affected individuals and others ... Available from http://www.ncbi.nlm.nih.gov/books/NBK424857/ Citation on PubMed Zhu EC, Soundy TJ, ... Bulletins Genetics Home Reference Celebrates Its 15th Anniversary ...

  19. 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

  20. The craving withdrawal model for alcoholism: Towards the DSM-V Improving the discriminant validity of alcohol use disorder diagnosis

    NARCIS (Netherlands)

    de Bruijn, Carla; van den Brink, Wim; de Graaf, Ron; Vollebergh, Wilma A. M.

    2005-01-01

    Aims: To compare the discriminant validity of the DSM-IV and the ICD-10 classification of alcohol use disorders (AUD) with an alternative classification, the craving withdrawal model (CWM). CWM requires craving and withdrawal for the diagnosis of alcohol dependence and raises the alcohol abuse

  1. Alcohol and Substance Use Disorders in DSM-5

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    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.

  2. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol.

    Science.gov (United States)

    Baillie, Andrew J; Sannibale, Claudia; Stapinski, Lexine A; Teesson, Maree; Rapee, Ronald M; Haber, Paul S

    2013-07-30

    Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. Australian New Zealand Clinical Trials Registry: ACTRN12608000228381.

  3. MATERNAL ALCOHOL CONSUMPTION PRODUCING FETAL ALCOHOL SPECTRUM DISORDERS (FASD): QUANTITY, FREQUENCY, AND TIMING OF DRINKING

    Science.gov (United States)

    May, Philip A.; Blankenship, Jason; Marais, Anna-Susan; Gossage, J. Phillip; Kalberg, Wendy O.; Joubert, Belinda; Cloete, Marise; Barnard, Ronel; De Vries, Marlene; Hasken, Julie; Robinson, Luther K.; Adnams, Colleen M.; Buckley, David; Manning, Melanie; Parry, Charles; Hoyme, H. Eugene; Tabachnick, Barbara; Seedat, Soraya

    2013-01-01

    Background Concise, accurate measures of maternal prenatal alcohol use are needed to better understand fetal alcohol spectrum disorders (FASD). Methods Measures of drinking by mothers of children with specific FASD diagnoses and mothers of randomly-selected controls are compared and also correlated with physical and cognitive/behavioral outcomes. Results Measures of maternal alcohol use can differentiate maternal drinking associated with FASD from that of controls and some from mothers of alcohol-exposed normals. Six variables that combine quantity and frequency concepts distinguish mothers of FASD children from normal controls. Alcohol use variables, when applied to each trimester and three months prior to pregnancy, provide insight on critical timing of exposure as well. Measures of drinking, especially bingeing, correlate significantly with increased child dysmorphology and negative cognitive/behavioral outcomes in children, especially low non-verbal IQ, poor attention, and behavioral problems. Logistic regression links (palcohol consumption both within and between diagnostic groupings of mothers bearing children diagnosed within the FASD continuum. Drinking measures are empirically identified and correlated with specific child outcomes. Alcohol use, especially heavy use, should be avoided throughout pregnancy. PMID:23932841

  4. Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder.

    Science.gov (United States)

    Suter, Marius; Strik, Werner; Moggi, Franz

    2011-10-01

    Alcohol use disorder (AUD) and depressive disorders often co-occur. Findings on the effects of major depressive disorder (MDD) or depressive symptoms on posttreatment alcohol relapse are controversial. The study's aim is to examine the association of MDD and depressive symptoms with treatment outcomes after residential AUD programs. In a naturalistic-prospective, multisite study with 12 residential AUD treatment programs in the German-speaking part of Switzerland, 64 patients with AUD with MDD, 283 patients with AUD with clinically significant depressive symptoms at admission, and 81 patients with AUD with such problems at discharge were compared with patients with AUD only on alcohol use, depressive symptoms, and treatment service utilization. MDD was provisionally identified at admission and definitively defined at discharge. Whereas patients with MDD did not differ from patients with AUD only at 1-year follow-up, patients with AUD with clinically significant depressive symptoms had significantly shorter time-to-first-drink and a lower abstinence rate. These patients also had elevated AUD indices and treatment service utilization for psychiatric disorders. Our results suggest that clinically significant depressive symptoms are a substantial risk factor for relapse so that it may be important to treat them during and after residential AUD treatment programs. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Searching for an environmental effect of parental alcoholism on offspring alcohol use disorder: A genetically-informed study of children of alcoholics

    Science.gov (United States)

    Slutske, Wendy S.; D’Onofrio, Brian M.; Turkheimer, Eric; Emery, Robert E.; Harden, K. Paige; Heath, Andrew C.; Martin, Nicholas G.

    2009-01-01

    The children-of-twins design was used to isolate a potentially causal environmental impact of having an alcoholic parent on offspring alcohol use disorder by examining whether the children of alcoholics were at a higher risk for alcohol use disorders than the children of non-alcoholic parents even after correlated familial factors were controlled. Participants were 1,224 male and female twins from 836 twin pairs selected from the Australian Twin Registry, 2,334 of their 18–39 year-old offspring, and 983 spouses of the twins. Lifetime histories of DSM-IV alcohol use disorders were obtained by structured psychiatric telephone interviews conducted individually with each of the family members. Comparisons of the offspring of twins discordant for alcoholism indicated that there was no longer a statistically significant difference between the children of alcoholics and the children of non-alcoholics after genetic and family environmental factors correlated with having an alcoholic parent were controlled. The results of this study suggest that the direct causal effect of being exposed to an alcoholic parent on offspring alcohol use disorder is modest at best. PMID:18729607

  6. The association between alcohol use, alcohol use disorders and tuberculosis (TB. A systematic review

    Directory of Open Access Journals (Sweden)

    Room Robin

    2009-12-01

    Full Text Available Abstract Background In 2004, tuberculosis (TB was responsible for 2.5% of global mortality (among men 3.1%; among women 1.8% and 2.2% of global burden of disease (men 2.7%; women 1.7%. The present work portrays accumulated evidence on the association between alcohol consumption and TB with the aim to clarify the nature of the relationship. Methods A systematic review of existing scientific data on the association between alcohol consumption and TB, and on studies relevant for clarification of causality was undertaken. Results There is a strong association between heavy alcohol use/alcohol use disorders (AUD and TB. A meta-analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 (95% CI: 1.89-4.59. Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition, there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB, social marginalization and drift, higher rate of re-infection, higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data, about 10% of the TB cases globally were estimated to be attributable to alcohol. Conclusion The epidemiological and other evidence presented indicates that heavy alcohol use/AUD constitute a risk factor for incidence and re-infection of TB. Consequences for prevention and clinical interventions are discussed.

  7. 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.

  8. 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.

  9. Exercise as adjunctive treatment for alcohol use disorder

    DEFF Research Database (Denmark)

    Roessler, Kirsten K.; Bilberg, Randi; Søgaard Nielsen, Anette

    2017-01-01

    AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled stu...... was protective against excessive drinking following treatment. A dose-response effect of exercise on drinking outcome supports the need for implementing physically active lifestyles for patients in treatment for alcohol use disorder.......AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled study...... regression model was used to evaluate the odds of excessive drinking among the three groups, based on intention-to-treat. Changes in level of physical activity in all three groups were tested by using a generalized linear mixed model. A multiple linear model was used to test if there was an association...

  10. Chronic alcoholism-mediated metabolic disorders in albino rat testes.

    Science.gov (United States)

    Shayakhmetova, Ganna M; Bondarenko, Larysa B; Matvienko, Anatoliy V; Kovalenko, Valentina M

    2014-09-01

    There is good evidence for impairment of spermatogenesis and reductions in sperm counts and testosterone levels in chronic alcoholics. The mechanisms for these effects have not yet been studied in detail. The consequences of chronic alcohol consumption on the structure and/or metabolism of testis cell macromolecules require to be intensively investigated. The present work reports the effects of chronic alcoholism on contents of free amino acids, levels of cytochrome P450 3A2 (CYP3A2) mRNA expression and DNA fragmentation, as well as on contents of different cholesterol fractions and protein thiol groups in rat testes. Wistar albino male rats were divided into two groups: I - control (intact animals), II - chronic alcoholism (15% ethanol self-administration during 150 days). Following 150 days of alcohol consumption, testicular free amino acid content was found to be significantly changed as compared with control. The most profound changes were registered for contents of lysine (-53%) and methionine (+133%). The intensity of DNA fragmentation in alcohol-treated rat testes was considerably increased, on the contrary CYP3A2 mRNA expression in testis cells was inhibited, testicular contents of total and etherified cholesterol increased by 25% and 45% respectively, and protein SH-groups decreased by 13%. Multidirectional changes of the activities of testicular dehydrogenases were detected. We thus obtained complex assessment of chronic alcoholism effects in male gonads, affecting especially amino acid, protein, ATP and NADPH metabolism. Our results demonstrated profound changes in testes on the level of proteome and genome. We suggest that the revealed metabolic disorders can have negative implication on cellular regulation of spermatogenesis under long-term ethanol exposure.

  11. 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...

  12. Family history density of substance use problems among undergraduate college students: Associations with heavy alcohol use and alcohol use disorder.

    Science.gov (United States)

    Powers, Gregory; Berger, Lisa; Fuhrmann, Daniel; Fendrich, Michael

    2017-08-01

    A family history of alcoholism has been found associated with problematic alcohol use among college students, but less research has examined the effects of family history density of substance use problems in this population. This study examined the prevalence of family history density of substance use problems and its associations with heavy alcohol use, negative alcohol consequences, and alcohol use disorder in a college sample. Based on a secondary analysis of a probability sample, data were analyzed from 606 undergraduate students. Family history density of substance use problems included both first and second degree biological relatives. Heavy alcohol use was the total number of days in which participants drank five/four or more drinks for men/women, negative alcohol consequences were derived from items commonly asked in college student surveys, and an alcohol use disorder was defined as meeting diagnostic criteria for alcohol abuse or dependence. Point prevalence estimated rates of family history density of substance use problems, and negative binomial, ANCOVA, and logistic regression models examined associations between family history density and the alcohol variables while adjusting for sociodemographic variables. Family history density of substance use problems was not significantly associated with total days of heavy alcohol use. Having a second degree, a first degree, or both a first and second degree relative(s) with a substance use problem, however, was significantly associated with experiencing negative alcohol consequences. In addition, having both a first and second degree relative(s) with a substance use problem significantly increased the odds of having an alcohol use disorder. Family history density of substance use problems may play a role in experiencing negative alcohol consequences and in having an alcohol use disorder among undergraduate college students and may be an important risk factor to assess by college health professionals. Copyright

  13. Personality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders

    Science.gov (United States)

    Hasin, Deborah; Fenton, Miriam C.; Skodol, Andrew; Krueger, Robert; Keyes, Katherine; Geier, Timothy; Greenstein, Eliana; Blanco, Carlos; Grant, Bridget

    2012-01-01

    Context Little is known about the role of a broad range of personality disorders in the course of substance use disorder (SUD), and whether these differ by substance. The existing literature focuses mostly on antisocial personality disorder and does not come to clear conclusions. Objective To determine the association between the ten DSM-IV personality disorders and the persistence of common SUDs in a 3-year prospective study of a national sample. Design Data were drawn from participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had alcohol dependence (N=1,172), cannabis use disorder (N=454) or nicotine dependence (N=4,017) at baseline and who were re-interviewed three years later. Control variables included demographic characteristics, family history of substance disorders, baseline Axis I disorders and treatment status, and prior SUD duration. Main outcome measure Persistent SUD, defined as meeting full criteria for the relevant SUD throughout the 3-year follow-up period. Results Persistent SUD was found among 30.1% of participants with alcohol dependence, 30.8% with cannabis use disorder, and 56.6% with nicotine dependence at baseline. Axis I disorders did not have strong or consistent associations with persistent SUD. In contrast, antisocial personality disorder was significantly associated with persistent alcohol, cannabis and nicotine use disorders (adjusted odds ratios: 2.46-3.51), as was borderline personality disorder (adjusted odds ratios: 2.04-2.78) and schizotypal personality disorder (adjusted odds ratios: 1.65-5.90). Narcissistic, schizoid, and obsessive-compulsive personality disorders were less consistently associated with SUD persistence. Conclusions The consistent findings on the association of antisocial, borderline and schizotypal personality disorders with persistent SUD indicates the importance of these personality disorders in understanding the course of SUD. Future studies should examine dimensional

  14. Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

    OpenAIRE

    Book, Sarah W.; Thomas, Suzanne E.; Randall, Patrick K.; Randall, Carrie L.

    2007-01-01

    Patients with social anxiety disorder who are seen in clinical practice commonly have additional psychiatric comorbidity, including alcohol use disorders. The first line treatment for social anxiety disorder is selective-serotonin-reuptake-inhibitors (SSRIs), such as paroxetine. However, the efficacy of SSRIs has been determined with studies that excluded alcoholics. Forty two subjects with social anxiety and a co-occurring alcohol use disorder participated in a 16-week, double-blind, placebo...

  15. 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.

  16. 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

  17. 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…

  18. 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.

  19. Alcohol expectancies pre-and post-alcohol use disorder treatment: Clinical implications.

    Science.gov (United States)

    Coates, Jason M; Gullo, Matthew J; Feeney, Gerald F X; Young, Ross McD; Dingle, Genevieve A; Connor, Jason P

    2018-05-01

    Modification of elevated positive expectations of alcohol consumption (alcohol outcome expectancies; AOEs) is a key feature of Cognitive Behaviour Therapy (CBT) approaches to Alcohol Use Disorders (AUDs). Despite extensive research supporting the efficacy of CBT for AUD, few studies have examined AOE change. This study aimed to assess AOE change following completion of CBT for AUD and its association with drinking behaviour. One-hundred and seventy-five patients who completed a 12-week CBT program for AUD were administered the Drinking Expectancy Questionnaire (DEQ) at pre-treatment assessment and upon completion of treatment. Abstinence was achieved by 108 (61.7%) of completing patients. For patients who lapsed, the mean proportion of abstinent days was 93%. DEQ scales assessing expectations of positive alcohol effects on tension reduction, assertiveness, and cognitive enhancement were significantly lower post-treatment (pscale. Greater percentage of abstinent days over treatment was associated with lower pre-and post-treatment tension reduction expectancy scores (p<0.05). Drinking during treatment was associated with smaller changes in expectations of negative effects of alcohol on mood (p<0.05). Individuals who completed CBT treatment for AUD showed significant AOE change. Tension reduction and affective change expectancies may be particularly important for abstinence and useful markers of lapse risk. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): quantity, frequency, and timing of drinking.

    Science.gov (United States)

    May, Philip A; Blankenship, Jason; Marais, Anna-Susan; Gossage, J Phillip; Kalberg, Wendy O; Joubert, Belinda; Cloete, Marise; Barnard, Ronel; De Vries, Marlene; Hasken, Julie; Robinson, Luther K; Adnams, Colleen M; Buckley, David; Manning, Melanie; Parry, Charles D H; Hoyme, H Eugene; Tabachnick, Barbara; Seedat, Soraya

    2013-12-01

    Concise, accurate measures of maternal prenatal alcohol use are needed to better understand fetal alcohol spectrum disorders (FASD). Measures of drinking by mothers of children with specific FASD diagnoses and mothers of randomly-selected controls are compared and also correlated with physical and cognitive/behavioral outcomes. Measures of maternal alcohol use can differentiate maternal drinking associated with FASD from that of controls and some from mothers of alcohol-exposed normals. Six variables that combine quantity and frequency concepts distinguish mothers of FASD children from normal controls. Alcohol use variables, when applied to each trimester and three months prior to pregnancy, provide insight on critical timing of exposure as well. Measures of drinking, especially bingeing, correlate significantly with increased child dysmorphology and negative cognitive/behavioral outcomes in children, especially low non-verbal IQ, poor attention, and behavioral problems. Logistic regression links (p<.001) first trimester drinking (vs. no drinking) with FASD, elevating FASD likelihood 12 times; first and second trimester drinking increases FASD outcomes 61 times; and drinking in all trimesters 65 times. Conversely, a similar regression (p=.008) indicates that drinking only in the first trimester makes the birth of a child with an FASD 5 times less likely than drinking in all trimesters. There is significant variation in alcohol consumption both within and between diagnostic groupings of mothers bearing children diagnosed within the FASD continuum. Drinking measures are empirically identified and correlated with specific child outcomes. Alcohol use, especially heavy use, should be avoided throughout pregnancy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. 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.

  2. GLIA AND NEURODEVELOPMENT: FOCUS ON FETAL ALCOHOL SPECTRUM DISORDERS

    Directory of Open Access Journals (Sweden)

    Marina eGuizzetti

    2014-11-01

    Full Text Available During the last 20 years new and exciting roles for glial cells in brain development have been described. Moreover, several recent studies implicated glial cells in the pathogenesis of neurodevelopmental disorders including Down syndrome, Fragile X syndrome, Rett Syndrome, Autism Spectrum Disorders, and Fetal Alcohol Spectrum Disorders (FASD.Abnormalities in glial cell development and proliferation and increased glial cell apoptosis contribute to the adverse effects of ethanol on the developing brain and it is becoming apparent that the effects of fetal alcohol are due, at least in part, to effects on glial cells affecting their ability to modulate neuronal development and function. The three major classes of glial cells, astrocytes, oligodendrocytes, and microglia as well as their precursors are affected by ethanol during brain development. Alterations in glial cell functions by ethanol dramatically affect neuronal development, survival, and function and ultimately impair the development of the proper brain architecture and connectivity. For instance, ethanol inhibits astrocyte-mediated neuritogenesis and oligodendrocyte development, survival and myelination; furthermore, ethanol induces microglia activation and oxidative stress leading to the exacerbation of ethanol-induced neuronal cell death.This review article describes the most significant recent findings pertaining the effects of ethanol on glial cells and their significance in the pathophysiology of FASD and other neurodevelopmental disorders.

  3. The prevalence and correlates of alcohol use disorder amongst bipolar patients in a hospital setting, Malaysia.

    Science.gov (United States)

    Yee, Hway Ann; Loh, Huai Seng; Ng, Chong Guan

    2013-10-01

    To determine the prevalence of alcohol-use disorder and associated correlates amongst bipolar patients in a university hospital in Malaysia. In this cross-sectional study, a total of 121 bipolar disorder patients were included. Their alcohol use disorders were assessed with the Mini International Neuropsychiatric Interview (plus version) and the Addiction Severity Index-Lite-Clinical Factors version. The number of lifetime hospitalizations and the survival days (the number of days between the last discharge and the most current readmission) were calculated. The prevalence of alcohol-use disorder amongst bipolar patients was 18.2%. Indian ethnicity was the only demographic factor that was statistically associated with alcohol-use disorder (p rate of suicidal attempt (p Malaysia. Since alcohol-use disorder, as well as the potential interactions with the course of the disorder, is highly prevalent amongst bipolar patients, alcohol use should be addressed in these patients.

  4. [Alcohol consumption in patients with psychiatric disorders: assessment and treatment].

    Science.gov (United States)

    Lang, J-P; Bonnewitz, M-L; Kusterer, M; Lalanne-Tongio, L

    2014-09-01

    Alcohol consumption in France exceeds the European average (12.7L of pure alcohol/habitant/year in 2009 for an average of 12.5 L). This consumption has a major professional, social and health impact on the individuals and their families. The cost of such, estimated in Europe to be of 155.8 billion Euros in 2010, is the highest among the central nervous system diseases in Europe, far higher than that of depression or dementia. Patients suffering from psychiatric disorders are more frequently affected by problems related to alcohol use than the general population. They are also more vulnerable to the immediate and subsequent consequences of their consumption. The alcohol related disorders that are often accompanied by risk taking and other addictive behaviour require a global assessment of the addiction, with and without substance, and of the complications. These have a strong impact on risk taking, compliance with care, and the morbidity of somatic and psychiatric disorders, as well as access to optimal care and the life span of patients suffering from psychiatric disorders. The development of addictology care, with integrative treatment programs, is recommended in response to these public health issues. Nevertheless, specific addictology practices and partners with addictology care structures are still scarcely developed in psychiatry. Firstly, it would be necessary to set up such integrated treatments through the systematisation of an "addictology" checkup on admission, a global assessment of addictive behaviour and cognitive disorders, using pragmatic tools that are user-friendly for the care teams, maintain the reduction in risk taking, and apply prescriptions for addiction to psychotropic treatments, in liaison with the referring general practitioner. As early as possible, accompanied by specific training in addictology for the psychiatrists and the mental health nursing teams, such care could be enhanced by the development of liaison and advanced psychiatric

  5. 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.

  6. Free and Cued Recall Memory in Parkinson’s Disease Associated with Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Costa, Alberto; Monaco, Marco; Zabberoni, Silvia; Peppe, Antonella; Perri, Roberta; Fadda, Lucia; Iannarelli, Francesca; Caltagirone, Carlo; Carlesimo, Giovanni A.

    2014-01-01

    The hypothesis has been advanced that memory disorders in individuals with Parkinson’s disease (PD) are related to either retrieval or consolidation failure. However, the characteristics of the memory impairments of PD patients with amnestic mild cognitive impairment have not been clarified. This study was aimed at investigating whether memory deficits in PD patients with amnestic mild cognitive impairment (PDaMCI) are due to failure of retrieval or consolidation processes. Sixteen individuals with PDaMCI, 20 with amnestic mild cognitive impairment without PD (aMCINPD), and 20 healthy controls were recruited. Participants were administered the Free and Cued Selective Reminding Test. An index of cueing was computed for each subject to capture the advantage in retrieval of cued compared to free recall. Individuals with PDaMCI performed worse than healthy controls on the free recall (pcued recall (p>0.10) task, and they performed better than aMCINPD subjects on both recall measures (p0.10) but it was significantly higher than that of the aMCINPD sample (precall trials was significantly predicted by scores on a test investigating executive functions (i.e., the Modified Card Sorting Test; p = 0.042). Findings of the study document that, in subjects with amnestic mild cognitive impairment associated to PD, episodic memory impairment is related to retrieval rather than to consolidation failure. The same data suggest that, in these individuals, memory deficits might be due to altered frontal-related executive functioning. PMID:24465977

  7. Quality of Smartphone Apps Related to Alcohol Use Disorder.

    Science.gov (United States)

    Penzenstadler, Louise; Chatton, Anne; Van Singer, Mathias; Khazaal, Yasser

    2016-01-01

    Apps for smartphones are opening an important range of opportunities for improving the care of people with alcohol use disorders (AUDs). This study aimed to evaluate the quality of English language apps for AUDs and to compare paid and free apps. The keywords 'alcohol', 'alcohol addiction', 'alcohol help' and 'stop drinking' were entered into the iTunes Store search engine. Apps were evaluated using a standardized assessment designed to rate the quality of apps in terms of accountability, interactivity, self-help score and evidence-based content. The Brief DISCERN score and the criteria of the 'Health on the Net' label were also used as content quality indicators. Of the 137 unique apps identified, 52 met the inclusion criteria. Overall, the content quality and self-help scores of these AUD apps were poor. The main quality indicators were not linked to payment status. Multiple linear regressions showed that the Brief DISCERN score significantly predicted content quality. Poor content quality and self-help scores of AUD smartphone apps underline the gap between their potential promises and the overall quality of available products in stores. The quality indicators used in the present study may be used for further app developments. © 2016 S. Karger AG, Basel.

  8. The roles of outlet density and norms in alcohol use disorder

    OpenAIRE

    Ahern, J; Balzer, L; Galea, S

    2015-01-01

    © 2015 Elsevier Ireland Ltd. Background: Alcohol outlet density and norms shape alcohol consumption. However, due to analytic challenges we do not know: (a) if alcohol outlet density and norms also shape alcohol use disorder, and (b) whether they act in combination to shape disorder. Methods: We applied a new targeted minimum loss-based estimator for rare outcomes (rTMLE) to a general population sample from New York City (N= 4000) to examine the separate and combined relations of neighborhood...

  9. Molecular Neuropathology of Astrocytes and Oligodendrocytes in Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    José J. Miguel-Hidalgo

    2018-03-01

    Full Text Available Postmortem studies reveal structural and molecular alterations of astrocytes and oligodendrocytes in both the gray and white matter (GM and WM of the prefrontal cortex (PFC in human subjects with chronic alcohol abuse or dependence. These glial cellular changes appear to parallel and may largely explain structural and functional alterations detected using neuroimaging techniques in subjects with alcohol use disorders (AUDs. Moreover, due to the crucial roles of astrocytes and oligodendrocytes in neurotransmission and signal conduction, these cells are very likely major players in the molecular mechanisms underpinning alcoholism-related connectivity disturbances between the PFC and relevant interconnecting brain regions. The glia-mediated etiology of alcohol-related brain damage is likely multifactorial since metabolic, hormonal, hepatic and hemodynamic factors as well as direct actions of ethanol or its metabolites have the potential to disrupt distinct aspects of glial neurobiology. Studies in animal models of alcoholism and postmortem human brains have identified astrocyte markers altered in response to significant exposures to ethanol or during alcohol withdrawal, such as gap-junction proteins, glutamate transporters or enzymes related to glutamate and gamma-aminobutyric acid (GABA metabolism. Changes in these proteins and their regulatory pathways would not only cause GM neuronal dysfunction, but also disturbances in the ability of WM axons to convey impulses. In addition, alcoholism alters the expression of astrocyte and myelin proteins and of oligodendrocyte transcription factors important for the maintenance and plasticity of myelin sheaths in WM and GM. These changes are concomitant with epigenetic DNA and histone modifications as well as alterations in regulatory microRNAs (miRNAs that likely cause profound disturbances of gene expression and protein translation. Knowledge is also available about interactions between astrocytes and

  10. Epigenetic mechanisms: A possible link between autism spectrum disorders and fetal alcohol spectrum disorders.

    Science.gov (United States)

    Varadinova, Miroslava; Boyadjieva, Nadka

    2015-12-01

    The etiology of autism spectrum disorders (ASDs) still remains unclear and seems to involve a considerable overlap between polygenic, epigenetic and environmental factors. We have summarized the current understanding of the interplay between gene expression dysregulation via epigenetic modifications and the potential epigenetic impact of environmental factors in neurodevelopmental deficits. Furthermore, we discuss the scientific controversies of the relationship between prenatal exposure to alcohol and alcohol-induced epigenetic dysregulations, and gene expression alterations which are associated with disrupted neural plasticity and causal pathways for ASDs. The review of the literature suggests that a better understanding of developmental epigenetics should contribute to furthering our comprehension of the etiology and pathogenesis of ASDs and fetal alcohol spectrum disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use.

    Science.gov (United States)

    Brinkman, William B; Epstein, Jeffery N; Auinger, Peggy; Tamm, Leanne; Froehlich, Tanya E

    2015-02-01

    The association of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) with tobacco and alcohol use has not been assessed in a young adolescent sample representative of the U.S. population. Data are from the 2000-2004 National Health and Nutrition Examination Survey, a cross-sectional sample representative of the U.S. population. Participants were age 12-15 years (N=2517). Exposure variables included diagnosis of ADHD and CD, and counts of ADHD and CD symptoms based on caregiver responses to the Diagnostic Interview Schedule for Children. Primary outcomes were adolescent-report of any use of tobacco or alcohol and age of initiating use. Multivariate logistic regression and Cox proportional hazard models were conducted. Adolescents with ADHD+CD diagnoses had a 3- to 5-fold increased likelihood of using tobacco and alcohol and initiated use at a younger age compared to those with neither disorder. Having ADHD alone was associated with an increased likelihood of tobacco use but not alcohol use. Hyperactive-impulsive symptom counts were not independently associated with any outcome, while every one symptom increase in inattention increased the likelihood of tobacco and alcohol use by 8-10%. Although participants with a diagnosis of CD alone (compared to those without ADHD or CD) did not have a higher likelihood of tobacco or alcohol use, for every one symptom increase in CD symptoms the odds of tobacco use increased by 31%. ADHD and CD diagnoses and symptomatology are linked to higher risk for a range of tobacco and alcohol use outcomes among young adolescents in the U.S. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Major life events and risk of alcohol use disorders

    DEFF Research Database (Denmark)

    Just-Østergaard, Emilie; Mortensen, Erik L.; Flensborg-Madsen, Trine

    2018-01-01

    , household income, cohabitation status and psychiatric comorbidity. Findings: Serious family conflicts in childhood [hazard ratio (HR) = 1.35; 95% confidence interval (CI) = 1.00, 1.83] and serious economic problems in adult life (HR = 2.22; 95% CI = 1.64, 3.01) were associated significantly with increased......Aims: To estimate associations of individual major life events as well as accumulated major life events in childhood, adult private life and adult work life with risk of alcohol use disorders (AUD). Design: Prospective cohort study with baseline examination in 1991–93 and linkage to national...

  13. 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…

  14. 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

    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

  15. 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

    Although 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 overlap and

  16. Long-Term Influence of Duration and Frequency of Participation in Alcoholics Anonymous on Individuals With Alcohol Use Disorders.

    Science.gov (United States)

    Moos, Rudolf H.; Moos, Bernice S.

    2004-01-01

    This study examined the influence of the duration and frequency of a baseline episode of participation in Alcoholics Anonymous (AA) among 473 individuals with alcohol use disorders on 1-year and 8-year outcomes and the effect of additional participation and delayed participation on outcomes. Compared with individuals who did not participate,…

  17. Drinking motives in alcohol use disorder patients with and without social anxiety disorder.

    Science.gov (United States)

    Cooper, R; Hildebrandt, S; Gerlach, A L

    2014-01-01

    The high comorbidity of alcohol use disorders (AUD) and social anxiety disorder (SAD) is often explained by excessive drinking in social situations to self-medicate social anxiety. Indeed, the motive to drink alcohol to lower social fears was found to be elevated in socially anxious persons. However, this social anxiety specific motive has not been directly investigated in primarily alcohol dependent individuals. We explored social anxiety, the motivation to drink alcohol in order to cope with social fears, and social anxiety as a consequence of drinking in AUD with and without comorbid SAD. Male AUD inpatients with (AUD+SAD group, N=23) and without comorbid SAD (N=37) completed a clinical interview and a questionnaire assessment. AUD+SAD patients reported higher levels of depression and an elevated motive to drink due to social anxiety but did not experience more social fears as a consequence of drinking. Previous results concerning alcohol drinking motives in order to relieve social fears could be replicated in a clinical AUD sample. Additionally, our findings suggest comorbid AUD+SAD patients to be more burdened regarding broader psychopathological symptoms. Thus, accessibility to SAD-specific screening and treatment procedures may be beneficial for primary AUD patients.

  18. THEORY OF MIND IN CHILDREN WITH FETAL ALCOHOL SPECTRUM DISORDERS

    Science.gov (United States)

    Lindinger, Nadine M.; Malcolm-Smith, Susan; Dodge, Neil C.; Molteno, Christopher D.; Thomas, Kevin G. F.; Meintjes, Ernesta M.; Jacobson, Joseph L.; Jacobson, Sandra W.

    2015-01-01

    Background Theory of mind (ToM) refers to the ability to understand and make inferences about other people’s intentions, feelings, and beliefs. Although children with fetal alcohol spectrum disorders (FASD) are known to have deficits in social-cognitive function, little is known about ToM in FASD. Methods ToM ability was assessed using a developmentally sensitive ToM battery, including the Reading the Mind in the Eyes (RME) test, a measure of mental inferential ability that has been found to be impaired in other clinical populations. IQ and executive function (EF) were assessed as potential mediating variables. The battery was administered to 63 children (aged 9–11 years) from Cape Town, South Africa, whose mothers had been prospectively recruited during pregnancy. Children with fetal alcohol syndrome (FAS; n=8) and partial FAS (PFAS; n=19), as well as nonsyndromal heavily exposed children (HE; n=17), were compared to children born to abstaining or light drinkers (n=19) from the same community. Results No FASD group differences were found on the less challenging ToM tasks. By contrast, children with FAS and PFAS performed more poorly than controls on a more challenging ToM task, the RME test. A continuous measure of prenatal alcohol exposure was more sensitive than FASD diagnosis in that it was related to four higher-order ToM measures, particularly the ability to attribute mental states assessed on RME. IQ only partially mediated the effect of exposure on RME performance, and these effects were not mediated by EF. Hence, the data suggest that these ToM measures tap into a specific alcohol-related social-cognitive deficit that does not merely reflect poorer EF. FASD diagnosis and prenatal alcohol exposure were each also related to RME after control for Attention Deficit/Hyperactivity Disorder. Conclusions These findings suggest that deficits in higher-order ToM function may play a significant role in the social-cognitive behavioural impairment in FASD. PMID

  19. Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) and prevalence of alcohol use among Iranian psychiatric outpatients.

    Science.gov (United States)

    Noorbakhsh, Simasadat; Shams, Jamal; Faghihimohamadi, Mohamadmahdi; Zahiroddin, Hanieh; Hallgren, Mats; Kallmen, Hakan

    2018-01-30

    Iran is a developing and Islamic country where the consumption of alcoholic beverages is banned. However, psychiatric disorders and alcohol use disorders are often co-occurring. We used the Alcohol Use Disorders Identification Test (AUDIT) to estimate the prevalence of alcohol use and examined the psychometric properties of the test among psychiatric outpatients in Teheran, Iran. AUDIT was completed by 846 consecutive (sequential) patients. Descriptive statistics, internal consistency (Cronbach alpha), confirmatory and exploratory factor analyses were used to analyze the prevalence of alcohol use, reliability and construct validity. 12% of men and 1% of women were hazardous alcohol consumers. Internal reliability of the Iranian version of AUDIT was excellent. Confirmatory factor analyses showed that the construct validity and the fit of previous factor structures (1, 2 and 3 factors) to data were not good and seemingly contradicted results from the explorative principal axis factoring, which showed that a 1-factor solution explained 77% of the co-variances. We could not reproduce the suggested factor structure of AUDIT, probably due to the skewed distribution of alcohol consumption. Only 19% of men and 3% of women scored above 0 on AUDIT. This could be explained by the fact that alcohol is illegal in Iran. In conclusion the AUDIT exhibited good internal reliability when used as a single scale. The prevalence estimates according to AUDIT were somewhat higher among psychiatric patients compared to what was reported by WHO regarding the general population.

  20. Parental Divorce and Family History of Alcohol Disorder: Associations with Young Adults' Alcohol Problems, Marijuana Use, and Interpersonal Relations.

    Science.gov (United States)

    Windle, Michael; Windle, Rebecca C

    2018-06-01

    This study used prospective data from 706 young adults to evaluate the impact of parental divorce and family history of alcoholism (FH+) on the outcomes of offspring alcohol problems, marijuana use, and interpersonal relationships with parents. Assessments of parental divorce were based on parent reports, and young adult outcomes were collected from an offspring cohort (n = 706; X age = 33.25 years; females = 53%) via computer-based individual interviews (CAPI and ACASI). Family history of alcohol disorders for parents was based on assessments by mothers, fathers, and young adults. Parental divorce significantly predicted marijuana use but not alcohol problems. Maternal, but not paternal, alcoholism also significantly predicted marijuana use. Two-way interactions indicated that sex moderated several of the relationships. For example, among those with divorced parents, daughters reported higher levels of conflict with fathers than sons, and sons reported lower levels of maternal support than daughters. Paternal alcoholism was also associated with higher levels of alcohol problems among sons relative to daughters. There was also a significant 2-way interaction between divorce status and maternal alcoholism indicating that young adults who experienced both maternal alcoholism and parental divorce had the highest levels of marijuana use. These findings highlight the role that parental divorce and FH+ have on alcohol problems, marijuana use, and interpersonal relationships in young adulthood, and how sex may moderate some of these more nuanced relationships. Copyright © 2018 by the Research Society on Alcoholism.

  1. 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

  2. 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

    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

  3. Fetal alcohol spectrum disorders har fået danske kriterier

    DEFF Research Database (Denmark)

    Broccia, Marcella; Vikre-Jørgensen, Jennifer; Rausgaard, Nete Lundager Klokker

    2017-01-01

    The Danish Paediatric Society presents the first Danish definition of fetal alcohol spectrum disorders (FASD) in a new guideline. FASD is an umbrella term for conditions caused by prenatal alcohol exposure. To varying degrees, fetal alcohol damages manifest as physical defects, characteristic fac...

  4. Fetal alcohol spectrum disorders har fået danske kriterier

    DEFF Research Database (Denmark)

    Broccia, Marcella; Vikre-Jørgensen, Jennifer; Rausgaard, Nete Lundager Klokker

    2017-01-01

    The Danish Paediatric Society presents the first Danish definition of fetal alcohol spectrum disorders (FASD) in a new guideline. FASD is an umbrella term for conditions caused by prenatal alcohol exposure. To varying degrees, fetal alcohol damages manifest as physical defects, characteristic...

  5. The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) in the assessment of alcohol use disorders among acute injury patients.

    Science.gov (United States)

    Wade, Darryl; Varker, Tracey; Forbes, David; O'Donnell, Meaghan

    2014-01-01

    The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is a brief alcohol screening test and a candidate for inclusion in recommended screening and brief intervention protocols for acute injury patients. The objective of the current study was to examine the performance of the AUDIT-C to risk stratify injury patients with regard to their probability of having an alcohol use disorder. Participants (n = 1,004) were from a multisite Australian acute injury study. Stratum-specific likelihood ratio (SSLR) analysis was used to examine the performance of previously recommended AUDIT-C risk zones based on a dichotomous cut-point (0 to 3, 4 to 12) and risk zones derived from SSLR analysis to estimate the probability of a current alcohol use disorder. Almost a quarter (23%) of patients met criteria for a current alcohol use disorder. SSLR analysis identified multiple AUDIT-C risk zones (0 to 3, 4 to 5, 6, 7 to 8, 9 to 12) with a wide range of posttest probabilities of alcohol use disorder, from 5 to 68%. The area under receiver operating characteristic curve (AUROC) score was 0.82 for the derived AUDIT-C zones and 0.70 for the recommended AUDIT-C zones. A comparison between AUROCs revealed that overall the derived zones performed significantly better than the recommended zones in being able to discriminate between patients with and without alcohol use disorder. The findings of SSLR analysis can be used to improve estimates of the probability of alcohol use disorder in acute injury patients based on AUDIT-C scores. In turn, this information can inform clinical interventions and the development of screening and intervention protocols in a range of settings. Copyright © 2013 by the Research Society on Alcoholism.

  6. Clinical exercise interventions in alcohol use disorders: a systematic review.

    Science.gov (United States)

    Giesen, Esther S; Deimel, Hubertus; Bloch, Wilhelm

    2015-05-01

    The therapeutic impact of exercise interventions in psychiatric diseases such as depression, anxiety and schizophrenia has already been proven through several reviews whereas substance use disorders such as alcohol use disorders (AUD) have so far less frequently been a matter of investigation. Although several publications have summarized studies focusing on physical activities in substance use disorders, no systematic review exists summarizing the evidence of exercise interventions in AUD. A total of 14 studies using the Medline Database, CCMed, Cochrane Library and PsychINFO were identified and met the inclusion criteria. In order to evaluate the evidence, we used the evaluation system of the Oxford Centre for Evidence-Based Medicine (2011). Due to methodological flaws the overall evidence of the studies is rated level "3" but primarily findings confirm that exercise interventions as a complementary treatment component in AUD are feasible and safe. No adverse events were reported. This systematic review indicates that exercise may have beneficial effects on certain domains of physical functioning including VO2max, basal heart rate, physical activity level and strength. Inconsistent effects with a slight trend towards a positive effect on anxiety, mood management, craving, and drinking behavior have been shown and need to be verified. Results must be interpreted cautiously due to the numerous methodological flaws and the heterogeneity of the interventions and measures. However, according to preclinical studies several mechanisms of action are conceivable, especially as to alcohol-related outcomes and additionally seem to be promising. RCTs with high methodological quality are urgently needed in future research to establish evidence-based exercise recommendations for the treatment of AUD. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-07-01

    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 relapse. Data are from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). We selected 506 people in ≥12-month DSM-5 AUD remission at baseline and assessed their status at 3-year follow-up. AUD symptoms and drinking patterns were assessed using the Composite International Diagnostic Interview 3.0. Time since remission was assessed retrospectively at baseline and ranged from 1 to 48 years. Predictors for relapse were examined using Cox regression analysis. Cumulative AUD relapse rate was 5.6% at 5 years, 9.1% at 10 years and 12.0% at 20 years. Relapse was predicted by both medium (15-28/22-42 drinks weekly for women/men) and high (≥29/43) past alcohol intake, 6+ lifetime AUD symptoms, 'impaired control over use', and at-risk (≥8/15) current intake. The risk of relapse was especially high when medium or high past intake or 6+ lifetime symptoms coincided with current at-risk drinking. Only a minority of people in DSM-5 AUD remission relapsed, but the risk of relapse increased substantially with the presence of at least one of the risk factors. Moreover, at-risk current drinking coupled with other risk factors substantially increased the likelihood of relapse. Therefore, current drinking may provide an adequate reference point for relapse prevention. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  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. Challenges of Parenting Children with a Fetal Alcohol Spectrum Disorder: A Concept Map

    Science.gov (United States)

    Brown, Jason D.; Bednar, Lisa M.

    2004-01-01

    The purpose of the study was to describe the challenges of parents of children with a fetal alcohol spectrum disorder (FASD). Nineteen birth, foster or adoptive parents were asked to answer the following question: "What are the challenges you face parenting a child with a fetal alcohol spectrum disorder?" The data were analyzed using…

  11. TO DETERMINE THE PERSONALITY TRAITS, CLINICAL CHARACTERISTICS AND COGNITIVE FUNCTIONS IN BIPOLAR DISORDER PATIENTS WITH COMORBID ALCOHOL USE DISORDERS

    Directory of Open Access Journals (Sweden)

    Ahalya Thinaharan

    2016-12-01

    Full Text Available BACKGROUND Comorbidity of bipolar disorder and substance use disorder is common. It is difficult to treat bipolar disorder patients with comorbid alcohol use disorder since the disease course is more severe and they have greater difficulties in cognitive functions than those without alcohol use. Whether alcohol negatively affects specific cognitive functions or the deficits are more diffuse in nature is unclear. Alcoholic bipolar patients present with high scores in openness to experience and neuroticism personality traits. Personality to an extent mediates the co-occurrence of substance use in bipolar disorder. Thus, identifying these personality traits in bipolar or substance use disorder patients, will help us to prevent the co-occurrence of the second disorder. The aim of the study is to evaluate the clinical characteristics, personality traits and cognitive functions of patients with bipolar and comorbid alcohol use disorders. MATERIALS AND METHODS A sample of 100 patients, 50 with bipolar and alcohol use disorder (cases and 50 with bipolar disorder (controls attending tertiary care hospital outpatient department at Chennai was selected. Alcohol status was assessed using AUDIT (alcohol use disorder identification test and SADQ (severity of alcohol dependence questionnaire. Personality was assessed using NEO-five factor inventory. Cognition was assessed using frontal lobe assessment battery, Stroop test, DSST (digit symbol substitution test and verbal N back test. RESULTS The cases group had more number of hospitalisations and mixed episodes than control group. They also performed poorer on frontal lobe assessment battery, Stroop test and digit symbol substitution test. Duration of alcohol use was associated positively with total number of hospitalisations and number of episodes. The cases group scored significantly higher on the personality traits of neuroticism and openness to experience. CONCLUSION The study confirmed the higher

  12. Fetal alcohol spectrum disorders har fået danske kriterier

    DEFF Research Database (Denmark)

    Broccia, Marcella; Vikre-Jørgensen, Jennifer; Rausgaard, Nete Lundager Klokker

    2017-01-01

    The Danish Paediatric Society presents the first Danish definition of fetal alcohol spectrum disorders (FASD) in a new guideline. FASD is an umbrella term for conditions caused by prenatal alcohol exposure. To varying degrees, fetal alcohol damages manifest as physical defects, characteristic...... facial features and poor growth, as well as behavioural and cognitive disorders. It requires both somatic and psychological evaluation to identify these damages. Early diagnosis and identification of problems are important for prognosis as professional care has a positive preventive effect...

  13. 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...

  14. Hope, coping skills, and the prefrontal cortex in alcohol use disorder recovery.

    Science.gov (United States)

    Bradshaw, Spencer D; Shumway, Sterling T; Dsauza, Cynthia M; Morris, Neli; Hayes, Nicholas D

    2017-09-01

    Alcohol use disorders adversely affect individual and societal health. These disorders are a chronic brain disease, and protective factors against relapse should be studied. Prefrontal cortex (PFC) dysfunction is evident in alcohol use disorders, and research that explores recovery of the PFC in alcohol use disorders is needed, specifically in regard to how psychological and behavioral factors can augment medicalized treatments and protect against relapse. For example, hope or a belief that recovery is possible is an important cognitive construct-thought to precede behavioral action-that has been associated with relapse. In this study, associations between healthy coping skills and hope (psychological/behavioral factors) and PFC regional activation in response to alcohol cue exposure were examined. It was also examined whether such associations were unique to alcohol cues. Forty-two participants, 32 males and nine females in recovery from an alcohol use disorder (AUD), were administered a subjective hope and coping in recovery measure. They also viewed alcohol, positive, negative, and neutral cues during functional near-infrared spectroscopy (fNIR) PFC assessment. Levels of healthy coping skills positively correlated with activation in the right dorsomedial prefrontal cortex (DMPFC) in response to alcohol cues. This finding was unique to alcohol cues. The association between coping skills and activation of the right DMPFC in response to alcohol cues may reflect greater action restraint and top-down PFC control processing that may protect against relapse.

  15. The performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in a population of depressed or anxious persons

    NARCIS (Netherlands)

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

    2010-01-01

    BACKGROUND: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it

  16. The Knowledge of Rehabilitation Professionals Concerning Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Birch, Stephanie M; Carpenter, Heidi A; Marsh, Anna M; McClung, Kimberly A; Doll, Joy D

    2016-01-01

    The purpose of this study was to explore rehabilitation professionals' knowledge regarding signs and symptoms, prevention, and intervention of fetal alcohol spectrum disorders (FASD). Participants were 111 rehabilitation practitioners (e.g., occupational therapy, physical therapy, and speech-language pathology practitioners) recruited through email using a quantitative online survey design with purposive, snowball sampling. Results showed the majority of participants' demonstrated accurate knowledge of the signs and symptoms of FASD. Since professionals who received formal education on FASD reported significantly higher feelings of preparedness to identify children with FASD and manage/coordinate intervention plans, this study suggests rehabilitation professionals may be better prepared to treat individuals with FASD if they participate in formal training.

  17. 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.

  18. Alcohol and other drug use disorders among homeless people in Australia.

    Science.gov (United States)

    Teesson, Maree; Hodder, Tracey; Buhrich, Neil

    2003-01-01

    This paper describes alcohol and drug-use disorders among 210 homeless people in Australia, and compares the Australian findings with the international literature. While the prevalence of alcohol-use disorders among people who are homeless in Australia is comparable with other international studies, drug-use disorders appear to be more prevalent among Australian homeless than comparable international studies. Reasons for this difference are explored.

  19. Fine motor skills in children with prenatal alcohol exposure or fetal alcohol spectrum disorder.

    Science.gov (United States)

    Doney, Robyn; Lucas, Barbara R; Jones, Taryn; Howat, Peter; Sauer, Kay; Elliott, Elizabeth J

    2014-01-01

    Prenatal alcohol exposure (PAE) can cause fetal alcohol spectrum disorders (FASD) and associated neurodevelopmental impairments. It is uncertain which types of fine motor skills are most likely to be affected after PAE or which assessment tools are most appropriate to use in FASD diagnostic assessments. This systematic review examined which types of fine motor skills are impaired in children with PAE or FASD; which fine motor assessments are appropriate for FASD diagnosis; and whether fine motor impairments are evident at both "low" and "high" PAE levels. A systematic review of relevant databases was undertaken using key terms. Relevant studies were extracted using a standardized form, and methodological quality was rated using a critical appraisal tool. Twenty-four studies met inclusion criteria. Complex fine motor skills, such as visual-motor integration, were more frequently impaired than basic fine motor skills, such as grip strength. Assessment tools that specifically assessed fine motor skills more consistently identified impairments than those which assessed fine motor skills as part of a generalized neurodevelopmental assessment. Fine motor impairments were associated with "moderate" to "high" PAE levels. Few studies reported fine motor skills of children with "low" PAE levels, so the effect of lower PAE levels on fine motor skills remains uncertain. Comprehensive assessment of a range of fine motor skills in children with PAE is important to ensure an accurate FASD diagnosis and develop appropriate therapeutic interventions for children with PAE-related fine motor impairments.

  20. The role of conduct disorder in the relationship between alcohol, nicotine and cannabis use disorders.

    Science.gov (United States)

    Grant, J D; Lynskey, M T; Madden, P A F; Nelson, E C; Few, L R; Bucholz, K K; Statham, D J; Martin, N G; Heath, A C; Agrawal, A

    2015-12-01

    Genetic influences contribute significantly to co-morbidity between conduct disorder and substance use disorders. Estimating the extent of overlap can assist in the development of phenotypes for genomic analyses. Multivariate quantitative genetic analyses were conducted using data from 9577 individuals, including 3982 complete twin pairs and 1613 individuals whose co-twin was not interviewed (aged 24-37 years) from two Australian twin samples. Analyses examined the genetic correlation between alcohol dependence, nicotine dependence and cannabis abuse/dependence and the extent to which the correlations were attributable to genetic influences shared with conduct disorder. Additive genetic (a(2) = 0.48-0.65) and non-shared environmental factors explained variance in substance use disorders. Familial effects on conduct disorder were due to additive genetic (a(2) = 0.39) and shared environmental (c(2) = 0.15) factors. All substance use disorders were influenced by shared genetic factors (rg = 0.38-0.56), with all genetic overlap between substances attributable to genetic influences shared with conduct disorder. Genes influencing individual substance use disorders were also significant, explaining 40-73% of the genetic variance per substance. Among substance users in this sample, the well-documented clinical co-morbidity between conduct disorder and substance use disorders is primarily attributable to shared genetic liability. Interventions targeted at generally reducing deviant behaviors may address the risk posed by this shared genetic liability. However, there is also evidence for genetic and environmental influences specific to each substance. The identification of these substance-specific risk factors (as well as potential protective factors) is critical to the future development of targeted treatment protocols.

  1. 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

    hospital with a psychiatric disorder. The prospective cohort study, the Copenhagen City Heart Study (n=18,146), was used, containing three updated sets of alcohol intake and lifestyle covariates and up to 26 years follow-up. Alcohol intake was measured by self-report while psychiatric disorders were......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.......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...

  2. Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

    Science.gov (United States)

    Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz

    2015-11-01

    There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley

  3. 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…

  4. State of the art and setting priorities for fetal alcohol spectrum disorder(s) prevention and management

    NARCIS (Netherlands)

    Roozen, Sylvia; Peters, Gjalt-Jorn; Kok, Gerjo; Townend, David; Koek, Ger; Nijhuis, Jan; Curfs, Leopold

    2017-01-01

    Background: Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term for one of the leading preventable forms of mental retardation affecting individuals and societies worldwide. Alcohol and its interference with the development of the fetus and child are complex and highly variable. The aim of

  5. 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

    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......, but not of breast cancer and colorectal cancer, in patients with alcohol use disorders....... incidence of colon, rectal or urinary bladder cancer. CONCLUSIONS: In conclusion, this study confirms the well-established association between high alcohol intake and cancer of the upper digestive tract and liver. In addition, the results indicate a significantly elevated occurrence of renal cancer...

  6. Childhood adversities, bonding, and personality in social anxiety disorder with alcohol use disorder.

    Science.gov (United States)

    Rambau, Stefanie; Forstner, Andreas J; Wegener, Ingo; Mücke, Martin; Wissussek, Christine T S; Staufenbiel, Sabine M; Geiser, Franziska; Schumacher, Johannes; Conrad, Rupert

    2018-04-01

    Social anxiety disorder (SAD) is frequently associated with alcohol use disorders (abuse/dependence). However, there has been little research on the characteristics of this subgroup so far. In the current study we investigated individuals with SAD and comorbid alcohol use disorder (AUD) with regard to socialization experiences and personality. The sample comprised 410 individuals diagnosed with SAD by the Structured Clinical Interview of DSM-IV. 108 participants with comorbid AUD were compared to 302 participants without comorbid AUD concerning traumatic experiences during childhood and adolescence (Adverse Childhood Experiences Questionnaire; ACE), parental bonding (Parental Bonding Instrument; PBI), and personality (Temperament and Character Inventory; TCI). MANCOVA with covariates sex and depression displayed that individuals with SAD plus AUD reported significantly more traumatic events during childhood and adolescence, lower levels of maternal care, as well as lower cooperativeness. Our results highlight that adverse childhood experiences and unfavourable maternal bonding characterize individuals suffering from SAD plus AUD. These experiences might be reflected in a personality-based tendency to distance themselves from others, which corresponds to low scores on the character dimension cooperativeness. A deeper understanding of personality and specific socialization experiences is necessary to develop new treatment options in this clinically challenging subgroup. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Fetal alcohol spectrum disorder: New Zealand birth mothers' experiences.

    Science.gov (United States)

    Salmon, Jenny

    2008-01-01

    The aim of this study was to describe the 'lived' experiences of New Zealand birth mothers, from pregnancy onwards, of a child/ren diagnosed with Fetal Alcohol Spectrum Disorder (FASD). A qualitative paradigm was utilized so that the participants could tell their stories through words and text rather than collecting statistical data which is the domain of quantitative research. The adoption of a feminist standpoint theory bridged a communication gap, adjusted the balance of power within society and gave visibility and voice to the women. Eight New Zealand-resident multipara biological mothers ages 18 and over, who had nurtured or were still living with their affected offspring, were studied. Their ages ranged from 29 to 64. The mothers were interviewed in depth, face-to-face, using unstructured, open-ended questions. Data were analyzed using the constant comparative method. The mothers described a range of issues of concern for their disabled offspring and themselves (as advocates) relating to health, social, educational, judicial systems, lack of knowledge by professionals and problems in diagnosis, to being oppressed and stigmatized. Cognitive concerns for the offspring included attention-deficit, absence of fear, diminished memory and comprehension and inability to acknowledge and understand consequences. Behavioural issues included excessive crying or no crying as a baby, lying, stealing, hyper-activity, aggressiveness, destructiveness, sexual promiscuity and few friends. Other issues of concern were delayed milestones and numerous health problems. All mothers stated that the pregnancy, labour and delivery of their child with FASD were different from their other non-compromised pregnancies/labours/deliveries. Most mothers said that the doctors used medical language which they did not understand, thus giving power to the former. Seven mothers were either married to or partners of alcoholics when they conceived their offspring with FASD. All mothers had been

  8. Alcohol use and alcohol use disorder among male outpatients in a primary care setting in rural Puducherry

    Directory of Open Access Journals (Sweden)

    Akkilagunta Sujiv

    2015-01-01

    Full Text Available Context: Alcohol use contributes to considerable morbidity and mortality worldwide. Screening for alcohol use and alcohol use disorder (AUD at the primary care level can help in reducing this burden. While several community studies have been conducted to estimate the AUD, there apparently are no studies on opportunistic screening in a primary care setting in India. Aims: The aim was to estimate the prevalence of alcohol use and AUD in a primary care setting. Settings and Design: A hospital-based cross-sectional study was conducted among adult male outpatients in a primary care setting in Puducherry, South India. Subjects and Methods: Male outpatients aged 18 and above were interviewed for alcohol use. Current alcohol users were screened for AUD using World Health Organization - AUD identification test (AUDIT questionnaire, respectively. Statistical Analysis Used: Proportions were used to describe the study population and the main study findings. The Chi-square test was used to find out the association between sociodemographic factors and alcohol use. Results: Of 256 subjects studied, 39.8% were found to be current alcohol users and 10.9% had AUD (AUDIT score ≥8. The sociodemographic factors did not show any association with an alcohol use in the current setting. Conclusion: Based on the findings of the present study, four current alcohol users are to be screened to identify one patient with AUD. Screening at the primary health care level can help in identifying the risk group and thus help in reducing the morbidity and mortality due to alcohol use in the population.

  9. 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…

  10. Free and cued recall memory in Parkinson's disease associated with amnestic mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Alberto Costa

    Full Text Available The hypothesis has been advanced that memory disorders in individuals with Parkinson's disease (PD are related to either retrieval or consolidation failure. However, the characteristics of the memory impairments of PD patients with amnestic mild cognitive impairment have not been clarified. This study was aimed at investigating whether memory deficits in PD patients with amnestic mild cognitive impairment (PDaMCI are due to failure of retrieval or consolidation processes. Sixteen individuals with PDaMCI, 20 with amnestic mild cognitive impairment without PD (aMCINPD, and 20 healthy controls were recruited. Participants were administered the Free and Cued Selective Reminding Test. An index of cueing was computed for each subject to capture the advantage in retrieval of cued compared to free recall. Individuals with PDaMCI performed worse than healthy controls on the free recall (p0.10 task, and they performed better than aMCINPD subjects on both recall measures (p0.10 but it was significantly higher than that of the aMCINPD sample (p<0.01. Moreover, PD patients' performance on free recall trials was significantly predicted by scores on a test investigating executive functions (i.e., the Modified Card Sorting Test; p = 0.042. Findings of the study document that, in subjects with amnestic mild cognitive impairment associated to PD, episodic memory impairment is related to retrieval rather than to consolidation failure. The same data suggest that, in these individuals, memory deficits might be due to altered frontal-related executive functioning.

  11. Behavioral predictors of alcohol drinking in a neurodevelopmental rat model of schizophrenia and co-occurring alcohol use disorder.

    Science.gov (United States)

    Khokhar, Jibran Y; Todd, Travis P

    2018-04-01

    Alcohol use disorder commonly occurs in patients with schizophrenia and contributes greatly to its morbidity. Unfortunately, the neural and behavioral underpinnings of alcohol drinking in these patients are not well understood. In order to begin to understand the cognitive and reward-related changes that may contribute to alcohol drinking, this study was designed to address: 1) latent inhibition; 2) conditioning; and 3) extinction of autoshaping in a neurodevelopmental rat model with relevance to co-occurring schizophrenia and alcohol use disorders, the neonatal ventral hippocampal lesioned (NVHL) rat. NVHL lesions (or sham surgeries) were performed on post-natal day 7 (PND7) and animals were given brief exposure to alcohol during adolescent (PND 28-42). Latent inhibition of autoshaping, conditioning and extinction were assessed between PND 72-90. On PND90 animals were given alcohol again and allowed to establish stable drinking. Latent inhibition of autoshaping was found to be prolonged in the NVHL rats; the NVHL rats pre-exposed to the lever stimulus were slower to acquire autoshaping than sham pre-exposed rats. NVHL rats that were not pre-exposed to the lever stimulus did not differ during conditioning, but were slower to extinguish conditioned responding compared to sham controls. Finally, the NVHL rats from both groups drank significantly more alcohol than sham rats, and the extent of latent inhibition predicted future alcohol intake in the pre-exposed animals. These findings suggest that the latent inhibition of autoshaping procedure can be used to model cognitive- and reward-related dysfunctions in schizophrenia, and these dysfunctions may contribute to the development of co-occurring alcohol use. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Personality disorder and alcohol treatment outcome: systematic review and meta-analysis.

    Science.gov (United States)

    Newton-Howes, Giles M; Foulds, James A; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

    2017-07-01

    Background Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes. Aims To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD. Method We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies. Results Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall. Conclusions Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area. © The Royal College of Psychiatrists 2017.

  13. Understanding Gut Fermentation Syndrome in the Psychiatric Evaluation of Patients with Suspected Alcohol Use Disorder

    Science.gov (United States)

    2017-10-18

    Fermentation Syndrome in the Psychiatric Evaluation of Patients with Suspected Alcohol Use Disorder Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6...by ANSI Std. Z39.18 Adobe Professional 7. 0 Introduction Gut Fermentation Syndrome, also known as auto- brewery syndrome, is a phenomenon not well...patient stated abstinence from alcohol use and that Gut Fermentation Syndrome was the cause of continually elevated blood alcohol levels. We will

  14. Visual Defects in a Mouse Model of Fetal Alcohol Spectrum Disorder

    OpenAIRE

    Lantz, Crystal L.; Pulimood, Nisha S.; Rodrigues-Junior, Wandilson S.; Chen, Ching-Kang; Manhaes, Alex C.; Kalatsky, Valery A.; Medina, Alexandre Esteves

    2014-01-01

    Alcohol consumption during pregnancy can lead to a multitude of neurological problems in offspring, varying from subtle behavioral changes to severe mental retardation. These alterations are collectively referred to as Fetal Alcohol Spectrum Disorders (FASD). Early alcohol exposure can strongly affect the visual system and children with FASD can exhibit an amblyopia-like pattern of visual acuity deficits even in the absence of optical and oculomotor disruption. Here, we test whether early alc...

  15. [Social return on internet interventions for alcohol use disorders].

    Science.gov (United States)

    Blankers, M

    One of the main reasons for treating patients using internet interventions is that this modality is considered highly efficient. However, little is known about the actual cost-effectiveness of internet interventions for alcohol use disorders (aud). AIM: To provide insight in the cost-effectiveness of internet interventions for the treatment of aud. METHOD: Review of the relevant literature in this area. RESULTS: A considerable amount of research has been performed on the effectiveness of internet interventions for aud, with mostly positive findings. However, research on the cost-effectiveness of these interventions has been relatively sparse. Based on the available evidence there are indications that internet interventions for aud can be cost-effective - although findings in the literature are mixed. CONCLUSION: More research is needed to make valid estimates of the cost-effectiveness of internet interventions for aud. Potential savings can only be estimated after the system has been used over a longer period. However, the evidence obtained thus far is promising.

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

    NARCIS (Netherlands)

    de Bruijn, Carla; van den Brink, Wim; de Graaf, Ron; Vollebergh, Wilma A. M.

    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

  17. 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

    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.

  18. Drug and Alcohol Exposed Children: Implications for Special Education for Students Identified as Behaviorally Disordered.

    Science.gov (United States)

    Bauer, Anne M.

    1991-01-01

    This article reviews the literature on children prenatally exposed to drugs and alcohol, the potential impact on the educational and social services systems, and implications for programing for children identified as behaviorally disordered. (Author/JDD)

  19. 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. Copyright © 2015. Published by

  20. 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

  1. 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…

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

    NARCIS (Netherlands)

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

    2015-01-01

    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

  3. 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…

  4. Alcohol abuse, personality disorders, and aggression : The quest for a common underlying mechanism

    NARCIS (Netherlands)

    Garofalo, C.; Wright, Aidan G.C.

    2017-01-01

    Alcohol abuse and personality disorders are often comorbid, and their co-occurrence is associated with worse rognostic expectations, poor therapeutic outcomes, as well as deleterious behavioral and interpersonal consequences. The current review aims at untangling the association among alcohol abuse,

  5. Alcohol consumption and risk of aging macula disorder in a general population: the Rotterdam Study

    NARCIS (Netherlands)

    Boekhoorn, Sharmila S.; Vingerling, Johannes R.; Hofman, Albert; de Jong, Paulus T. V. M.

    2008-01-01

    To investigate the possible relationship between overall or specific alcohol consumption and risk of aging macula disorder (AMD), a synonym for age-related macular degeneration, in a general population. Alcohol consumption and risk of early or late incident AMD (iAMD) were examined among all

  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. Alcohol use disorder and tuberculosis treatment: A longitudinal mixed method study in Thailand

    Directory of Open Access Journals (Sweden)

    Samai Laprawat

    2017-05-01

    Full Text Available Objective: The relationship between tuberculosis (TB treatment and alcohol use disorders over time is under-researched. The aim of this investigation was to study alcohol use and TB medication adherence and its predictors among TB patients over a period of 6 months. Methods: A longitudinal investigation was carried out with new TB and TB retreatment patients systematically selected from two hospitals and had screened positive for hazardous or harmful alcohol use in Sisaket Province in Thailand. Alcohol use disorders were measured with Alcohol Use Disorder Identification Test (AUDIT-C at baseline, 3 months and 6 months. Results: Of the 295 TB patients who were screened with AUDIT-C, 72 (24.4% tested positive for hazardous or harmful alcohol use. At 6 months, 72 TB patients had completed the follow- up. At the 6-month follow-up, hazardous or harmful drinking was reduced by 84.7%. Multivariate logistic regression analysis using generalised estimation equation modelling found that alcohol use significantly reduced over time, whereas there was no change in current tobacco use. Conclusion: The prevalence of alcohol use disorders significantly reduced over a period of 6 months.

  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. Treatment outcome of alcohol use disorder outpatients with or without medically assisted detoxification

    NARCIS (Netherlands)

    Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten W. J.; de Wildt, Wencke A. J. M.; Vedel, Ellen; Goudriaan, Anna E.; van den Brink, Wim

    2014-01-01

    Little is known about the incremental effects of medically assisted detoxification on outpatient treatment for alcohol use disorders. The objective of this study was to compare drinking outcomes in a psychosocial treatment program between two groups of heavy drinking patients who had an alcohol use

  10. 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…

  11. Emotion-based decision-making in children with fetal alcohol spectrum disorders

    OpenAIRE

    Vaurio, Linnea

    2011-01-01

    Neurobehavioral outcomes associated with prenatal alcohol exposure range from severe intellectual deficiency to subtle attention and motor deficits. Diagnosis of individuals with fetal alcohol spectrum disorders (FASD) can be challenging especially when physical markers are absent or prenatal histories are unavailable. In addition, due to neurobehavioral similarities, individuals with FASD and those with attention-deficit/hyperactivity disorder (ADHD) can be confused clinically, making differ...

  12. Alcohol Use Disorder History Moderates the Relationship Between Avoidance Coping and Posttraumatic Stress Symptoms

    OpenAIRE

    Hruska, Bryce; Fallon, William; Spoonster, Eileen; Sledjeski, Eve M.; Delahanty, Douglas L.

    2011-01-01

    Avoidance coping (AVC) is common in individuals with posttraumatic stress disorder (PTSD) and in individuals with alcohol use disorder (AUD). Given that PTSD and AUD commonly co-occur, AVC may represent a risk factor for the development of comorbid post-traumatic stress and alcohol use. In this study, the relationship between AVC and PTSD symptoms (PTSS) was examined in individuals with versus without AUDs. Motor vehicle accident (MVA) victims were assessed 6-weeks post accident for AUD histo...

  13. Are patients with panic disorder respiratory subtype more vulnerable to tobacco, alcohol or illicit drug use?

    Directory of Open Access Journals (Sweden)

    Rafael C. Freire

    2013-01-01

    Full Text Available BACKGROUND: Studies have documented high use of tobacco, alcohol and illicit drugs in patients with panic disorder (PD. The comorbid substance use disorders worsen the prognosis of mood and anxiety disorders. The respiratory subtype (RS of PD seems to represent a more severe and distinct form of this disorder associated with higher familial history of PD and more comorbidity with other anxiety disorders. OBJECTIVES: Describe the patterns of tobacco, alcohol or illicit drug use in PD patients, and also to ascertain if patients with the RS use these substances more than those of the non-respiratory subtype. METHODS: This is a cross-sectional study with 71 PD patients. The Alcohol Use Disorders Identification Test and Fagerstrom Tobacco Questionnaire were used in the evaluation. Patients with four or five respiratory symptoms were classified in the RS, the remaining patients were classified as non-respiratory subtype. RESULTS: In our sample 31.0% were smokers, 11.3% were hazardous alcohol users and none of them was using illicit drugs. There were no differences between the respiratory and non-respiratory subtypes regarding the use of tobacco, alcohol, cannabis, cocaine, stimulants and hallucinogens. DISCUSSION: The RS was not correlated to the use of tobacco, alcohol and illicit drugs. Additional epidemiological and clinical studies focusing the relationship between PD and substance use are warranted.

  14. Prescription for antidepressant in reducing future alcohol-related readmission in patients suffering from depression and alcohol use disorder: a retrospective medical record review.

    Science.gov (United States)

    Chan, Patrick; Yomen, Katie; Turcios, Jennifer; Richman, Mark

    2015-12-21

    Patients suffering from major depressive disorder are more likely to suffer from alcohol use disorder. The data is inconclusive for the effectiveness of antidepressant treatment of patients suffering from both illnesses in regards to improving sobriety and reducing alcohol-related healthcare expenses such as hospitalizations. The objective of this study is to determine if a new prescription of an antidepressant upon inpatient discharge is associated with a reduction in the number of future acute alcohol-related hospital readmissions to the same institution in patients suffering from major depressive disorder and alcohol-use disorder. A retrospective, medical record review study was conducted at a publicly-supported hospital in Sylmar, CA. A query was performed for adult patients admitted between 1/1/2005-12/31/2013 who had ICD-9 codes for both alcohol-use disorder and depression. Index admission was the first hospitalization in which the patient was currently consuming alcohol and had depression as identified by physician documentation as a problem. Acute alcohol-related admissions were those for alcohol intoxication or withdrawal (indicating current alcohol use). Patients were excluded if they were receiving an antidepressant on index admission, depressive disorder with a prescription for an antidepressant is not associated with a reduction in future readmissions, nor significantly increase the number of days to readmission. The study does not support the concept of antidepressants in reducing acute alcohol-related readmissions.

  15. Determinants of Blood Brain-Derived Neurotrophic Factor Blood Levels in Patients with Alcohol Use Disorder.

    Science.gov (United States)

    Nubukpo, Philippe; Ramoz, Nicolas; Girard, Murielle; Malauzat, Dominique; Gorwood, Philip

    2017-07-01

    Blood brain-derived neurotrophic factor (BDNF) levels are influenced by both addiction and mood disorders, as well as somatic conditions, gender, and genetic polymorphisms, leading to widely varying results. Depressive symptoms and episodes are frequently observed in patients with alcohol use disorder, and vary widely over time, making it a challenge to determine which aspects are specifically involved in variations of serum BDNF levels in this population. We assessed 227 patients with alcohol dependence involved in a detoxification program, at baseline and after a follow-up of 6 months, for the Alcohol Use Disorders Identification Test score, the length of alcohol dependence, and the number of past detoxification programs. The Beck Depression Inventory and information on current tobacco and alcohol use, suicidal ideation, body mass index, age, gender, and psychotropic treatments were also collected. Serum BDNF (ELISA) and 2 genetic polymorphisms of the BDNF gene (Val33Met and rs962369) were analyzed. The presence of the Met allele, 2 markers of the history of alcohol dependence (gamma glutamyl transferase and the number of past treatments in detoxification programs), and the presence of a depressive episode (but not depressive score) were significantly associated with the 2 blood levels of BDNF at baseline and after 6 months. After controlling for baseline BDNF levels, the presence of the Met allele and an ongoing depressive episode were the only variables associated with changes in BNDF levels after 6 months. Low serum BDNF levels are associated with characteristics related to alcohol consumption and mood disorders, and variants of the BDNF gene in alcohol use disorder patients. The factors that most strongly influenced changes in serum BDNF levels following treatment in an alcohol detoxification program were variants of the BDNF gene and ongoing depression. Copyright © 2017 by the Research Society on Alcoholism.

  16. Comparing diagnostic classification of neurobehavioral disorder associated with prenatal alcohol exposure with the Canadian fetal alcohol spectrum disorder guidelines: a cohort study.

    Science.gov (United States)

    Sanders, James L; Breen, Rebecca E Hudson; Netelenbos, Nicole

    2017-01-01

    Diagnostic criteria have recently been introduced in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), for neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). The purpose of this study is to assess the classification of this condition using the Canadian fetal alcohol spectrum disorder (FASD) multidisciplinary diagnostic guidelines as the standard of comparison. First, classification of ND-PAE was compared with Canadian FASD diagnoses of fetal alcohol syndrome (FAS), partial FAS and alcohol-related neurodevelopmental disorder. Second, classification of ND-PAE was compared with FAS and pFAS only, a criterion for which includes facial features highly predictive of prenatal alcohol exposure and effects. Eighty-two patients underwent multidisciplinary clinical evaluations using the Canadian FASD diagnostic guidelines between 2011 and 2015. Two clinicians independently reviewed patient files for evidence of diagnostic criteria for ND-PAE when applying an impairment cut-off level of 2 or more standard deviations below the mean, or clinically significant impairment in the absence of standardized norm-referenced measures. Good interrater reliability was established between clinicians (κ = 0.79). Classifications of ND-PAE and Canadian FASD diagnoses, including alcohol-related neurodevelopmental disorder, were moderately correlated (Cramer V [82] = 0.44, p 0.05). Although there is considerable overlap between both sets of criteria, ND-PAE was less likely to identify patients with FASD. Although the neurobehavioral domains assessed by ND-PAE are supported in research, its diagnostic structure restricts the identification of FASD at the impairment threshold of 2 or more standard deviations. A disconnect remains with regard to impairment thresholds between FASD, which relies on neurodevelopmental data, and ND-PAE, which relies on clinical judgment.

  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. 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

    suicide, AUD, Psychotic disorders, Anxiety disorders, Mood disorders, Personality disorders, Drug abuse, and Other psychiatric disorders. Individuals registered with AUD were at significantly increased risk of committing suicide, with a crude hazard ratio (HR) of 7.98 [Confidence interval (CI): 5......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.......27-12.07] compared to individuals without AUD. Adjusting for all psychiatric disorders the risk fell to 3.23 (CI: 1.96-5.33). In the stratified sub-sample of individuals without psychiatric disorders, the risk of completed suicide was 9.69 (CI: 4.88-19.25) among individuals with AUD. The results indicate...

  19. 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...... to the primary outcome of an intake of alcohol below 30 and 20 g/d for men and women, respectively, as well as secondary outcomes such as days until relapse, alcohol intake, and numbers of drinking days. Methods: A systematic review of the literature was conducted using MEDLINE, EMBASE, and Cochrane Central...

  20. Effects of stress and alcohol cues in men with and without problem gambling and alcohol use disorder.

    Science.gov (United States)

    Steinberg, Lindsay; Tremblay, Anne-Marie; Zack, Martin; Busto, Usoa E; Zawertailo, Laurie A

    2011-12-01

    Relapse is a serious challenge in problem gambling (PG), as it is in substance addiction. Stress and cues are implicated in relapse in both conditions. However, experimental research on motivational effects of stress in PG subjects is scant. This study examined subjective-motivational, cognitive and physiological effects of stress and alcohol cues in subjects with PG, alcohol use disorder (AD), co-occurring PG and AD (CO), and healthy controls (HC). Fifty-two (12/clinical group; 16 HC) physically healthy men received stress in the form of 10-min uncontrollable noise (U-Noise vs. controllable noise; C-Noise) and cues (355 ml non-alcoholic 'placebo' beer; P-Beer vs. soft drink) under Separate or Combined conditions on two test sessions. Visual analogue scales assessed subjective effects. Emotional Stroop and Go/No-Go 'Shift' tasks assessed inhibitory control. Systolic blood pressure (SBP) indexed physiological reactivity. U-Noise and C-Noise increased desire for alcohol in all groups. U-Noise selectively inhibited desire to gamble in PG subjects. Both U-Noise and C-Noise inhibited desire to gamble in CO subjects. Neither manipulation reliably altered cognitive performance. Compared to Neutral words, Alcohol words impaired Stroop color-naming in all groups except PG, which displayed relatively faster color-naming of Alcohol words (facilitation). U-Noise increased SBP relative to C-Noise in AD and HC groups. U-Noise plus P-Beer and U-Noise per se decreased SBP in PG and CO groups, respectively. Noise stress has opposite motivational and physiological effects in men with problem gambling vs. alcohol use disorder. A homeostatic process may explain the impact of stress in problem gamblers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  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. Aripiprazole for relapse prevention and craving in alcohol use disorder: current evidence and future perspectives.

    Science.gov (United States)

    Martinotti, Giovanni; Orsolini, Laura; Fornaro, Michele; Vecchiotti, Roberta; De Berardis, Domenico; Iasevoli, Felice; Torrens, Marta; Di Giannantonio, Massimo

    2016-06-01

    Among other approaches, the modulation of the dopaminergic pathway has been advocated in the therapeutic management of Alcohol Use Disorders (AUD). A potential avenue toward the modulation of the dopaminergic pathway across varying substance disorders seems to be provided by aripiprazole, a second-generation antipsychotic characterized by a peculiar pharmacodynamics signature. In this review, the authors provided a qualitative synthesis and a critical perspective on the efficacy of aripiprazole in relapse prevention and craving in AUD. A systematic search was carried out through MEDLINE/Embase/PsycINFO/Cochrane Library from inception until September 2015, combining free terms and MESH headings for the topics of AUD and aripiprazole as following: (((Alcohol use Disorder) OR (Alcohol use)) AND aripiprazole). Based both on a qualitative synthesis and a critical interpretation of the evidence, the authors submit that aripiprazole would promote alcohol abstinence and reduce the alcohol seeking behaviour possibly via dopaminergic and serotoninergic modulations at the fronto-subcortical circuits underpinning alcohol reward and craving, impulsive behaviour as well as reduce alcohol-related anxiety/low mood and anhedonia. However, due to the lack of published studies, a conclusive statement about any direct effect of aripiprazole in the prevention of craving and/or alcohol consumption is not possible.

  3. 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

    2016-01-01

    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. PMID:26784248

  4. Neurodevelopmental profile of Fetal Alcohol Spectrum Disorder: A systematic review.

    Science.gov (United States)

    Lange, Shannon; Rovet, Joanne; Rehm, Jürgen; Popova, Svetlana

    2017-06-23

    In an effort to improve the screening and diagnosis of individuals with Fetal Alcohol Spectrum Disorder (FASD), research has focused on the identification of a unique neurodevelopmental profile characteristic of this population. The objective of this review was to identify any existing neurodevelopmental profiles of FASD and review their classification function in order to identify gaps and limitations of the current literature. A systematic search for studies published up to the end of December 2016 reporting an identified neurodevelopmental profile of FASD was conducted using multiple electronic bibliographic databases. The search was not limited geographically or by language of publication. Original research published in a peer-reviewed journal that involved the evaluation of the classification function of an identified neurodevelopmental profile of FASD was included. Two approaches have been taken to determine the pathognomonic neurodevelopmental features of FASD, namely the utilization of i) behavioral observations/ratings by parents/caregivers and ii) subtest scores from standardized test batteries assessing a variety of neurodevelopmental domains. Both approaches show some promise, with the former approach (which is dominated by research on the Neurobehavioral Screening Tool) having good sensitivity (63% to 98%), but varying specificity (42% to 100%), and the latter approach having good specificity (72% to 96%), but varying sensitivity (60% to 88%). The current review revealed that research in this area remains limited and a definitive neurodevelopmental profile of FASD has not been established. However, the identification of a neurodevelopmental profile will aid in the accurate identification of individuals with FASD, by adding to the armamentarium of clinicians. The full review protocol is available in PROSPERO ( http://www.crd.york.ac.uk/PROSPERO/ ); registration number CRD42016039326; registered 20 May 2016.

  5. Modeling alcohol use disorder severity: an integrative structural equation modeling approach

    Directory of Open Access Journals (Sweden)

    Nathasha R Moallem

    2013-07-01

    Full Text Available Background: Alcohol dependence is a complex psychological disorder whose phenomenology changes as the disorder progresses. Neuroscience has provided a variety of theories and evidence for the development, maintenance, and severity of addiction; however, clinically, it has been difficult to evaluate alcohol use disorder (AUD severity. Objective: This study seeks to evaluate and validate a data-driven approach to capturing alcohol severity in a community sample. Method: Participants were non-treatment seeking problem drinkers (n = 283. A structural equation modeling (SEM approach was used to (a verify the latent factor structure of the indices of AUD severity; and (b test the relationship between the AUD severity factor and measures of alcohol use, affective symptoms, and motivation to change drinking. Results: The model was found to fit well, with all chosen indices of AUD severity loading significantly and positively onto the severity factor. In addition, the paths from the alcohol use, motivation, and affective factors accounted for 68% of the variance in AUD severity. Greater AUD severity was associated with greater alcohol use, increased affective symptoms, and higher motivation to change.Conclusions: Unlike the categorical diagnostic criteria, the AUD severity factor is comprised of multiple quantitative dimensions of impairment observed across the progression of the disorder. The AUD severity factor was validated by testing it in relation to other outcomes such as alcohol use, affective symptoms, and motivation for change. Clinically, this approach to AUD severity can be used to inform treatment planning and ultimately to improve outcomes.

  6. Neuropsychological characteristics of Italian children with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Aragón, Alfredo S; Coriale, Giovanna; Fiorentino, Daniela; Kalberg, Wendy O; Buckley, David; Gossage, J Phillip; Ceccanti, Mauro; Mitchell, Elisha R; May, Philip A

    2008-11-01

    Children with fetal alcohol spectrum disorders (FASD) display many problems ranging from deficits in intelligence to behavioral difficulties. Thus, many studies have aimed at defining the neuropsychological characteristics of children with FASD. The current article describes the neuropsychological characteristics of Italian children with severe diagnosis within FASD and compares them with controls. It was expected that intellectual functioning, language comprehension, academic skills, and inattention/hyperactivity would discriminate children with FASD from randomly selected peers without FASD. This article presents data from a second cohort of children examined in 2005 as part of an in-school epidemiological study of FASD in Italy. Of 80 children, 23 diagnosed with a FASD, and 57 randomly selected control children from the same first-grade classes, participated. After screening for FASD via growth and dysmorphology, the children were administered a test of general intelligence (WISC-R) as well as tests of nonverbal reasoning (Raven Colored Progressive Matrices), language comprehension (Rustioni), academic achievement (IPDA), and problem behavior (Disruptive Behavior Disorder Rating Scale). Children diagnosed with a FASD achieved lower scores than control children on Verbal, Performance, and Full Scale IQ. Profile analysis of the WISC-R indicates overall differences between the groups. However, some intact functioning within the FASD group was found, as the Similarities and Vocabulary subtests were similar to the controls. After an alpha adjustment to 0.004, the Block Design, Object Assembly, and Mazes subtests were significantly different from controls. On tests of nonverbal reasoning, language comprehension, and academic achievement, the children with a FASD scored significantly lower. Moreover, teachers rated children with a severe diagnosis within FASD as showing more inattentive symptoms than controls, while hyperactive/impulsive characteristics among children

  7. 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

    of alcohol misuse was examined. Method: Subjects were selected from a Danish birth cohort (9,125), which included 223 sons of alcoholic fathers (high risk) and 106 matched sons of nonalcoholic fathers (low risk). These subjects have been studied systematically over the past 40 years. They were evaluated...... in their teens (n = 238), later as adults at age 30 (n = 241), and more recently at age 40 (n = 202). At 19-year/20-year follow-ups, an ADHD scale was derived from teacher ratings and a CD scale was derived from a social worker interview. At 30-year and 40-year follow-ups, a psychiatrist used structured...... 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...

  8. 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.

  9. Impaired affective prosody decoding in severe alcohol use disorder and Korsakoff syndrome.

    Science.gov (United States)

    Brion, Mélanie; de Timary, Philippe; Mertens de Wilmars, Serge; Maurage, Pierre

    2018-06-01

    Recognizing others' emotions is a fundamental social skill, widely impaired in psychiatric populations. These emotional dysfunctions are involved in the development and maintenance of alcohol-related disorders, but their differential intensity across emotions and their modifications during disease evolution remain underexplored. Affective prosody decoding was assessed through a vocalization task using six emotions, among 17 patients with severe alcohol use disorder, 16 Korsakoff syndrome patients (diagnosed following DSM-V criteria) and 19 controls. Significant disturbances in emotional decoding, particularly for negative emotions, were found in alcohol-related disorders. These impairments, identical for both experimental groups, constitute a core deficit in excessive alcohol use. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Aggression in war veterans suffering from posttraumatic stress disorder with co-morbid alcoholism.

    Science.gov (United States)

    Babić, Dragan; Martinac, Marko; Bjelanović, Vedran; Babić, Romana; Sutović, Alija; Sinanović, Osman

    2010-03-01

    For thousands of years it has been known that aggression as a symptom appears in numerous psychiatric disorders and diseases. During the last decade the appearance of the aggressive behavior related to the posttraumatic stress disorder (PTSD) has been frequently investigated, often associated with war trauma. The goal of this study is to analyze the impact of alcoholism on a way war veterans suffering from chronic PTSD express and control aggression. The sample included 240 war veterans with chronic PTSD. The subjects were divided in two groups. PTSD group (n=147) and controlled group composed of those suffering from alcoholism in addition to PTSD (n=93). In this study, the following psychological instruments were used: The Harvard trauma questionnaire for PTSD diagnosis (HTQ); the questionnaire for self-evaluation of aggression (STAXI); The Profile Index Emotion (PIE); questionnaire for auto-diagnosis of alcoholism (CAGE). The obtained results indicate that subjects who have PTSD with co-morbid alcoholism are more deprived, aggressive (p alcoholism (PIE). The aggression is statistically more expressed in subjects with PTSD who have also been diagnosed with alcoholism on all subscales in comparison to subjects with PTDS who have not been diagnosed with alcoholism: the current state of aggression, the general state of aggression, aggression towards an unfair treatment, aggression directed inwards and outwards (p alcoholism show a higher degree of aggression in comparison to subjects with PTDS who are not diagnosed with alcoholism.

  11. Dr. George Koob: "Alcohol use disorders are a major problem …" | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... recipe. Treatment and Support In addition to Alcohol Anonymous and other mutual support groups, alcohol use disorders can be treated with medications, behavioral therapies, and combinations of treatments. Email and the Internet have opened new avenues for diagnosis and treatment. ...

  12. Understanding Lay Assessments of Alcohol Use Disorder: Need for Treatment and Associated Stigma.

    Science.gov (United States)

    Weine, Erienne R; Kim, Nancy S; Lincoln, Alisa K

    2016-01-01

    Three-quarters of people with an alcohol use disorder in the USA never receive treatment. Our understandings of who receives care are informed by sociological perspectives, theories and models, each of which discuss the role of lay people's understanding of illness. However, comparatively little work has been done to unpack the cognitive processes underlying lay assessment. In the context of the Framework Integrating Normative Influences on Stigma (FINIS), we aim to understand key factors guiding lay people's stigmatizing attitudes, perceptions and assessments of alcohol use disorder behaviors. Lay people read a vignette depicting a male or female adult with a diagnosable alcohol use disorder, along with either a causal life-event explanation for the alcohol use disorder behaviors or no explanation. They then made judgments of the need for treatment, psychological abnormality and the stigma they felt toward the person depicted. Causal life-event explanations decreased lay judgments of the need for treatment, psychological abnormality and stigma. The results suggest that the availability of a causal life-event explanation may have a complex effect on lay judgments, decreasing the likelihood of recommending treatment for alcohol use disorders, yet simultaneously reducing stigmatizing perceptions (and presumably social distance). © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  13. Neurobiology of comorbid post-traumatic stress disorder and alcohol-use disorder

    Science.gov (United States)

    Gilpin, N. W.; Weiner, J. L.

    2016-01-01

    Post-traumatic stress disorder (PTSD) and alcohol-use disorder (AUD) are highly comorbid in humans. Although we have some understanding of the structural and functional brain changes that define each of these disorders, and how those changes contribute to the behavioral symptoms that define them, little is known about the neurobiology of comorbid PTSD and AUD, which may be due in part to a scarcity of adequate animal models for examining this research question. The goal of this review is to summarize the current state-of-the-science on comorbid PTSD and AUD. We summarize epidemiological data documenting the prevalence of this comorbidity, review what is known about the potential neurobiological basis for the frequent co-occurrence of PTSD and AUD and discuss successes and failures of past and current treatment strategies. We also review animal models that aim to examine comorbid PTSD and AUD, highlighting where the models parallel the human condition, and we discuss the strengths and weaknesses of each model. We conclude by discussing key gaps in our knowledge and strategies for addressing them: in particular, we (1) highlight the need for better animal models of the comorbid condition and better clinical trial design, (2) emphasize the need for examination of subpopulation effects and individual differences and (3) urge cross-talk between basic and clinical researchers that is reflected in collaborative work with forward and reverse translational impact. PMID:27749004

  14. Neurobiology of comorbid post-traumatic stress disorder and alcohol-use disorder.

    Science.gov (United States)

    Gilpin, N W; Weiner, J L

    2017-01-01

    Post-traumatic stress disorder (PTSD) and alcohol-use disorder (AUD) are highly comorbid in humans. Although we have some understanding of the structural and functional brain changes that define each of these disorders, and how those changes contribute to the behavioral symptoms that define them, little is known about the neurobiology of comorbid PTSD and AUD, which may be due in part to a scarcity of adequate animal models for examining this research question. The goal of this review is to summarize the current state-of-the-science on comorbid PTSD and AUD. We summarize epidemiological data documenting the prevalence of this comorbidity, review what is known about the potential neurobiological basis for the frequent co-occurrence of PTSD and AUD and discuss successes and failures of past and current treatment strategies. We also review animal models that aim to examine comorbid PTSD and AUD, highlighting where the models parallel the human condition, and we discuss the strengths and weaknesses of each model. We conclude by discussing key gaps in our knowledge and strategies for addressing them: in particular, we (1) highlight the need for better animal models of the comorbid condition and better clinical trial design, (2) emphasize the need for examination of subpopulation effects and individual differences and (3) urge cross-talk between basic and clinical researchers that is reflected in collaborative work with forward and reverse translational impact. © 2016 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

  15. 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...... 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...... women or men. CONCLUSIONS: Individuals who include wine when they drink alcohol have lower risks of AUD, independent of the total amount of alcohol consumed. The most likely explanation of these results is that lifestyle factors and personal characteristics are associated with beverage preference....

  16. Resilience in the Face of Adversity: Stories from Adults with Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Knorr, Lyndsay; McIntyre, Laureen J.

    2016-01-01

    This study explored the school and life experiences of four adults diagnosed with a fetal alcohol spectrum disorder (FASD) from an urban area in western Canada. Semi-structured interviews provided insight into the lives of these adults, including their experiences with this disorder as it related to their social interactions and peer relationships…

  17. PTSD symptom presentation among people with alcohol and drug use disorders: Comparisons by substance of abuse.

    Science.gov (United States)

    Dworkin, Emily R; Wanklyn, Sonya; Stasiewicz, Paul R; Coffey, Scott F

    2018-01-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) commonly co-occur, and there is some evidence to suggest that PTSD symptom clusters are differentially related to various substances of abuse. However, few studies to date have compared PTSD symptom patterns across people with different types of SUDs, and fewer still have accounted for the presence of comorbidity across types of SUDs in understanding symptom patterns. Thus, in the current study, we use a treatment-seeking sample of people with elevated symptoms of PTSD and problem alcohol use to explore differential associations between past-year SUDs with active use and PTSD symptoms, while accounting for the presence of multiple SUDs. When comparing alcohol and drug use disorders, avoidance symptoms were elevated in those with alcohol use disorder, and hyperarousal symptoms were elevated in those who had a drug use disorder. In the subsample with alcohol use disorder, hyperarousal symptoms were elevated in people with co-occurring cocaine use disorders and numbing symptoms were elevated in people with co-occurring sedative/hypnotic/anxiolytic use disorder. These findings provide evidence for different symptom cluster patterns between PTSD and various types of SUDs and highlight the importance of examining the functional relationship between specific substances of abuse when understanding the interplay between PTSD and SUDs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Stability of Comorbid Psychiatric Diagnosis among Youths in Treatment and Aftercare for Alcohol Use Disorders

    Science.gov (United States)

    Hawke, Josephine M.; Kaminer, Yifrah; Burke, Rebecca; Burleson, Joseph A.

    2008-01-01

    Objectives: To examine the stability of comorbid psychiatric diagnoses among a sample of 50 adolescents in cognitive-behaviorally-based treatment for alcohol and other substance use disorders (AOSUD). Methods: A standardized psychiatric interview was administered at baseline and 12 month later to obtain current comorbid psychiatric disorders. Chi…

  19. Validity of Alcohol Use Disorder Identification Test-Korean Revised Version for Screening Alcohol Use Disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria.

    Science.gov (United States)

    Chang, Jung Wei; Kim, Jong Sung; Jung, Jin Gyu; Kim, Sung Soo; Yoon, Seok Joon; Jang, Hak Sun

    2016-11-01

    The Alcohol Use Disorder Identification Test (AUDIT) has been widely used to identify alcohol use disorder (AUD). This study evaluated the validity of the AUDIT-Korean revised version (AUDIT-KR) for screening AUD according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. This research was conducted with 443 subjects who visited the Chungnam National University Hospital for a comprehensive medical examination. All subjects completed the demographic questionnaire and AUDIT-KR without assistance. Subjects were divided into two groups according to DSM-5 criteria: an AUD group, which included patients that fit the criteria for AUD (120 males and 21 females), and a non-AUD group, which included 146 males and 156 females that did not meet AUD criteria. The appropriate cut-off values, sensitivity, specificity, and positive and negative predictive values of the AUDIT-KR were evaluated. The mean±standard deviation AUDIT-KR scores were 10.32±7.48 points in males and 3.23±4.42 points in females. The area under the receiver operating characteristic curve (95% confidence interval, CI) of the AUDIT-KR for identifying AUD was 0.884 (0.840-0.920) in males and 0.962 (0.923-0.985) in females. The optimal cut-off value of the AUDIT-KR was 10 points for males (sensitivity, 81.90%; specificity, 81.33%; positive predictive value, 77.2%; negative predictive value, 85.3%) and 5 points for females (sensitivity, 100.00%; specificity, 88.54%; positive predictive value, 52.6%; negative predictive value, 100.0%). The AUDIT-KR has high reliability and validity for identifying AUD according to DSM-5 criteria.

  20. 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.

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

    Science.gov (United States)

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

    2014-01-01

    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 (meth)amphetamine (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 limitation of this study was the combined suicidal behaviors as a suicidality risk. Mental or alcohol use disorders found in this population actually increased the suicide risk. These findings support the coexisting relationship that mental and alcohol use disorders play a vital role in increasing the suicide

  2. Diving into the world of alcohol teratogenesis: a review of zebrafish models of fetal alcohol spectrum disorder.

    Science.gov (United States)

    Fernandes, Yohaan; Buckley, Desire M; Eberhart, Johann K

    2018-04-01

    The term fetal alcohol spectrum disorder (FASD) refers to the entire suite of deleterious outcomes resulting from embryonic exposure to alcohol. Along with other reviews in this special issue, we provide insight into how animal models, specifically the zebrafish, have informed our understanding of FASD. We first provide a brief introduction to FASD. We discuss the zebrafish as a model organism and its strengths for alcohol research. We detail how zebrafish has been used to model some of the major defects present in FASD. These include behavioral defects, such as social behavior as well as learning and memory, and structural defects, disrupting organs such as the brain, sensory organs, heart, and craniofacial skeleton. We provide insights into how zebrafish research has aided in our understanding of the mechanisms of ethanol teratogenesis. We end by providing some relatively recent advances that zebrafish has provided in characterizing gene-ethanol interactions that may underlie FASD.

  3. Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders.

    Science.gov (United States)

    Chakravorty, Subhajit; Chaudhary, Ninad S; Brower, Kirk J

    2016-11-01

    Sleep-related complaints are widely prevalent in those with alcohol dependence (AD). AD is associated not only with insomnia, but also with multiple sleep-related disorders as a growing body of literature has demonstrated. This article will review the various aspects of insomnia associated with AD. In addition, the association of AD with other sleep-related disorders will be briefly reviewed. The association of AD with insomnia is bidirectional in nature. The etiopathogenesis of insomnia has demonstrated multiple associations and is an active focus of research. Treatment with cognitive behavioral therapy for insomnia is showing promise as an optimal intervention. In addition, AD may be associated with circadian abnormalities, short sleep duration, obstructive sleep apnea, and sleep-related movement disorder. The burgeoning knowledge on insomnia associated with moderate-to-severe alcohol use disorder has expanded our understanding of its underlying neurobiology, clinical features, and treatment options. Copyright © 2016 by the Research Society on Alcoholism.

  4. Daily Patterns of Marijuana and Alcohol Co-Use Among Individuals with Alcohol and Cannabis Use Disorders.

    Science.gov (United States)

    Metrik, Jane; Gunn, Rachel L; Jackson, Kristina M; Sokolovsky, Alexander W; Borsari, Brian

    2018-04-15

    The study aims were to examine daily associations between marijuana and alcohol use and the extent to which the association differs as a function of cannabis use disorder (CUD) and/or alcohol use disorder (AUD) diagnosis. Timeline Followback interview data was collected in a study of veterans (N = 127) recruited from a Veterans Affairs hospital who reported at least 1 day of co-use of marijuana and alcohol in the past 180 days (22,860 observations). Participants reported 40% marijuana use days, 28% drinking days, with 37% meeting DSM-5 criteria for CUD, 40% for AUD, and 15% for both. Use of marijuana on a given day was used to predict a 3-level gender-adjusted drinking variable (heavy: ≥5 (men)/4 (women) drinks; moderate: 1 to 4/3 drinks; or none: 0 drinks). A categorical 4-level variable (no diagnosis, AUD, CUD, or both) was tested as a moderator of the marijuana-alcohol relationship. Multilevel modeling analyses demonstrated that participants were more likely to drink heavily compared to moderately (OR = 2.34) and moderately compared to not drinking (OR = 1.61) on marijuana use days relative to nonuse days. On marijuana use days, those with AUD and those with AUD + CUD were more likely to drink heavily (OR = 1.91; OR = 2.51, respectively), but those with CUD were less likely to drink heavily (OR = 0.32) compared to moderately, nonsignificant differences between any versus moderate drinking in interaction models. Heavy drinking occurs on days when marijuana is also used. This association is particularly evident in individuals diagnosed with both AUD and CUD and AUDs alone but not in those with only CUDs. Findings suggest that alcohol interventions may need to specifically address marijuana use as a risk factor for heavy drinking and AUD. Copyright © 2018 by the Research Society on Alcoholism.

  5. Gender Difference in Offspring's Alcohol Use Disorder by 21 Years: A Longitudinal Study of Maternal Influences.

    Science.gov (United States)

    Tran, Nam T; Clavarino, Alexandra; Williams, Gail M; Najman, Jake M

    2018-04-16

    There is little known about the extent to which maternal alcohol consumption influences offspring's alcohol use disorder. This study aims to examine whether different maternal alcohol consumption trajectories predict gender difference in adolescent alcohol use disorder at child age 21 years. Data are from a prospective cohort, the Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes. The study involves 2531 mother-child pairs for whom data are available at the 21-year follow-up survey. Maternal alcohol consumption trajectories were determined by group-based trajectory modelling. Offspring's lifetime ever alcohol use disorder was assessed using DSM-IV diagnostic criteria. Over 14 years of follow-up after the birth of a child, three distinct alcohol consumption trajectories were identified (abstainer, low-stable. and moderate-escalating drinker). A maternal trajectory of moderate-escalating alcohol consumption independently predicted offspring's lifetime ever alcohol use disorder at 21 years after adjustment for a range of potential confounders. "Cross-gender influence" is observed in the study. A maternal life course pattern of alcohol consumption may have an independent effect on offspring alcohol consumption, with male offspring being more vulnerable to the effects of maternal alcohol use than are female offspring. Programs intended to address alcohol consumption by adolescents and young adults need to focus on the behaviors of both parents but acknowledging that maternal patterns of alcohol consumption may be particularly important for male offspring.

  6. The cost-effectiveness of therapies to treat alcohol use disorders.

    Science.gov (United States)

    Rehm, J; Barbosa, C

    2018-02-01

    Alcohol use is a major risk factor for mortality and morbidity burden, and alcohol use disorders contribute markedly to this burden. Effective interventions for alcohol use disorders improve health, and are potentially cost-effective or even cost saving. Areas covered: We searched the literature for the cost-effectiveness of alcohol interventions. We included behavioral, pharmacological and combined interventions, and research from both a health care provider and a societal perspective. Overall, many economic research studies pointed towards existing cost-beneficial therapies from the perspective of a health care provider; i.e. the costs for interventions were smaller than the savings in services delivery in the years thereafter. Even if this was not the case, the interventions proved to be cost-effective with a threshold below $20,000 per quality-adjusted life year. Expert Commentary: While most of the economic research to date shows promising results, such research is relatively scarce and not always rigorous. More, and more rigorous economic research is needed to fully understand the potential impact of alcohol interventions. However, even with this research, something needs to be done to reduce stigmatization of alcohol use disorders in order to fully reap the benefits of alcohol interventions.

  7. Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders.

    Science.gov (United States)

    Muroff, Jordana; Robinson, Winslow; Chassler, Deborah; López, Luz M; Gaitan, Erika; Lundgren, Lena; Guauque, Claudia; Dargon-Hart, Susan; Stewart, Emily; Dejesus, Diliana; Johnson, Kimberly; Pe-Romashko, Klaren; Gustafson, David H

    2017-01-01

    Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. The evidence-based smartphone recovery application Addiction-Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to

  8. 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

    2015-12-01

    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. 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). 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. 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.

  9. Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca

    Directory of Open Access Journals (Sweden)

    Paulo Cesar Ribeiro Barbosa

    2018-04-01

    Full Text Available The aims of this study were to assess the impact of ceremonial use of ayahuasca—a psychedelic brew containing N,N-dimethyltryptamine (DMT and β-carboline —and attendance at União do Vegetal (UDV meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample (n = 7,939. Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25–34 and over 34 years old, but not for the age range of 18–24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder.

  10. What are symptoms of an alcohol use disorder

    Science.gov (United States)

    ... standard drinks you're being served in a restaurant or bar that uses large glasses and generous ... drinking habits. For more information, see A Family History of Alcoholism: Are You at Risk? Pace yourself: ...

  11. Fetal Alcohol Spectrum Disorders (FASDs): Data and Statistics

    Science.gov (United States)

    ... alcohol screening and counseling for all women Data & Statistics Recommend on Facebook Tweet Share Compartir Prevalence of ... conducted annually by the National Center for Health Statistics (NCHS), CDC, to produce national estimates for a ...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: The proportion of 60+ years with excessive alcohol intake varies in western countries between 6-16 % among men and 2-7 % among women. Specific events related to aging (e.g. loss of job, physical and mental capacity, or spouse) may contribute to onset or continuation of alcohol use...... into the possible interaction of service system differences and related patient characteristics in predictionof treatment outcome. TRIAL REGISTRATION: Clinical Trials.gov NCT02084173 , March 7, 2014....

  13. Paternal genetic contribution influences fetal vulnerability to maternal alcohol consumption in a rat model of fetal alcohol spectrum disorder.

    Directory of Open Access Journals (Sweden)

    Laura J Sittig

    2010-04-01

    Full Text Available Fetal alcohol exposure causes in the offspring a collection of permanent physiological and neuropsychological deficits collectively termed Fetal Alcohol Spectrum Disorder (FASD. The timing and amount of exposure cannot fully explain the substantial variability among affected individuals, pointing to genetic influences that mediate fetal vulnerability. However, the aspects of vulnerability that depend on the mother, the father, or both, are not known.Using the outbred Sprague-Dawley (SD and inbred Brown Norway (BN rat strains as well as their reciprocal crosses, we administered ethanol (E, pair-fed (PF, or control (C diets to the pregnant dams. The dams' plasma levels of free thyroxine (fT4, triiodothyronine (T3, free T3 (fT3, and thyroid stimulating hormone (TSH were measured to elucidate potential differences in maternal thyroid hormonal environment, which affects specific aspects of FASD. We then compared alcohol-exposed, pair fed, and control offspring of each fetal strain on gestational day 21 (G21 to identify maternal and paternal genetic effects on bodyweight and placental weight of male and female fetuses.SD and BN dams exhibited different baseline hypothalamic-pituitary-thyroid function. Moreover, the thyroid function of SD dams was more severely affected by alcohol consumption while that of BN dams was relatively resistant. This novel finding suggests that genetic differences in maternal thyroid function are one source of maternal genetic effects on fetal vulnerability to FASD. The fetal vulnerability to decreased bodyweight after alcohol exposure depended on the genetic contribution of both parents, not only maternal contribution as previously thought. In contrast, the effect of maternal alcohol consumption on placental weight was consistent and not strain-dependent. Interestingly, placental weight in fetuses with different paternal genetic contributions exhibited opposite responses to caloric restriction (pair feeding. In summary

  14. Associations of alcohol use disorder, alcohol use, housing, and service use in a homeless sample of 255 individuals followed over two years.

    Science.gov (United States)

    Asana, Olubunmi O; Ayvaci, Emine R; Pollio, David E; Hong, Barry A; North, Carol S

    2018-03-29

    Homeless individuals with alcohol use disorders have multiple comorbidities and therefore various service needs. Despite need for services, homeless individuals face numerous barriers to treatment. Little is known about the associations of specific services in relation to homelessness in the context of alcohol problems. The current study analyzed 2-year prospective longitudinal data on a homeless sample, examining relationships between alcohol use disorder, alcohol use, housing status, and service use over time. 255 of 400 individuals recruited systematically from shelters and street locations completed 3 annual assessments (69% completion). Data on lifetime and current psychiatric disorders, housing status, and past year service use were obtained and merged with service use data gathered from local agencies. GEE models were created to predict dependent outcome variables of stable housing, alcohol use, and service use in both follow-up years. Lifetime alcohol use disorder was positively associated with substance and medical service use. Alcohol problems did not hinder attainment of stable housing, and placement in housing did not necessarily increase risk for alcohol use. Stable housing was negatively associated with psychiatric and substance service use. In the second year, when alcohol use was finally associated with receiving substance services, it appears that these services provided a gateway to psychiatric services. The psychiatric services in turn appeared to provide a gateway to medical services. Alcohol use acted differently compared to lifetime alcohol use disorder in relation to service use. Lack of association between alcohol use and housing supports Housing First policy. Obtaining housing may have ameliorative effects on mental health, diminishing perceived need for psychiatric services. Services may also be more accessible during homelessness. Obtaining substance treatment may provide a gateway for those who use alcohol after becoming homeless to

  15. Psychiatric disorders among individuals who drive after the recent use of alcohol and drugs.

    Science.gov (United States)

    Faller, Sibele; Webster, J Matthew; Leukefeld, Carl G; Bumaguin, Daniela Benzano; Duarte, Paulina do Carmo Arruda Vieira; De Boni, Raquel; Pechansky, Flavio

    2012-10-01

    This cross-sectional study assessed the prevalence of psychiatric disorders among drivers , as well as the association between recent alcohol and drug use and psychiatric diagnoses using telephone interviews. Drivers (n = 1,134) included in a roadside survey from 25 Brazilian state capitals were given a breathalyzer test, and their saliva was tested for psychoactive drugs. A telephone interview was conducted to perform psychiatric disorder evaluations using the MINI. This association was analyzed with a Poisson regression model. The prevalence of any psychiatric disorder was 40.5% among drivers with recent alcohol or drug use, compared with 12.9% among the other drivers. Alcohol/drug-positive drivers reported a higher prevalence of depression (19.4%), mania (6.5%), hypomania (5.4%), post-traumatic stress disorder (8.6%), antisocial personality (7.8%), and substance/alcohol abuse or dependence (48.1%) compared with other drivers (3.5, 2.5, 2.1, 0.5, 1.3 and 18.3% [p < 0.001], respectively). Drivers with recent alcohol or drug use were 2.5 times more likely to have a psychiatric diagnosis (CI: 1.8-3.6, p < 0.001). This is the first study in a low-/middle-income country to evaluate psychiatric disorders in drivers with recent alcohol or drug using telephone interviews. Psychiatric disorders were found to be associated with drug and alcohol use. This type of epidemiological information for curtailing related driving problems, as these psychiatric conditions are diagnosable. The results of this study can aid in the design of interventions, treatment programs and focused psychiatric evaluations, both in Brazil and abroad.

  16. Physical activity and risk of alcohol use disorders: results from a prospective cohort study.

    Science.gov (United States)

    Ejsing, Louise Kristiansen; Becker, Ulrik; Tolstrup, Janne S; Flensborg-Madsen, Trine

    2015-03-01

    To examine the effect of physical activity on risk of developing alcohol use disorders in a large prospective cohort study with focus on leisure-time physical activity. Data came from the four examinations of the Copenhagen City Heart Study (CCHS), performed in 1976-1978, 1981-1983, 1991-1994 and 2001-2003. Information on physical activity (classified as Moderate/high, low or sedentary) and covariates was obtained through self-administered questionnaires, and information on alcohol use disorders was obtained from the Danish Hospital Discharge Register, the Danish Psychiatric Central Research Register and the Winalco database. In total, 18,359 people participated in the study, a mean follow-up time of 20.9 years. Cox proportional hazards model with delayed entry was used. Models were adjusted for available covariates (age, smoking habits, alcohol intake, education, income and cohabitation status) including updated time-dependent variables whenever possible. A low or moderate/high leisure-time physical activity was associated with almost half the risk of developing alcohol use disorder compared with a sedentary leisure-time physical activity. This translates into a 1.5- to 2-fold 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, no association was observed in women with psychiatric comorbidity. Residual confounding may have been present in this study, especially according to rough measures of income and education. In both men and women, being sedentary in leisure time was a risk factor for developing an alcohol use disorder. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  17. Olfactory identification in amnestic and non-amnestic mild cognitive impairment and its neuropsychological correlates.

    Science.gov (United States)

    Vyhnalek, Martin; Magerova, Hana; Andel, Ross; Nikolai, Tomas; Kadlecova, Alexandra; Laczo, Jan; Hort, Jakub

    2015-02-15

    Olfactory identification impairment in amnestic mild cognitive impairment (aMCI) patients is well documented and considered to be caused by underlying Alzheimer's disease (AD) pathology, contrasting with less clear evidence in non-amnestic MCI (naMCI). The aim was to (a) compare the degree of olfactory identification dysfunction in aMCI, naMCI, controls and mild AD dementia and (b) assess the relation between olfactory identification and cognitive performance in aMCI compared to naMCI. 75 patients with aMCI and 32 with naMCI, 26 patients with mild AD and 27 controls underwent the multiple choice olfactory identification Motol Hospital Smell Test with 18 different odors together with a comprehensive neuropsychological examination. Controlling for age and gender, patients with aMCI and naMCI did not differ significantly in olfactory identification and both performed significantly worse than controls (pmemory and visuospatial tests were significantly related to better olfactory identification ability. Conversely, no cognitive measure was significantly related to olfactory performance in naMCI. Olfactory identification is similarly impaired in aMCI and naMCI. Olfactory impairment is proportional to cognitive impairment in aMCI but not in naMCI. Copyright © 2015. Published by Elsevier B.V.

  18. Alcohol

    Science.gov (United States)

    ... because that's how many accidents occur. 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 ...

  19. 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 ...

  20. Alcohol

    International Nuclear Information System (INIS)

    Navarro Junior, L.

    1988-01-01

    The alcohol production as a secondary energy source, the participation of the alcohol in Brazilian national economic and social aspects are presented. Statistical data of alcohol demand compared with petroleum by-products and electricity are also included. (author)

  1. 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.

  2. Relationship of genetically transmitted alpha EEG traits to anxiety disorders and alcoholism

    Energy Technology Data Exchange (ETDEWEB)

    Enoch, M.A.; Rohrbaugh, W.; Harris, C.R. [Washington School of Medicine, St. Louis, MO (United States)] [and others

    1995-10-09

    We tested the hypothesis that a heritable EEG trait, the low voltage alpha (LV), is associated with psychiatric disorders. Modest to moderate evidence for genetic linkage of both panic disorder and the low voltage alpha trait to the same region of chromosome 20q has recently been reported, raising the issue of whether there is a phenotypic correlation between these traits. A total of 124 subjects including 50 unrelated index subjects and 74 relatives were studied. Alpha EEG power was measured and EEG phenotypes were impressionistically classified. Subjects were psychiatrically interviewed using the SADS-L and blind-rated by RDC criteria. Alcoholics were four times more likely to be LV (including so-called borderline low voltage alpha) than were nonalcoholic, nonanxious subjects. Alcoholics with anxiety disorder are 10 times more likely to be LV. However, alcoholics without anxiety disorder were similar to nonalcoholics in alpha power. An anxiety disorder (panic disorder, phobia, or generalized anxiety) was found in 14/17 LV subjects as compared to 34/101 of the rest of the sample (P < 0.01). Support for these observations was found in the unrelated index subjects in whom no traits would be shared by familial clustering. Lower alpha power in anxiety disorders was not state-dependent, as indicated by the Spielberger Anxiety Scale. Familial covariance of alpha power was 0.25 (P < 0.01). These findings indicate there may be a shared factor underlying the transmissible low voltage alpha EEG variant and vulnerability to anxiety disorders with associated alcoholism. This factor is apparently not rare, because LV was found in approximately 10% of unrelated index subjects and 5% of subjects free of alcoholism and anxiety disorders. 43 refs., 1 fig., 3 tabs.

  3. NIAAA Alcohol Treatment Navigator

    Science.gov (United States)

    ... What to Know About Alcohol Treatment What Is Alcohol Use Disorder (AUD)? What Types of Alcohol Treatment Are Available? ... What to Know About Alcohol Treatment What is alcohol use disorder (AUD)? A health condition that can improve with ...

  4. Proceedings of the 2009 annual meeting of the Fetal Alcohol Spectrum Disorders Study Group.

    Science.gov (United States)

    Zhou, Feng C; Kane, Cynthia J M; Smith, Susan M

    2012-02-01

    The annual meeting of the Fetal Alcohol Spectrum Disorders Study Group (FASDSG) was held on June 20, 2009 in San Diego, CA, as a satellite of the Research Society on Alcoholism Meeting. The FASDSG membership includes clinical, basic, and social scientists who meet to discuss recent advances and issues in Fetal Alcohol Spectrum Disorders research. The main theme of the meeting was "Epigenetics and Development." Two keynote speakers, Dr. Randy Jirtle and Dr. Michael Skinner, addressed the role of epigenetics and environmental inputs, including alcohol, during critical stages of development and their potential critical and long-lasting effects. Members of the FASDSG provided new findings through brief "FASt" data reports, and national agency representatives provided updates on activities and funding priorities. Scientific presentations were made by recipients of the Student Research Merit Award and Rosett Award. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Conduct Disorder and Alcohol Use Disorder Trajectories, Predictors, and Outcomes for Indigenous Youth.

    Science.gov (United States)

    Greenfield, Brenna L; Sittner, Kelley J; Forbes, Miriam K; Walls, Melissa L; Whitbeck, Les B

    2017-02-01

    The aim of this study was to identify separate and joint trajectories of conduct disorder (CD) and alcohol use disorder (AUD) DSM-IV diagnostic symptoms among American Indian and First Nation (Indigenous) youth aged 10 to 18 years, and to characterize baseline profiles and later outcomes associated with joint trajectory group membership. Data were collected between 2002 and 2010 on three indigenous reservations in the northern Midwest and four Canadian reserves (N = 673). CD and substance use disorder (SUD) were measured using the DSM-IV Diagnostic Interview Schedule for Children-Revised (DISC-R), administered at four time points. Using group-based trajectory modeling, three CD and four AUD trajectories were found. Both had a small group with high symptoms, but the largest groups for both had no symptoms (55% and 73%, respectively). CD symptom trajectories began at age 10 years and peaked at age 14; AUD trajectories began at age 12 years and were highest from age 16 on. Eight joint trajectories were identified. Of the sample, 53% fell into the group with no CD or AUD symptoms. Compared to symptomatic groups, this group had greater caretaker warmth, positive school adjustment, less discrimination, and fewer deviant peers, and were less likely to have a caretaker with major depression at baseline. Symptomatic groups had higher odds of high school dropout, sex under the influence, and arrest at age 17 to 20 years. Despite significant risk factors, a large proportion of Indigenous youth had no CD-SUD symptoms over time. CD-SUD symptoms have multiple development trajectories and are related to early developmental risk and later psychosocial outcomes. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Is alexithymia a risk factor for major depression, personality disorder, or alcohol use disorders? A prospective population-based study.

    Science.gov (United States)

    Honkalampi, Kirsi; Koivumaa-Honkanen, Heli; Lehto, Soili M; Hintikka, Jukka; Haatainen, Kaisa; Rissanen, Teemu; Viinamäki, Heimo

    2010-03-01

    Disagreements concerning the stability of alexithymia and its ability to predict subsequent psychiatric disorders prevail. The aim of this 7-year follow-up study was to examine whether alexithymia predicts subsequent major depression, personality disorder, or alcohol use disorders in a population-based sample. The four-phase Kuopio Depression Study (KUDEP) was conducted in the eastern part of Central Finland. The study population (aged 25-64, n=2050) was randomly selected from the National Population Register. Data were collected in 1998, 1999, and 2001. In 2005, a subsample (n=333, 43 were excluded) of the 3-year follow-up population (1998-2001) was gathered and their diagnoses of mental disorders were confirmed by the Structure Clinical Interview for DSM-IV Axis I (SCID-I). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20) and depressive symptoms using the Beck Depression Inventory (BDI-21). For both of these measures, two groups were formed based on the median of their sum score (summing the 1998, 1999, and 2001 scores). Logistic regression analyses were performed. BDI sum scores, but not those of TAS, were associated with subsequent major depressive disorder, personality disorder, and alcohol use disorders in 2005. The BDI sum scores explained 35.7% of the variation in concurrent TAS sum scores. Alexithymia did not predict diagnoses of major depressive disorder, personality disorder, or alcohol use disorders. Alexithymia was closely linked to concurrent depressive symptoms. Thus, depressive symptoms may act as a mediator between alexithymia and psychiatric morbidity. Copyright 2010 Elsevier Inc. All rights reserved.

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

    OpenAIRE

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

    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 ...

  8. Childhood maltreatment, personality disorders and 3-year persistence of adult alcohol and nicotine dependence in a national sample.

    Science.gov (United States)

    Elliott, Jennifer C; Stohl, Malka; Wall, Melanie M; Keyes, Katherine M; Skodol, Andrew E; Eaton, Nicholas R; Shmulewitz, Dvora; Goodwin, Renee D; Grant, Bridget F; Hasin, Deborah S

    2016-05-01

    Persistent cases of alcohol and nicotine dependence are associated with considerable morbidity and mortality, and are predicted by childhood maltreatment and personality disorders. Our aim was to test whether personality disorders (individually or conjointly) mediate the relationship between childhood maltreatment and the persistence of dependence. Personality disorders, modeled dimensionally, were tested as mediators of the relationship between childhood maltreatment and the 3-year persistence of alcohol and nicotine dependence in participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had current alcohol and nicotine dependence in their baseline interview. Individual personality disorders were assessed in separate models. Then, those that were significant were examined jointly in multiple mediator models to determine their total and unique effects. A large, nationally representative US survey. Participants ≥ 18 years who completed baseline and 3-year follow-up NESARC interviews who had baseline alcohol dependence (n = 1172; 68% male) or nicotine dependence (n = 4017; 52.9% male). Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-IV) measures of childhood maltreatment, personality disorders and alcohol/nicotine dependence. Individual models indicated that many personality disorders mediated the relationship between childhood maltreatment and the 3-year persistence of alcohol and nicotine dependence (each explaining 6-46% of the total effect, Ps Personality disorder symptoms (especially borderline and antisocial) help explain the association between childhood maltreatment and persistent alcohol and nicotine dependence. © 2016 Society for the Study of Addiction.

  9. Estimating demand for primary care-based treatment for substance and alcohol use disorders.

    Science.gov (United States)

    Barry, Colleen L; Epstein, Andrew J; Fiellin, David A; Fraenkel, Liana; Busch, Susan H

    2016-08-01

    While there is broad recognition of the high societal costs of substance use disorders (SUD), treatment rates are low. We examined whether, in the United States, participants with substance or alcohol use disorder would report a greater willingness to enter SUD treatment located in a primary care setting (primary care) or more commonly found specialty care setting in the United States (usual care). Randomized survey-embedded experiment. US web-based research panel in which participants were randomized to read one-paragraph vignettes describing treatment in usual care (specialty drug or alcohol treatment center), primary care or collaborative care within a primary care setting. A total of 42 451 panelists aged 18+ were screened for substance or alcohol use disorder using validated diagnostic criteria. Participants included 344 with a substance use disorder and 634 with an alcohol use disorder not in treatment with no prior treatment history. Willingness to enter treatment across vignettes by condition. Among participants with a substance use disorder, 24.6% of those randomized to usual care reported being willing to enter drug treatment compared with 37.2% for primary care [12.6 percentage point difference; 95% confidence interval (CI) = 0.8, 24.4) and 34.0% for collaborative care (9.4 percentage point difference; 95% CI = -2.0, 20.8). Among participants with an alcohol use disorder, 17.6% of those randomized to usual care reported being willing to enter alcohol treatment compared with 20.3% for primary care (2.6 percentage point difference; 95% CI = -4.9, 10.1) and 20.8% for collaborative care (3.1 percentage point difference; 95% CI = -4.3, 10.6). The most common reason for not being willing to enter drug (63%) and alcohol (78%) treatment was the belief that treatment was not needed. In the United States, people diagnosed with substance or alcohol use disorders appear to be more willing to enter treatment in a primary care setting than in a specialty drug

  10. Adolescent Social Isolation as a Model of Heightened Vulnerability to Comorbid Alcoholism and Anxiety Disorders.

    Science.gov (United States)

    Butler, Tracy R; Karkhanis, Anushree N; Jones, Sara R; Weiner, Jeffrey L

    2016-06-01

    Individuals diagnosed with anxiety-related illnesses are at increased risk of developing alcoholism, exhibit a telescoped progression of this disease and fare worse in recovery, relative to alcoholics that do not suffer from a comorbid anxiety disorder. Similarly, preclinical evidence supports the notion that stress and anxiety represent major risk factors for the development of alcohol use disorder (AUD). Despite the importance of understanding the link between anxiety and alcoholism, much remains unknown about the neurobiological substrates underlying this relationship. One stumbling block has been the lack of animal models that reliably reproduce the spectrum of behaviors associated with increased vulnerability to these diseases. Here, we review the literature that has examined the behavioral and neurobiological outcomes of a simple rodent adolescent social isolation procedure and discuss its validity as a model of vulnerability to comorbid anxiety disorders and alcoholism. Recent studies have provided strong evidence that adolescent social isolation of male rats leads to the expression of a variety of behaviors linked with increased vulnerability to anxiety and/or AUD, including deficits in sensory gating and fear extinction, and increases in anxiety measures and ethanol drinking. Neurobiological studies are beginning to identify mesolimbic adaptations that may contribute to the behavioral phenotype engendered by this model. Some of these changes include increased excitability of ventral tegmental area dopamine neurons and pyramidal cells in the basolateral amygdala and significant alterations in baseline and stimulated catecholamine signaling. A growing body of evidence suggests that adolescent social isolation may represent a reliable rodent model of heightened vulnerability to anxiety disorders and alcoholism in male rats. These studies provide initial support for the face, construct, and predictive validity of this model and highlight its utility in

  11. An update on CRF mechanisms underlying alcohol use disorders and dependence.

    Directory of Open Access Journals (Sweden)

    Isabel Marian Hartmann Quadros

    2016-10-01

    Full Text Available 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 towards 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.

  12. The alcoholic brain: neural bases of impaired reward-based decision-making in alcohol use disorders.

    Science.gov (United States)

    Galandra, Caterina; Basso, Gianpaolo; Cappa, Stefano; Canessa, Nicola

    2018-03-01

    Neuroeconomics is providing insights into the neural bases of decision-making in normal and pathological conditions. In the neuropsychiatric domain, this discipline investigates how abnormal functioning of neural systems associated with reward processing and cognitive control promotes different disorders, and whether such evidence may inform treatments. This endeavor is crucial when studying different types of addiction, which share a core promoting mechanism in the imbalance between impulsive subcortical neural signals associated with immediate pleasurable outcomes and inhibitory signals mediated by a prefrontal reflective system. The resulting impairment in behavioral control represents a hallmark of alcohol use disorders (AUDs), a chronic relapsing disorder characterized by excessive alcohol consumption despite devastating consequences. This review aims to summarize available magnetic resonance imaging (MRI) evidence on reward-related decision-making alterations in AUDs, and to envision possible future research directions. We review functional MRI (fMRI) studies using tasks involving monetary rewards, as well as MRI studies relating decision-making parameters to neurostructural gray- or white-matter metrics. The available data suggest that excessive alcohol exposure affects neural signaling within brain networks underlying adaptive behavioral learning via the implementation of prediction errors. Namely, weaker ventromedial prefrontal cortex activity and altered connectivity between ventral striatum and dorsolateral prefrontal cortex likely underpin a shift from goal-directed to habitual actions which, in turn, might underpin compulsive alcohol consumption and relapsing episodes despite adverse consequences. Overall, these data highlight abnormal fronto-striatal connectivity as a candidate neurobiological marker of impaired choice in AUDs. Further studies are needed, however, to unveil its implications in the multiple facets of decision-making.

  13. Eating Disorder Symptoms and Alcohol Use Among Adolescents in Substance Abuse Treatment

    Directory of Open Access Journals (Sweden)

    Janelle E. Arias

    2009-11-01

    Full Text Available Objective: To examine the relationship of eating disorder (ED symptoms with the severity of alcohol use among adolescents in treatment for alcohol and other substance use disorders (AOSUDs. Method: A sample consisted of 177 adolescents who participated in outpatient AOSUD treatment programs in Connecticut. Chi square tests, one-way ANOVAs and Pearson’s correlation coefficients were used to describe the prevalence and correlates of any eating disorders, and the related symptoms. Multivariate regression was used to test the associations between ED symptoms and alcohol consumption. Results: 26.4% of the participants had at least one ED symptom, with the highest number of symptoms occurring in females. The number of ED symptoms was associated with increases in the number of times that they became intoxicated in the year before entering treatment, the number of alcohol-related social problems, and the number of alcohol-related physical symptoms after taking into consideration the effects of age and gender. Conclusions: The prevalence of symptoms of EDs is high in adolescents with AOSUDs, with the number of ED symptoms correlating with increased alcohol consumption. Further studies on the course and treatment of adolescents with AOSUDs and symptoms of EDs are warranted.

  14. 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)

  15. Insecure attachment and college-age alcohol use disorders. A case report.

    Science.gov (United States)

    Kotov, Kimberly M

    2006-01-01

    Teens and young adults with insecure attachment may be remarkably susceptible to alcohol and substance use disorders. Particularly in the separation process of leaving-home and entering college, an underlying insecure attachment may manifest through symptoms of alcohol or drug abuse; as these young adults engage in what is perceived to be adult drinking behavior, they become too "attached" to the alcohol as a substitute for earlier, sporadically-available objects (usually parents). That is, they enact a similar relationship to this drug that they may have learned to have with an insecure parent: too close at times, but ultimately fostering guilt, dependence and destructive action. Fear of abandonment, rejection and negative judgment may be intensified in this age group as they struggle at the cusp of independence, but these issues are particularly relevant for insecurely attached teens. In this report, attachment theory is briefly described and applied to the assessment and treatment of a college freshman diagnosed with an alcohol use disorder. By engaging the patient in evaluating her actions and motives through the attachment model, the therapy helps her to channel help-seeking behavior appropriately, to establish expectations for consistency and reliability from significant people in her life and to feel safer without turning to alcohol as a crutch. An argument is made for the general application of attachment theory to alcohol and drug use disorders in this significant phase of young adult development.

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

    International Nuclear Information System (INIS)

    Goncalves, Rita de Cassia Ferreira; Vasconcelos, Marcio Moacyr; Faleiros, Leticia Oliveira; Brito, Adriana Rocha; Werner Junior, Jairo; Herdy, Gesmar Volga Haddad

    2009-01-01

    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 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)

  17. [Cognitive-behavioral therapy for alcohol and drug use disorders].

    Science.gov (United States)

    Rangé, Bernard P; Marlatt, G Alan

    2008-10-01

    Cognitive-behavioral therapies have been successfully used to treat addiction. This article is in part a review on addiction models such as relapse prevention by Marlatt & Gordon, stages of change by Prochaska, DiClemente & Norcross, deriving from motivational interview, developed by Miller & Rollnick, as well as the cognitive models by Beck et al. Based on literature evidence for the development of effective treatment programs, we report on a group treatment model used in a group of alcoholics referred by the Department of Worker's Health Surveillance at Universidade Federal do Rio de Janeiro to the Alcoholism Rehabilitation and Research Center. Results are presented indicating that this type of treatment could be one alternative to others treatments in use. New research is needed to better validate cognitive-behavioral approach to alcohol and drug problems.

  18. Does comorbid alcohol and substance abuse affect electroconvulsive therapy outcome in the treatment of mood disorders?

    Science.gov (United States)

    Moss, Lori; Vaidya, Nutan

    2014-03-01

    Antidepressant medications remain the principal agents used to treat patients with mood disorders, although 30% to 40% of these patients do not improve. One of the factors associated with poor medication response is alcohol and substance abuse. Persons with mood disorders are at the greatest risk for suicide, and alcoholism is a significant additional risk factor. Electroconvulsive therapy (ECT) is shown to be the most effective treatment for major depression especially when associated with psychosis, catatonia, and suicide intent. However, similar to most antidepressant trials, patients with depression and comorbid alcohol and substance abuse are excluded from ECT efficacy studies. Through a retrospective chart review, we compared response to ECT in patients with mood disorder and comorbid alcohol and drug abuse to those with mood disorder only. From 2004 to 2010, 80 patients with mood disorder received ECT. Fifty of these had comorbid alcohol or drug abuse. Using a 10-item psychopathology scale, we compared pre- and post-ECT symptom severity between the 2 groups. Outcome was determined by measuring a decrease in the pre-ECT and post-ECT score using Wilcoxon rank tests, with statistical significance at P = 0.05. There was no difference between the 2 groups in most demographics, ECT medication, or seizure quality. There was no difference in ECT outcome between those with comorbid alcohol abuse and those without based on percent decrease in pre- and post-ECT symptom scores (abuse: mean [SD], 0.89 [0.2] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 1332; P = 0.086). When we compared those who met the criteria for alcohol or drug dependence (19 patients) with those with no abuse, there was a trend for the dependence group to not do as well (dependence: mean [SD], 0.83 [0.25] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 405; P = 0.053). Those with combined drug and alcohol abuse (18 patients) did have a significantly worse outcome (combined: mean [SD], 0.82 [0

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

    Science.gov (United States)

    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

  20. 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.

  1. Oppositional defiant disorder (ODD), the forerunner of alcohol dependence: a controlled study.

    Science.gov (United States)

    Ghosh, Abhishek; Malhotra, Savita; Basu, Debasish

    2014-10-01

    There are common genetic, neurobiological and psycho-social substrates for oppositional defiant disorder (ODD) and substance dependence. ODD can be regarded as the mildest and earliest form of disruptive behavioral disorder and also represents the threshold of vulnerability for substance dependence. But it is a less researched area. The aim of this research was to study any possible association between childhood ODD and adult alcohol dependence. Data are presented from a non probability sample of 100 adult alcohol dependent subjects and equal number of biologically unrelated control subjects. Assessment was conducted by the instrument Semi-Structured Assessment for the Genetics of Alcoholism for both the assessment of ODD and alcohol dependence. The results of this study demonstrated significant association between childhood ODD and adult alcohol dependence. The association remained significant even after the exclusion of the possible confounding effects of the presence of conduct disorder and attention deficit hyperactivity disorder. Our study should encourage further research in this area and is expected to open up an opportunity for preventive research. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Family Stress and Coping From Hospitalization of Clients With Severe Alcohol Use Disorder in Korea.

    Science.gov (United States)

    Park, Gyu-Hee; Choi, Yun-Jung

    The rate of relapse and involuntary hospitalization among clients with alcohol use disorder exceeds 40% in South Korea. As a result, family members of clients experience considerable stress and require the assistance of professional services. This empirical study investigates levels of perceived stress and stress coping styles among family members of clients with severe alcohol use disorder and examines the correlations among these variables. Data were collected from three inpatient alcohol rehabilitation centers and five psychiatric hospitals in South Korea. Family stress levels and stress coping styles for 133 respondents were evaluated using the Hospital Stress Rating Scale for Family Members and the Stress Coping Style Checklist. There were significant differences in stress levels according to whether participants had attended a family educational program in the past or were doing so presently. Furthermore, significant differences in stress were observed among participants who were using the stress coping style of easing strained emotions during the client's hospitalization but who had never attended an educational program. Among the subcategories, stress levels had especially strong relationships with easing strained emotions, seeking advice, and solving problems. The results showed that families with severe alcohol use disorder experience stress from the client's hospitalization and seek advice from neighbors to deal with worries, privacy concerns, and economic problems. Family interventions are needed to provide family members with strategies to cope with stress, which can support recovery of clients with severe alcohol use disorder.

  3. Individual and community level risk-factors for alcohol use disorder among conflict-affected persons in Georgia.

    Science.gov (United States)

    Roberts, Bayard; Murphy, Adrianna; Chikovani, Ivdity; Makhashvili, Nino; Patel, Vikram; McKee, Martin

    2014-01-01

    The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia. A cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs) and former IDPs. Two alcohol use disorder outcomes were measured: (i) having at least hazardous alcohol use (AUDIT score ≥ 8); (ii) episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week). Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only). Of the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386), 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use). The findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for stronger

  4. Individual and community level risk-factors for alcohol use disorder among conflict-affected persons in Georgia.

    Directory of Open Access Journals (Sweden)

    Bayard Roberts

    Full Text Available The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia.A cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs and former IDPs. Two alcohol use disorder outcomes were measured: (i having at least hazardous alcohol use (AUDIT score ≥ 8; (ii episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week. Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only.Of the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386, 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use.The findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for

  5. Differential Cortical Neurotrophin and Cytogenetic Adaptation after Voluntary Exercise in Normal and Amnestic Rats

    Science.gov (United States)

    Hall, Joseph M.; Vetreno, Ryan P.; Savage, Lisa M.

    2013-01-01

    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 two-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 [VEGF]) 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 in the FC. Furthermore, VEx had a selective effect of only recovering oligodendrocyte precursor cells 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. PMID:24215977

  6. Teaching Students with Fetal Alcohol Spectrum Disorder: Building Strengths, Creating Hope. Programming for Students with Special Needs. Book 10

    Science.gov (United States)

    Clarren, Sandra G. Bernstein

    2004-01-01

    "Teaching Students with Fetal Alcohol Spectrum Disorder: Building Strengths, Creating Hope" is Book 10 in the Programming for Students with Special Needs series; a revision and expansion of the 1997 Alberta Learning teacher resource, "Teaching Students with Fetal Alcohol Syndrome and Possible Prenatal Alcohol-Related Effects."…

  7. Protective Behavioral Strategies and Alcohol Use Outcomes among College Women Drinkers: Does Disordered Eating and Race Moderate This Association?

    Science.gov (United States)

    Landry, Alicia S.; Moorer, Kayla D.; Madson, Michael B.; Zeigler-Hill, Virgil

    2014-01-01

    The current study examined the degree to which associations that protective behavioral strategy use had with alcohol consumption and alcohol-related negative consequences were moderated by disordered eating and race. Participants were 382 female undergraduates (ages 18-25) who had consumed alcohol at least once within the previous month.…

  8. [SEMERGEN positioning for the treatment of alcohol disorders in primary care].

    Science.gov (United States)

    Arbesú, José Ángel; Gual, Antoni; Casquero, Rafael; Bobes, Julio; Ortega, Patricia

    2015-12-01

    The present manuscript is based on the recommendations of a panel of health care professionals, including several experts in primary health care, psychiatry and addictions. The participants are recognized specialists in the treatment of alcohol use disorder. The panel met in Barcelona on 2015 April 22 with the aims of evaluating the current management of alcohol use disorder in primary health care and developing a strategy to address this problem, basing on the evidence and the recommendations of the scientific societies and national and international organizations. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  9. Sex differences in prevalence and comorbidity of alcohol and drug use disorders: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Goldstein, Risë B; Dawson, Deborah A; Chou, S Patricia; Grant, Bridget F

    2012-11-01

    The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders. Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms.

  10. Social networks and alcohol use disorders: findings from a nationally representative sample

    Science.gov (United States)

    Mowbray, Orion; Quinn, Adam; Cranford, James A.

    2014-01-01

    Background While some argue that social network ties of individuals with alcohol use disorders (AUD) are robust, there is evidence to suggest that individuals with AUDs have few social network ties, which are a known risk factor for health and wellness. Objectives Social network ties to friends, family, co-workers and communities of individuals are compared among individuals with a past-year diagnosis of alcohol dependence or alcohol abuse to individuals with no lifetime diagnosis of AUD. Method Respondents from Wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC) were assessed for the presence of past-year alcohol dependence or past-year alcohol abuse, social network ties, sociodemographics and clinical characteristics. Results Bivariate analyses showed that both social network size and social network diversity was significantly smaller among individuals with alcohol dependence, compared to individuals with alcohol abuse or no AUD. When social and clinical factors related to AUD status were controlled, multinomial logistic models showed that social network diversity remained a significant predictor of AUD status, while social network size did not differ among AUD groups. Conclusion Social networks of individuals with AUD may be different than individuals with no AUD, but this claim is dependent on specific AUD diagnosis and how social networks are measured. PMID:24405256

  11. 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.

  12. 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

  13. Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina.

    Science.gov (United States)

    López, Mariana Beatriz; Lichtenberger, Aldana; Conde, Karina; Cremonte, Mariana

    2017-07-01

    Background  Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective  To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPS-QF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods  A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results  All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions  In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low

  14. White matter microstructure alterations: a study of alcoholics with and without post-traumatic stress disorder.

    Directory of Open Access Journals (Sweden)

    Caitlin A Durkee

    Full Text Available Many brain imaging studies have demonstrated reductions in gray and white matter volumes in alcoholism, with fewer investigators using diffusion tensor imaging (DTI to examine the integrity of white matter pathways. Among various medical conditions, alcoholism and post-traumatic stress disorder (PTSD are two comorbid diseases that have similar degenerative effects on the white matter integrity. Therefore, understanding and differentiating these effects would be very important in characterizing alcoholism and PTSD. Alcoholics are known to have neurocognitive deficits in decision-making, particularly in decisions related to emotionally-motivated behavior, while individuals with PTSD have deficits in emotional regulation and enhanced fear response. It is widely believed that these types of abnormalities in both alcoholism and PTSD are related to fronto-limbic dysfunction. In addition, previous studies have shown cortico-limbic fiber degradation through fiber tracking in alcoholism. DTI was used to measure white matter fractional anisotropy (FA, which provides information about tissue microstructure, possibly indicating white matter integrity. We quantitatively investigated the microstructure of white matter through whole brain DTI analysis in healthy volunteers (HV and alcohol dependent subjects without PTSD (ALC and with PTSD (ALC+PTSD. These data show significant differences in FA between alcoholics and non-alcoholic HVs, with no significant differences in FA between ALC and ALC+PTSD in any white matter structure. We performed a post-hoc region of interest analysis that allowed us to incorporate multiple covariates into the analysis and found similar results. HV had higher FA in several areas implicated in the reward circuit, emotion, and executive functioning, suggesting that there may be microstructural abnormalities in white matter pathways that contribute to neurocognitive and executive functioning deficits observed in alcoholics. Furthermore

  15. 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…

  16. 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…

  17. Comparisons of Korsakoff and Non-Korsakoff Alcoholics on Neuropsychological Tests of Prefrontal Brain Functioning

    Science.gov (United States)

    Oscar-Berman, Marlene; Kirkley, Shalene M.; Gansler, David A.; Couture, Ashley

    2014-01-01

    Background Evidence suggests that alcoholics exhibit particular deficits in brain systems involving the prefrontal cortex, but few studies have directly compared patients with and without Korsakoff’s syndrome on measures of prefrontal integrity. Methods Neuropsychological tasks sensitive to dysfunction of frontal brain systems were administered, along with standard tests of memory, intelligence, and visuospatial abilities, to 50 healthy, abstinent, nonamnesic alcoholics, 6 patients with alcohol-induced persisting amnestic disorder (Korsakoff’s syndrome), 6 brain-damaged controls with right hemisphere lesions, and 82 healthy nonalcoholic controls. Results Korsakoff patients were impaired on tests of memory, fluency, cognitive flexibility, and perseveration. Non-Korsakoff alcoholics showed some frontal system deficits as well, but these were mild. Cognitive deficits in non-Korsakoff alcoholics were related to age, duration of abstinence (less than 5 years), duration of abuse (more than 20 years), and amount of alcohol intake. Conclusions Abnormalities of frontal system functioning are most apparent in alcoholics with Korsakoff’s syndrome. In non-Korsakoff alcoholics, factors contributing to cognitive performance are age, duration of abstinence, duration of alcoholism, and amount of alcohol consumed. PMID:15100620

  18. Nature and Treatment of Comorbid Alcohol Problems and Post Traumatic Stress Disorder Among American Military Personnel and Veterans.

    Science.gov (United States)

    Allen, John P; Crawford, Eric F; Kudler, Harold

    2016-01-01

    Many service members and veterans seeking treatment for alcohol problems also have post-traumatic stress disorder (PTSD). This article considers the effectiveness of treating alcohol problems and PTSD simultaneously. The authors begin by summarizing the extent of excessive alcohol use among military service members and veterans. They then explore the relationship between combat exposure and subsequent alcohol use; identify and briefly describe evidence-based treatments for alcohol problems and PTSD, separately; and review research on the effects of single treatments for both PTSD symptoms and alcohol use.

  19. Treating individuals with social anxiety disorder and at-risk drinking: Phasing in a brief alcohol intervention following paroxetine

    OpenAIRE

    Book, Sarah W.; Thomas, Suzanne E.; Smith, Joshua P.; Randall, Patrick K.; Kushner, Matt G.; Bernstein, Gail A.; Specker, Sheila M.; Miller, Peter M.; Randall, Carrie L.

    2013-01-01

    Paroxetine alone is not sufficient to decrease alcohol use in socially anxious alcoholics seeking anxiety treatment. We tested the hypothesis that adding a brief-alcohol-intervention (BI) to paroxetine would decrease alcohol use. All subjects (N = 83) had a diagnosis of social anxiety disorder, endorsed drinking to cope with anxiety, were NIAAA-defined at-risk drinkers, and were randomized to either paroxetine alone, or paroxetine plus BI. Both groups showed significant improvement in both so...

  20. Personality disorders among Danish alcoholics attending outpatient treatment

    DEFF Research Database (Denmark)

    Nordholm, Dorte; Nielsen, Bent

    2007-01-01

    of the Addiction Severity Index. A+PDC had significantly more serious medical problems than A-PD, while the A+PDB group had significantly more employment, drug use and social problems than the A-PD. As for psychiatric status, A-PD had significantly different scores compared with A+PDB and A+PDC. A+PDB were younger...... at the outpatient alcohol clinic at Odense University Hospital, Denmark. It was possible to re-interview 276 (76%) patients 1 year after onset of treatment. Of the 363 patients, 87% were alcohol-dependent (ICD-10) and 34% fulfilled the ICD-10-R criteria for PDs. The basic interviews focused on the seven main areas...

  1. Alcohol use disorder-related sick leave and mortality: a cohort study

    OpenAIRE

    Wedegaertner, Felix; Geyer, Siegfried; Arnhold-Kerri, Sonja; Sittaro, Nicola-Alexander; te Wildt, Bert

    2013-01-01

    Background Alcohol use disorders (AUDs) are associated with the highest all-cause mortality rates of all mental disorders. The majority of patients with AUDs never receive inpatient treatment for their AUD, and there is lack of data about their mortality risks despite their constituting the majority of those affected. Absenteeism from work (sick leave) due to an AUD likely signals worsening. In this study, we assessed whether AUD-related sick leave was associated with mortality in a cohort of...

  2. Epidemiology of drinking, alcohol use disorders, and related problems in US ethnic minority groups.

    Science.gov (United States)

    Caetano, Raul; Vaeth, Patrice A C; Chartier, Karen G; Mills, Britain A

    2014-01-01

    This chapter reviews selected epidemiologic studies on drinking and associated problems among US ethnic minorities. Ethnic minorities and the White majority group exhibit important differences in alcohol use and related problems, including alcohol use disorders. Studies show a higher rate of binge drinking, drinking above guidelines, alcohol abuse, and dependence for major ethnic and racial groups, notably, Blacks, Hispanics, and American Indians/Alaskan Natives. Other problems with a higher prevalence in certain minority groups are, for example, cancer (Blacks), cirrhosis (Hispanics), fetal alcohol syndrome (Blacks and American Indians/Alaskan Natives), drinking and driving (Hispanics, American Indians/Alaskan Natives). There are also considerable differences in rates of drinking and problems within certain ethnic groups such as Hispanics, Asian Americans, and American Indians/Alaskan Natives. For instance, among Hispanics, Puerto Ricans and Mexican Americans drink more and have higher rates of disorders such as alcohol abuse and dependence than Cuban Americans. Disparities also affect the trajectory of heavy drinking and the course of alcohol dependence among minorities. Theoretic accounts of these disparities generally attribute them to the historic experience of discrimination and to minority socioeconomic disadvantages at individual and environmental levels. © 2014 Elsevier B.V. All rights reserved.

  3. 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

  4. Treatment Professionals' Basic Beliefs About Alcohol Use Disorders: The Impact of Different Cultural Contexts.

    Science.gov (United States)

    Koski-Jännes, Anja; Pennonen, Marjo; Simmat-Durand, Laurence

    2016-01-01

    The treatment of alcohol abusers in different cultural contexts does not depend only on the methods used but also on the ways in which treatment providers perceive the problem and relate to their clients. This study compares treatment professionals' basic beliefs about alcohol use disorders in two culturally different European countries to find out to what extent these ideas are shaped by the respondents' socio-cultural context, profession, and other background variables. Similar postal surveys were conducted among professionals working in specialized addiction treatment units in Finland (n = 520) and France (n = 472). The data were analyzed by descriptive statistical methods and logistic regression analysis. Consistent cultural differences were found in almost all the questions asked and they remained significant even after controlling for the other background factors. The French professionals emphasized the addictiveness of alcohol more than their Finnish colleagues. They also believed less in the chances of recovery and attributed more responsibility for the problem to external factors, while the Finns emphasized individual responsibility. Profession, gender and some other background variables also modified beliefs about specific questions. Cultural factors shape the ways in which alcohol use disorders are perceived more pervasively than the other background variables. The French professionals' low trust in treatment and the Finnish professionals' lack of concern for the addiction potential of alcohol and stronger tendency to regard the person as responsible for the problem could be seen as potential impediments to effective ways of helping alcohol abusers in these countries.

  5. Population differences in dysmorphic features among children with fetal alcohol spectrum disorders.

    Science.gov (United States)

    May, Philip A; Gossage, J Phillip; Smith, Matthew; Tabachnick, Barbara G; Robinson, Luther K; Manning, Melanie; Cecanti, Mauro; Jones, Kenneth Lyons; Khaole, Nathaniel; Buckley, David; Kalberg, Wendy O; Trujillo, Phyllis M; Hoyme, H Eugene

    2010-05-01

    To examine the variation in significant dysmorphic features in children from 3 different populations with the most dysmorphic forms of fetal alcohol spectrum disorders, fetal alcohol syndrome (FAS), and partial fetal alcohol syndrome (PFAS). Advanced multiple regression techniques are used to determine the discriminating physical features in the diagnosis of FAS and PFAS among children from Northern Plains Indian communities, South Africa, and Italy. Within the range of physical features used to identify children with fetal alcohol spectrum disorders, specifically FAS and PFAS, there is some significant variation in salient diagnostic features from one population to the next. Intraclass correlations in diagnostic features between these 3 populations is 0.20, indicating that about 20% of the variability in dysmorphology core features is associated with location and, therefore, specific racial/ethnic population. The highly significant diagnostic indicators present in each population are identified for the full samples of FAS, PFAS, and normals and also among children with FAS only. A multilevel model for these populations combined indicates that these variables predict dysmorphology unambiguously: small palpebral fissures, narrow vermillion, smooth philtrum, flat nasal bridge, and fifth finger clinodactyly. Long philtrum varies substantially as a predictor in the 3 populations. Predictors not significantly related to fetal alcohol spectrum disorders dysmorphology across the 3 populations are centile of height (except in Italy) strabismus, interpupilary distance, intercanthal distance, and heart murmurs. The dysmorphology associated with FAS and PFAS vary across populations, yet a particular array of common features occurs in each population, which permits a consistent diagnosis across populations.

  6. Traumatic Experiences, Revictimization and Posttraumatic Stress Disorder in German Inpatients Treated for Alcohol Dependence.

    Science.gov (United States)

    Grundmann, Johanna; Lincoln, Tania M; Lüdecke, Daniel; Bong, Sönke; Schulte, Bernd; Verthein, Uwe; Schäfer, Ingo

    2018-03-21

    Traumatic experiences and posttraumatic stress disorder (PTSD) are prevalent in patients with alcohol use disorders (AUDs) and affect its course and outcome. Prior prevalence reports are limited by the inclusion of individuals with additional substance use disorders (SUDs), a focus on childhood events only and the use of self-ratings only. To examine the prevalence of traumatic experiences, revictimization and PTSD in inpatients treated for alcohol dependence without other SUD, emphasizing interpersonal violence across the whole lifespan. For this cross-sectional study alcohol-dependent patients without additional SUD (N = 230, 73% male, mean age 43 years) were recruited in an inpatient detoxification unit and were administered the Structured Trauma Interview, the Posttraumatic Diagnostic Scale, and the Structured Clinical Interview for DSM-IV. Data analysis comprised descriptive statistics and appropriate significance tests. 36.2% reported severe childhood physical or sexual abuse and 45.6% reported at least one of these types of abuse in adulthood. The lifetime rate of interpersonal violence was 61.1%. The prevalence of current PTSD was 13.2%. Women with a history of childhood abuse were about seven times as likely to be victimized in adulthood as women without these experiences, while in men revictimization was not significant. Even in patients with alcohol dependence without additional SUD experiences of interpersonal violence and PTSD are frequent. In order to adequately respond to the needs of this population, trauma and PTSD should routinely be assessed in alcohol-dependence treatment and considered in treatment planning if necessary.

  7. The Alcohol Use Disorders Identification Test and carbohydrate-deficient transferrin in alcohol-related sickness absence.

    Science.gov (United States)

    Hermansson, Ulric; Helander, Anders; Brandt, Lena; Huss, Anders; Rönnberg, Sten

    2002-01-01

    Previous studies have shown that elevated, risky levels of alcohol consumption may lead to higher rates of sickness absence. However, no studies have examined the Alcohol Use Disorders Identification Test (AUDIT) or serum carbohydrate-deficient transferrin (CDT) in relation to sickness absence in the workplace. The purpose of this study was to examine the relationship between sick-days, 12 months before screening, and the AUDIT and CDT (CDTect kit). Serum gamma-glutamyltransferase also was used for comparison. The study was carried out over 36 months in a large workplace and formed part of an ongoing controlled study. In conjunction with a routine health examination, employees were offered the opportunity to undergo an alcohol screening. Absence data were obtained from the company payroll system, and sickness absence was analyzed by using a three-ordinal level cumulative logistic model on the number of sick-days. Odds ratios (OR) and 95% confidence intervals (CI) are reported. Of the 989 subjects who participated in the study, 193 (19.5%) screened positive in relation to either the AUDIT (>or=8 points) or CDT (women), or both. Employees who screened positive with the AUDIT had a significantly higher proportion of sick-days (p = 0.047) compared with those who screened negative (OR = 1.4, CI 1.0-1.9). Neither long, continuous periods of sickness absence nor absence on Mondays or Fridays gave a clear indication of individuals who screened positive on the AUDIT or CDT test. Our data indicate that individuals with moderately elevated or risky levels of alcohol consumption show an increase in sick-days. Accordingly, workplaces have a good reason for using a more systematic approach to alcohol screening in routine workplace health examinations.

  8. Interventions for Increasing Alcohol Treatment Utilization Among Patients with Alcohol Use Disorders from Emergency Departments: A Systematic Review.

    Science.gov (United States)

    Simioni, Nicolas; Rolland, Benjamin; Cottencin, Olivier

    2015-11-01

    Alcohol use disorders (AUDs) are characterized by low treatment coverage. Emergency departments (EDs) have great potential to increase alcohol treatment coverage. While ED-based brief interventions (BIs) are rarely effective for reducing alcohol use and related consequences in people with AUDs, utilization of formal alcohol treatment has been demonstrated to be useful. Thus we conducted a systematic review to determine efficacious interventions for increasing subsequent alcohol treatment from EDs. A systematic search of the literature up to 31 December 2013 was undertaken in three electronic databases: PubMed, PsycINFO and The Cochrane Library. Only randomized controlled trials (RCTs), controlled clinical trials (CCTs) and non-randomized controlled trials (NRCTs) were included. A meta-analysis was judged inappropriate because of substantial discrepancies in term of interventions' characteristics across studies. From the 2182 identified records, 7 studies (4RCTs, 2 CCTs, 1NRCT) met inclusion criteria. Onsite brief advice (BA) was found efficacious in comparison to no active control condition, but no evidence of efficacy was found when compared to active control conditions. Referral to post-discharge BIs was not found efficacious either used alone or in addition to onsite BA. There is evidence, albeit limited, suggesting that more intensive interventions, such as referral to extended post-discharge interventions and onsite extended BI, might be useful. Based on the available evidence, onsite BA with leaflets appears to be the minimum level of intervention since it enables to actively intervene while fitting in the time concerns experienced in EDs. Further research is needed to confirm these findings given the limited quantity and quality of existing data and to determine whether more intensive interventions could actually be useful. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Higher Impulsivity As a Distinctive Trait of Severe Cocaine Addiction among Individuals Treated for Cocaine or Alcohol Use Disorders

    Directory of Open Access Journals (Sweden)

    Nuria García-Marchena

    2018-02-01

    Full Text Available AimsDespite alcohol being the most often used addictive substance among addicted patients, use of other substances such as cocaine has increased over recent years, and the combination of both drugs aggravates health impairment and complicates clinical assessment. The aim of this study is to identify and characterize heterogeneous subgroups of cocaine- and alcohol-addicted patients with common characteristics based on substance use disorders, psychiatric comorbidity and impulsivity.MethodsA total of 214 subjects with cocaine and/or alcohol use disorders were recruited from outpatient treatment programs and clinically assessed. A latent class analysis was used to establish phenotypic categories according to diagnosis of cocaine and alcohol use disorders, mental disorders, and impulsivity scores. Relevant variables were examined in the latent classes (LCs using correlation and analyses of variance and covariance.ResultsFour LCs of addicted patients were identified: Class 1 (45.3% formed by alcohol-dependent patients exhibiting lifetime mood disorder diagnosis and mild impulsivity; Class 2 (14% formed mainly by lifetime cocaine use disorder patients with low probability of comorbid mental disorders and mild impulsivity; Class 3 (10.7% formed by cocaine use disorder patients with elevated probability to course with lifetime anxiety, early and personality disorders, and greater impulsivity scores; and Class 4 (29.9% formed mainly by patients with alcohol and cocaine use disorders, with elevated probability in early and personality disorders and elevated impulsivity. Furthermore, there were significant differences among classes in terms of Diagnostic and Statistical Manual of Mental Disorders-4th Edition-Text Revision criteria for abuse and dependence: Class 3 showed more criteria for cocaine use disorders than other classes, while Class 1 and Class 4 showed more criteria for alcohol use disorders.ConclusionCocaine- and alcohol-addicted patients who

  10. A family history of alcoholism relates to alexithymia in substance use disorder patients

    NARCIS (Netherlands)

    de Haan, Hein A.; Joosten, Evelien A.G.; de Haan, Lydia; Schellekens, Arnt F.A.; Buitelaar, Jan K.; van der Palen, Jacobus Adrianus Maria; de Jong, Cor A.J.

    2013-01-01

    Objectives Previous research identified alexithymia as a potential risk factor for substance use disorders (SUD). More insight into the relation between alexithymia and SUD is needed in order to treat SUD effectively. Therefore, we investigated whether a familial vulnerability to alcoholism relates

  11. 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

  12. Treatment Seeking for Alcohol Use Disorders : Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; Ten Have, Margreet; Van Den Brink, Wim; Vollebergh, Wilma; De Graaf, Ron

    2016-01-01

    Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization

  13. Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

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

    2016-01-01

    This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The

  14. 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…

  15. The Effect of Rehearsal Training on Working Memory Span of Children with Fetal Alcohol Spectrum Disorder

    Science.gov (United States)

    Loomes, Carly; Rasmussen, Carmen; Pei, Jacqueline; Manji, Shazeen; Andrew, Gail

    2008-01-01

    A key area of weakness in individuals with fetal alcohol spectrum disorder (FASD) is working memory, thus the goal of this study was to determine whether teaching children (aged 4-11) with FASD verbal rehearsal would increase their memory. Rehearsal training has been effective in other populations with working memory difficulties, so we…

  16. Prevalence of Alcohol and Other Substance Use in Patients with Eating Disorders.

    Science.gov (United States)

    Fouladi, Farnaz; Mitchell, James E; Crosby, Ross D; Engel, Scott G; Crow, Scott; Hill, Laura; Le Grange, Daniel; Powers, Pauline; Steffen, Kristine J

    2015-11-01

    The major aim of this study was to investigate any association between binge eating and purging and alcohol and substance use. The Eating Disorder Questionnaire was completed by 2966 patients. Each patient was assigned to an approximate diagnostic group based on a DSM-5-based algorithm. Patients with bulimia nervosa (BN) used alcohol/other substances with higher frequencies compared to patients with anorexia nervosa-restricting type (AN-R), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS; p anorexia nervosa-binge eating/purging type (AN-BP) were more likely to use alcohol/substances than those with AN-R [odds ratio for alcohol use: 3.58 (p < 0.01); odds ratio for substance use: 30.14 (p < 0.01)]. Higher frequencies of binge eating and purging were associated with higher frequencies of substance use. Patients who manifest both binge eating and purging behaviour are at higher risk of substance use which may have important treatment implications. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  17. Temporal stability of diagnostic criteria for antisocial personality disorder in male alcohol dependent patients

    NARCIS (Netherlands)

    Verheul, R.; van den Brink, W.; Koeter, M. W.

    1998-01-01

    We evaluated the temporal stability of diagnostic criteria for antisocial personality disorder in 432 male alcohol dependent patients. Indicators for temporal stability were criterion continuation (i.e., the proportion of current or recent diagnoses among those with a lifetime diagnosis) and

  18. 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)

    2008-01-01

    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.

  19. 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

  20. Brief Interventions in the Treatment of Alcohol Use Disorders: Definition and Overview.

    Science.gov (United States)

    Osburn, Cynthia J.

    2001-01-01

    Reviews the literature and describes the nature and feasibility of brief interventions in the treatment of alcohol use disorders. Attention is given to the promising results of outcome studies, and recommendations are provided for the implementation of brief interventions with a heterogeneous clientele. (Contains 39 references.) (GCP)

  1. The association between neighborhood disorder, social cohesion and hazardous alcohol use: A national multilevel study

    NARCIS (Netherlands)

    Kuipers, M.A.; van Poppel, M.N.M.; van den Brink, W.; Wingen, M.; Kunst, A.E.

    2012-01-01

    Background: Evidence on associations of alcohol use with neighborhood disorder and social cohesion is limited. The aim of this study was to further investigate these associations. Methods: Individual data of 14,258 Dutch adults, living in 1546 neighborhoods across the Netherlands, were obtained from

  2. 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.

    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

  3. Family Based Prevention of Alcohol and Risky Sex for Older Teens

    Science.gov (United States)

    2018-05-08

    Alcohol Drinking; Alcohol Intoxication; Alcohol Poison; Alcohol-Related Disorders; Alcohol Impairment; Alcohol Withdrawal; Alcohol Abstinence; Alcohol; Harmful Use; Sex Behavior; Sexual Aggression; Sexual Harassment; Relation, Interpersonal

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

    Science.gov (United States)

    Moussas, George; Dadouti, Georgia; Douzenis, Athanassios; Poulis, Evangelos; Tzelembis, Athanassios; Bratis, Dimitris; Christodoulou, Christos; Lykouras, Lefteris

    2009-05-14

    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). This study aims to standardise the questionnaire in a Greek population. AUDIT was translated and back-translated from its original language by two English-speaking psychiatrists. The tool contains 10 questions. A score >or= 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. Internal reliability (Cronbach alpha) 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). 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.

  5. Postnatal nutritional treatment of neurocognitive deficits in fetal alcohol spectrum disorder.

    Science.gov (United States)

    Bastons-Compta, A; Astals, M; Andreu-Fernandez, V; Navarro-Tapia, E; Garcia-Algar, O

    2018-04-01

    Ethanol is the most important teratogen agent in humans. Prenatal alcohol exposure can lead to a wide range of adverse effects, which are broadly termed as fetal alcohol spectrum disorder (FASD). The most severe consequence of maternal alcohol abuse is the development of fetal alcohol syndrome, defined by growth retardation, facial malformations, and central nervous system impairment expressed as microcephaly and neurodevelopment abnormalities. These alterations generate a broad range of cognitive abnormalities such as learning disabilities and hyperactivity and behavioural problems. Socioeconomic status, ethnicity, differences in genetic susceptibility related to ethanol metabolism, alcohol consumption patterns, obstetric problems, and environmental influences like maternal nutrition, stress, and other co-administered drugs are all factors that may influence FASD manifestations. Recently, much attention has been paid to the role of nutrition as a protective factor against alcohol teratogenicity. There are a great number of papers related to nutritional treatment of nutritional deficits due to several factors associated with maternal consumption of alcohol and with eating and social disorders in FASD children. Although research showed the clinical benefits of nutritional interventions, most of work was in animal models, in a preclinical phase, or in the prenatal period. However, a minimum number of studies refer to postnatal nutrition treatment of neurodevelopmental deficits. Nutritional supplementation in children with FASD has a dual objective: to overcome nutritional deficiencies and to reverse or improve the cognitive deleterious effects of prenatal alcohol exposure. Further research is necessary to confirm positive results, to determine optimal amounts of nutrients needed in supplementation, and to investigate the collective effects of simultaneous multiple-nutrient supplementation.

  6. Frontal brain dysfunction in alcoholism with and without antisocial personality disorder

    Directory of Open Access Journals (Sweden)

    Marlene Oscar-Berman

    2009-05-01

    Full Text Available Marlene Oscar-Berman1,2, Mary M Valmas1,2, Kayle s Sawyer1,2, Shalene M Kirkley1, David A Gansler3, Diane Merritt1,2, Ashley Couture11Department of Veterans Affairs Healthcare System, Boston Campus, Boston, MA, USA; 2Boston University School of Medicine, Boston, MA, USA; 3Suffolk University, Boston, MA, USAAbstract: Alcoholism and antisocial personality disorder (ASPD often are comorbid conditions. Alcoholics, as well as nonalcoholic individuals with ASPD, exhibit behaviors associated with prefrontal brain dysfunction such as increased impulsivity and emotional dysregulation. These behaviors can influence drinking motives and patterns of consumption. Because few studies have investigated the combined association between ASPD and alcoholism on neuropsychological functioning, this study examined the influence of ASPD symptoms and alcoholism on tests sensitive to frontal brain deficits. The participants were 345 men and women. Of them, 144 were abstinent alcoholics (66 with ASPD symptoms, and 201 were nonalcoholic control participants (24 with ASPD symptoms. Performances among the groups were examined with Trails A and B tests, the Wisconsin Card Sorting Test, the Controlled Oral Word Association Test, the Ruff Figural Fluency Test, and Performance subtests of the Wechsler Adult Intelligence Scale. Measures of affect also were obtained. Multiple regression analyses showed that alcoholism, specific drinking variables (amount and duration of heavy drinking, and ASPD were significant predictors of frontal system and affective abnormalities. These effects were different for men and women. The findings suggested that the combination of alcoholism and ASPD leads to greater deficits than the sum of each.  Keywords: alcoholism, antisocial personality disorder (ASPD, frontal brain system, neuropsychological deficits, reward system

  7. The Impact of Stressful Life Events on Alcohol Relapse: Findings from the Collaborative Longitudinal Personality Disorders Study.

    Science.gov (United States)

    Reyes, Christina Delos; Pagano, Maria Elizabeth; Ronis, Robert J

    2009-04-01

    Alcohol relapse is impacted by a variety of environmental, interpersonal, and intrapersonal factors. We examined the interaction between stressful life events, personality disorder subtype, and alcohol relapse among individuals enrolled in the Collaborative Longitudinal Personality Disorders Study (CLPS). Negative life events predicted relapse in all subjects. In individuals with a history of an alcohol use disorder prior to study entry, positive life events also predicted alcohol relapse. Individuals with Antisocial Personality Disorder (ASPD) were found to be twice as likely to relapse in response to life stressors compared to individuals with Obsessive-Compulsive Personality Disorder (OCPD), who were half as likely to relapse in response to life stressors. Further analysis revealed that individuals with OCPD and no history of an alcohol use disorder were almost 10 times more likely to relapse in the face of a stressful romantic problem, while those with ASPD and a history of an alcohol use disorder were six times more likely to relapse in response to a stressful financial event. These findings have implications for both the assessment and the treatment of individuals who present with co-morbid personality and alcohol use disorders.

  8. Problem alcohol use and healthcare utilization among persons with cannabis use disorder in the United States.

    Science.gov (United States)

    John, William S; Wu, Li-Tzy

    2017-09-01

    The emergency department (ED) and hospital settings represent crucial opportunities for engaging treatment for cannabis use disorder (CUD). Thus, there is a need to identify factors associated with healthcare utilization among persons with CUD to improve screening and intervention approaches. Problematic alcohol use may be a salient risk factor. Using data from the 2005-2013 National Surveys on Drug Use and Health, we determined factors, including different patterns of alcohol use, associated with past-year ED admission and inpatient hospitalization among persons aged 12 years or older meeting criteria for CUD in the past year (N=16,757). We also determined the prevalence and correlates of problem alcohol use among persons with CUD to further inform its association with healthcare utilization. Among persons with CUD, 40.15% and 10.04% reported past-year ED admission and inpatient hospitalization, respectively. Severe alcohol use disorder (AUD) (≥6 AUD symptoms), female sex, Black race, low income, major depressive episode (MDE), and other substance use disorders were associated with increased odds of healthcare utilization; current (i.e., last month) alcohol use patterns were not. Persons with CUD that were males, ages 18-25 (vs. ages 12-17), Hispanic (vs. White), and with low income, other drug use disorders, or MDE had increased odds of AUD. Findings suggest that screening and intervention efforts for improving treatment initiation or engagement for CUD may target cannabis-using women, blacks, low-income adults or those with severe AUD in the past year, another substance use disorder, or MDE. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Gender differences in the effects of childhood adversity on alcohol, drug, and polysubstance-related disorders.

    Science.gov (United States)

    Evans, Elizabeth A; Grella, Christine E; Upchurch, Dawn M

    2017-07-01

    To examine gender differences in the associations between childhood adversity and different types of substance use disorders and whether gender moderates these relationships. We analyzed data from 19,209 women and 13,898 men as provided by Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender moderates the associations between childhood adversity and DSM-IV defined lifetime occurrence of alcohol, drug, and polysubstance-related disorders. We used multinomial logistic regression, weighted to be representative of the US adult civilian, noninstitutionalized population, and we calculated predicted probabilities by gender, controlling for covariates. To test which specific moderation contrasts were statistically significant, we conducted pair-wise comparisons corrected for multiple comparisons using Bonferroni's method. For each type of substance use disorder, risk was increased by more exposure to childhood adversity, and women had a lower risk than men. However, moderation effects revealed that with more experiences of childhood adversity, the gender gap in predicted probability for a disorder narrowed in relation to alcohol, it converged in relation to drugs such that risk among women surpassed that among men, and it widened in relation to polysubstances. Knowledge regarding substance-specific gender differences associated with childhood adversity exposure can inform evidence-based treatments. It may also be useful for shaping other types of gender-sensitive public health initiatives to ameliorate or prevent different types of substance use disorders.

  10. Social contexts of drinking and subsequent alcohol use disorder among college students

    Science.gov (United States)

    Beck, Kenneth H.; Caldeira, Kimberly M.; Vincent, Kathryn B.; Arria, Amelia M.

    2012-01-01

    Background Previous research has suggested important contextual factors that can differentiate problem and non-problem drinkers. Objectives To evaluate the strength of the prospective association between social contexts of drinking and subsequent alcohol use disorder and drunk driving 2 to 3 years later. Methods The sample consisted of 652 individuals who were originally recruited at college entry, had complete data on at least one social context subscale, met minimum criteria for Year 1 drinking, and had non-missing data on at least one of the outcome variables in Years 3 and/or 4. Social contexts of drinking were assessed in Year 1 using previously-validated scales measuring six different situational and motivational contexts in which alcohol is consumed. DSM-IV criteria for alcohol abuse and dependence and drunk driving were assessed annually. Results Holding constant gender, race/ethnicity, and baseline drinking frequency, the frequency of drinking in a context of social facilitation, sex-seeking, or in a motor vehicle during Year 1 was significantly related to a greater likelihood of alcohol abuse, alcohol dependence, and drunk driving in Years 3 and/or 4. Drinking in a context of emotional pain was related to alcohol dependence and drunk driving but not to alcohol abuse. Conclusions The Social Context of Drinking Scales have utility for identifying students who are at risk for developing alcohol-related problems. Scientific Significance: Identifying college students who might develop alcohol dependence requires an assessment of both situational and motivational factors that influence drinking, especially drinking in a motor vehicle. PMID:22746152

  11. Comorbidity of social anxiety disorder and antisocial personality disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC).

    Science.gov (United States)

    Galbraith, Todd; Heimberg, Richard G; Wang, Shuai; Schneier, Franklin R; Blanco, Carlos

    2014-01-01

    Social anxiety disorder (SAD) and antisocial personality disorder (ASPD) are not often thought of as being comorbid. However, recent research suggests the existence of a SAD subtype with characteristics atypical of SAD but common to ASPD. Thus, we explored two competing hypotheses: (1) SAD and ASPD represent opposite ends of a single dimension, or (2) SAD and ASPD exist on two separate dimensions that may be positively correlated. Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions. SAD-ASPD was related to greater impairment and psychiatric comorbidity than either disorder alone. The SAD-ASPD group was also more likely to seek treatment for their SAD symptoms and to drink before/during antisocial acts than the SAD only group. The presence of SAD for individuals with ASPD (and vice versa) does not appear to provide any "protective benefits." SAD and ASPD appear to be two separate but correlated disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Comorbidity of Social Anxiety Disorder and Antisocial Personality Disorder in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC)

    Science.gov (United States)

    Galbraith, Todd; Heimberg, Richard G.; Wang, Shuai; Schneier, Franklin R.; Blanco, Carlos

    2013-01-01

    Social anxiety disorder (SAD) and antisocial personality disorder (ASPD) are not often thought of as being comorbid. However, recent research suggests the existence of a SAD subtype with characteristics atypical of SAD but common to ASPD. Thus, we explored two competing hypotheses: 1) SAD and ASPD represent opposite ends of a single dimension, or 2) SAD and ASPD exist on two separate dimensions that may be positively correlated. Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions. SAD-ASPD was related to greater impairment and psychiatric comorbidity than either disorder alone. The SAD-ASPD group was also more likely to seek treatment for their SAD symptoms and to drink before/during antisocial acts than the SAD only group. The presence of SAD for individuals with ASPD (and vice versa) does not appear to provide any “protective benefits.” SAD and ASPD appear to be two separate but correlated disorders. PMID:24384071

  13. Comparing Attentional Networks in fetal alcohol spectrum disorder and the inattentive and combined subtypes of attention deficit hyperactivity disorder.

    Science.gov (United States)

    Kooistra, Libbe; Crawford, Susan; Gibbard, Ben; Kaplan, Bonnie J; Fan, Jin

    2011-01-01

    The Attention Network Test (ANT) was used to examine alerting, orienting, and executive control in fetal alcohol spectrum disorder (FASD) versus attention deficit hyperactivity disorder (ADHD). Participants were 113 children aged 7 to 10 years (31 ADHD-Combined, 16 ADHD-Primarily Inattentive, 28 FASD, 38 controls). Incongruent flanker trials triggered slower responses in both the ADHD-Combined and the FASD groups. Abnormal conflict scores in these same two groups provided additional evidence for the presence of executive function deficits. The ADHD-Primarily Inattentive group was indistinguishable from the controls on all three ANT indices, which highlights the possibility that this group constitutes a pathologically distinct entity.

  14. Alcohol use, anxiety, and insomnia in older adults with generalized anxiety disorder

    Science.gov (United States)

    Ivan, M. Cristina; Amspoker, Amber B.; Nadorff, Michael R.; Kunik, Mark E.; Cully, Jeffrey A.; Wilson, Nancy; Calleo, Jessica; Kraus-Schuman, Cynthia; Stanley, Melinda A.

    2013-01-01

    Objectives We examined the presence and frequency of alcohol consumption among older primary care patients with generalized anxiety disorder (GAD) and their relation to demographic variables, insomnia, worry, and anxiety. We expected alcohol-use distribution to be similar to previous reports and alcohol use to be associated with higher anxiety and insomnia. A third aim was to examine the moderating role of alcohol use on the relation between anxiety and insomnia. We expected alcohol use to worsen the relation between anxiety and insomnia. Design Baseline data from a randomized controlled trial Sample 223 patients, age 60 and older, with DSM-IV GAD diagnoses Setting Patients were recruited through internal medicine, family practice, and geriatric clinics at 2 diverse healthcare settings: Michael E. DeBakey Veterans Administration Medical Center and Baylor College of Medicine. Measurements Measures addressed alcohol use (presence and frequency); insomnia (Insomnia Severity Index); self-reported worry severity (Penn State Worry Questionnaire − Abbreviated); clinician-rated worry severity (Generalized Anxiety Disorder Severity Scale); self-reported anxiety severity (State-Trait Anxiety Inventory - Trait); and clinician-rated anxiety (Structured Interview Guidelines for the Hamilton Anxiety Rating Scale). Results Most patients endorsed alcohol use in the past month, but overall weekly frequency was low. Presence and frequency of use among patients with GAD were greater than in prior reports of primary care samples. Alcohol use among patients with GAD was associated with higher education and female gender. Higher education also was associated with more drinks per week, and Caucasians reported more drinks per week than African Americans. Alcohol use was associated with less severe insomnia, lower self-reported anxiety, and less clinician-rated worry and anxiety. More drinks per week were associated with lower clinician-rated anxiety. Moderation analyses revealed lower

  15. 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…

  16. The effects of maternal alcohol use disorders on childhood relationships and mental health.

    Science.gov (United States)

    Wolfe, Joseph D

    2016-10-01

    Despite millions of children living in the turmoil of their parents' active alcoholism or the aftermath of past abuse, research to date has not (1) provided a comprehensive examination of the effects of maternal alcohol use disorders (AUDs) on children's social ties outside of their relationships with parents, or (2) considered whether the number and quality of childhood social ties alter the effects of maternal AUDs on children's mental health. Using data from the National Longitudinal Surveys of Youth 1979 Children and Young Adults, analysis examined the influence of maternal AUDs on the number and quality of children's ties with siblings, extended family and family friends, peers, and neighborhood members. The analysis also considered how children's social ties influenced the association between maternal AUDs and children's internalizing and externalizing problems. Children of alcoholic mothers had similarly sized networks but more distant relationships with siblings and friends, negative interactions with classmates, and isolating neighborhoods. Controlling for these aspects of children's social ties substantially reduced mental health disparities between children of alcoholic mothers and other children. Findings support the view that maternal alcohol use disorders have the potential to damage children's mental health while also setting into motion long-term relationship problems. Future research should examine the networks of children who experience parental AUDs to further clarify the social processes that link parental AUDs to children's mental health.

  17. [Management of alcohol use disorders in ambulatory care: Which follow-up and for how long?].

    Science.gov (United States)

    Benyamina, A; Reynaud, M

    2016-02-01

    Alcohol consumption with its addictive potential may lead to physical and psychological dependence as well as systemic toxicity all of which have serious detrimental health outcomes in terms of morbimortality. Despite the harmful potential of alcohol use disorders, the disease is often not properly managed, especially in ambulatory care. Psychiatric and general practitioners in ambulatory care are first in line to detect and manage patients with excessive alcohol consumption. However, this is still often regarded as an acute medical condition and its management is generally considered only over the short-term. On the contrary, alcohol dependence has been defined as a primary chronic disease of the brain reward, motivation, memory and related circuitry, involving the signalling pathway of neurotransmitters such as dopamine, opioid peptides, and gamma-aminobutyric acid. Thus, it should be regarded in terms of long-term management as are other chronic diseases. To propose a standard pathway for the management of alcohol dependence in ambulatory care in terms of duration of treatment and follow-up. Given the lack of official recommendations from health authorities which may help ambulatory care physicians in long-term management of patients with alcohol dependence, we performed a review and analysis of the most recent literature regarding the long-term management of other chronic diseases (diabetes, bipolar disorders, and depression) drawing a parallel with alcohol dependence. Alcohol dependence shares many characteristics with other chronic diseases, including a prolonged duration, intermittent acute and chronic exacerbations, and need for prolonged and often-lifelong care. In all cases, this requires sustained psychosocial changes from the patient. Patient motivation is also a major issue and should always be taken into consideration by psychiatric and general practitioners in ambulatory care. In chronic diseases, such as diabetes, bipolar disorders, or depression

  18. Classification of alcohol use disorders among nightclub patrons: associations between high-risk groups, sociodemographic factors and illicit drug use.

    Science.gov (United States)

    Santos, Raissa; Baldin, Yago; Carlini, Claudia M; Sanchez, Zila M

    2015-01-01

    Nightclubs are favorable environments for alcohol abuse and the use of other drugs among patrons. To identify patterns of alcohol use in a high-risk population and their relationship with sociodemographic factors and illicit drug use. A portal survey technique was used to recruit patrons in 31 nightclubs in the city of São Paulo, Brazil. A two stage sampling method allowed the selection of nightclubs and patrons within a nightclub. A total of 1057 patrons answered to a three stages-survey (nightclub entrance and exit face-to-face interviews and a day-after online questionnaire). Entrance survey offered information on sociodemographic data and history of drug use. The day-after survey used the Alcohol Use Disorders Identifications Test (AUDIT) that identified patterns of alcohol abuse disorders. Data were modeled using an ordered logit regression analysis, considering sample weights. Almost half of the nightclub patrons presented any alcohol use disorder (AUDIT score ≥8). Being male (OR = 1.68; 95% CI = 1.09-2.60) and single (OR = 1.71; 95% CI = 1.05-2.76) increased the chances for more severe alcohol use disorders. Having a graduate degree (OR = 0.57; 95% CI = 0.38-0.87) and age ≥35 years (OR = 0.48; 95% CI = 0.27-0.85) decreased the chances of patrons' alcohol use disorders. The prevalence rates of past-year marijuana, cocaine and inhalants use increased with the increased level of alcohol use disorders. Patrons of nightclubs show higher prevalence rates for any alcohol use disorders than the general population. Patrons could benefit from governmental brief intervention or referral to treatment for alcohol used disorders disclosed in nightclubs.

  19. Intranasal Oxytocin Selectively Modulates Social Perception, Craving, and Approach Behavior in Subjects With Alcohol Use Disorder.

    Science.gov (United States)

    Mitchell, Jennifer M; Arcuni, Peter A; Weinstein, Dawn; Woolley, Josh D

    2016-01-01

    A pharmacotherapy that both improves social abilities and promotes abstinence may be particularly helpful for the treatment of alcohol use disorder. Recent clinical and preclinical evidence suggests that oxytocin has prosocial and antiaddiction effects. We performed a pilot, laboratory-based, preclinical trial of oxytocin in subjects with alcohol abuse (as per Diagnostic and Statistical Manual of Mental Disorders, 4 Edition criteria) to evaluate therapeutic potential and assess tolerability. Social perceptual ability, cue-induced craving, and approach bias for alcohol and appetitive imagery were quantified after intranasal oxytocin and placebo administration to 32 nontreatment-seeking individuals with alcohol abuse in a double-blind, crossover study. Because attachment style can moderate the effects of oxytocin, we also explored whether attachment style moderated oxytocin's effects on our behavioral measures. Oxytocin significantly improved recognition of easier items on a social perception task, but had no significant group-level effect on cue-induced craving. However, oxytocin effects on craving were moderated by attachment anxiety, with oxytocin reducing craving in more anxiously attached individuals and increasing craving in less anxiously attached individuals. Subjects did not display an approach bias to alcohol images on the placebo day, preventing meaningful analysis of this measure. Subjects did display an approach bias to appetitive images on the placebo day, which was significantly reduced by oxytocin administration. No adverse reactions were observed. Intranasal oxytocin has potential to improve social perception, reduce cue-induced alcohol cravings, and reduce appetitive approach bias in subjects with alcohol abuse, and can be safely tolerated in this population. The effects of oxytocin are complex, however, and require further investigation.

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

    Science.gov (United States)

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

    2016-07-01

    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. We used the data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a cohort of 2230 Dutch adolescents. Working memory, inhibition, and attention were measured at ages 11 and 19. At age 19, lifetime DSM-IV diagnoses were determined, resulting in a control group (n = 1111) and two AUD groups, i.e., alcohol abusers (n = 381) and alcohol dependents (n = 51). Regression analyses assessed whether EF at age 11 predicted the transition to AUD in late adolescence and whether AUD affected maturation of EF from age 11 to 19. EF in early adolescence did not predict AUD in late adolescence. A significant interaction effect emerged between gender and alcohol dependence for shift attention (β = 0.12, SE=0.36), with girls showing smaller maturational rates. This effect remained significant after controlling for alcohol intake (ages 16 and 19) and comorbid psychiatric disorders. Our results do not replicate the finding that EF in early adolescence is a significant predictor of AUD in late adolescence. Furthermore, for the majority of tasks, adolescents with AUD do not differ in EF maturation over the course of adolescence. Alcohol dependent girls however, show less maturation of shift attention. This is independent of the quantity of alcohol intake, which could suggest that non-normative maturation of EF is associated with the behavioural components of AUD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Alcohol use disorder-related sick leave and mortality: a cohort study.

    Science.gov (United States)

    Wedegaertner, Felix; Geyer, Siegfried; Arnhold-Kerri, Sonja; Sittaro, Nicola-Alexander; te Wildt, Bert

    2013-01-30

    Alcohol use disorders (AUDs) are associated with the highest all-cause mortality rates of all mental disorders. The majority of patients with AUDs never receive inpatient treatment for their AUD, and there is lack of data about their mortality risks despite their constituting the majority of those affected. Absenteeism from work (sick leave) due to an AUD likely signals worsening. In this study, we assessed whether AUD-related sick leave was associated with mortality in a cohort of workers in Germany. 128,001 workers with health insurance were followed for a mean of 6.4 years. We examined the associations between 1) AUD-related sick leave managed on an outpatient basis and 2) AUD-related psychiatric inpatient treatment, and mortality using survival analysis, and Cox proportional hazard regression models (separately by sex) adjusted for age, education, and job code classification. We also stratified analyses by sick leave related to three groups of alcohol-related conditions (all determined by International Classification of Diseases 9th ed. (ICD-9) codes): alcohol abuse and dependence; alcohol-induced mental disorder; and alcohol-induced medical conditions. Outpatient-managed AUD-related sick leave was significantly associated with higher mortality (hazard ratio (HR) 2.90 (95% Confidence interval (CI) 2.24-3.75) for men, HR 5.83 (CI 2.90-11.75) for women). The magnitude of the association was similar for receipt of AUD-related psychiatric inpatient treatment (HR 3.2 (CI 2.76-3.78) for men, HR 6.5 (CI 4.41-9.47) for women). Compared to those without the conditions, higher mortality was observed consistently for outpatients and inpatients across the three groups of alcohol-related conditions. Those with alcohol-related medical conditions who had AUD-related psychiatric inpatient treatment appeared to have the highest mortality. Alcohol use disorder-related sick leave as documented in health insurance records is associated with higher mortality. Such sick leave does

  2. Sleep difficulties and alcohol use motives in female rape victims with posttraumatic stress disorder.

    Science.gov (United States)

    Nishith, P; Resick, P A; Mueser, K T

    2001-07-01

    The purpose of this study was to assess the relationship between sleep difficulties and drinking motives in female rape victims with posttraumatic stress disorder (PTSD). Seventy-four participants were assessed for PTSD symptoms, depression, sleep difficulties, and drinking motives. Results demonstrated that neither PTSD symptoms nor depression were related to any motives for using alcohol. On the other hand, after controlling for education, sleep difficulties were significantly related to drinking motives for coping with negative affect, but not pleasure enhancement or socialization. The findings suggest that sleep difficulties may be an important factor contributing to alcohol use in rape victims with PTSD.

  3. Preventing fetal alcohol spectrum disorders: the role of protection motivation theory.

    Science.gov (United States)

    Cismaru, Magdalena; Deshpande, Sameer; Thurmeier, Robin; Lavack, Anne M; Agrey, Noreen

    2010-01-01

    This article examines health communication campaigns aimed at preventing alcohol consumption among women who are pregnant or attempting to become pregnant. Relevant communication materials were gathered and a qualitative review was conducted. A majority of the campaigns followed the tenets of protection motivation theory by focusing on the threat variables of severity and vulnerability, as well as emphasizing response efficacy. Few campaigns focused on costs or self-efficacy. Future fetal alcohol spectrum disorders prevention initiatives should attempt to reduce perceived costs, as well as include self-efficacy messages in order to increase women's confidence that they can carry out the recommended actions.

  4. Visual defects in a mouse model of fetal alcohol spectrum disorder.

    Science.gov (United States)

    Lantz, Crystal L; Pulimood, Nisha S; Rodrigues-Junior, Wandilson S; Chen, Ching-Kang; Manhaes, Alex C; Kalatsky, Valery A; Medina, Alexandre Esteves

    2014-01-01

    Alcohol consumption during pregnancy can lead to a multitude of neurological problems in offspring, varying from subtle behavioral changes to severe mental retardation. These alterations are collectively referred to as Fetal Alcohol Spectrum Disorders (FASD). Early alcohol exposure can strongly affect the visual system and children with FASD can exhibit an amblyopia-like pattern of visual acuity deficits even in the absence of optical and oculomotor disruption. Here, we test whether early alcohol exposure can lead to a disruption in visual acuity, using a model of FASD to mimic alcohol consumption in the last months of human gestation. To accomplish this, mice were exposed to ethanol (5 g/kg i.p.) or saline on postnatal days (P) 5, 7, and 9. Two to three weeks later we recorded visually evoked potentials to assess spatial frequency detection and contrast sensitivity, conducted electroretinography (ERG) to further assess visual function and imaged retinotopy using optical imaging of intrinsic signals. We observed that animals exposed to ethanol displayed spatial frequency acuity curves similar to controls. However, ethanol-treated animals showed a significant deficit in contrast sensitivity. Moreover, ERGs revealed a market decrease in both a- and b-waves amplitudes, and optical imaging suggest that both elevation and azimuth maps in ethanol-treated animals have a 10-20° greater map tilt compared to saline-treated controls. Overall, our findings suggest that binge alcohol drinking restricted to the last months of gestation in humans can lead to marked deficits in visual function.

  5. Maternal drinking behavior and Fetal Alcohol Spectrum Disorders in adolescents with criminal behavior in southern Brazil

    Directory of Open Access Journals (Sweden)

    Wakana Momino

    2012-01-01

    Full Text Available Prenatal alcohol exposure can have serious and permanent adverse effects. The developing brain is the most vulnerable organ to the insults of prenatal alcohol exposure. A behavioral phenotype of prenatal alcohol exposure including conduct disorders is also described. This study on a sample of Brazilian adolescents convicted for criminal behavior aimed to evaluate possible clinical features of Fetal Alcohol Syndrome (FAS. These were compared to a control group of school adolescents, as well as tested for other environmental risk factors for antisocial behavior. A sample of 262 institutionalized male adolescents due to criminal behavior and 154 male students aged between 13 and 21 years comprised the study population. Maternal use of alcohol was admitted by 48.8% of the mothers of institutionalized adolescents and by 39.9% of the school students. In this sample of adolescents we could not identify -individual cases with a clear diagnosis of FAS, but signs suggestive of FASD were more common in the institutionalized adolescents. Social factors like domestic and family violence were frequent in the risk group, this also being associated to maternal drinking during pregnancy. The inference is that in our sample, criminal behavior is more related to complex interactions between environmental and social issues including prenatal alcohol exposure.

  6. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. A preclinical model for identifying rats at risk of alcohol use disorder

    KAUST Repository

    Jadhav, Kshitij S.; Magistretti, Pierre J.; Halfon, Olivier; Augsburger, Marc; Boutrel, Benjamin

    2017-01-01

    Alcohol use is one of the world's leading causes of death and disease, although only a small proportion of individuals develop persistent alcohol use disorder (AUD). The identification of vulnerable individuals prior to their chronic intoxication remains of highest importance. We propose here to adapt current methodologies for identifying rats at risk of losing control over alcohol intake by modeling diagnostic criteria for AUD: Inability to abstain during a signaled period of reward unavailability, increased motivation assessed in a progressive effortful task and persistent alcohol intake despite aversive foot shocks. Factor analysis showed that these three addiction criteria loaded on one underlying construct indicating that they represent a latent construct of addiction trait. Further, not only vulnerable rats displayed higher ethanol consumption, and higher preference for ethanol over sweetened solutions, but they also exhibited pre-existing higher anxiety as compared to resilient rats. In conclusion, the present preclinical model confirms that development of an addiction trait not only requires prolonged exposure to alcohol, but also depends on endophenotype like anxiety that predispose a minority of individuals to lose control over alcohol consumption.

  8. Life Goals Increase Self-regulation Among Male Patients with Alcohol Use Disorder.

    Science.gov (United States)

    Won, Sung-Doo; Kim, Im-Yel

    2018-01-24

    Alcohol use disorder (AUD) has been conceptualized as a chronic self-regulation failure. The aim of this study was to examine the most probable pathways related to self-regulation among patients with AUD. In this study, a hypothetical model was proposed that focused on the relationship between risk factors (extrinsic life goals, emotion dysregulation) and protective factors (intrinsic life goals, self-control, and abstinence self-efficacy). Male patients with AUD (N = 188) were recruited from alcohol centers of four psychiatric hospitals between March 2015 and September 2015. All participants completed psychological assessments, including the Future Oriented Goals Scale (FOGS), the Alcohol Abstinence Self-Efficacy Scale (AASE), the Brief Self-Control Scale (BSCS), and the Difficulties in Emotion Regulation Scale (DERS) as well as sociodemographic characteristics. The final model was found to be a good fit to data. In testing indirect effects, it was shown that intrinsic life goals via emotion dysregulation, self-control, and alcohol abstinence self-efficacy decreased alcohol self-regulation failure. On the other hand, extrinsic life goals via these factors increased alcohol self-regulation failure. Conclusions/Importance: These results suggest that intrinsic goals might indirectly be the important and protective factors for AUD. Moreover, the findings implicate that self-regulation through goal setting may be necessary to alleviate symptoms and improve function among patients with AUD.

  9. A preclinical model for identifying rats at risk of alcohol use disorder

    KAUST Repository

    Jadhav, Kshitij S.

    2017-08-21

    Alcohol use is one of the world\\'s leading causes of death and disease, although only a small proportion of individuals develop persistent alcohol use disorder (AUD). The identification of vulnerable individuals prior to their chronic intoxication remains of highest importance. We propose here to adapt current methodologies for identifying rats at risk of losing control over alcohol intake by modeling diagnostic criteria for AUD: Inability to abstain during a signaled period of reward unavailability, increased motivation assessed in a progressive effortful task and persistent alcohol intake despite aversive foot shocks. Factor analysis showed that these three addiction criteria loaded on one underlying construct indicating that they represent a latent construct of addiction trait. Further, not only vulnerable rats displayed higher ethanol consumption, and higher preference for ethanol over sweetened solutions, but they also exhibited pre-existing higher anxiety as compared to resilient rats. In conclusion, the present preclinical model confirms that development of an addiction trait not only requires prolonged exposure to alcohol, but also depends on endophenotype like anxiety that predispose a minority of individuals to lose control over alcohol consumption.

  10. The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2

    NARCIS (Netherlands)

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

    2012-01-01

    Much is unclear about the association between attention-deficit/hyperactivity disorder (ADHD) and alcohol use (disorder). Research on this subject is hindered by the role of conduct disorder (CD). We investigate whether (1) childhood ADHD is associated with higher prevalence and earlier onset of

  11. A gender-focused perspective on health service utilization in comorbid bipolar I disorder and alcohol use disorders: results from the national epidemiologic survey on alcohol and related conditions.

    Science.gov (United States)

    Goldstein, Benjamin I; Levitt, Anthony J

    2006-06-01

    This study compares health service utilization by individuals with comorbid lifetime bipolar I disorder and lifetime alcohol use disorders (AUD) to that of individuals with either diagnosis alone, using nationally representative data. The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to identify respondents with bipolar I disorder only (BD-only; N = 636), AUD only (N = 11,068), and comorbid bipolar I disorder and AUD (BD-AUD; N = 775). Diagnoses were generated using the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. The 3 groups were compared with respect to self-reported health service utilization. For both men and women, respondents in the BD-AUD group were significantly more likely than AUD-only respondents to report any alcohol-related service utilization (p disorder-related hospital admissions as compared with BD-only respondents among males only (p = .009). Within the BD-AUD group, males reported significantly greater utilization of AUD treatment only (p disorder treatment only (p disorder services. As expected, individuals with comorbid bipolar I disorder and AUD utilize significantly more mental health services than individuals with either disorder alone. The primary original finding is that among those with comorbid bipolar I disorder and AUD, bipolar I disorder is more likely to go untreated among males and AUD is more likely to go untreated among females. Gender may be an important factor to consider in future health service planning for comorbid bipolar I disorder and AUD.

  12. Alcohol use and substance use disorders in Gulf War, Afghanistan, and Iraq War veterans compared with nondeployed military personnel.

    Science.gov (United States)

    Kelsall, Helen Louise; Wijesinghe, Millawage Supun Dilara; Creamer, Mark Christopher; McKenzie, Dean Philip; Forbes, Andrew Benjamin; Page, Matthew James; Sim, Malcolm Ross

    2015-01-01

    Although recent veterans have been found to be at increased risk of psychiatric disorders, limited research has focused on alcohol or substance use disorders. This systematic review and meta-analysis examined whether alcohol or substance use disorders were more common in Gulf War, Afghanistan, and Iraq War veterans compared with military comparison groups nondeployed to the corresponding conflict, including never deployed personnel. Literature was searched (1990-2014) in multiple electronic databases. Studies were assessed for eligibility and quality, including risk of bias. Eighteen studies (1997-2014) met inclusion criteria. Pooled analysis based on a random-effects model yielded a summary odds ratio of 1.33 (95% confidence interval (CI): 1.22, 1.46) for alcohol (7 studies) and 2.13 (95% CI: 0.96, 4.72) for substance use (3 studies) disorders among Gulf War veterans, as well as 1.36 (95% CI: 1.11, 1.66) for alcohol (7 studies) and 1.14 (95% CI: 1.04, 1.25) for substance use (4 studies) disorders among Iraq/Afghanistan veterans; meta-regressions found no statistically significant association between theater of war and alcohol use or substance use disorders. Our findings indicate that Gulf and Iraq/Afghanistan war veterans are at higher alcohol use disorder risk than nondeployed veterans, but further studies with increased power are needed to assess substance use disorder risk in Gulf War veteran populations. © Commonwealth of Australia 2015.

  13. Significant relationship between lifetime alcohol use disorders and suicide attempts in an Australian schizophrenia sample.

    Science.gov (United States)

    McLean, Duncan; Gladman, Beverley; Mowry, Bryan

    2012-02-01

    Suicide and attempted suicide are common in individuals with schizophrenia, and evidence exists for a link between substance use disorders and suicidality in this disorder. However, alcohol has not been consistently implicated. We examined the relationship between substance use disorders and suicide attempts in schizophrenia. We recruited a schizophrenia sample in Australia (n = 821) for genetic analyses. We analysed demographic and clinical variables, including substance use disorders, and their relationship to suicide attempts using generalised equation modelling. A significant association was identified between lifetime alcohol abuse/dependence and suicide attempts (OR = 1.66; 95% CI, 1.23 to 2.24; p = 0.001) after adjustment for potential confounders, but not between cannabis abuse/dependence and suicide attempts, nor between other illicit drug abuse/dependence and suicide attempts. Polysubstance abuse/dependence was also not implicated. These results suggest that the presence of alcohol abuse/dependence may be a risk factor for suicide attempts in individuals with schizophrenia, independent of comorbid substance abuse/dependence.

  14. Prescription procedures in medication for relapse prevention after inpatient treatment for alcohol use disorders in Switzerland.

    Science.gov (United States)

    Buri, Caroline; Moggi, Franz; Giovanoli, Anna; Strik, Werner

    2007-01-01

    In randomized controlled trials with high internal validity, pharmacotherapy using acamprosate, naltrexone, and, to a somewhat lesser extent, disulfiram has proved effective in preventing relapse in patients with alcohol use disorders (AUD). There remains, however, a paucity of studies with sufficient external validity in which the effectiveness of pharmacotherapy in clinical practice is investigated. This study aimed to make a contribution to close this gap in research. In this naturalistic, prospective study, a comparison on indices of substance use, psychiatric symptoms, and treatment service utilization was carried out using samples of 92 patients who received pharmacotherapy and 323 patients who did not receive pharmacotherapy following discharge from 12 residential AUD programmes (index stay). Patients that received pharmacotherapy were more likely to use alcohol during the index stay and at the 1-year follow-up. Moreover, this patient group more readily utilized treatment services during a 2-year period prior to and a 1-year period following index stay than patients who were not given pharmacotherapy. Nevertheless, when pharmacotherapy was prescribed before first post-treatment alcohol use, it was associated with delay of alcohol use, fewer relapses, and a reduced need for inpatient treatment. In many cases, however, medication was not prescribed until alcohol use and relapse had occurred. The length of time to first alcohol use was longer, and the cumulative abstinence rate higher, for disulfiram than for acamprosate, the latter being generally prescribed for more severely alcohol-dependent patients. There is a need for further studies to probe the reasons why medication for relapse prevention is not prescribed upon discharge from residential treatment and for less severely alcohol-dependent patients.

  15. Craving as a DSM-5 Symptom of Alcohol Use Disorder in Non-Treatment Seekers.

    Science.gov (United States)

    Hartwell, Emily E; Ray, Lara A

    2018-05-01

    DSM-5 has added craving as a new criterion and changed the diagnostic structure of alcohol use disorder (AUD). Though craving has long been a target of intervention, less is known about the impact this addition will have on prevalence and factor structure of AUD, particularly in non-treatment seeker with alcohol problems. Non-treatment seeking individuals reporting alcohol-related problems (N = 296) completed a structured clinical interview and the Penn Alcohol Craving Scale (PACS). PACS scores greater than 20 were considered to meet diagnostic criteria for the alcohol craving symptom. This study examined DSM-IV to DSM-5 diagnostic conversion and conducted an exploratory factor analysis to test the factor structure of the DSM-5 symptoms, including craving. The mean PACS score was 13.1 and alcohol craving was strongly correlated with other measures of alcohol use. Using the proposed cut-off score of PACS > 20, 46 participants (16.2%) met criteria for alcohol craving. Craving loaded moderately (0.47) onto the retained DSM symptoms and produced a unidimensional factor structure. The majority of participants who met for a DSM-IV AUD also met for a DSM-5 AUD (98.8%). Craving prevalence using the PACS was relatively low compared to the remaining 10 DSM-5 symptoms, possibly due to the non-treatment seeking nature of the sample. Conversion of DSM-IV to DSM-5 in this sample led to a small increase in overall AUD prevalence. Craving loaded well onto a single factor structure for AUD.

  16. Correlates of major depressive disorder with and without comorbid alcohol use disorder nationally in the veterans health administration.

    Science.gov (United States)

    Yoon, Gihyun; Petrakis, Ismene L; Rosenheck, Robert A

    2015-08-01

    This study assesses medical and psychiatric comorbidities, service utilization, and psychotropic medication prescriptions in veterans with comorbid major depressive disorder (MDD) and alcohol use disorder (AUD) relative to veterans with MDD alone. Using cross-sectional administrative data (fiscal year [FY]2012: October 1, 2011-September 30, 2012) from the Veterans Health Administration (VHA), we identified veterans with a diagnosis of current (12-month) MDD nationally (N = 309,374), 18.8% of whom were also diagnosed with current (12-month) AUD. Veterans with both MDD and AUD were compared to those with MDD alone on sociodemographic characteristics, current (12-month) medical and psychiatric disorders, service utilization, and psychotropic prescriptions. We then used logistic regression analyses to calculate odds ratio and 95% confidence interval of characteristics that were independently different between the groups. Dually diagnosed veterans with MDD and AUD, relative to veterans with MDD alone, had a greater number of comorbid health conditions, such as liver disease, drug use disorders, and bipolar disorder as well as greater likelihood of homelessness and higher service utilization. Dually diagnosed veterans with MDD and AUD had more frequent medical and psychiatric comorbidities and more frequently had been homeless. These data suggest the importance of assessing the presence of comorbid medical/psychiatric disorders and potential homelessness in order to provide appropriately comprehensive treatment to dually diagnosed veterans with MDD and AUD and indicate a need to develop more effective treatments for combined disorders. © American Academy of Addiction Psychiatry.

  17. [Alcohol].

    Science.gov (United States)

    Zima, T

    1996-07-14

    Alcohol is one of the most widely used addictive substances. It can be assumed that everybody encounters alcohol--ethanol in various forms and concentrations in the course of their lives. A global and social problem of our civilization is alcohol consumption which has a rising trend. Since 1989 the consumption of alcoholic beverages is rising and the mean annual consumption of concentrated ethanol per head is cea 10 litres. In ethanol abuse the organism is damaged not only by ethanol alone but in particular by substances formed during its metabolism. Its detailed knowledge is essential for the knowledge and investigations of the metabolic and toxic effect of ethanol on the organism. Ingested alcohol is in 90-98% eliminated from the organism by three known metabolic pathways: 1-alcohol dehydrogenase, 2-the microsomal ethanol oxidizing system and 3-catalase. Alcohol is a frequent important risk factor of serious "diseases of civilization" such as IHD, hypertension, osteoporosis, neoplastic diseases. Cirrhosis of the liver and chronic pancreatitis are the well known diseases associated with alcohol ingestion and also their most frequent cause. It is impossible to list all organs and diseases which develop as a result of alcohol consumption. It is important to realize that regular and "relatively" small amounts in the long run damage the organism and may be even fatal.

  18. Psychiatric comorbidity in alcohol use disorders: results from the German S3 guidelines.

    Science.gov (United States)

    Preuss, U W; Gouzoulis-Mayfrank, E; Havemann-Reinecke, U; Schäfer, I; Beutel, M; Hoch, E; Mann, K F

    2018-04-01

    Alcohol use disorders (AUD) have a high comorbidity with mental disorders. Vice versa, alcohol consumption plays an important role in affective disorders, anxiety disorders, ADHD, schizophrenic psychosis, and other mental disorders. In developing the current interdisciplinary, evidence-based treatment guideline on screening, diagnostics, and treatment of AUD, available research on comorbid mental diseases in AUD has been compiled to generate recommendations for treatment. The guideline was prepared under the responsibility of the German Association for Psychiatry, Psychotherapy, and Psychosomatics (DGPPN) and the German Association for Addiction Research and Therapy (DG-Sucht). To meet the methodological criteria for the highest quality guidelines ("S3-criteria") as defined by the Association of Scientific Medical Societies in Germany (AWMF), the following criteria were employed: (1) a systematic search, selection, and appraisal of the international literature; (2) a structured process to reach consensus; and (3) inclusion of all relevant representatives of future guideline users. After assessing and grading the available literature, the expert groups generated several recommendations for the screening, diagnosis, and treatment of comorbid mental disorders. These recommendations were subdivided into psycho-, pharmaco-, and combination therapies. These are the first guidelines ever to make specific treatment recommendations for comorbid mental diseases in AUD. The recommendations extend to different treatment approaches including diagnostics and settings to present available effective and state-of-the-art treatment approaches to clinicians. Hitherto, many clinical constellations have not been addressed in research. Therefore, recommendations for future research are specified.

  19. Rates of undiagnosed attention deficit hyperactivity disorder in London drug and alcohol detoxification units

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    Huntley Zoe

    2012-12-01

    Full Text Available Abstract Background ADHD is a common childhood onset mental health disorder that persists into adulthood in two-thirds of cases. One of the most prevalent and impairing comorbidities of ADHD in adults are substance use disorders. We estimate rates of ADHD in patients with substance abuse disorders and delineate impairment in the co-morbid group. Method Screening for ADHD followed by a research diagnostic interview in people attending in-patient drug and alcohol detoxification units. Results We estimated prevalence of undiagnosed ADHD within substance use disorder in-patients in South London around 12%. Those individuals with substance use disorders and ADHD had significantly higher self-rated impairments across several domains of daily life; and higher rates of substance abuse and alcohol consumption, suicide attempts, and depression recorded in their case records. Conclusions This study demonstrates the high rates of untreated ADHD within substance use disorder populations and the association of ADHD in such patients with greater levels of impairment. These are likely to be a source of additional impairment to patients and represent an increased burden on clinical services.

  20. 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.

  1. Adrenal disorders and non-alcoholic fatty liver disease.

    Science.gov (United States)

    Papanastasiou, Labrini; Fountoulakis, Stelios; Vatalas, Ioannis-Anastasios

    2017-06-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the developed world and its pathogenesis is complex and multifactorial. It is considered the hepatic manifestation of the metabolic syndrome and is the leading cause of hepatic cirrhosis. This review aims to present current knowledge on the involvement of the adrenal glands in the development of NAFLD. Clinical and animal studies have shown that excess glucocorticoids (GC) have been implicated in the pathogenesis of NAFLD. Patients with NAFLD seem to have a subtle chronic activation of the hypothalamic pituitary adrenal axis leading to a state of subclinical hypercortisolism. Regulators of GC such as 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), an enzyme that regenerates cortisol from inactive cortisone, and 5α/5β-reductases, enzymes that increase cortisol clearance, are implicated in the development of NAFLD by amplifying local GC action. Adrenal androgen (dehydroepiandrosterone) abnormalities and increased aldosterone levels may also have a role in the development of NAFLD whereas the contribution of adrenergic signaling in NAFLD pathogenesis remains unclear.

  2. 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

    2017-07-14

    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. multicentre cohort study in adults (>18 years) seeking their first treatment of the disorder. Patients sign an informed consent and data is collected in an online platform specifically designed for the study; patients are also requested to provide biological samples that are stored in a biobank. Baseline and prospective, socio-demographic, epidemiological, clinical and treatment data are collected. Currently there are 10 participating centres that expect to recruit more than 1,000 patients. As of December 2015, 344 patients (77% men) were included. Median age at admission was 50 years (IQR: 43-55 years). Median age at the start of alcohol consumption was 15 years (IQR: 14-18 years) and 61% of cases reported antecedents of alcohol use disorder in the family. During the 30 days prior to admission, alcohol consumption amounted to 12.5 SDU/day (IQR: 7.1-20 SDU/day), 72% of the patients were tobacco smokers and 30% currently used cocaine. Organising an open cohort of patients with alcohol use disorder may be crucial to better understand the clinical consequences of alcoholism in Spain. This cohort may potentiate quantitative and qualitative research within the Spanish Network on Addictive Disorders-RTA/RETICS. Having a well-established, representative cohort of patients will increase translational research on consequences of alcoholism in our country.

  3. Timing of alcohol use and the incidence of premenstrual syndrome and probable premenstrual dysphoric disorder.

    Science.gov (United States)

    Bertone-Johnson, Elizabeth R; Hankinson, Susan E; Johnson, Susan R; Manson, JoAnn E

    2009-12-01

    Relatively little is known about factors that influence the initial development of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), although these conditions are common in reproductive age women and are associated with substantial impairment. Previous studies have observed higher alcohol use in prevalent PMS/PMDD patients compared with controls, but it is unknown if drinking predisposes women to developing these disorders or is instead influenced by symptom experience. To address this, we conducted a case-control study nested within the prospective Nurses' Health Study II (NHS2). Participants were a subset of women aged 27-44 and free from PMS at baseline (1991), including 1057 women who developed PMS over 10 years of follow-up, 762 of whom also met criteria consistent with PMDD, and 1968 control women. Alcohol use at various time periods, before and after onset of menstrual symptoms, was assessed by questionnaire. Overall, alcohol use was not strongly associated with the incidence of PMS and probable PMDD. Relative risks (RR) for women with the highest cumulative alcohol use vs. never drinkers were 1.19 (95% confidence interval [CI] 0.84-1.67) for PMS and 1.28 (95% CI 0.86-1.91) for PMDD, although results did suggest a positive relationship in leaner women (p trend=0.002). Women who first used alcohol before age 18 had an RR of PMS of 1.26 (95% CI 0.91-1.75) compared with never drinkers; the comparable RR for PMDD was 1.35 (95% CI 0.93-1.98). These findings suggest alcohol use is not strongly associated with the development of PMS and PMDD, although early age at first use and long-term use may minimally increase risk.

  4. Prevalence of alcohol use in pregnant women with substance use disorder.

    Science.gov (United States)

    Bakhireva, Ludmila N; Shrestha, Shikhar; Garrison, Laura; Leeman, Lawrence; Rayburn, William F; Stephen, Julia M

    2018-06-01

    Prenatal care programs for women with opioid use disorder (OUD) often focus treatment/counseling plans around illicit substances, while concurrent use of alcohol might present an equal or greater risk to the fetus. This study evaluated self-reported prevalence of alcohol use in patients participating in a comprehensive prenatal care program for women with substance use disorder (SUD; n = 295), of which 95% are treated for OUD, and pregnant women being served through general obstetrical clinics at the University of New Mexico (n = 365). During the screening phase of a prospective study, patients were asked to report alcohol use in the periconceptional period, and between the last menstrual period and pregnancy recognition. The screening interview was conducted at 22.3 (median = 22; Q1 = 16; Q3 = 29) gestational weeks. Among patients screened at the SUD clinic, 28.8% and 24.1% reported at least one binge drinking episode in the periconceptional period and in early pregnancy, respectively. The prevalence of binge drinking was similar in the general obstetrics population (24.7% and 24.4%, respectively). Among those who reported drinking in early pregnancy, median number of binge drinking episodes was higher among patients screened at the SUD clinic (median = 3; Q1 = 1; Q3 = 10) compared to the general obstetrics group (median = 1; Q1 = 1; Q3 = 3; p < 0.001). This study demonstrates a high prevalence of prenatal alcohol use in early pregnancy in both groups, while patients with SUD/OUD consume more alcohol. These findings underscore the need for targeted screening and intervention for alcohol use in all pregnant women, especially those with SUD/OUD. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. 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)

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

    2011-01-01

    Introduction: 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. Methods: Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were

  6. 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)

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

    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

  7. 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.

  8. A behavioral rehabilitation intervention for amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Greenaway, Melanie C.; Hanna, Sherrie M.; Lepore, Susan W.; Smith, Glenn E.

    2010-01-01

    Individuals with amnestic Mild Cognitive Impairment (MCI) currently have few treatment options for combating their memory loss. The Memory Support System (MSS) is a calendar and organization system with accompanying 6-week curriculum designed for individuals with progressive memory impairment. Ability to learn the MSS and its utility were assessed in 20 participants. Participants were significantly more likely to successfully use the calendar system after training. Ninety-five percent were compliant with the MSS at training completion, and 89% continued to be compliant at follow-up. Outcome measures revealed a medium effect size for improvement in functional ability. Subjects further reported improved independence, self-confidence, and mood. This initial examination of the MSS suggests that with appropriate training, individuals with amnestic MCI can and will use a memory notebook system to help compensate for memory loss. These results are encouraging that the MSS may help with the symptoms of memory decline in MCI. PMID:18955724

  9. Alcohol Use-Related Problems Among a Rural Indian Population of West Bengal: An Application of the Alcohol Use Disorders Identification Test (AUDIT).

    Science.gov (United States)

    Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit

    2016-03-01

    To examine alcohol use and related problems among a rural subset of the Indian population. The Alcohol Use Disorders Identification Test (AUDIT) was used as part of Health and Demographic Surveillance of 36,611 individuals aged ≥18 years. From this survey data on 3671 current alcohol users were analysed using bivariate and multivariate ordered logit regression. Over 19% of males and 2.4% of females were current alcohol users. Mean ethanol consumption on a typical drinking day among males was estimated to be higher (96.3 gm) than females (56.5 gm). Mean AUDIT score was 11 among current alcohol users. AUDIT showed in the ordered logit regression estimated alcohol use-related problems to be low among women, Scheduled Tribes and unmarried people, whereas alcohol use-related problems registered high among Muslims. This rural population appears to be in need of an effective intervention program, perhaps targeting men and the household, aimed at reducing the level of alcohol use and related problems. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  10. Deficits in response inhibition correlate with oculomotor control in children with fetal alcohol spectrum disorder and prenatal alcohol exposure.

    Science.gov (United States)

    Paolozza, Angelina; Rasmussen, Carmen; Pei, Jacqueline; Hanlon-Dearman, Ana; Nikkel, Sarah M; Andrew, Gail; McFarlane, Audrey; Samdup, Dawa; Reynolds, James N

    2014-02-01

    Children with fetal alcohol spectrum disorder (FASD) or prenatal alcohol exposure (PAE) frequently exhibit impairment on tasks measuring inhibition. The objective of this study was to determine if a performance-based relationship exists between psychometric tests and eye movement tasks in children with FASD. Participants for this dataset were aged 5-17 years and included those diagnosed with an FASD (n=72), those with PAE but no clinical FASD diagnosis (n=21), and typically developing controls (n=139). Participants completed a neurobehavioral test battery, which included the NEPSY-II subtests of auditory attention, response set, and inhibition. Each participant completed a series of saccadic eye movement tasks, which included the antisaccade and memory-guided tasks. Both the FASD and the PAE groups performed worse than controls on the subtest measures of attention and inhibition. Compared with controls, the FASD group made more errors on the antisaccade and memory-guided tasks. Among the combined FASD/PAE group, inhibition and switching errors were negatively correlated with direction errors on the antisaccade task but not on the memory-guided task. There were no significant correlations in the control group. These data suggests that response inhibition deficits in children with FASD/PAE are associated with difficulty controlling saccadic eye movements which may point to overlapping brain regions damaged by prenatal alcohol exposure. The results of this study demonstrate that eye movement control tasks directly relate to outcome measures obtained with psychometric tests that are used during FASD diagnosis, and may therefore help with early identification of children who would benefit from a multidisciplinary diagnostic assessment. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Novel QTL at chromosome 6p22 for alcohol consumption: Implications for the genetic liability of alcohol use disorders

    Science.gov (United States)

    Kos, Mark Z.; Glahn, David C.; Carless, Melanie A.; Olvera, Rene; McKay, D. Reese; Quillen, Ellen E.; Gelernter, Joel; Chen, Xiang-Ding; Deng, Hong-Wen; Kent, Jack W.; Dyer, Thomas D.; Göring, Harald H.H.; Curran, Joanne E.; Duggirala, Ravi; Blangero, John; Almasy, Laura

    2014-01-01

    Linkage studies of alcoholism have implicated several chromosome regions, leading to the successful identification of susceptibility genes, including ADH4 and GABRA2 on chromosome 4. Quantitative endophenotypes that are potentially closer to gene action than clinical endpoints offer a means of obtaining more refined linkage signals of genes that predispose alcohol use disorders (AUD). In this study we examine a self-reported measure of the maximum number of drinks consumed in a 24-hour period (abbreviated Max Drinks), a significantly heritable phenotype (h2 = 0.32 ± 0.05; P = 4.61 × 10−14) with a strong genetic correlation with AUD (ρg = 0.99 ± 0.13) for the San Antonio Family Study (n = 1,203). Genome-wide SNPs were analyzed using variance components linkage methods in the program SOLAR, revealing a novel, genome-wide significant QTL (LOD = 4.17; P = 5.85 × 10−6) for Max Drinks at chromosome 6p22.3, a region with a number of compelling candidate genes implicated in neuronal function and psychiatric illness. Joint analysis of Max Drinks and AUD status shows that the QTL has a significant non-zero effect on diagnosis (P = 4.04 × 10−3), accounting for 8.6% of the total variation. Significant SNP associations for Max Drinks were also identified at the linkage region, including one, rs7761213 (P = 2.14 × 10−4), obtained for an independent sample of Chinese families. Thus, our study identifies a potential risk locus for AUD at 6p22.3, with significant pleiotropic effects on the heaviness of alcohol consumption that may not be population specific. PMID:24692236

  12. 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.

  13. Gaps in clinical prevention and treatment for alcohol use disorders: costs, consequences, and strategies.

    Science.gov (United States)

    Willenbring, Mark L

    2013-01-01

    Heavy drinking causes significant morbidity, premature mortality, and other social and economic burdens on society, prompting numerous prevention and treatment efforts to avoid or ameliorate the prevalence of heavy drinking and its consequences. However, the impact on public health of current selective (i.e., clinical) prevention and treatment strategies is unclear. Screening and brief counseling for at-risk drinkers in ambulatory primary care has the strongest evidence for efficacy, and some evidence indicates this approach is cost-effective and reduces excess morbidity and dysfunction. Widespread implementation of screening and brief counseling of nondependent heavy drinkers outside of the medical context has the potential to have a large public health impact. For people with functional dependence, no appropriate treatment and prevention approaches currently exist, although such strategies might be able to prevent or reduce the morbidity and other harmful consequences associated with the condition before its eventual natural resolution. For people with alcohol use disorders, particularly severe and recurrent dependence, treatment studies have shown improvement in the short term. However, there is no compelling evidence that treatment of alcohol use disorders has resulted in reductions in overall disease burden. More research is needed on ways to address functional alcohol dependence as well as severe and recurrent alcohol dependence.

  14. Natural Course of Co-Occurring PTSD and Alcohol Use Disorder Among Recent Combat Veterans.

    Science.gov (United States)

    Possemato, Kyle; Maisto, Stephen A; Wade, Michael; Barrie, Kimberly; Johnson, Emily M; Ouimette, Paige C

    2017-06-01

    Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur in veterans, yet little is known about the longitudinal course of PTSD and drinking in comorbid populations. This study assessed the natural course of daily alcohol consumption and weekly changes in PTSD symptoms in 112 recent combat veterans over the course of 11 months. Latent class growth mixture modeling was used to classify individuals into distinct classes with similar PTSD symptom and alcohol use growth trajectories. We then investigated theorized predictors of class membership including sociodemographics; pre-, peri-, and postdeployment factors; coping; symptom severity; and number of mental health/substance use appointments attended. Results revealed that most participants had severe and nonremitting PTSD. Trajectories for alcohol use included gradual and drastic declines, and chronic low-level drinking. The use of behavioral health services (odds ratio = 2.47) and fewer current stressors (odds ratio = 0.42) predicted AUD remission. Because little variation was observed in the PTSD course, our study did not observe coordinated fluctuations of PTSD symptoms and heavy drinking. Our findings suggest that treatment impacts the course of AUD and that recent combat veterans who do not seek PTSD treatment may have chronic and severe PTSD symptoms. Copyright © 2017 International Society for Traumatic Stress Studies.

  15. Performance of the AUDIT in Detecting DSM-5 Alcohol Use Disorders in College Students.

    Science.gov (United States)

    Hagman, Brett T

    2016-09-18

    It is critical that our alcohol screening instruments maintain their accuracy at detecting DSM-5 Alcohol Use Disorder (AUD) symptomatology. The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used alcohol screening instruments, despite no studies evaluating its performance for detecting DSM-5 AUDs. The present study evaluated the performance of the AUDIT in the screening of DSM-5 AUDs in non-treatment seeking college students. Participants (N = 251) were undergraduate students who had at least one binge drinking occasion in the past 90-days. The AUROC value for DSM-5 AUD status in the overall sample was.779 (SE =.029; 95% CIs =.721 to.837). The AUROC values for the reference groups of any DSM-IV AUD and any binge drinker were.798 (SE =.028; 95% CIs =.742 to.853) and.827 (SE =.03; 95% CIs.768 -.886), respectively. A similar pattern of findings emerged between males and females. Gender differences emerged in the identification of AUDIT cut-off scores. A score of ≥ 8 and ≥ 9 had the best balance of sensitivity and specificity for females and males in college, respectively. Findings indicate that the AUDIT has a reasonable degree of diagnostic proficiency in screening for DSM-5 AUDs in college students.

  16. The Gesture Imitation in Alzheimer's Disease Dementia and Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Li, Xudong; Jia, Shuhong; Zhou, Zhi; Hou, Chunlei; Zheng, Wenjing; Rong, Pei; Jiao, Jinsong

    2016-07-14

    Alzheimer's disease dementia (ADD) has become an important health problem in the world. Visuospatial deficits are considered to be an early symptom besides memory disorder. The gesture imitation test was devised to detect ADD and amnestic mild cognitive impairment (aMCI). A total of 117 patients with ADD, 118 with aMCI, and 95 normal controls were included in this study. All participants were administered our gesture imitation test, the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Clinical Dementia Rating Scale (CDR). Patients with ADD performed worse than normal controls on global scores and had a lower success rate on every item (p imitation test scores were positively correlated with the MMSE (r = 0.637, p imitation test is an easy, rapid tool for detecting ADD, and is suitable for the patients suspected of mild ADD and aMCI in outpatient clinics.

  17. Treatment, alcoholics anonymous, and 16-year changes in impulsivity and legal problems among men and women with alcohol use disorders.

    Science.gov (United States)

    Blonigen, Daniel M; Timko, Christine; Moos, Bernice S; Moos, Rudolf H

    2009-09-01

    The link between impulsive personality traits and alcohol use disorders (AUDs) is well established. No studies, however, have investigated whether receipt of help for AUDs predicts change in impulsivity or whether such change is associated with relevant outcomes such as legal problems. The present study examined predictive associations between the duration of help for AUDs (Alcoholics Anonymous [AA], professional treatment) and impulsivity and legal problems over 16 years in men and women with AUDs. Participants who were initially untreated for their AUDs (n(men) = 332, n(women) = 296) completed follow-up telephone interviews at 1 and 16 years after their baseline assessment. Impulsivity and legal problems declined between baseline and the 1-year and 16-year follow-ups among both women and men. A longer duration of participation in AA predicted a decline in impulsivity at both follow-up assessments, and, in turn, a decline in impulsivity predicted a decline in legal problems at Years 1 and 16. In addition, a longer duration of participation in AA predicted fewer legal problems at Year 1, and this association was moderated by gender (significant in men) and impulsivity (significant for individuals with higher baseline scores). The results highlight the potential for AA and professional treatment to reduce the expression of impulsivity and related disinhibitory traits and legal problems in individuals with AUDs.

  18. 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

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

    OpenAIRE

    Prakash, Om; Sharma, Neelu; Singh, Amool R.; Sengar, K. S.; Chaudhury, Suprakash; Ranjan, Jay Kumar

    2015-01-01

    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 parameter...

  20. Sleep Difficulties and Alcohol Use Motives in Female Rape Victims With Posttraumatic Stress Disorder

    OpenAIRE

    Nishith, Pallavi; Resick, Patricia A.; Mueser, Kim T.

    2001-01-01

    The purpose of this study was to assess the relationship between sleep difficulties and drinking motives in female rape victims with posttraumatic stress disorder (PTSD). Seventy-four participants were assessed for PTSD symptoms, depression, sleep difficulties, and drinking motives. Results demonstrated that neither PTSD symptoms nor depression were related to any motives for using alcohol. On the other hand, after controlling for education, sleep difficulties were significantly related to dr...

  1. Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review

    Directory of Open Access Journals (Sweden)

    Elisabeth Lima Dias da Cruz

    2017-09-01

    Conclusions: It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students.

  2. Children adopted from Poland display a high risk of foetal alcohol spectrum disorders and some may go undiagnosed

    NARCIS (Netherlands)

    Knuiman, S.; Rijk, C.H.A.M.; Hoksbergen, R.A.C.; van Baar, A.L.

    2015-01-01

    Aim: Children adopted from Central and Eastern Europe often have negative early experiences, including prenatal exposure to alcohol. We examined a group of Polish children, adopted by Dutch parents, to see how many were diagnosed with foetal alcohol spectrum disorders (FASD) and to what extent

  3. 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…

  4. 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…

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

    Science.gov (United States)

    Kim, Soo Ryon; Baek, Min Jae; Kim, HyangHee

    2015-01-01

    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. PMID:26347214

  6. 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.

  7. 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

    to investigate the ability to predict the outcome of alcohol use disorders through Cloninger's temperament and character inventory (TCI-R). this is a prospective study consisting of 237 outpatients with alcohol use disorders who underwent follow-up treatment for 6 months and whose personality traits were studied using TCI-R. At the end of that period, the scores of each TCI-R trait were analyzed in terms of those who remained in treatment and those who dropped out. The whole group scored highly in novelty seeking (NS) and harm avoidance (HA) and produced low scores in self-directedness (SD), these last traits are considered prominent. The drop-out group scored significantly (p=.004) higher in novelty seeking (NS) than the follow-up group. Also, when the score was higher than the 67 percentile the likelihood of abandoning the treatment was 1.07 times higher. Cloninger's temperament and character inventory is a good instrument to predict the outcome of treatment of patients with alcohol use disorders and the novelty seeking (NS) dimension is strongly related to therapeutic drop-out.

  8. Neurotic Personality Traits and Risk for Adverse Alcohol Outcomes: Chained Mediation through Emotional Disorder Symptoms and Drinking to Cope.

    Science.gov (United States)

    Chinneck, A; Thompson, K; Dobson, K S; Stuart, H; Teehan, M; Stewart, S H

    2018-02-02

    Rates of alcohol abuse are high on Canadian postsecondary campuses. Individual trait differences have been linked to indices of alcohol use/misuse, including neurotic traits like anxiety sensitivity (AS) and hopelessness (HOP). We know little, though, about how these traits confer vulnerability. AS and HOP are related to anxiety and depression, respectively, and to drinking to cope with symptoms of those disorders. Neurotic personality may therefore increase risk of alcohol use/abuse via (1) emotional disorder symptoms and/or (2) coping drinking motives. Allan and colleagues (2014) found chained mediation through AS-generalized anxiety-coping motives-alcohol problems and AS-depression-coping motives-alcohol problems. We sought to expand their research by investigating how emotional disorder symptoms (anxiety, depression) and specific coping motives (drinking to cope with anxiety, depression) may sequentially mediate the AS/HOP-to-hazardous alcohol use/drinking harms relationships among university students. This study used cross-sectional data collected in Fall 2014 as part of the Movember-funded Caring Campus Project (N = 1,883). The survey included the SURPS, adapted DMQ-R SF, and AUDIT-3. AS and HOP were both related to hazardous alcohol and drinking harms via emotional disorder symptoms and, in turn, coping drinking motives. All indirect pathways incorporating both mediators were statistically significant, and additional evidence of partial specificity was found. Conclusions/Importance: The study's results have important implications for personality-matched interventions for addictive disorders.

  9. 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

  10. The Neurobiological Mechanism of Chemical Aversion (Emetic Therapy for Alcohol Use Disorder: An fMRI Study

    Directory of Open Access Journals (Sweden)

    Ralph L. Elkins

    2017-09-01

    Full Text Available A recent NIH epidemiology study found the lifetime prevalence of alcohol use disorder in the United States to be 29%. Alcohol drinking behavior is strongly “learned” via pleasure center activation/reinforcement. Alcohol craving is a powerful desire to drink alcoholic beverages. Craving was added as one of the defining criteria for alcohol use disorder in DSM5, and craving reduction is becoming an increasingly important treatment goal. In the current study, patients with alcohol use disorder received 10 days of inpatient multi-modal treatments at Schick Shadel Hospital (SSH of Seattle. The treatments included five chemical aversion conditioning sessions that associated alcohol cues (and alcohol with nausea and emesis. All patients met DSM4 criteria for alcohol use disorder, were heavy drinkers, and reported craving alcohol pre-treatment. Craving reduction was one of the primary treatment goals. This is the first fMRI study to measure the effects of chemical aversion therapy on alcohol craving-related brain activity. Patients were recruited as subjects for the University of Washington (UW brain scan study following SSH admission but before treatment onset. Prior to treatment, patients reported craving/desire for alcohol. After treatment (after four SSH chemical aversion treatments, again after five SSH chemical treatments, 30 and 90-days post-discharge, these same patients reported avoidance/aversion to alcohol. Most of the participants (69% reported being still sober 12 months post-treatment. Consistent with a craving reduction mechanism of how chemical aversion therapy facilitates sobriety, results of the UW fMRI brain scans showed significant pre- to post-treatment reductions in craving-related brain activity in the occipital cortex. Additional fMRI brain scan studies are needed to further explore the neurobiological mechanism of chemical aversion therapy treatment for alcohol use disorder, and other substance use disorders for which

  11. 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.

  12. Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review.

    Science.gov (United States)

    Cruz, Elisabeth Lima Dias da; Martins, Priscila Diniz de Carvalho; Diniz, Paula Rejane Beserra

    To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator "AND" were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10-19 years), original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms "anxiety disorder" and "alcohol use" in the title and abstract were excluded. 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students. Copyright © 2017. Published by Elsevier Editora Ltda.

  13. In alcohol-dependent drinkers, what does the presence of nicotine dependence tell us about psychiatric and addictive disorders comorbidity?

    Science.gov (United States)

    Le Strat, Yann; Ramoz, Nicolas; Gorwood, Philip

    2010-01-01

    To examine the pattern of psychiatric comorbidity associated with nicotine dependence among alcohol-dependent respondents in the general population. Drawn from a US national survey of 43,000 adults The (National Epidemiologic Survey on Alcohol and Related Conditions) who took part in a face-to-face interview, data were examined on the 4782 subjects with lifetime alcohol dependence, and comparisons were made between those with and those without nicotine dependence. Nicotine dependence was reported by 48% of the alcohol-dependent respondents. They reported higher lifetime rates of panic disorder, specific and social phobia, generalized anxiety disorder, major depressive episode, manic disorder, suicide attempt, antisocial personality disorder and all addictive disorders than those without nicotine dependence. After controlling for the effects of any psychiatric and addictive disorder, alcohol-dependent subjects with nicotine dependence were more than twice as likely as non-nicotine-dependent, alcohol-dependent subjects to have at least one other lifetime addiction diagnosis (adjusted odds ratio 2.36; 95% confidence interval 2.07-2.68). Nicotine dependence represents a general marker of psychiatric comorbidity, particularly of addictive comorbidity. It may be used as a screening measure for psychiatric diagnoses in clinical practice as well as in future trials.

  14. Alcohol use and sickness absence due to all causes and mental- or musculoskeletal disorders: a nationally representative study.

    Science.gov (United States)

    Kaila-Kangas, Leena; Koskinen, Aki; Leino-Arjas, Päivi; Virtanen, Marianna; Härkänen, Tommi; Lallukka, Tea

    2018-01-17

    Previous studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels of alcohol use, as well as in lifelong abstainers, former drinkers, and people with clinical alcohol use disorders. The data of the population-based Health 2000 Survey (BRIF8901) of 3666 Finns aged 30-55 were linked with national registers on medically certified sickness absences lasting for > 10 working days (long-term) for all causes (2000 - 2010) and for mental or musculoskeletal disorders (2004-2010), as well as with registers on pensions and death (2000-2010). Alcohol use was assessed by questionnaire. Chronic somatic diseases were evaluated at baseline in a clinical examination, and common mental and alcohol use disorders using the Composite International Diagnostic Interview (CIDI). Cox regression analyses were conducted with censoring for death and retirement from work. During an average 10-year follow-up, 56.0% of the participants had at least one long-term sickness absence period. Compared with light drinkers, those having an alcohol use disorder had increased risk of all-cause sickness absence (HR = 1.27; 95% CI = 1.04 - 1.54) and sickness absence due to mental disorders (HR = 2.16; 95% CI = 1.39 - 3.35), when somatic and mental disorders as well as demographic, lifestyle-related and occupational factors at baseline were accounted for. Lifelong abstainers did not differ from light drinkers. Also high-volume drinking (HR = 1.52; 95% CI 1.03 - 2.25) and former drinking (HR = 1.57; 95% CI = 1.15 - 2.15) were associated with long-term sickness absence due to mental disorders. Alcohol use was not predictive of sickness absence due to musculoskeletal disorders. These results

  15. Screening for bipolar disorders in patients with alcohol or substance use disorders: Performance of the Mood Disorder Questionnaire

    NARCIS (Netherlands)

    van Zaane, Jan; van den Berg, Belinda; Draisma, Stasja; Nolen, Willem A.; van den Brink, Wim

    2012-01-01

    Background: Screening properties of the Mood Disorder Questionnaire (MDQ) to detect bipolar disorder (BD) in patients with substance use disorders are unknown. Methods: 403 treatment seeking patients with a substance use disorder completed the MDQ and subsequently 111 MDQ positives and 59 MDQ

  16. Screening for bipolar disorders in patients with alcohol or substance use disorders : Performance of the Mood Disorder Questionnaire

    NARCIS (Netherlands)

    van Zaane, Jan; van den Berg, Belinda; Draisma, Stasja; Nolen, Willem A.; van den Brink, Wim

    2012-01-01

    Background: Screening properties of the Mood Disorder Questionnaire (MDQ) to detect bipolar disorder (BD) in patients with substance use disorders are unknown. Methods: 403 treatment seeking patients with a substance use disorder completed the MDQ and subsequently 111 MDQ positives and 59 MDQ

  17. Alcohol

    Science.gov (United States)

    ... created when grains, fruits, or vegetables are fermented . Fermentation is a process that uses yeast or bacteria to change the sugars in the food into alcohol. Fermentation is used to produce many necessary items — everything ...

  18. Toward DSM-V: mapping the alcohol use disorder continuum in college students.

    Science.gov (United States)

    Hagman, Brett T; Cohn, Amy M

    2011-11-01

    The present study examined the dimensionality of DSM-IV Alcohol Use Disorder (AUD) criteria using Item Response Theory (IRT) methods and tested the validity of the proposed DSM-V AUD guidelines in a sample of college students. Participants were 396 college students who reported any alcohol use in the past 90 days and were aged 18 years or older. We conducted factor analyses to determine whether a one- or two-factor model provided a better fit to the AUD criteria. IRT analyses estimated item severity and discrimination parameters for each criterion. Multivariate analyses examined differences among the DSM-V diagnostic cut-off (AUD vs. No AUD) and severity qualifiers (no diagnosis, moderate, severe) across several validating measures of alcohol use. A dominant single-factor model provided the best fit to the AUD criteria. IRT analyses indicated that abuse and dependence criteria were intermixed along the latent continuum. The "legal problems" criterion had the highest severity parameter and the tolerance criterion had the lowest severity parameter. The abuse criterion "social/interpersonal problems" and dependence criterion "activities to obtain alcohol" had the highest discrimination parameter estimates. Multivariate analysis indicated that the DSM-V cut-off point, and severity qualifier groups were distinguishable on several measures of alcohol consumption, drinking consequences, and drinking restraint. Findings suggest that the AUD criteria reflect a latent variable that represents a primary disorder and provide support for the proposed DSM-V AUD criteria in a sample of college students. Continued research in other high-risk samples of college students is needed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. 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.

  20. Video Modeling of SBIRT for Alcohol Use Disorders Increases Student Empathy in Standardized Patient Encounters.

    Science.gov (United States)

    Crisafio, Anthony; Anderson, Victoria; Frank, Julia

    2018-04-01

    The purpose of this study was to assess the usefulness of adding video models of brief alcohol assessment and counseling to a standardized patient (SP) curriculum that covers and tests acquisition of this skill. The authors conducted a single-center, retrospective cohort study of third- and fourth-year medical students between 2013 and 2015. All students completed a standardized patient (SP) encounter illustrating the diagnosis of alcohol use disorder, followed by an SP exam on the same topic. Beginning in August 2014, the authors supplemented the existing formative SP exercise on problem drinking with one of two 5-min videos demonstrating screening, brief intervention, and referral for treatment (SBIRT). P values and Z tests were performed to evaluate differences between students who did and did not see the video in knowledge and skills related to alcohol use disorders. One hundred ninety-four students were included in this analysis. Compared to controls, subjects did not differ in their ability to uncover and accurately characterize an alcohol problem during a standardized encounter (mean exam score 41.29 vs 40.93, subject vs control, p = 0.539). However, the SPs' rating of students' expressions of empathy were significantly higher for the group who saw the video (81.63 vs 69.79%, p videos would improve students' recognition and knowledge of alcohol-related conditions. However, feedback from the SPs produced the serendipitous finding that the communication skills demonstrated in the videos had a sustained effect in enhancing students' professional behavior.

  1. Magnetic resonance imaging (MRI) findings among children with fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS) and alcohol related neurodevelopmental disorders (ARND).

    Science.gov (United States)

    Anna Dyląg, Katarzyna; Sikora-Sporek, Aleksanda; Bańdo, Bożena; Boroń-Zyss, Joanna; Drożdż, Dorota; Dumnicka, Paulina; Przybyszewska, Katarzyna; Sporek, Mateusz; Walocha, Jerzy W; Wojciechowski, Wadim; Urbanik, Andrzej

    The aim of the study was to analyze the findings in MRI (magnetic resonance imaging) of the brain amongst children diagnosed with fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS) or alcohol related neurodevelopmental disorders (ARND). The issue has been studied in several researches previously but the experts agree that there is still few data on the MRI results in the group of younger children. MRI results of 121 patients with either FAS or pFAS or ARND diagnosed with Canadian criteria were analyzed regarding the presence of abnormalities. The group consisted of 71 patients diagnosed with FAS, 33 diagnosed with pFAS and 17 diagnosed with ARND. The mean age of the patients was 8.03 years (standard deviation 4.07). In the total group of FASD patients 61.98% of the patients’ MRI results were abnormal. The most common abnormality in MRI of the patients were demyelination plaques (incidence 23.1%) and corpus callosum narrowing (20.7%) as well as ventricular asymmetry (18.8%).The demyelination plaques and corpus callosum narrowing were more frequent among children ≤4 years old (41.7% vs 18.6%; p=0.016 and 50.0% vs.13.4%; ppFAS and ARND. Both age ≤4 years and FAS diagnosis were independent predictors for multiple anomalies in multiple logistic regression. In structural brain MRI of younger children, multiple anomalies were found more frequently than among older children. Demyelination plaques and corpus callosum narrowing were more common in younger FASD patients than in older ones.

  2. 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.

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

    Science.gov (United States)

    Gajecki, Mikael; Berman, Anne H; Sinadinovic, Kristina; Andersson, Claes; Ljótsson, Brjánn; Hedman, Erik; Rück, Christian; Lindefors, Nils

    2014-01-01

    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. 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). 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. 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.

  4. Visual deficits in a mouse model of Fetal alcohol spectrum disorders

    Directory of Open Access Journals (Sweden)

    Crystal L Lantz

    2014-10-01

    Full Text Available Alcohol consumption during pregnancy can lead to a multitude of neurological problems in offspring, varying from subtle behavioral changes to severe mental retardation. These alterations are collectively referred to as Fetal Alcohol Spectrum Disorders (FASD. Early alcohol exposure can strongly affect the visual system and children with FASD can exhibit an amblyopia-like pattern of visual acuity deficits even in the absence of optical and oculormotor disruption.Here we test whether early alcohol exposure can lead to a disruption in visual acuity, using a model of FASD to mimic alcohol consumption in the last months of human gestation. To accomplish this, mice were exposed to ethanol (5g/kg i.p or saline on postnatal days (P 5, 7 and 9. Two to three weeks later we recorded visually evoked potentials (VEPs to assess spatial frequency detection and contrast sensitivity, conducted electroretinography (ERGs to further assess visual function and imaged retinotopy using optical imaging of intrinsic signals. We observed that animals exposed to ethanol displayed spatial frequency acuity curves similar to controls. However, ethanol-treated animals showed a significant deficit in contrast sensitivity. Moreover, ERGs revealed a market decrease in both a- and b- waves amplitudes, and optical imaging suggest that both elevation and azimuth maps in ethanol-treated animals have a 10-20o greater map tilt compared to saline-treated controls. Overall, our findings suggest that binge alcohol drinking restricted to the last months of gestation in humans can lead to marked deficits in visual function.

  5. Chronic Ethanol Exposure Effects on Vitamin D Levels among Subjects with Alcohol Use Disorder

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    Olalekan Ogunsakin

    2016-01-01

    Full Text Available 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(OHD 3 ] and active vitamin D [1, 25(OH 2 D 3 ] 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(OHD 3 , active vitamin D (1, 25(OH 2 D 3 , 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.

  6. Maternal risk factors for fetal alcohol spectrum disorders in a province in Italy.

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    Ceccanti, Mauro; Fiorentino, Daniela; Coriale, Giovanna; Kalberg, Wendy O; Buckley, David; Hoyme, H Eugene; Gossage, J Phillip; Robinson, Luther K; Manning, Melanie; Romeo, Marina; Hasken, Julie M; Tabachnick, Barbara; Blankenship, Jason; May, Philip A

    2014-12-01

    Maternal risk factors for fetal alcohol spectrum disorders (FASD) in Italy and Mediterranean cultures need clarification, as there are few studies and most are plagued by inaccurate reporting of antenatal alcohol use. Maternal interviews (n = 905) were carried out in a population-based study of the prevalence and characteristics of FASD in the Lazio region of Italy which provided data for multivariate case control comparisons and multiple correlation models. Case control findings from interviews seven years post-partum indicate that mothers of children with FASD are significantly more likely than randomly-selected controls or community mothers to: be shorter; have higher body mass indexes (BMI); be married to a man with legal problems; report more drinking three months pre-pregnancy; engage in more current drinking and drinking alone; and have alcohol problems in her family. Logistic regression analysis of multiple candidate predictors of a FASD diagnosis indicates that alcohol problems in the child's family is the most significant risk factor, making a diagnosis within the continuum of FASD 9 times more likely (95%C.I. = 1.6 to 50.7). Sequential multiple regression analysis of the child's neuropsychological performance also identifies alcohol problems in the child's family as the only significant maternal risk variable (p < .001) when controlling for other potential risk factors. Underreporting of prenatal alcohol use has been demonstrated among Italian and other Mediterranean antenatal samples, and it was suspected in this sample. Nevertheless, several significant maternal risk factors for FASD have been identified. Copyright © 2014. Published by Elsevier Ireland Ltd.

  7. Maternal Risk Factors for Fetal Alcohol Spectrum Disorders in a Province in Italy*

    Science.gov (United States)

    Ceccanti, Mauro; Fiorentino, Daniela; Coriale, Giovanna; Kalberg, Wendy O.; Buckley, David; Hoyme, H. Eugene; Gossage, J. Phillip; Robinson, Luther K.; Manning, Melanie; Romeo, Marina; Hasken, Julie M.; Tabachnick, Barbara; Blankenship, Jason

    2016-01-01

    Background Maternal risk factors for fetal alcohol spectrum disorders (FASD) in Italy and Mediterranean cultures need clarification, as there are few studies and most are plagued by inaccurate reporting of antenatal alcohol use. Methods Maternal interviews (n=905) were carried out in a population-based study of the prevalence and characteristics of FASD in the Lazio region of Italy which provided data for multivariate case control comparisons and multiple correlation models. Results Case control findings from interviews seven years post-partum indicate that mothers of children with FASD are significantly more likely than randomly-selected controls or community mothers to: be shorter; have higher body mass indexes (BMI); be married to a man with legal problems; report more drinking three months pre-pregnancy; engage in more current drinking and drinking alone; and have alcohol problems in her family. Logistic regression analysis of multiple candidate predictors of a FASD diagnosis indicates that alcohol problems in the child’s family is the most significant risk factor, making a diagnosis within the continuum of FASD 9 times more likely (95% C.I. = 1.6 to 50.7). Sequential multiple regression analysis of the child’s neuropsychological performance also identifies alcohol problems in the child’s family as the only significant maternal risk variable (p<.001) when controlling for other potential risk factors. Conclusions Underreporting of prenatal alcohol use has been demonstrated among Italian and other Mediterranean antenatal samples, and it was suspected in this sample. Nevertheless, several significant maternal risk factors for FASD have been identified. PMID:25456331

  8. Alcohol disorders and re-employment in a 5-year follow-up of long-term unemployed.

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    Claussen, B

    1999-01-01

    To establish whether the high prevalence of alcohol abuse among unemployed people is explained by alcohol abuse causing unemployment, or vice versa. A 5-year postal follow-up survey of a community sample of unemployed from Grenland, southern Norway. Two hundred and twenty-eight unemployed people, registered for more than 12 weeks, aged 16 to 63 years. Response rate 74%. The Alcohol Use Disorder Identification Test (AUDIT) and DSM-III diagnoses of alcohol disorders in medical examinations. At the 5-year follow up, 23% of those still unemployed and 12% of those re-employed scored higher than the AUDIT cut-point of 10. Re-employment reduced the chance of scoring positive on the AUDIT to 34% of the chance for those still unemployed. Significant selection to long-term unemployment according to AUDIT score was not demonstrated. None of the 7% who had a DSM-III diagnosis of an alcohol disorder had a job 5 years later, however, suggesting that alcohol-related selection to unemployment does occur. The high prevalence of harmful drinking among Norwegian unemployed is explained mainly by unemployment causing alcohol abuse rather than vice versa. Reducing unemployment should contribute to reduced alcohol problems in Norway.

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

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    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.

  10. Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees

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    Fartein Ask Torvik

    2016-08-01

    Full Text Available Abstract Background Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. Methods Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. Results All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. Conclusions Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among

  11. Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees.

    Science.gov (United States)

    Torvik, Fartein Ask; Reichborn-Kjennerud, Ted; Gjerde, Line C; Knudsen, Gun Peggy; Ystrom, Eivind; Tambs, Kristian; Røysamb, Espen; Østby, Kristian; Ørstavik, Ragnhild

    2016-08-03

    Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among individuals with somatic disorders. This disorder has good treatment

  12. Determining if Borderline Personality Disorder and Bipolar Disorder Are Alternative Expressions of the Same Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    de la Rosa, Iris; Oquendo, María A; García, Gemma; Stanley, Barbara; González-Pinto, Ana; Liu, Shang-Min; Blanco, Carlos

    To examine whether bipolar disorder and borderline personality disorder represent 2 different disorders or alternative manifestations of the same disorder. The data were collected between January 1, 2004, and December 31, 2005. The analyses were conducted between December 21 and December 27, 2010. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed on 25 symptoms assessing depression, mania, and borderline personality disorder from the National Epidemiologic Survey on Alcohol and Related Conditions, a large nationally representative sample of the US adult population (N = 34,653). DSM-IV criteria were used for diagnosis of bipolar disorder and borderline personality disorder. A 3-factor solution provided an excellent fit in both the EFA (root mean square error of approximation [RMSEA] = 0.017, comparative fix index [CFI] = 0.997) and the CFA (RMSEA = 0.024, CFI = 0.993). Factor 1 (Borderline Personality Disorder) loaded on all 9 borderline personality disorder symptoms, factor 2 (Depression) loaded on 8 symptoms of depression, and factor 3 (Mania) loaded on 7 symptoms of mania plus the psychomotor agitation item of the depression section. The correlations between the Borderline Personality Disorder and Depression factors (r = 0.328) and between the Borderline Personality Disorder and Mania factors (r = 0.394) were lower than the correlation between Depression and Mania factors (r = 0.538). A model with 3 positively correlated factors provided an excellent fit for the latent structure of borderline personality disorder and bipolar disorder symptoms. The pattern of pairwise correlations between the 3 factors is consistent with the clinical presentation of 2 syndromes (depression and mania) that can be characterized as a unitary psychiatric entity (bipolar disorder) and a third syndrome (borderline personality disorder) that is often comorbid with bipolar disorder. The findings converge in suggesting that bipolar disorder and

  13. Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study

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    Carolina D. Wiener

    2017-06-01

    Full Text Available Objective: To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. Methods: This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI. Results: Alcohol abuse and/or dependence was identified in 187 (9.60% individuals (5.10% among women and 15.20% among men. Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. Conclusion: These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

  14. Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study.

    Science.gov (United States)

    Wiener, Carolina D; Moreira, Fernanda P; Zago, Alethea; Souza, Luciano M; Branco, Jeronimo C; Oliveira, Jacqueline F de; Silva, Ricardo A da; Portela, Luis V; Lara, Diogo R; Jansen, Karen; Oses, Jean P

    2018-01-01

    To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI). Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

  15. Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review

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    Elisabeth Lima Dias da Cruz

    Full Text Available Abstract Objective: To identify the risk factors related to the association between social anxiety disorder and alcohol use in adolescents. Source of data: The PICO research strategy was used to perform a systematic review in Medline, LILACS, Pubmed, IBECS and Cochrane Library databases. DeCS/MeSH: Phobic Disorders, Adolescent, Behavior, Ethanol, Risk Factors, and the Boolean operator “AND” were used. Inclusion criteria were: cross-sectional, prospective/retrospective cohort, and case-control studies, carried out in adolescents (10–19 years, original articles on social anxiety disorder and alcohol use published between 2010 and 2015. Studies that did not report the terms “anxiety disorder” and “alcohol use” in the title and abstract were excluded. Synthesis of data: 409 articles were retrieved; after the exclusion of 277 repeated articles, the following were eligible: 94 in MEDLINE, 68 in Pubmed, 12 in IBCS, and three in LILACS. Titles and abstracts were independently read by two examiners, which resulted in the selection of eight articles for the analysis. Risk factors associated to the two disorders were female gender, age, peer approval and affective problems for alcohol use, confrontation situations and/or compliance reasons, frequency of alcohol use, and secondary comorbidities, such as depression and generalized anxiety. Conclusions: It is necessary to assess the period of social anxiety disorders first symptom onset, as well as the risks for alcohol use in order to establish corrective intervention guidelines, especially for socially anxious students.

  16. Targeting the subthalamic nucleus in a preclinical model of alcohol use disorder.

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    Pelloux, Yann; Baunez, Christelle

    2017-07-01

    The subthalamic nucleus (STN) has only recently been considered to have a role in reward processing. In rats, inactivation of the STN by lesion or high-frequency stimulation (HFS) decreases motivation for cocaine but increases motivation for sucrose. For ethanol, the effect of STN lesion depends on the individual's baseline intake; decreasing motivation for ethanol in rats with lower ethanol intake, while increasing motivation for ethanol in rats with higher-but still limited-ethanol intake. However, the involvement of the STN in behaviour more closely resembling some aspects of alcohol use disorder has not been assessed. This study aimed to determine the effect of STN lesions on the escalation of ethanol intake, subsequent increases in the motivation to "work" for ethanol and the choice of ethanol over a non-drug alternative. We found that STN lesion prevented increases in ethanol intake observed during intermittent ethanol access and after a long period of ethanol privation. STN lesion also decreased the motivation to work for ethanol after escalated intake. Surprisingly, STN lesion increased the choice of alcohol over saccharin. This was associated with a blunting of the hedonic responses to the taste of the reinforcement alternatives. These results evidence the involvement of the STN in different ethanol-motivated behaviours and therefore position the STN as an interesting target for the treatment of alcohol use disorders.

  17. Reliability and Validity of a Treatment Barriers Scale for Individuals With Alcohol Use Disorder.

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    Possemato, Kyle; Funderburk, Jennifer; Spinola, Suzanne; Hutchison, Dezarie; Maisto, Stephen A; Lantinga, Larry J; Oslin, David W

    2016-01-01

    Few studies have measured addiction-specific barriers to treatment. A measurement of barriers with psychometric support that has been tested in diverse samples and that assesses multiple components of addiction treatment barriers is needed to inform providers and treatment programs. This paper aims to provide an initial psychometric investigation of a measure of barriers to seeking addictions treatment. Data were collected from 196 Veterans Affairs primary care patients with Alcohol Use Disorder that participated in a randomized clinical trial. A Principal Components Analysis revealed that the 32-item Treatment Barriers Scale (TBS) can be reduced to 14 items, measuring 4 factors: stigma, dislike of the treatment process, alcohol problem identification, and logistical concerns. Acceptable internal consistent reliability (α = .64-.76) and excellent precision of alpha (α = 0.001-0.009) was found for each subscale. Support for the measure's concurrent validity was found, for example, participants who reported more motivation to reduce their drinking perceived significantly fewer barriers to care. Support for the measure's predictive validity was also found, including that more barriers were related to future drinking among all participants and less mental health and addictions treatment visits among participants in one treatment condition. Conclusions/ Importance: Our results provide initial support for the utility of the TBS-14 among primary care patients with Alcohol Use Disorder. Use of the TBS-14 could enable healthcare providers to better understand patient-specific treatment barriers, provide corrective information on treatment misconceptions, and inform individualized treatment plans that increase patient engagement in addiction services.

  18. The effect of an anger management program for family members of patients with alcohol use disorders.

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    Son, Ju-Young; Choi, Yun-Jung

    2010-02-01

    This study was aimed to test the structured anger management nursing program for the family members of patients with alcohol use disorders (AUDs). Families with the AUDs suffer from the dysfunctional family dynamic caused by the patients' deteriorative disease processes of alcohol dependence. Family members of AUDs feel bitter and angry about the uncontrolled behaviors and relapses of the patients in spite of great effort for a long time. This chronic anger threatens the optimal function of the family as well as obstructs the family to help the patients who are suffering from AUDs. Sixty three subjects were participated who were referred from community mental health centers, alcohol consultation centers, and an alcohol hospital in Korea. Pre-post scores of the Korean Anger Expression Inventory were used to test the program. An anger management program was developed and implemented to promote anger expression and anger management for the family members of the patients with AUDs. The total anger expression score of the experimental group was significantly more reduced as compared with that of the control group. Subjects in the experimental group reported after the program that they felt more comfortable and their life was changed in a better way. The anger management program was effective to promote anger expression and anger management for family members of AUDs. Nurses need to include family members in their nursing process as well as to care of patients with AUDs to maximize nursing outcome and patient satisfaction. 2010 Elsevier Inc. All rights reserved.

  19. [Validity of AUDIT test for detection of disorders related with alcohol consumption in women].

    Science.gov (United States)

    Pérula-de Torres, Luis Angel; Fernández-García, José Angel; Arias-Vega, Raquel; Muriel-Palomino, María; Márquez-Rebollo, Encarnación; Ruiz-Moral, Roger

    2005-11-26

    Early detection of patients with alcohol problems is important in clinical practice. The AUDIT (Alcohol Use Disorders Identification Test) questionnaire is a valid tool for this aim, especially in the male population. The objective of this study was to validate how useful is this questionnaire in females patients and to assess their test cut-off point for the diagnosis of alcohol problems in women. 414 woman were recruited in 2 health center and specialized center for addiction treatment. The AUDIT test and a semistructured interview (SCAN as gold standard) were performed to all patients. Internal consistency and criteria validity was assessed. Cronbach alpha was 0.93 (95% confidence interval [CI], 0.921-0.941). When the DSM-IV was taken as reference the most useful cut-off point was 6 points, with 89.6% (95% CI, 76.11-96.02) sensitivity and 95.07% (95% CI, 92.18-96.97) specificity. When CIE-10 was taken as reference the sensitivity was 89.58% (95% CI, 76.56-96.10) and the specificity was 95.33% (95% CI, 92.48-97.17). AUDIT is a questionnaire with good psychometrics properties and is valid for detecting dependence and risk alcohol consumption in women.

  20. The onset and progression of alcohol use disorders: A qualitative study from Goa, India.

    Science.gov (United States)

    Mackinnon, Nathalie; Bhatia, Urvita; Nadkarni, Abhijit

    2017-06-30

    Quantitative evidence about the burden of alcohol use disorders (AUDs) needs to be complemented with a nuanced qualitative understanding of explanatory models to help supplement public health strategies that are too often steeped uncritically in biomedical models. The aim of this study was to identify the role of various factors in the onset and persistence of AUD and recovery from AUD. This was a qualitative study nested in a population cohort from Goa, India. In-depth interviews of men with incident, recovered, and persistent AUD covered topics such as changes in drinking habits over time, perceptions and experiences about starting/stopping drinking, and so on. Data were analyzed using thematic analysis. Reasons to begin drinking included social drinking, functional use of alcohol, stress, and boredom. Progression to problematic drinking patterns was characterized by drinking alone, alternating between abstinent and heavy drinking periods, and drinking based on the availability of finances. Some enablers to reduce/stop drinking included consequences of drinking lifestyle and personal resolve; some barriers included availability of alcohol at social events and stress. Some reasons for persisting heavy use of alcohol included lack of family support, physical withdrawal symptoms, peer pressure, stress, and easy availability. This article offers a strong conceptualization and nuanced understanding of AUD across a spectrum of developmental courses. This adds to the limited literature on explanatory models of AUD in India and identifies potential targets for prevention and treatment strategies for AUD in low- and middle-income country settings.

  1. Maternal factors predicting cognitive and behavioral characteristics of children with fetal alcohol spectrum disorders.

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    May, Philip A; Tabachnick, Barbara G; Gossage, J Phillip; Kalberg, Wendy O; Marais, Anna-Susan; Robinson, Luther K; Manning, Melanie A; Blankenship, Jason; Buckley, David; Hoyme, H Eugene; Adnams, Colleen M

    2013-06-01

    To provide an analysis of multiple predictors of cognitive and behavioral traits for children with fetal alcohol spectrum disorders (FASDs). Multivariate correlation techniques were used with maternal and child data from epidemiologic studies in a community in South Africa. Data on 561 first-grade children with fetal alcohol syndrome (FAS), partial FAS (PFAS), and not FASD and their mothers were analyzed by grouping 19 maternal variables into categories (physical, demographic, childbearing, and drinking) and used in structural equation models (SEMs) to assess correlates of child intelligence (verbal and nonverbal) and behavior. A first SEM using only 7 maternal alcohol use variables to predict cognitive/behavioral traits was statistically significant (B = 3.10, p < .05) but explained only 17.3% of the variance. The second model incorporated multiple maternal variables and was statistically significant explaining 55.3% of the variance. Significantly correlated with low intelligence and problem behavior were demographic (B = 3.83, p < .05) (low maternal education, low socioeconomic status [SES], and rural residence) and maternal physical characteristics (B = 2.70, p < .05) (short stature, small head circumference, and low weight). Childbearing history and alcohol use composites were not statistically significant in the final complex model and were overpowered by SES and maternal physical traits. Although other analytic techniques have amply demonstrated the negative effects of maternal drinking on intelligence and behavior, this highly controlled analysis of multiple maternal influences reveals that maternal demographics and physical traits make a significant enabling or disabling contribution to child functioning in FASD.

  2. Parental psychopathology moderates the influence of parental divorce on lifetime alcohol use disorders among Israeli adults

    Science.gov (United States)

    Thompson, Ronald G.; Shmulewitz, Dvora; Meyers, Jacquelyn L.; Stohl, Malki; Aharonovich, Efrat; Spivak, Baruch; Weizman, Abraham; Frisch, Amos; Grant, Bridget F.; Hasin, Deborah

    2014-01-01

    Background Parental divorce and psychopathology are well-documented risk factors for alcohol use disorders (AUD) in the United States and other countries where divorce is common and per capita total alcohol consumption is moderate to high. However, little is known about these relationships in countries where divorce and alcohol problems are less common, such as Israel. Methods Israeli adult household residents (N=797) age 21–45 were interviewed in person between 2007 and 2009. Logistic regression models were used to examine main and additive interaction effects of parental divorce and psychopathology on lifetime DSM-IV AUD, adjusting for age, gender, and ethnicity. Results Parental divorce (OR=2.18, p≤.001) and parental psychopathology (OR=1.61, p≤.01) were independently associated with lifetime AUD and, when considered together, showed significant interaction (p=.026). Specifically, the effect of divorce on AUD was only significant among those who also reported parental psychopathology. Conclusions This is the first study showing the influence of parental divorce and psychopathology on risk for AUD among Israeli adults, where both divorce and AUD are less common than in the United States. Alcohol prevention and treatment professionals should recognize that children who experience parental divorce and/or psychopathology could be more vulnerable to later developing AUD than those whose parents remain together and without psychopathology. PMID:24939440

  3. Parental psychopathology moderates the influence of parental divorce on lifetime alcohol use disorders among Israeli adults.

    Science.gov (United States)

    Thompson, Ronald G; Shmulewitz, Dvora; Meyers, Jacquelyn L; Stohl, Malki; Aharonovich, Efrat; Spivak, Baruch; Weizman, Abraham; Frisch, Amos; Grant, Bridget F; Hasin, Deborah S

    2014-08-01

    Parental divorce and psychopathology are well-documented risk factors for alcohol use disorders (AUD) in the United States and other countries where divorce is common and per capita total alcohol consumption is moderate to high. However, little is known about these relationships in countries where divorce and alcohol problems are less common, such as Israel. Israeli adult household residents (N=797) age 21-45 were interviewed in person between 2007 and 2009. Logistic regression models were used to examine main and additive interaction effects of parental divorce and psychopathology on lifetime DSM-IV AUD, adjusting for age, gender, and ethnicity. Parental divorce (OR=2.18, p≤0.001) and parental psychopathology (OR=1.61, p≤0.01) were independently associated with lifetime AUD and, when considered together, showed significant interaction (p=0.026). Specifically, the effect of divorce on AUD was only significant among those who also reported parental psychopathology. This is the first study showing the influence of parental divorce and psychopathology on risk for AUD among Israeli adults, where both divorce and AUD are less common than in the United States. Alcohol prevention and treatment professionals should recognize that children who experience parental divorce and/or psychopathology could be more vulnerable to later developing AUD than those whose parents remain together and without psychopathology. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices.

    Science.gov (United States)

    Probst, Charlotte; Manthey, Jakob; Martinez, Alicia; Rehm, Jürgen

    2015-08-12

    Alcohol use disorders are among the mental disorders with the lowest treatment rates. Increasing the treatment rates requires insight on the reasons why patients do not seek treatment. This study examined self-reported reasons for not seeking treatment and their association with alcohol use disorder severity among primary health care patients diagnosed with an alcohol use disorder. Alcohol use disorders, health service utilization, and reasons for not seeking treatment were assessed via interviews on regionally representative samples of primary care patients from 6 European countries (Italy, Germany, Hungary, Latvia, Poland and Spain, total N = 9,098). Additionally, general practitioners had to fill in a questionnaire assessing their patients' alcohol use and alcohol use disorders. A multinomial logistic regression was performed to investigate the association between reasons for not seeking treatment and alcohol use disorder severity. Of 1,008 patients diagnosed with an alcohol use disorder (via general practitioner or patient interview) in the past 12 months, the majority (N = 810) did not receive treatment and 251 of those gave a reason for not seeking treatment. The most frequent reason was 'lack of problem awareness' (55.3% of those who responded), the second most common response was 'stigma or shame' (28.6%), followed by 'encounter barriers' (22.8%) and 'cope alone' (20.9%). The results indicated lower probabilities of reporting 'denial' and higher probabilities to report 'encounter barriers' as alcohol use disorders severity increases. However, both trends were discontinued for patients with severe alcohol use disorders. Particularly at lower levels of alcohol use disorder severity, a lack of problem awareness prevents patients from seeking treatment. Routinely alcohol consumption monitoring in primary care practices could help primary and secondary prevention of alcohol use disorders and increase treatment coverage.

  5. Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

    Science.gov (United States)

    Goldstein, Risë B.; Chou, S. Patricia; Smith, Sharon M.; Jung, Jeesun; Zhang, Haitao; Saha, Tulshi D.; Pickering, Roger P.; June Ruan, W.; Huang, Boji; Grant, Bridget F.

    2015-01-01

    Objective: The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. Method: The National Epidemiologic Survey on Alcohol and Related Conditions–III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule–5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Results: Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Conclusions: Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes innosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs

  6. Comorbid post-traumatic stress disorder in alcohol use disorder: relationships to demography, drinking and neuroimmune profile.

    Science.gov (United States)

    Neupane, Sudan Prasad; Bramness, Jørgen G; Lien, Lars

    2017-08-29

    This study examined how alcohol use disorder (AUD) patients with post-traumatic stress disorder (PTSD) differed from those without PTSD in terms of demography, drinking patterns and C-reactive protein, inflammatory cytokines, tryptophan metabolism parameters, and brain-derived neurotrophic factor (BDNF). A consecutive sample (N = 187) of treatment-receiving AUD individuals were recruited from Nepalese facilities. They underwent fully structured psychiatric interviews. Serum levels of inflammatory cytokines [interleukin (IL)-6, IL-1 Receptor antagonist (IL-1Ra), IL-10, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ)] were determined by a multiplex assay, kynurenine and tryptophan levels by high-performance liquid chromatography, and BDNF by enzyme-linked immunosorbent assay (ELISA). The prevalence of exposure to severe trauma and PTSD was 74% and 17%, respectively. PTSD comorbidity was not associated with age, gender, or socioeconomic status, but with co-occurring major depression, history of attempted suicide, earlier peak of drinking problems, higher drinking quantity and withdrawal symptoms, experiencing alcoholic blackouts, and drinking problems among parents. None of the assessed neuroimmune parameters was related to comorbid PTSD. The findings support routine trauma screening in AUD treatment samples and screening for risky drinking in trauma populations to help guide interventions. The expected aberrations in neuroimmune functioning may not be found when examined in a sample with multiple psychiatric morbidities.

  7. 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

  8. Hearing, speech, language, and vestibular disorders in the fetal alcohol syndrome: a literature review.

    Science.gov (United States)

    Church, M W; Kaltenbach, J A

    1997-05-01

    Fetal alcohol syndrome (FAS) is characterized in part by mental impairment, as well as craniofacial and ocular anomalies. These conditions are traditionally associated with childhood hearing disorders, because they all have a common embryonic origin in malformations of the first and second branchial arches, and have similar critical periods of vulnerability to toxic insult. A review of human and animal research indicates that there are four types of hearing disorders associated with FAS. These are: (1) a developmental delay in auditory maturation, (2) sensorineural hearing loss, (3) intermittent conductive hearing loss due to recurrent serous otitis media, and (4) central hearing loss. The auditory and vestibular systems share the same peripheral apparatuses (the inner ear and eighth cranial nerve) and are embryologically and structurally similar. Consequently, vestibular disorders in FAS children might be expected. The evidence for vestibular dysfunction in FAS is ambiguous, however. Like other syndromes associated with craniofacial anomalies, hearing disorders, and mental impairment, FAS is also characterized by a high prevalence of speech and language pathology. Hearing disorders are a form of sensory deprivation. If present during early childhood, they can result in permanent hearing, language, and mental impairment. Early identification and intervention to treat hearing, language, and speech disorders could therefore result in improved outcome for the FAS child. Specific recommendations are made for intervention and future research.

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

    Science.gov (United States)

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

    2018-04-15

    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.

  10. 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

    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

  11. Risks for Conduct Disorder Symptoms Associated with Parental Alcoholism in Stepfather Families versus Intact Families from a Community Sample

    Science.gov (United States)

    Foley, Debra L.; Pickles, Andrew; Rutter, Michael; Gardner, Charles O.; Maes, Hermine H.; Silberg, Judy L.; Eaves, Lindon J.

    2004-01-01

    Background: It is not known if the prevalence of parental psychiatric disorders is higher in stepfather than intact families, or if parental alcoholism is differentially associated with risk for conduct disorder (CD) symptoms in stepfather families versus intact families. Method: The sample comprised 839 girls and 741 boys from 792 intact families…

  12. The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder.

    Science.gov (United States)

    Jervis, Lori L; Spicer, Paul; Belcourt, Annie; Sarche, Michelle; Novins, Douglas K; Fickenscher, Alexandra; Beals, Janette

    2014-02-01

    Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.

  13. Understanding and managing sleep disruption in children with fetal alcohol spectrum disorder.

    Science.gov (United States)

    Hanlon-Dearman, Ana; Chen, Maida Lynn; Olson, Heather Carmichael

    2018-04-01

    Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children's disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families.

  14. Understanding Fetal Alcohol Spectrum Disorders (FASDs: Toward Identification of a Behavioral Phenotype

    Directory of Open Access Journals (Sweden)

    Kelly Nash

    2008-01-01

    Full Text Available Fetal alcohol spectrum disorders (FASDs currently represent the leading cause of mental retardation in North America, ahead of Down syndrome and cerebral palsy. The damaging effects of alcohol on the developing brain have a cascading impact on the social and neurocognitive profiles of affected individuals. Researchers investigating the profiles of children with FASDs have found impairments in learning and memory, executive functioning, and language, as well as hyperactivity, impulsivity, poor communication skills, difficulties with social and moral reasoning, and psychopathology. The primary goal of this review paper is to examine current issues pertaining to the identification of a behavioral phenotype in FASDs, as well as to address related screening and diagnostic concerns. We conclude that future research initiatives comparing children with FASDs to nonalcohol-exposed children with similar cognitive and socioemotional profiles should aid in uncovering the unique behavioral phenotype for FASDs.

  15. Experimental psychopathology paradigms for alcohol use disorders: Applications for translational research.

    Science.gov (United States)

    Bujarski, Spencer; Ray, Lara A

    2016-11-01

    In spite of high prevalence and disease burden, scientific consensus on the etiology and treatment of Alcohol Use Disorder (AUD) has yet to be reached. The development and utilization of experimental psychopathology paradigms in the human laboratory represents a cornerstone of AUD research. In this review, we describe and critically evaluate the major experimental psychopathology paradigms developed for AUD, with an emphasis on their implications, strengths, weaknesses, and methodological considerations. Specifically we review alcohol administration, self-administration, cue-reactivity, and stress-reactivity paradigms. We also provide an introduction to the application of experimental psychopathology methods to translational research including genetics, neuroimaging, pharmacological and behavioral treatment development, and translational science. Through refining and manipulating key phenotypes of interest, these experimental paradigms have the potential to elucidate AUD etiological factors, improve the efficiency of treatment developments, and refine treatment targets thus advancing precision medicine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Altering ethanol pharmacokinetics to treat alcohol use disorder: can you teach an old dog new tricks?

    Science.gov (United States)

    Haass-Koffler, Carolina L.; Akhlaghi, Fatemeh; Swift, Robert M.; Leggio, Lorenzo

    2018-01-01

    Disulfiram was the first pharmacotherapy approved to treat alcohol use disorder (AUD) in the 1950s. Disulfiram alters ethanol pharmacokinetics (PK) and causes uncomfortable reactions (e.g.: headache, tachycardia, nausea, flushing and hypotension) when alcohol is consumed. Subsequently, a better understanding of the neurobiological pathways involved in AUD led to the development of other medications (e.g.: naltrexone and acamprosate) to treat AUD. These neurobiological-based medications act on AUD-related phenotypes including craving, stress, and/or withdrawal. The original approach to treat AUD, by altering ethanol PK has been much less investigated. Recent research on ethanol PK has shed light on the mechanisms of action underlying AUD and how some medications that alter ethanol PK may be helpful in treating AUD. This review summarizes and discusses the complex PK of ethanol, and proposes that altering ethanol PK via novel pharmacological approaches may be a viable approach to treat AUD. PMID:28093021

  17. 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. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  18. Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires.

    Science.gov (United States)

    Seo, Yu Ri; Kim, Jong Sung; Kim, Sung Soo; Yoon, Seok Joon; Suh, Won Yoon; Youn, Kwangmi

    2016-01-01

    This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.

  19. 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

  20. 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…

  1. 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.

  2. Alcohol use disorders increase the risk for mechanical ventilation in medical patients.

    Science.gov (United States)

    de Wit, Marjolein; Best, Al M; Gennings, Chris; Burnham, Ellen L; Moss, Marc

    2007-07-01

    Annually, more than 300,000 patients receive mechanical ventilation in an intensive care unit in the United States. The hospital mortality for ventilated patients may approach 50%, depending on the primary diagnosis. In trauma and surgical patients, a diagnosis of alcohol use disorder (AUD) is common and is associated with a prolonged duration of mechanical ventilation. The objective of this study is to determine whether the presence of AUD and the development of alcohol withdrawal are associated with an increased use and duration of mechanical ventilation in patients with medical disorders that commonly require intensive care unit admission. We performed a retrospective cohort study using the Nationwide Inpatient Sample, a large all-payer inpatient database representing approximately 1,000 hospitals. For the years 2002 to 2003, adult patients with 1 of the 6 most common diagnoses associated with medical intensive care unit admission were included in the study. Both univariate analysis and multivariable logistic regression were performed to determine whether AUD and alcohol withdrawal were independently associated with the use and duration of mechanical ventilation in these patients. There were a total 785,602 patients who fulfilled 1 of the 6 diagnoses, 26,577 (3.4%) had AUD, 3,967 (0.5%) had alcohol withdrawal, and 65,071 (8.3%) underwent mechanical ventilation (53% or =96 hours). Independent of the medical diagnosis, AUD was associated with an increased risk of requiring mechanical ventilation (13.7 vs 8.1%, odds ratio=1.49, 95% confidence interval [1.414; 1.574], palcohol withdrawal was associated with a longer duration of mechanical ventilation (57 vs 47%> or =96 hours, odds ratio=1.48, 95% confidence interval [1.266; 1.724], palcohol withdrawal is associated with a longer duration of mechanical ventilation.

  3. Alcohol

    Science.gov (United States)

    ... to do. Wondering if adding a glass of wine or beer might help lower your blood glucose if it is high? The effects of alcohol can be unpredictable and it is not recommended as a treatment for high blood glucose. The risks likely outweigh any benefit that may be seen in blood glucose alone. ...

  4. Overweight and obesity among children and adolescents with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Fuglestad, Anita J; Boys, Christopher J; Chang, Pi-Nian; Miller, Bradley S; Eckerle, Judith K; Deling, Lindsay; Fink, Birgit A; Hoecker, Heather L; Hickey, Marie K; Jimenez-Vega, Jose M; Wozniak, Jeffrey R

    2014-09-01

    Because prenatal alcohol exposure is associated with growth deficiency, little attention has been paid to the potential for overweight and obesity in children with fetal alcohol spectrum disorders (FASD). This study examined the prevalence of overweight/obesity (body mass index [BMI]) in a large clinical sample of children with FASD. Children, aged 2 to 19 years, who were evaluated for FASD at University Clinics, included 445 with an FASD diagnosis and 171 with No-FASD diagnosis. Prevalence of overweight/obesity (BMI ≥ 85 percentile) was compared to national and state prevalence. BMI was examined in relation to FASD diagnosis, gender, and age. Dietary intake data were examined for a young subsample (n = 42). Thirty-four percent with any FASD diagnosis were overweight or obese, which did not differ from the No-FASD group or U.S. prevalence. Underweight was prevalent in those with fetal alcohol syndrome (FAS) (17%). However, increased rates of overweight/obesity were seen in those with partial FAS (40%). Among adolescents, those with any FASD diagnosis had increased overweight/obesity (42%), particularly among females (50%). The rate in adolescent females with FASD (50%) was nearly 3 times higher than state prevalence for adolescent females (17 to 18%), p overweight/obese consumed more calories, protein, and total fat per day than those who were not overweight or obese. Rates of overweight/obesity are increased in children with partial FAS. In adolescents, rates are increased for any FASD diagnosis (particularly in females). Results are suggestive of possible metabolic/endocrine disruption in FASD-a hypothesis for which there is evidence from animal models. These data suggest that clinicians may consider prenatal alcohol exposure as a risk factor for metabolic/endocrine disruption, should evaluate diet as a risk in this population, and may need to target interventions to females prior to puberty to effect changes in overweight-related outcomes. Copyright © 2014 by

  5. What the Spectrum of Microglial Functions Can Teach us About Fetal Alcohol Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Elissa L. Wong

    2017-06-01

    Full Text Available Alcohol exposure during gestation can lead to severe defects in brain development and lifelong physical, behavioral and learning deficits that are classified under the umbrella term fetal alcohol spectrum disorder (FASD. Sadly, FASD is diagnosed at an alarmingly high rate, affecting 2%–5% of live births in the United States, making it the most common non-heritable cause of mental disability. Currently, no standard therapies exist that are effective at battling FASD symptoms, highlighting a pressing need to better understand the underlying mechanisms by which alcohol affects the developing brain. While it is clear that sensory and cognitive deficits are driven by inappropriate development and remodeling of the neural circuits that mediate these processes, alcohol’s actions acutely and long-term on the brain milieu are diverse and complex. Microglia, the brain’s immune cells, have been thought to be a target for alcohol during development because of their exquisite ability to rapidly detect and respond to perturbations affecting the brain. Additionally, our view of these immune cells is rapidly changing, and recent studies have revealed a myriad of microglial physiological functions critical for normal brain development and long-term function. A clear and complete understanding of how microglial roles on this end of the spectrum may be altered in FASD is currently lacking. Such information could provide important insights toward novel therapeutic targets for FASD treatment. Here we review the literature that links microglia to neural circuit remodeling and provide a discussion of the current understanding of how developmental alcohol exposure affects microglial behavior in the context of developing brain circuits.

  6. The Chinese translations of Alcohol Use Disorders Identification Test (AUDIT) in China: a systematic review.

    Science.gov (United States)

    Li, Qing; Babor, Thomas F; Hao, Wei; Chen, Xinguang

    2011-01-01

    To systematically review the literature on the Chinese translations of the Alcohol Use Disorders Identification Test (AUDIT) and their cross-cultural applicability in Chinese language populations. We identified peer-reviewed articles published in English (n = 10) and in Chinese (n = 11) from 1980 to September 2009, with key words China, Chinese and AUDIT among PubMed, EBSCO, PsycInfo, FirstSearch electronic databases and two Chinese databases. Five teams from Beijing, Tibet, Taiwan and Hong Kong reported their region-specific translation procedures, cultural adaptations, validity (0.93-0.95 in two versions) and reliability (0.63-0.99). These Chinese translations and short versions demonstrated relatively high sensitivity (0.880-0.997) and moderate specificity (0.709-0.934) for hazardous/harmful drinking and alcohol dependence, but low specificity for alcohol dependence among Min-Nan Taiwanese (0.58). The AUDIT and its adaptations were most utilized in workplace- and hospital-settings for screening and brief intervention. However, they were under-utilized in population-based surveys, primary care settings, and among women, adolescents, rural-to-urban migrants, the elderly and minorities. Among 12 studies from mainland China, four included both women and men, and only one in Tibet was published in English. There is a growing amount of psychometric, epidemiologic and treatment research using Chinese translations of the AUDIT, much of it still unavailable in the English-language literature. Given the increase in burden of disease and injury attributable to alcohol use in the Western Pacific region, the use of an internationally comparable instrument (such as the AUDIT) in research with Chinese populations presents a unique opportunity to expand clinical and epidemiologic knowledge about alcohol problem epidemics.

  7. 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.

  8. Sympathy, shame, and few solutions: News media portrayals of fetal alcohol spectrum disorders.

    Science.gov (United States)

    Eguiagaray, Ines; Scholz, Brett; Giorgi, Caterina

    2016-09-01

    there is a lack of public understanding about fetal alcohol spectrum disorders (FASD), and many countries lack policies to deal with FASD concerns. Given the role of news media in disseminating a range of health information, the aim of the current study was to explore the media coverage on alcohol use during pregnancy and FASD, and to identify ways to improve associated health messages. the current study uses a framing analysis of news media reports about FASD over a 1-year period. Framing analysis seeks to better understand how media messages serve to shape the thoughts, feelings, and decisions of readers. two frames dominated the media coverage of FASD: a frame of sympathy, and a frame of shame. Some news media encouraged feelings of sympathy for children with FASD, while others encouraged sympathy towards mothers of these children. At the same time, mothers were also portrayed as deserving of shame. the interrelated frames of sympathy and shame may confuse readers, as they inconsistently hold different parties responsible for the impact of FASD. Media portrayals that encourage women to refrain from alcohol consumption during pregnancy might be more useful than stigmatising and isolating those who do. practitioners should be aware that conflicting messages about alcohol consumption during pregnancy might lead to shame and confusion, and should encourage openness with mothers to challenge stigma. Guidelines for media reporting should discourage stigmatising frames, and media articles should also consider the role that government, non-government organisations, and the alcohol industry could play for improving FASD shame. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Comparison of Alcohol Use Disorder Screens During College Athlete Pre-Participation Evaluations.

    Science.gov (United States)

    Majka, Erek; Graves, Travis; Diaz, Vanessa A; Player, Marty S; Dickerson, Lori M; Gavin, Jennifer K; Wessell, Andrea

    2016-05-01

    The US Preventive Services Task Force (USPSTF) recommends screening adults for alcohol misuse, a challenge among young adults who may not have regular primary care. The pre-participation evaluation (PPE) provides an opportunity for screening, but traditional screening tools require extra time in an already busy visit. The objective of this study was to compare the 10-item Alcohol Use Disorders Identification Test (AUDIT) with a single-question alcohol misuse screen in a population of college-aged athletes. This cross-sectional study was performed during an athletic PPE clinic at a college in the Southeastern United States among athletes ages 18 years and older. Written AUDIT and single-question screen "How many times in the past year have you had X or more drinks in a day?" (five for men, four for women) asked orally were administered to each participant. Sensitivity, specificity, and positive and negative predictive values for the single-question screen were compared to AUDIT. A total of 225 athletes were screened; 60% were female; 29% screened positive by AUDIT; 59% positive by single-question instrument. Males were more likely to screen positive by both methods. Compared to the AUDIT, the brief single-question screen had 92% sensitivity for alcohol misuse and 55% specificity. The negative predictive value of the single-question screen was 95% compared to AUDIT. A single-question screen for alcohol misuse in college-aged athletes had a high sensitivity and negative predictive value compared to the more extensive AUDIT screen. Ease of administration of this screening tool is ideal for use within the pre-participation physical among college-aged athletes who may not seek regular medical care.

  10. 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…

  11. Overview of Alcohol Consumption

    Science.gov (United States)

    ... of Alcohol Consumption Alcohol's Effects on the Body Alcohol Use Disorder Fetal Alcohol Exposure Support & Treatment Alcohol Policy Special ... experience alcohol’s longer-term effects, which can include: Alcohol use disorder Health problems Increased risk for certain cancers In ...

  12. Lifetime posttraumatic stress disorder in Turkish alcohol-dependent inpatients: relationship with depression, anxiety and erectile dysfunction.

    Science.gov (United States)

    Evren, Cuneyt; Can, Suat; Evren, Bilge; Saatcioglu, Omer; Cakmak, Duran

    2006-02-01

    The aim of the present study was to evaluate the prevalence of lifetime posttraumatic stress disorder (PTSD) in Turkish male alcohol-dependent inpatients, and to investigate the relationship of lifetime PTSD diagnosis with anxiety, depression, hopelessness, erectile dysfunction and psychosocial problems related with alcohol dependency. Eighty-two male inpatients who met DSM-IV criteria for alcohol dependence and 48 subjects without substance use disorder as a control group were included in the study. Subjects were applied the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Michigan Alcoholism Screening Test (MAST), the Beck Hopelessness Scale (BHS) and the International Index of Erectile Function (IIEF). Rate of lifetime PTSD diagnosis was found to be 26.8% among alcohol-dependent inpatients. The mean age of patients with lifetime PTSD was lower than in patients without this diagnosis, while there were no significant differences between these two groups in terms of age of first alcohol use, lifetime major depression, current depression, presence and severity of erectile dysfunction. Mean scores of HAM-D, HAM-A, BHS and MAST in the group with lifetime PTSD were significantly higher than the group without this diagnosis. There was a positive relationship between lifetime PTSD diagnosis and depression, anxiety, hopelessness and severity of psychosocial problems related to alcohol dependency, while there was no relationship between lifetime PTSD comorbidity and erectile dysfunction in alcohol-dependent patients.

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

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    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

  14. Mental health and alcohol, drugs and tobacco: a review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs.

    Science.gov (United States)

    Jané-Llopis, Eva; Matytsina, Irina

    2006-11-01

    This paper reviews some major epidemiological studies undertaken in high-income countries during the last 15 years which have reported the prevalence of mental disorders and substance use disorders and their relationship. Comorbidity between mental and substance use disorders is highly prevalent across countries. In general, people with a substance use disorder had higher comorbid rates of mental disorders than vice versa, and people with illicit drug disorders had the highest rates of comorbid mental disorders. There is a strong direct association between the magnitude of comorbidity and the severity of substance use disorders. While causal pathways differ across substances and disorders, there is evidence that alcohol is a casual factor for depression, in some European countries up to 10% of male depression. Policies that reduce the use of substances are likely to reduce the prevalence of mental disorders. Treatment should be available in an integrated fashion for both mental and substance use disorders. There is a need to expand the evidence base on comorbidity, particularly in low-income countries.

  15. Prevalence and associated factors with alcohol use disorders among adults: a population-based study in southern Brazil.

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    Reisdorfer, Emilene; Büchele, Fátima; Pires, Rodrigo Otávio Moretti; Boing, Antonio Fernando

    2012-09-01

    The study aimed to describe the prevalence of alcohol use disorders in an adult population from Brazil and its association with demographic, socioeconomic, behavioral variables and health conditions. A population-based cross-sectional survey was conducted with adults (20 to 59 years) of a medium-sized city in Southern Brazil with a random sample of 1,720 individuals. Cluster sampling was done in two stages: census tract first and household second. Alcohol use disorders were measured using the Alcohol Use Disorders Identification Test (AUDIT) and associations were tested with selected variables by Poisson Regression. Results of multivariate analysis were expressed as prevalence ratios. The prevalence of alcohol use disorders in the population was 18.4% (95% CI: 16.6% - 20.3%), higher among men (29.9%) than in women (9.3%). The prevalence of abstinence was 30.6%; 6.8% of respondents had already caused problems to themselves or to others after drinking; and 10.3% reported that a relative, friend or doctor had already shown concern on their drinking. After multivariate analysis, an association with alcohol use disorders remained for: being male, age 20 to 29 years, being single, declaring to be light-skinned blacks and being an ex-smoker or current smoker. The prevalence of alcohol use disorders identified is high compared with other similar studies, with differences according to being male, age 20 to 29, skin color and tobacco use. These issues must be considered in formulating public health policies aimed at reducing problems related to alcohol use.

  16. Medications for addiction treatment: an opportunity for prescribing clinicians to facilitate remission from alcohol and opioid use disorders.

    Science.gov (United States)

    Park, Tae Woo; Friedmann, Peter D

    2014-10-01

    Substance use disorders are a leading cause of morbidity and mortality in the United States. Medications for the treatment of substance use disorders are effective yet underutilized. This article reviews recent literature examining medications used for the treatment of alcohol and opioid use disorders. The neurobehavioral rationale for medication treatment and the most common ways medications work in the treatment of substance use disorders are discussed. Finally, the medications and the evidence behind their effectiveness are briefly reviewed. Physicians and other prescribing clinicians should take an active role in facilitating remission and recovery from substance use disorders by prescribing these effective medications with brief medical management counseling.

  17. Maternal smoking during pregnancy and risk of alcohol use disorders among adult offspring.

    Science.gov (United States)

    Nomura, Yoko; Gilman, Stephen E; Buka, Stephen L

    2011-03-01

    The aim of this study was to evaluate the association between maternal smoking during pregnancy (MSP) and lifetime risk for alcohol use disorder (AUD) and to explore possible mechanisms through which MSP may be related to neurobehavioral conditions during infancy and childhood, which could, in turn, lead to increased risk for AUD. A sample of 1,625 individuals was followed from pregnancy for more than 40 years. Capitalizing on the long follow-up time, we used survival analysis to examine lifetime risks of AUD (diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) in relation to levels of MSP (none, pregnancy) and child (to improve academic functioning) may reduce the risk for subsequent AUD.

  18. Sleep and melatonin secretion abnormalities in children and adolescents with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Goril, Shery; Zalai, Dora; Scott, Louise; Shapiro, Colin M

    2016-07-01

    Caregivers describe significant sleep disturbances in the vast majority of children and adolescents, which is diagnosed as fetal alcohol spectrum disorders (FASD), but objective data on sleep disorders in this population are almost completely lacking. Animal models suggest that intrauterine alcohol exposure may disrupt sleep wake patterns, cause sleep fragmentation, and specifically affect the suprachiasmatic nucleus, thus disrupting melatonin secretion. The objective of this pioneering study was to evaluate sleep and melatonin abnormalities in children with FASD using objective, gold-standard measures. Children and adolescents (N = 36, 6-18 years) with FASD participated in clinical assessments by sleep specialists, overnight polysomnography (PSG), and a dim light melatonin onset (DLMO) test in a pediatric sleep laboratory. PSG was analyzed according to standardized scoring guidelines and sleep architecture was compared with normative data. DLMOs were determined and melatonin secretion curves were evaluated qualitatively to classify melatonin profiles. Sleep disorders were evaluated according to international diagnostic criteria. There was a high prevalence (58%) of sleep disorders. The most common sleep problems were parasomnias (27.9%) and insomnia (16.8%). The sleep studies showed lower than normal sleep efficiency and high rates of sleep fragmentation. Most participants (79%) had an abnormal melatonin profile. This study led to the recognition that both sleep and melatonin secretion abnormalities are present in children with FASD. Therefore, to be effective in managing the sleep problems in children with FASD, one needs to consider both the sleep per se and a possible malfunction of the circadian regulation. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Muralidharan, Pooja; Sarmah, Swapnalee; Zhou, Feng C; Marrs, James A

    2013-06-19

    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.

  20. 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.

  1. Prevention of Fetal Alcohol Spectrum Disorder: Current Canadian Efforts and Analysis of Gaps

    Directory of Open Access Journals (Sweden)

    Nancy Poole

    2016-01-01

    Full Text Available Effective prevention of risky alcohol use in pregnancy involves much more than providing information about the risk of potential birth defects and developmental disabilities in children. To categorize the breadth of possible initiatives, Canadian experts have identified a four-part framework for fetal alcohol spectrum disorder (FASD prevention: Level 1, public awareness and broad health promotion; Level 2, conversations about alcohol with women of childbearing age and their partners; Level 3, specialized support for pregnant women; and Level 4, postpartum support for new mothers. In order to describe the level of services across Canada, 50 Canadian service providers, civil servants, and researchers working in the area of FASD prevention were involved in an online Delphi survey process to create a snapshot of current FASD prevention efforts, identify gaps, and provide ideas on how to close these gaps to improve FASD prevention. Promising Canadian practices and key areas for future action are described. Overall, Canadian FASD prevention programming reflects evidence-based practices; however, there are many opportunities to improve scope and availability of these initiatives.

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

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    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.

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

    Science.gov (United States)

    de Vries, Marlene M.; Joubert, Belinda; Cloete, Marise; Roux, Sumien; Baca, Beth A.; Hasken, Julie M.; Barnard, Ronel; Buckley, David; Kalberg, Wendy O.; Snell, Cudore L.; Marais, Anna-Susan; Seedat, Soraya; Parry, Charles D. H.; May, Philip A.

    2015-01-01

    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. PMID:26703708

  4. Mapping White Matter Integrity and Neurobehavioral Correlates in Children with Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Sowell, Elizabeth R.; Johnson, Arianne; Kan, Eric; Lu, Lisa H.; Van Horn, John Darrell; Toga, Arthur W.; O’Connor, Mary J.; Bookheimer, Susan Y.

    2013-01-01

    Brain structural abnormalities and neurocognitive dysfunction have been observed in individuals with fetal alcohol spectrum disorders (FASDs). Little is known about how white matter integrity is related to these functional and morphological deficits. We used a combination of diffusion tensor and T1-weighted magnetic resonance imaging to evaluate white matter integrity in individuals with FASDs and related these findings to neurocognitive deficits. Seventeen children and adolescents with FASDs were compared with 19 typically developing age-and gender-matched controls. Lower fractional anisotropy (FA) was observed in individuals with FASDs relative to controls in the right lateral temporal lobe and bilaterally in the lateral aspects of the splenium of the corpus callosum. White matter density was also lower in some, but not all regions in which FA was lower. FA abnormalities were confirmed to be in areas of white matter in post hoc region of interest analyses, further supporting that less myelin or disorganized fiber tracts are associated with heavy prenatal alcohol exposure. Significant correlations between performance on a test of visuomotor integration and FA in bilateral splenium, but not temporal regions were observed within the FASD group. Correlations between the visuomotor task and FA within the splenium were not significant with in the control group, and were not significant for measures of reading ability. This suggests that this region of white matter is particularly susceptible to damage from prenatal alcohol exposure and that disruption of splenial fibers in this group is associated with poorer visuomotor integration. PMID:18256251

  5. Theory of Mind in Children with Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Lindinger, Nadine M; Malcolm-Smith, Susan; Dodge, Neil C; Molteno, Christopher D; Thomas, Kevin G F; Meintjes, Ernesta M; Jacobson, Joseph L; Jacobson, Sandra W

    2016-02-01

    Theory of mind (ToM) refers to the ability to understand and make inferences about other people's intentions, feelings, and beliefs. Although children with fetal alcohol spectrum disorders (FASD) are known to have deficits in social-cognitive function, little is known about ToM in FASD. ToM ability was assessed using a developmentally sensitive ToM battery, including the reading the mind in the eyes (RME) test, a measure of mental inferential ability that has been found to be impaired in other clinical populations. IQ and executive function (EF) were assessed as potential mediating variables. The battery was administered to 63 children (aged 9 to 11 years) from Cape Town, South Africa, whose mothers had been prospectively recruited during pregnancy. Children with fetal alcohol syndrome (FAS; n = 8) and partial FAS (PFAS; n = 19), as well as nonsyndromal heavily exposed children (n = 17), were compared to children born to abstaining or light drinkers (n = 19) from the same community. No FASD group differences were found on the less challenging ToM tasks. By contrast, children with FAS and PFAS performed more poorly than controls on a more challenging ToM task, the RME test. A continuous measure of prenatal alcohol exposure (PAE) was more sensitive than FASD diagnosis in that it was related to 4 higher-order ToM measures, particularly the ability to attribute mental states assessed on RME. IQ only partially mediated the effect of exposure on RME performance, and these effects were not mediated by EF. Hence, the data suggest that these ToM measures tap into a specific alcohol-related social-cognitive deficit that does not merely reflect poorer EF. FASD diagnosis and PAE were each also related to RME after control for attention deficit/hyperactivity disorder. These findings suggest that deficits in higher-order ToM function may play a significant role in the social-cognitive behavioral impairment in FASD. Copyright © 2016 by the Research Society on Alcoholism.

  6. Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

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    Preuss UW

    2012-05-01

    Full Text Available Ulrich W Preuss,1 Jörg Zimmermann,2,3 Gabriele Schultz,2 Anna Watzke,2 Peggy Schmidt,4 Bärbel Löhnert,5 Michael Soyka2,61Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle-Wittenberg, Halle, Germany; 2Ev Krankenhaus Bethanien GmbH, Fachklinik Gristower Wiek, Johanna-Odebrecht-Stiftung, Germany; 3Karl-Jaspers-Klinik, Fachkrankenhaus für Psychiatrie und Psychotherapie, Psychiatrieverbund Oldenburger Land, Germany; 4Department of Psychiatry, Ludwig-Maximilians-Universität Munich, Germany; 5Klientenzentrierte Problemberatung, Dachau/Munich, Germany; 6Privatklinik Meiringen, Meiringen, Switzerland Background: Rehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion.Methods: A total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncompleters for any reason.Results: A total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be

  7. Polymorphisms of genes in neurotransmitter systems were associated with alcohol use disorders in a Tibetan population.

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    Yan Xu

    Full Text Available Studies of linkage and association in various ethnic populations have revealed many predisposing genes of multiple neurotransmitter systems for alcohol use disorders (AUD. However, evidence often is contradictory regarding the contribution of most candidate genes to the susceptibility of AUD. We, therefore, performed a case-control study to investigate the possible associations of genes selected from multiple neurotransmitter systems with AUD in a homogeneous Tibetan community population in China. AUD cases (N = 281 with an alcohol use disorder identification test (AUDIT score ≥10, as well as healthy controls (N = 277 with an AUDIT score ≤5, were recruited. All participants were genotyped for 366 single nucleotide polymorphisms (SNPs of 34 genes selected from those involved in neurotransmitter systems. Association analyses were performed using PLINK version 1.07 software. Allelic analyses before adjustment for multiple tests showed that 15 polymorphisms within seven genes were associated with AUD (p<0.05. After adjustment for the number of SNPs genotyped within each gene, only the association of a single marker (rs10044881 in HTR4 remained statistically significant. Haplotype analysis for two SNPs in HTR4 (rs17777298 and rs10044881 showed that the haplotype AG was significantly associated with the protective effect for AUD. In conclusion, the present study discovered that the HTR4 gene may play a marked role in the pathogenesis of AUD. In addition, this Tibetan population sample marginally replicated previous evidence regarding the associations of six genes in AUD.

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

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    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

  9. Risky alcohol use in young persons with emerging bipolar disorder is associated with increased oxidative stress.

    Science.gov (United States)

    Chitty, Kate M; Lagopoulos, Jim; Hickie, Ian B; Hermens, Daniel F

    2013-09-25

    Alcohol misuse is highly prevalent in bipolar disorder (BD) and has been associated with increased formation of reactive oxygen species in the CNS. Proton magnetic resonance spectroscopy ((1)H-MRS) is an in vivo tissue-based imaging modality that allows the investigation of changes in the brains primary antioxidant, glutathione (GSH), as a result of alcohol use in this population. Thirty-three patients with BD and 17 controls aged 18-30 years were recruited. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and underwent (1)H-MRS. Levels of GSH in the anterior cingulate cortex (ACC) were determined. ANOVA was conducted to determine differences between high and low risk drinking bipolar participants and controls. ANOVA with all groups revealed a significant difference in GSH between bipolar high and low risk drinkers, with those in the high-risk group displaying reduced GSH levels. A significant negative correlation was found between total AUDIT score and GSH in bipolar (R=-0.478, p=0.005) which remained significant when controlling for age and medication status. Our participant sample consisted of a heterogeneous group of patients, most of whom were medicated at time of testing. Young people with emerging BD who drink at risky levels display reduced levels of ACC-GSH. Increased oxidative stress and its resulting neurotoxic effects may be especially detrimental in an emerging bipolar sample where the illness trajectory is unclear and the brain is still undergoing significant development. © 2013 Elsevier B.V. All rights reserved.

  10. The Impact of Mobile Apps on Alcohol Use Disorder: A Systematic Review Protocol.

    Science.gov (United States)

    Sawares, Antoine Sa; Shen, Nelson; Xue, Yunlin; Abi-Jaoude, Alexxa; Wiljer, David

    2017-04-04

    Alcohol use disorder (AUD) is among the most prevalent mental disorders worldwide and is associated with a diverse range of physical and psychological comorbidities. Despite various types of treatment, there are many barriers to accessing treatment (ie, stigma, cost, accessibility of service, etc). Mobile apps have the potential to overcome these barriers and provide support to those who need it. The purpose of this systematic review is to assess the effectiveness of mobile apps in reducing alcohol consumption for individuals with AUD and understand the psychological outcomes of using the apps (ie, client empowerment, self-efficacy, etc). The search strategy was applied to 7 health sciences and interdisciplinary databases. Two reviewers will independently assess all titles and abstracts for relevance and then full texts of relevant articles for eligibility. To be included, the article must be a quantitative evaluation of clinical outcomes using the intervention and the intervention must be a consumer-facing app focused on supporting individuals with AUD. Two reviewers will independently extract data from all eligible articles using a standardized extraction worksheet and will independently assess the study quality. A meta-analysis will be conducted if appropriate. Depending on outcomes reported, pooled risk ratios or standardized mean differences will be calculated and reported in the review. The search strategy yielded 699 unique citations. Of those, 63 (9.0%, 63/699) articles were assessed as relevant for full-text review. The full-text reviews are currently underway and the final review is projected to be completed in the summer of 2017. There is potential for mobile apps to support individuals with AUD to reduce their alcohol consumption. This review will be the first to assess the effectiveness of AUD mobile apps and client experiences using the apps. ©Antoine SA Sawares, Nelson Shen, Yunlin Xue, Alexxa Abi-Jaoude, David Wiljer. Originally published in JMIR

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

    Science.gov (United States)

    Obadeji, Adetunji; Oluwole, Lateef O; Dada, Mobolaji U; Ajiboye, Adedotun S

    2015-01-01

    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. 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. 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. 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.

  12. Beyond alcoholism: Wernicke-Korsakoff syndrome in patients with psychiatric disorders.

    Science.gov (United States)

    McCormick, Laurie M; Buchanan, Judith R; Onwuameze, Obiora E; Pierson, Ronald K; Paradiso, Sergio

    2011-12-01

    Wernicke encephalopathy and Korsakoff syndrome (the combined disorder is named Wernicke-Korsakoff syndrome [WKS]) are preventable, life-threatening neuropsychiatric syndromes resulting from thiamine deficiency. WKS has historically been associated with alcoholism; more recently, it has been recognized in patients who have anorexia nervosa or have undergone bariatric surgery for obesity. However, patients with nutritional deficiencies of any origin are at risk for WKS. We present clinical histories and neuroimaging data on 2 young adults with underlying psychiatric disorders who became malnourished and developed WKS. A young woman with bipolar disorder and somatization disorder was hospitalized for intractable vomiting. A young man with chronic paranoid schizophrenia developed delusions that food and water were harmful, and was hospitalized after subsisting for 4 months on soda pop. Acute, life-threatening Wernicke encephalopathy was confirmed in both patients by brain magnetic resonance imaging showing classic thalamic injury. The patients were left with persistent cognitive and physical disabilities that were consistent with Korsakoff syndrome. Failure to suspect a vitamin deficiency led to permanent cognitive and physical disabilities that may necessitate lifelong care for these patients. The neuropsychiatric consequences could have been prevented by prompt recognition of their thiamine deficiency.

  13. Alcohol use disorders and associated chronic disease – a national retrospective cohort study from France

    Directory of Open Access Journals (Sweden)

    Michaël Schwarzinger

    2017-07-01

    Full Text Available Abstract Background Evidence on diseases caused by or associated with alcohol use disorders (AUDs has been based on two meta-analyses including rather dated studies. The objective of this contribution was to estimate the risks of all-cause mortality and alcohol-attributable disease categories depending on a diagnosis of AUDs in a national sample for France. Methods In a national retrospective cohort study on all inpatient acute and rehabilitation care patients in Metropolitan France 2008–2012 (N = 26,356,361, AUDs and other disease categories were identified from all discharge diagnoses according to standard definitions, and we relied on in-hospital death for mortality (57.4% of all deaths. Results 704,803 (2.7% patients identified with AUDs had a threefold higher risk of death (HR = 2.98; 95% CI: 2.96–3.00 and died on average 12.2 years younger (men: 10.4, 95% CI: 10.3–10.5; women: 13.7, 95% CI: 13.6–13.9. AUDs were associated with significantly higher risks of hospital admission for all alcohol-attributable disease categories: digestive diseases, cancers (exception: breast cancer, cardiovascular diseases, dementia, infectious diseases, and injuries. Elevated risks were highest for liver diseases that were associated with about two-third of deaths in patients with AUDs (men: 64.3%; women: 71.1%. Conclusions AUDs were associated with marked premature mortality and higher risks of alcohol-attributable disease categories. Our results support the urgent need of measures to reduce the burden of AUDs.

  14. An exploration of the experiences and perspectives of New Zealanders with fetal alcohol spectrum disorder.

    Science.gov (United States)

    Salmon, Jenny V; Buetow, Stephen A

    2012-01-01

    The experiences and perspectives of New Zealanders with fetal alcohol spectrum disorder (FASD) need to be heard since no research to date has been performed. FASD, a neuro-developmental disability with life-lasting effects, is irreversible. The condition is caused by prenatal exposure to alcohol. This study aimed to explore and understand the daily challenges of New Zealand individuals with FASD. Our sequential mixed methods design used two discrete but compatible qualitative methodologies--transcendental phenomenology in Phase One and classic grounded theory in Phase Two--framed by the meta-theory of pragmatism, which allows the use of 'what works' in research. One methodology alone would not have answered our research question. Using the same sample of 14 individuals, 14 to 37 years, two separate data sets were produced sequentially using face-to-face unstructured interviews. Participants had been diagnosed with either fetal alcohol syndrome (FAS) or fetal alcohol effects (FAE). Data credibility was checked using triangulation. Six themes common to the participants' experiences emerged: daily challenges in the classroom; daily challenges in the workplace; coping with mental health issues; memory problems; socialization difficulties and involvement with the law and authority. Phase Two's emerging theory revealed that because the participants perceived they had been under-supported by the social/health systems, many engaged in illegal behaviours (secondary disabilities) and experienced employment and social problems. Many disavowed having the disability, but with maturity and knowing the signs and symptoms, accepted it. They suggested ways in which their concerns could be resolved. In order that progress in this field can take place, health and social agencies, educational and criminal justice systems and policy-makers need to have increased awareness of the disability and the complex problems that individuals with the disability and their families face.

  15. DSM-5 Alcohol Use Disorder Severity in Puerto Rico: Prevalence, Criteria Profile, and Correlates.

    Science.gov (United States)

    Caetano, Raul; Gruenewald, Paul; Vaeth, Patrice A C; Canino, Glorisa

    2018-02-01

    Our aim was to examine lifetime criteria profiles and correlates of severity (mild, moderate, severe) of DSM-5 alcohol use disorders (AUD) in Puerto Rico. Data are from a household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. The survey response rate was 83%. DSM-5 AUD was identified with the Spanish version of the World Health Organization's Composite International Diagnostic Interview. The analyses also identify correlates of each severity level using an ordered logistic regression model. The prevalence of lifetime DSM-5 AUD among men and women was 38 and 16%, respectively. Mild lifetime DSM-5 AUD was the most prevalent severity level among both men (18%) and women (9%). The most common criteria, independent of gender and severity level, were drinking larger quantities and for longer than planned (men range: 80 to 97%; women range: 78 to 91%) and hazardous use (men range: 56 to 91%; women range: 42 to 74%). Results from ordered logistic regression showed that the adjusted odds ratio for weekly drinking frequency, greater volume of alcohol consumed per drinking occasion, positive attitudes about drinking, drinking norms, and male gender invariantly increased risks across all DSM-5 AUD severity levels (mild, moderate, severe). Greater negative attitudes about drinking, low family cohesion, and Protestant religion were related to greater risks at higher AUD severity levels. AUD prevalence is high in San Juan, Puerto Rico. Prevalence rates for some criteria are equally high across severity levels and poorly differentiate between mild, moderate, or severe DSM-5 AUD. The sociodemographic and alcohol-related risks vary across DSM-5 severity levels. Copyright © 2018 by the Research Society on Alcoholism.

  16. Feeling safe but appearing anxious: Differential effects of alcohol on anxiety and social performance in individuals with social anxiety disorder.

    Science.gov (United States)

    Stevens, Stephan; Cooper, Ruth; Bantin, Trisha; Hermann, Christiane; Gerlach, Alexander L

    2017-07-01

    Social anxiety disorder (SAD) and alcohol use disorders (AUD) co-occur frequently and there is preliminary evidence that alcohol might reduce social anxiety. It is, however, unclear which mechanisms contribute to the anxiety reducing effect, particularly regarding key aspects of social anxiety such as deficits in social performance. We compared self-rated and physiological measures of anxiety as well as self- and observer-rated social performance in a sample of 62 individuals with SAD and 60 nonanxious control participants during a speech task after receiving either alcohol, an alcohol-free placebo drink or orange juice. SAD patients reported more anxiety during the speech task than did control participants. Furthermore, SAD patients underestimated their performance in comparison to observer ratings. Alcohol reduced self-report anxiety only in SAD patients, while observers rated all participants as less competent when intoxicated. Although individuals with SAD experience a reduction in anxiety when drinking alcohol, simultaneous decreases in social performance might contribute to negative reactions from others and consequently increase the risk of further alcohol use to cope with these negative reactions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. The use of alcohol use disorders identification test (AUDIT) in detecting alcohol use disorder and risk drinking in the general population: validation of AUDIT using schedules for clinical assessment in neuropsychiatry.

    Science.gov (United States)

    Lundin, Andreas; Hallgren, Mats; Balliu, Natalja; Forsell, Yvonne

    2015-01-01

    The alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) are commonly used in population surveys but there are few validations studies in the general population. Validity should be estimated in samples close to the targeted population and setting. This study aims to validate AUDIT and AUDIT-C in a general population sample (PART) in Stockholm, Sweden. We used a general population subsample age 20 to 64 that answered a postal questionnaire including AUDIT who later participated in a psychiatric interview (n = 1,093). Interviews using Schedules for Clinical Assessment in Neuropsychiatry was used as criterion standard. Diagnoses were set according to the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Agreement between the diagnostic test and criterion standard was measured with area under the receiver operator characteristics curve (AUC). A total of 1,086 (450 men and 636 women) of the interview participants completed AUDIT. There were 96 individuals with DSM-IV-alcohol dependence, 36 DSM-IV-Alcohol Abuse, and 153 Risk drinkers. AUCs were for DSM-IV-alcohol use disorder 0.90 (AUDIT-C 0.85); DSM-IV-dependence 0.94 (AUDIT-C 0.89); risk drinking 0.80 (AUDIT-C 0.80); and any criterion 0.87 (AUDIT-C 0.84). In this general population sample, AUDIT and AUDIT-C performed outstanding or excellent in identifying dependency, risk drinking, alcohol use disorder, any disorder, or risk drinking. Copyright © 2015 by the Research Society on Alcoholism.

  18. Evidence for phase-based psychotherapy as a treatment for dissociative identity disorder comorbid with major depressive disorder and alcohol dependence.

    Science.gov (United States)

    Pollock, Brianna E; Macfie, Jenny; Elledge, L Christian

    2017-01-01

    We report on the treatment and successful outcome of a 58-year-old Native American male with a history of complex trauma presenting with dissociative identity disorder (DID) and major depressive disorder. The treatment included a trauma-informed phase-based psychotherapy as recommended by the International Society for the Study of Trauma and Dissociation for treating DID. We assessed symptoms at baseline and at three additional time points over the course of 14 months. We utilized the Reliable Change Index to examine statistically significant change in symptoms over the course of treatment. Significant symptom improvements were realized posttreatment across all measured domains of functioning, including dissociative symptoms, alcohol abuse, depression, anxiety, and emotion regulation skills. Moreover, the client no longer met criteria for DID, major depressive disorder, or alcohol abuse. Results are discussed in terms of the effectiveness of trauma-focused, phase-based treatment for DID for cases of complex trauma with comorbid disorders.

  19. Posttraumatic stress disorder, depression, and alcohol and tobacco use in public health workers after the 2004 Florida hurricanes.

    Science.gov (United States)

    Fullerton, Carol S; McKibben, Jodi B A; Reissman, Dori B; Scharf, Ted; Kowalski-Trakofler, Kathleen M; Shultz, James M; Ursano, Robert J

    2013-02-01

    We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.

  20. Effects of two doses of alcohol on simulator driving performance in adults with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Barkley, Russell A; Murphy, Kevin R; O'Connell, Trisha; Anderson, Deborah; Connor, Daniel F

    2006-01-01

    Prior studies have documented greater impairments in driving performance and greater alcohol consumption among adults with attention-deficit/hyperactivity disorder (ADHD). This study examined whether alcohol consumption produces a differentially greater impairment in driving among adults with ADHD in comparison to a community control group. The present study compared 50 adults with ADHD (mean age 33 years) and 40 control adults (mean age 29 years) on the effects of 2 single, acute doses of alcohol (0.04 and 0.08 blood alcohol concentration) and a placebo on their driving performance. The authors used a virtual reality driving simulator, examiner and self-ratings of simulator performance, and a continuous performance test (CPT) to evaluate attention and inhibition. Approximately half of the adults in each group were randomized to either the low or high dose alcohol treatment arms. Alcohol consumption produced a greater impact on the CPT inattention measures of the ADHD than the control group. Similar results were obtained for the behavioral observations taken during the operation of the driving simulator. Driving simulator scores, however, showed mainly a deleterious effect of alcohol on all participants but no differentially greater effect on the ADHD group. The present results demonstrated that alcohol may have a greater detrimental effect on some aspects of driving performance in ADHD than control adults.

  1. Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment

    Science.gov (United States)

    Gimeno, Carmen; Dorado, Marisa Luisa; Roncero, Carlos; Szerman, Nestor; Vega, Pablo; Balanzá-Martínez, Vicent; Alvarez, F. Javier

    2017-01-01

    Patients with alcohol-use disorders (AUDs) have a high prevalence of anxiety disorders (AnxDs). “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives. PMID:29018367

  2. Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment

    Directory of Open Access Journals (Sweden)

    Carmen Gimeno

    2017-09-01

    Full Text Available Patients with alcohol-use disorders (AUDs have a high prevalence of anxiety disorders (AnxDs. “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs, especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives.

  3. Negative Affect Intensity and Hostility in Individuals with Alcohol Use Disorder with or without Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Gandelman, Erin; Petrakis, Ismene; Kachadourian, Lorig; Ralevski, Elizabeth

    2018-02-20

    Negative affect intensity and hostility have both been implicated in alcohol use disorders (AUD) and post-traumatic stress disorder (PTSD) when they occur separately, but have neither been compared nor explored among those with dual diagnosis AUD and PTSD. This study is a secondary analysis designed to compare levels of negative affect intensity and hostility among those with AUD to those with dual diagnosis AUD and PTSD. Participants (n = 113) were recruited from the placebo-controlled groups of two distinct 12-week clinical trials (NCT00342563 and NCT00744055). The Short Affect Intensity Scale and Buss-Durkee Hostility Inventory were administered at weeks 0, 4, 8 and 12 to all study participants to assess negative affect intensity and hostility levels, respectively. Dual diagnosis AUD and PTSD individuals showed significantly higher levels of negative affect intensity and hostility than individuals with single diagnosis AUD. These levels remained relatively stable over the course of the study in spite of all study participants showing clinically significant improvements in AUD severity and PTSD symptomology (for those with dual diagnosis). Our results indicate that individuals with dual diagnosis AUD and PTSD have higher levels of negative affect and higher levels of hostility compared to individuals with single diagnosis AUD. In addition, these heightened levels of negative affect intensity and hostility appear to function somewhat independently of diagnosis severity and symptomology improvement. To our knowledge, this is the first study to compare negative affect intensity and hostility levels between single diagnosis AUD and dual diagnosis AUD and PTSD individuals.

  4. Alcohol-related and mental health care for patients with unhealthy alcohol use and posttraumatic stress disorder in a National Veterans Affairs cohort.

    Science.gov (United States)

    Chen, Jessica A; Owens, Mandy D; Browne, Kendall C; Williams, Emily C

    2018-02-01

    Unhealthy alcohol use and posttraumatic stress disorder (PTSD) frequently co-occur. Patients with both conditions have poorer functioning and worse treatment adherence compared to those with either condition alone. Therefore, it is possible that PTSD, when co-occurring with unhealthy alcohol use, may influence receipt of evidence-based alcohol-related care and mental health care. We evaluated receipt of interventions for unhealthy alcohol use and receipt of mental health follow-up care among patients screening positive for unhealthy alcohol use with and without PTSD in a national sample from the Veterans Health Administration (VA). National clinical and administrative data from VA's electronic medical record were used to identify all patients who screened positive for unhealthy alcohol use (AUDIT-C score≥5) between 10/1/09-5/30/13. Unadjusted and adjusted Poisson regression models were fit to estimate the relative rate and prevalence of receipt of: brief interventions (advice to reduce or abstain from drinking≤14days after positive screening), specialty addictions treatment for alcohol use disorder (AUD; documented visit≤365days after positive screening), pharmacotherapy for AUD (filled prescription≤365days after positive screening), and mental health care ≤14days after positive screening for patients with and without PTSD (documented with ICD-9 CM codes). In secondary analyses, we tested effect modification by both severity of unhealthy alcohol use and age. Among 830,825 patients who screened positive for unhealthy alcohol use, 140,388 (16.9%) had documented PTSD. Of the full sample, 71.6% received brief interventions, 10.3% received specialty AUD treatment, 3.1% received pharmacotherapy for AUD, and 24.0% received mental health care. PTSD was associated with increased likelihood of receiving all types of care. Adjusted relative rates were 1.04 (95% CI 1.03-1.05) for brief interventions, 1.06 (1.05-1.08) for specialty AUD treatment, 1.35 (1.31-1.39) for

  5. A review of social skills deficits in individuals with fetal alcohol spectrum disorders and prenatal alcohol exposure: profiles, mechanisms, and interventions.

    Science.gov (United States)

    Kully-Martens, Katrina; Denys, Kennedy; Treit, Sarah; Tamana, Sukhpreet; Rasmussen, Carmen

    2012-04-01

    Individuals gestationally exposed to alcohol experience a multitude of sociobehavioral impairments, including deficits in adaptive behaviors such as social skills. The goal of this report is to critically review research on social skills deficits in individuals with prenatal alcohol exposure, including individuals with and without fetal alcohol spectrum disorders (FASD). Social deficits are found in alcohol-exposed children, adults, and adolescents with and without a clinical presentation. These deficits tend to persist across the lifespan and may even worsen with age. Social deficits in this population appear to be independent of facial dysmorphology and IQ and are worse than can be predicted based on atypical behaviors alone. Abnormalities in neurobiology, executive function, sensory processing, and communication likely interact with contextual influences to produce the range of social deficits observed in FASD. Future investigations should strive to reconcile the relationship between social skills deficits in FASD and variables such as gender, age, cognitive profile, and structural and functional brain impairments to enable better characterization of the deficits observed in this population, which will enhance diagnosis and improve remediation. Copyright © 2011 by the Research Society on Alcoholism.

  6. Stress-induced change in serum BDNF is related to quantitative family history of alcohol use disorder and age at first alcohol use.

    Science.gov (United States)

    Sharma, Shobhit; Graham, Reiko; Rohde, Rodney; Ceballos, Natalie A

    2017-02-01

    Previous research in animal models suggests that brain-derived neurotrophic factor (BDNF) is involved in stress-modulated alcohol consumption. However, relatively few studies have investigated this issue in humans, and results of existing studies have been heterogeneous. The primary aim of the current study was to examine the within-subjects effect of acute stress (timed math plus cold pressor) on serum BDNF levels (ΔBDNF: post- minus pre-stress) in healthy social drinkers (N=68, 20 male). A secondary aim was to explore which heritable and environmental factors in our limited sample might exert the greatest influences on ΔBDNF. Importantly, presence versus absence of the BDNF Val 66 Met polymorphism (rs6265), which has often been discounted in studies of human serum BDNF, was included as a between-subjects control variable in all statistical analyses. Our results indicated that acute stress decreased serum BDNF. Further, multiple regression analyses revealed that quantitative family history of alcohol use disorder (qFH) and age at first alcohol use together accounted for 15% of the variance in ΔBDNF. Thus, the influences of qFH and age at first alcohol use may explain some of the heterogeneity that exists in previous studies of human serum BDNF. These results parallel findings in animal models and suggest that stress-related changes in serum BDNF are influenced by both heritable (qFH) and environmental (early alcohol consumption) factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Exposure to the Lebanon War of 2006 and effects on alcohol use disorders: The moderating role of childhood maltreatment☆

    Science.gov (United States)

    Keyes, Katherine M.; Shmulewitz, Dvora; Greenstein, Eliana; McLaughlin, Kate; Wall, Melanie; Aharonovich, Efrat; Weizman, Abraham; Frisch, Amos; Spivak, Baruch; Grant, Bridget F.; Hasin, Deborah

    2013-01-01

    Background Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history. Methods Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1306 respondents. War measures included self-reported days in an exposed region. Results Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95%C.I. 1.01–27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95%C.I. 0.25–1.01); test for interaction: X2 = 5.28, df = 1, P = 0.02. Conclusions Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened the risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life. PMID:24262650

  8. Exposure to the Lebanon War of 2006 and effects on alcohol use disorders: the moderating role of childhood maltreatment.

    Science.gov (United States)

    Keyes, Katherine M; Shmulewitz, Dvora; Greenstein, Eliana; McLaughlin, Kate; Wall, Melanie; Aharonovich, Efrat; Weizman, Abraham; Frisch, Amos; Spivak, Baruch; Grant, Bridget F; Hasin, Deborah

    2014-01-01

    Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history. Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1306 respondents. War measures included self-reported days in an exposed region. Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95%C.I. 1.01-27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95%C.I. 0.25-1.01); test for interaction: X(2)=5.28, df=1, P=0.02. Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened the risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Alcohol-use disorders and suicide: Results from a psychological autopsy study in Australia.

    Science.gov (United States)

    Kõlves, Kairi; Draper, Brian M; Snowdon, John; De Leo, Diego

    2017-11-01

    People who die by suicide have a higher risk of an alcohol-use disorder (AUD) at the time of death. The present study aims to compare 1) suicide cases with and without AUD, and 2) suicide and sudden-death controls with AUD. The psychological autopsy method was utilized to investigate suicide and sudden death in Australia (QLD and NSW). Initial information was gathered from coroners' offices. Potential informants were approached and semi-structured interviews were conducted. Univariate and multivariate logistic regression were applied. People with AUD who died by suicide were significantly more likely to have another substance-use disorder, history of suicide attempt, recent serious arguments with spouse/partner and other family members, been unfaithful to partner/spouse, be victims of a crime, and were less likely to be from a non-English speaking background. They were also younger and had higher levels of aggression compared to non-AUD suicides. AUD suicides were more likely to have mood disorders, previous suicide attempt, expressing hopelessness, higher scores in aggression towards self, romantic relationship breakup, and serious arguments with other family members than AUD sudden deaths. Aggressive behavior, having another substance-use disorder, and history of serious arguments with family members remained significant in the final model comparing suicides with and without AUD. Our findings support that aggressive behavior, comorbidity with other psychiatric disorders as predisposing factors, and recent interpersonal conflicts such as breakup and family conflicts can trigger suicide in people with AUD. There is a need for proper diagnosis, risk assessment, and treatment in suicidal people with AUD. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Determinants of common mental disorder, alcohol use disorder and cognitive morbidity among people coming for HIV testing in Goa, India.

    Science.gov (United States)

    Mayston, Rosie; Patel, Vikram; Abas, Melanie; Korgaonkar, Priya; Paranjape, Ramesh; Rodrigues, Savio; Prince, Martin

    2015-03-01

    To investigate associations between background characteristics (psychosocial adversity, risk behaviours/perception of risk and HIV-related knowledge, perceptions and beliefs) and psychological and cognitive morbidity among people coming for testing for HIV/AIDS in Goa, India. Analysis of cross-sectional baseline data (plus HIV status) from a prospective cohort study. Participants were recruited at the time of coming for HIV testing. Consistent with associations found among general population samples, among our sample of 1934 participants, we found that indicators of psychosocial adversity were associated with CMD (common mental disorder - major depression, generalised anxiety and panic disorder) among people coming for testing for HIV. Similarly, perpetration of intimate partner violence was associated with AUD (alcohol use disorder). Two STI symptoms were associated with CMD, and sex with a non-primary partner was associated with AUD. Suboptimal knowledge about HIV transmission and prevention was associated with low cognitive test scores. In contrast with other studies, we found no evidence of any association between stigma and CMD. There was no evidence of modification of associations by HIV status. Among people coming for testing for HIV/AIDS in Goa, India, we found that CMD occurred in the context of social and economic stressors (violence, symptoms of STI, poor education and food insecurity) and AUD was associated with violence and risky sexual behaviour. Further research is necessary to understand the role of gender, stigma and social norms in determining the relationship between sexual and mental health. Understanding associations between these background characteristics and psychological morbidity may help inform the design of appropriate early interventions for depression among people newly diagnosed HIV/AIDS. © 2014 John Wiley & Sons Ltd.

  11. A behavioral-genetic investigation of bulimia nervosa and its relationship with alcohol use disorder

    Science.gov (United States)

    Trace, Sara Elizabeth; Thornton, Laura Marie; Baker, Jessica Helen; Root, Tammy Lynn; Janson, Lauren Elizabeth; Lichtenstein, Paul; Pedersen, Nancy Lee; Bulik, Cynthia Marie

    2013-01-01

    Bulimia nervosa (BN) and alcohol use disorder (AUD) frequently co-occur and may share genetic factors; however, the nature of their association is not fully understood. We assessed the extent to which the same genetic and environmental factors contribute to liability to BN and AUD. A bivariate structural equation model using a Cholesky decomposition was fit to data from 7,241 women who participated in the Swedish Twin study of Adults: Genes and Environment. The proportion of variance accounted for by genetic and environmental factors for BN and AUD and the genetic and environmental correlations between these disorders were estimated. In the best-fitting model, the heritability estimates were 0.55 (95% CI: 0.37; 0.70) for BN and 0.62 (95% CI: 0.54; 0.70) for AUD. Unique environmental factors accounted for the remainder of variance for BN. The genetic correlation between BN and AUD was 0.23 (95% CI: 0.01; 0.44), and the correlation between the unique environmental factors for the two disorders was 0.35 (95% CI: 0.08; 0.61), suggesting moderate overlap in these factors. Findings from this investigation provide additional support that some of the same genetic factors may influence liability to both BN and AUD. PMID:23790978

  12. Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving.

    Science.gov (United States)

    Di Nicola, Marco; Tedeschi, Daniela; De Risio, Luisa; Pettorruso, Mauro; Martinotti, Giovanni; Ruggeri, Filippo; Swierkosz-Lenart, Kevin; Guglielmo, Riccardo; Callea, Antonino; Ruggeri, Giuseppe; Pozzi, Gino; Di Giannantonio, Massimo; Janiri, Luigi

    2015-03-01

    The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving. 95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample. 28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (paddictive behaviors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. [Reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test].

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    Zhang, C; Yang, G P; Li, Z; Li, X N; Li, Y; Hu, J; Zhang, F Y; Zhang, X J

    2017-08-10

    Objective: To assess the reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test (AUDIT) among medical students in China and to provide correct way of application on the recommended scales. Methods: An E-questionnaire was developed and sent to medical students in five different colleges. Students were all active volunteers to accept the testings. Cronbach's α and split-half reliability were calculated to evaluate the reliability of AUDIT while content, contract, discriminant and convergent validity were performed to measure the validity of the scales. Results: The overall Cronbach's α of AUDIT was 0.782 and the split-half reliability was 0.711. Data showed that the domain Cronbach's α and split-half reliability were 0.796 and 0.794 for hazardous alcohol use, 0.561 and 0.623 for dependence symptoms, and 0.647 and 0.640 for harmful alcohol use. Results also showed that the content validity index on the levels of items I-CVI) were from 0.83 to 1.00, the content validity index of scale level (S-CVI/UA) was 0.90, content validity index of average scale level (S-CVI/Ave) was 0.99 and the content validity ratios (CVR) were from 0.80 to 1.00. The simplified version of AUDIT supported a presupposed three-factor structure which could explain 61.175% of the total variance revealed through exploratory factor analysis. AUDIT semed to have good convergent and discriminant validity, with the success rate of calibration experiment as 100%. Conclusion: AUDIT showed good reliability and validity among medical students in China thus worth for promotion on its use.

  14. Employment Status, Depression, Drinking, and Alcohol Use Disorder in Puerto Rico.

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    Caetano, Raul; Vaeth, Patrice A C; Mills, Britain; Canino, Glorisa

    2016-04-01

    Our aim was to examine the association between employment status, depression, drinking, binge drinking, and DSM-5 alcohol use disorder in Puerto Rico. Data are from a 2013 to 2014 household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. Bivariate analyses showed that depression was 5 times higher among unemployed males than among those employed full time (21% vs. 4%) and 2 times higher among unemployed females compared to those employed part time or full time (18% vs. 7% and 9%). Employment status was not associated with weekly volume of drinking, but nonparticipation in the workforce was protective against drinking (odds ratio [OR] = 2.17; 95% confidence interval [CI]: 1.03 to 4.57; p gender was a factor of risk for being a current drinker (OR = 2; 95% CI = 1.53 to 2.6; p gender was protective against depression (OR = 0.32; 95% CI = 0.14 to 0.73; p employed only part time were almost 5 times more likely than females employed full time to be depressed (OR = 4.66; 95% CI = 1.25 to 17.38; p Employment status in Puerto Rico is associated with depression and with current drinking, but not with other alcohol-related outcomes. Perhaps Puerto Rico is a "wet" environment, where drinking is already at a relatively high level that is not affected by employment status. Perhaps the chronic high rate of unemployment in the island has also created familial (e.g., support) and personal level accommodations (e.g., participation in the informal economy) that do not include increased drinking. Copyright © 2016 by the Research Society on Alcoholism.

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

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    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

  16. Psychological distress among Plains Indian mothers with children referred to screening for Fetal Alcohol Spectrum Disorders

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    Parker Tassy

    2010-09-01

    Full Text Available Abstract Background Psychological distress (PD includes symptoms of depression and anxiety and is associated with considerable emotional suffering, social dysfunction and, often, with problematic alcohol use. The rate of current PD among American Indian women is approximately 2.5 times higher than that of U.S. women in general. Our study aims to fill the current knowledge gap about the prevalence and characteristics of PD and its association with self-reported current drinking problems among American Indian mothers whose children were referred to screening for fetal alcohol spectrum disorders (FASD. Methods Secondary analysis of cross-sectional data was conducted from maternal interviews of referred American Indian mothers (n = 152 and a comparison group of mothers (n = 33 from the same Plains culture tribes who participated in an NIAAA-funded epidemiology study of FASD. Referred women were from one of six Plains Indian reservation communities and one urban area who bore children suspected of having an FASD. A 6-item PD scale (PD-6, Cronbach's alpha = .86 was constructed with a summed score range of 0-12 and a cut-point of 7 indicating serious PD. Multiple statistical tests were used to examine the characteristics of PD and its association with self-reported current drinking problems. Results Referred and comparison mothers had an average age of 31.3 years but differed (respectively on: education ( Conclusions Psychological distress among referred mothers is significantly associated with having a self-reported drinking problem. FASD prevention requires multi-level prevention efforts that provide real opportunities for educational attainment and screening and monitoring of PD and alcohol use during the childbearing years. Mixed methods studies are needed to illuminate the social and cultural determinants at the base of the experience of PD and to identify the strengths and protective factors of unaffected peers who reside within the same

  17. Should symptom frequency be factored into scalar measures of alcohol use disorder severity?

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    Dawson, Deborah A; Grant, Bridget F

    2010-09-01

    To evaluate whether weighting counts of alcohol use disorder (AUD) criteria or symptoms by their frequency of occurrence improves their association with correlates of AUD. Data were collected in personal interviews with a representative sample of US adults interviewed in 1991-92. Analyses were conducted among past-year drinkers (12+ drinks, n = 18 352) and individuals with past-year DSM-IV AUD (n = 2770). Thirty-one symptom item indicators, whose frequency of occurrence was measured in eight categories, were used to create unweighted and frequency-weighted counts of DSM-IV past-year AUD symptoms and criteria. Correlates included density of familial alcoholism and past-year volume of ethanol intake, frequency of intoxication and utilization of alcohol treatment. Although the AUD correlates were associated strongly and positively with the frequency of AUD symptom occurrence, weighting for symptom frequency did not strengthen their association consistently with AUD severity scores. Improved performance of the weighted scores was observed primarily among AUD correlates linked closely with the frequency of heavy drinking and among individuals with AUD. Criterion counts were correlated nearly as strongly as symptom counts with the AUD correlates. Frequency weighting may add somewhat to the validity of AUD severity measures, especially those that are intended for use among individuals with AUD, e.g. in clinical settings. For studying the etiology and course of AUD in the general population, an equally effective and less time-consuming alternative to obtaining symptom frequency may be the use of unweighted criterion counts accompanied by independent measures of frequency of heavy drinking.

  18. Positive Drinking Consequences Are Associated With Alcohol Use and Alcohol-Related Problems Among Veterans Seeking Treatment for Alcohol Use Disorder.

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    Morean, Meghan E; Cooney, Judith L

    2015-01-01

    Military service is associated with increased rates of heavy drinking. Widely used clinical practices (e.g., motivational interviewing) indicate that addressing both negative and positive drinking consequences is essential to effective treatment. However, research on effectively assessing positive drinking consequences in a clinical population is absent. The current study (1) evaluated the utility of the Positive Drinking Consequences Questionnaire (PDCQ), a measure previously validated in an undergraduate sample, for use with treatment-seeking veterans, and (2) evaluated relationships between positive drinking consequences and alcohol expectancies, pre-treatment alcohol use, and alcohol-related problems. Ninety-seven veterans seeking treatment for alcohol problems completed an anonymous survey (97.9% male; mean age = 49.76[11.40], 67.0% Caucasian). The PDCQ evidenced a single factor latent structure and internal consistency (Cronbach's alpha = .90). Positive drinking consequences and expectancies were related yet distinct constructs. After controlling for demographic factors, experiencing more positive drinking consequences at program intake was associated with heavier pretreatment drinking (ηp(2) = .10, p = .003) and alcohol-related problems (ηp(2) = .18, p alcohol use (ηp(2) = .12, p = .002) and alcohol-related problems (ηp(2) = .11, p = .003) when expectancies also were included in the model. Positive drinking consequences are assessed reliably by the PDCQ in a clinical sample and appear to play an important role in the drinking behavior of veterans seeking alcohol treatment.

  19. Delinquency as a mediator of the relation between negative affectivity and adolescent alcohol use disorder.

    Science.gov (United States)

    Shoal, Gavin D; Gudonis, Lauren C; Giancola, Peter R; Tarter, Ralph E

    2007-12-01

    This investigation examined mediators of the longitudinal relation between negative affectivity and the development of problematic drinking behavior in adolescent boys and girls. In the present study, 499 early adolescents completed inventories of negative affectivity, attitudes toward delinquency, personal delinquency, and affiliation with delinquent peers. Positive attitudes toward delinquency emerged as the most consistent mediator and strongly predicted drinking frequency in various situations. Compared with personal delinquency, both attitudes toward delinquency and peer delinquency were superior predictors of affect-related drinking. Our results also demonstrated that positive attitudes toward delinquency mediated the relation between negative affectivity and later development of an alcohol use disorder. These findings suggest that a proneness to unpleasant affect impacts adolescent drinking by heightening risk for general rejection of normative behavior, rather than by increasing drinking as a means of managing affect. The importance and implications of testing delinquency variables together in the same model are discussed.

  20. Virtual Sensorimotor Training for Balance: Pilot Study Results for Children With Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Jirikowic, Tracy; Westcott McCoy, Sarah; Price, Robert; Ciol, Marcia A; Hsu, Lin-Ya; Kartin, Deborah

    2016-01-01

    To examine the effects of Sensorimotor Training to Affect Balance, Engagement, and Learning (STABEL), a virtual reality system to train sensory adaptation for balance control, for children with fetal alcohol spectrum disorders (FASDs). Twenty-three children with FASDs received STABEL training in a university laboratory, or home, or were controls. The Movement Assessment Battery for Children-2nd edition (MABC-2) and Pediatric Clinical Test of Sensory Interaction for Balance-2 (P-CTSIB-2) were analyzed by group (lab, home, and control), session (pre-STABEL, 1 week post-STABEL, and 1 month post-STABEL), and group-by-session interaction. Significant effects were group and session for MABC-2 Balance and interaction for MABC-2 Total Motor and P-CTSIB-2. Preliminary results support improved sensory adaptation, balance, and motor performance post-STABEL, which warrant further study with a larger, randomized sample.

  1. Women’s Motivators for Seeking Treatment for Alcohol Use Disorders

    Science.gov (United States)

    Grosso, Justine A.; Epstein, Elizabeth E.; McCrady, Barbara S.; Gaba, Ayorkor; Cook, Sharon; Backer-Fulghum, Lindsey M.; Graff, Fiona S.

    2013-01-01

    This study examined types of internal and external motivation for seeking treatment and the predictive utility of different types of motivation among 180 women with an alcohol use disorder (AUD) participating in a two-armed trial testing different individual and couple therapies for AUDs. Reasons for seeking treatment were coded for type of internal or external motivation. Most women (97%) cited internal reasons for seeking help, including: concern about progression of AUD (61.1%), health (43.3%), mental health (38.9%), and family (38.3%). Occupational concerns, an internal motivator cited by 6% of women, were associated with better drinking outcomes; interpersonal-family concerns were associated with poorer outcomes. Some motivators for seeking treatment may not be related to sustained changes in drinking, suggesting that understanding motivators for treatment may be inadequate to maintain change. Reasons for help-seeking may need to be addressed in treatment to produce long-lasting change. PMID:23501141

  2. Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder.

    Science.gov (United States)

    Verduin, Marcia L; LaRowe, Steven D; Myrick, Hugh; Cannon-Bowers, Jan; Bowers, Clint

    2013-03-01

    This study examined the impact of a computer simulation designed to provide the opportunity for individuals with alcohol use disorders (AUDs) to practice relapse prevention skills. Participants were 41 male veterans enrolled in an intensive outpatient substance abuse treatment program. Participants were randomly assigned to either view educational slides about treatment for AUD or play a simulation videogame for eight sessions within 12 weeks. Participants were assessed at a 4-week follow-up visit. Outcome measures included relapse rates as well as ratings on the Obsessive Compulsive Drinking Scale (OCDS) and a custom-designed relapse prevention self efficacy scale. While rates of relapse did not differ between groups, those who played the game showed overall reductions in ratings on the OCDS, as well as higher ratings of self-efficacy at week 8, suggesting that the videogame simulation may be a useful adjunct to AUD treatment. Published by Elsevier Inc.

  3. Caregivers' management of schooling for their children with fetal alcohol spectrum disorder.

    Science.gov (United States)

    Swart, Suretha; Hall, Wendy A; McKee, William T; Ford, Laurie

    2014-11-01

    In this article we describe a grounded theory study of how caregivers of school-aged children with fetal alcohol spectrum disorder (FASD) managed their children's schooling. We completed 30 interviews with 17 caregivers residing in a western Canadian province, as well as document analysis and 25 hours of participant observation. We used constant comparative analysis to construct our substantive theory: intertwining to fit in. The core variable is an iterative cycle caregivers used to resolve their main concerns: preventing their children from failing academically and in social interactions and preventing themselves from being regarded as unacceptable parents. To intertwine to fit in, caregivers used two strategies: orchestrating schooling and keeping up appearances. They also regulated their relationships with their children. "Intertwining to fit in" contributes to the literature on attachment and parenting and extends explanations about caregivers' advocacy for their children with FASD. The theory has implications for school personnel and practitioners, as well as researchers. © The Author(s) 2014.

  4. Evaluating the psycholegal abilities of young offenders with fetal alcohol spectrum disorder.

    Science.gov (United States)

    McLachlan, Kaitlyn; Roesch, Ronald; Viljoen, Jodi L; Douglas, Kevin S

    2014-02-01

    Individuals with a diagnosis of fetal alcohol spectrum disorder (FASD) experience a range of physical, cognitive, and behavioral deficits thought to interfere with their ability to competently navigate the arrest, interrogation, and trial process. This study examined the psycholegal abilities of young offenders with FASD, including their understanding and appreciation of Miranda rights, and adjudication capacities (factual knowledge of criminal procedure, appreciation of the nature and object of the proceedings, ability to participate in a defense and communicate with counsel). Two groups of young offenders (50 with FASD and 50 without prenatal alcohol exposure) completed Grisso's Instruments for Assessing Understanding and Appreciation of Miranda rights and the Fitness Interview Test-Revised to assess overall rates of impairment in youth with FASD, as well as differences between the groups. Potentially important predictors of psycholegal abilities were also evaluated. Results indicated the majority of young offenders with FASD (90%) showed impairment in at least one psycholegal ability, and rates of impairment were significantly higher than the comparison group. However, considerable within-group variability was observed. IQ and reading comprehension emerged as robust predictors of participants' psycholegal abilities, while the FASD diagnosis differentiated participants' scores on the FIT-R. These findings underscore the importance of individualized and comprehensive forensic assessments of psycholegal abilities in this population when warranted. Additional system level strains for this population are discussed, including problems in approaching competency remediation, and the potentially growing need for accommodation and forensic assessments in the face of limited financial and professional resources in legal settings.

  5. 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

  6. Resilience Associated with Self-Disclosure and Relapse Risks in Patients with Alcohol Use Disorders.

    Science.gov (United States)

    Yamashita, Ayako; Yoshioka, Shin-Ichi

    2016-12-01

    The aim of this study was to clarify the self-disclosure and risks of relapse associated with promoting resilience of patients with alcohol use disorders (AUD) and participating in self-help groups. An anonymous, self-administered questionnaire survey was administered to 48 patients with AUD and participating in self-help groups; this questionnaire consisted of basic attributes, a bidimensional resilience scale to assess both innate and acquired resilience factors, a scale to assess depth of self-disclosure, and a scale assessing relapse risks. We conducted an evaluation by dividing the respondents into a high group and low group based on their median values for both innate and acquired resilience. Innate/acquired resilience had a mutually reinforcing relationship, and, compared with the low resilience group, the high resilience group had significantly reduced risks for relapses and resulted in deeper self-disclosure. Patients with high resilience had lower risk of alcohol relapse and deeper self-disclosure. The results suggest that one way of supporting patients with AUD in recovery is assisting them in building personal relationships with others and in deepening self-disclosure in a setting where they can relax, thus promoting their natural ability to recover.

  7. Comorbidity of Alcohol Use Disorder and Chronic Pain: Genetic Influences on Brain Reward and Stress Systems.

    Science.gov (United States)

    Yeung, Ellen W; Craggs, Jason G; Gizer, Ian R

    2017-11-01

    Alcohol use disorder (AUD) is highly comorbid with chronic pain (CP). Evidence has suggested that neuroadaptive processes characterized by reward deficit and stress surfeit are involved in the development of AUD and pain chronification. Neurological data suggest that shared genetic architecture associated with the reward and stress systems may contribute to the comorbidity of AUD and CP. This monograph first delineates the prevailing theories of the development of AUD and pain chronification focusing on the reward and stress systems. It then provides a brief summary of relevant neurological findings followed by an evaluation of evidence documented by molecular genetic studies. Candidate gene association studies have provided some initial support for the genetic overlap between AUD and CP; however, these results must be interpreted with caution until studies with sufficient statistical power are conducted and replications obtained. Genomewide association studies have suggested a number of genes (e.g., TBX19, HTR7, and ADRA1A) that are either directly or indirectly related to the reward and stress systems in the AUD and CP literature. Evidence reviewed in this monograph suggests that shared genetic liability underlying the comorbidity between AUD and CP, if present, is likely to be complex. As the advancement in molecular genetic methods continues, future studies may show broader central nervous system involvement in AUD-CP comorbidity. Copyright © 2017 by the Research Society on Alcoholism.

  8. Complexities in Understanding Attentional Functioning among Children with Fetal Alcohol Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Kimberly eLane

    2014-03-01

    Full Text Available Parental reports of attention problems and clinical symptomatology of ADHD among children with fetal alcohol syndrome disorder (FASD were assessed in relation to performance on standardized subtests of attantional control/shifting and selective attention from the Test of Everyday Attention for Children (TEA-Ch; Manly et al., 1998. The participants included 14 children with FASD with a mean CA of 11.7 years and a mean MA of 9.7 years, and 14 typically developing (TD children with no reported history of prenatal exposure to alcohol or attention problems with a mean CA of 8.4 years and a mean MA of 9.6 years. The children with FASD were rated by their caregivers as having clinically significant attention difficulties for their developmental age. The reported symptomatology for the majority of the children with FASD were consistent with a diagnosis of ADHD, combined type, and only one child had a score within the average range. These reports are consistent with the finding here that the children with FASD demonstrated difficulties on the Creature Counting subtest of attentional control/shifting, but inconsistent with the finding that they outperformed the TD children on the Map Mission subtest of selective attention. These findings are considered within the context of the complexity in understanding attentional functioning among children with FASD and discrepancies across sources of information and components of attention.

  9. Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments.

    Science.gov (United States)

    Naqvi, Nasir H; Morgenstern, Jon

    2015-01-01

    Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.

  10. The Marulu Strategy 2008-2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley.

    Science.gov (United States)

    Fitzpatrick, James P; Oscar, June; Carter, Maureen; Elliott, Elizabeth J; Latimer, Jane; Wright, Edie; Boulton, John

    2017-10-01

    Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy. A review of literature focusing on community-led FASD strategies identified key components that informed the Marulu FASD strategy. These included strategy ownership, leadership, and governance by participating communities, and a research framework. Community meetings and workshops led to the development of The Marulu FASD Strategy (2008). Feasibility and community consent to conduct a FASD prevalence study (the Lililwan Project) was confirmed, and implementation was progressed (2010-2013). Concurrent FASD prevention activities were conducted. In 2012, the Marulu FASD Unit was established within a local Aboriginal organisation to sustain and coordinate ongoing strategy activities. Community control of public health initiatives can be achieved when Aboriginal communities prioritise issues of significant concern, and engage strategic partners to overcome them. Implications for public health: The Marulu Strategy forms a template for action to address FASD and other public health issues in Aboriginal communities in Australia and internationally. © 2017 The Authors.

  11. How Do Individuals Develop Alcohol Use Disorder After Bariatric Surgery? A Grounded Theory Exploration.</