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Sample records for alcohol dependent patients

  1. Consumption of Noncommercial Alcohol among Alcohol-Dependent Patients

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    Y. E. Razvodovsky

    2013-01-01

    Full Text Available This study explores types of alcohol and surrogates consumed, patterns of consumption, and reasons behind noncommercial alcohol consumption among alcohol-dependent patients in Belarus. The study was conducted in the Belarusian city Grodno in 2012 with 223 alcoholics admitted to narcological clinic using structured interviews. The results suggest that at least 20.2% of alcohol dependent patients regularly consume samogon and 11.8% of patients use surrogates, the most popular among which are medications with a high percentage of ethanol and industrial spirits. The belief that, according to quality criteria, samogon exceeds licensed vodka is the main motive for its consumption. The results of this study suggest the existence of the problem of consumption of noncommercial alcohol among alcohol dependent patients in Belarus.

  2. Should we train alcohol-dependent patients to avoid alcohol?

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    R.W. Wiers; T.E. Gladwin; M. Rinck

    2013-01-01

    Spruyt et al. (2013) report an interesting study in which they compared an alcohol approach-bias, as measured with the Relevant-feature Stimulus Response Compatibility task (R-SRC) in 40 abstaining alcohol-dependent patients and 40 non-dependent controls. While controls had an approach-bias for alco

  3. Prevalence of Demodex spp among alcohol-dependent patients

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    Mehmet Hanifi Kokacya

    2016-06-01

    Conclusion: Demodex spp. are more common in alcohol-dependent patients due conditions of reduced self-care and immunosuppression. Demodex parasites should be considered in alcohol-dependent patients with skin lesions, especially on the face, and should to be treated if needed. [Cukurova Med J 2016; 41(2.000: 259-263

  4. Prevalence of Demodex spp among alcohol-dependent patients

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    Mehmet Hanifi Kokacya; Ozlem Aycan Kaya; Umit Sertan Copoglu; Sibel Elmacioglu

    2016-01-01

    Purpose: Demodex folliculorum and Demodex brevis are common ectoparasites found in humans and live on the pilosebaceous glands and hair follicles especially on the facial region. Chronic alcohol consumption can weaken immune system and cause more severe infections. Demodex spp is assumed to be more common in alcohol-dependent patients due to partial suppression of immune system and lack of good self-care. The present study aims to investigate the prevalence of Demodex spp. ectoparasite in alc...

  5. Sexual dysfunction in patients with alcohol and opioid dependence

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    Sandeep Grover

    2014-01-01

    Full Text Available There are limited numbers of studies which have evaluated the sexual dysfunction (SD in patients with alcohol and opioids dependence. This article reviews the existing literature. Electronic searches were carried out using the PubMed, Google Scholar, and ScienceDirect to locate the relevant literature. Subjects addicted to heroin or on methadone maintenance treatment (MMT or buprenorphine maintenance treatment (BMT show higher rates of SD in comparison to the general population. SD rates have ranged 34-85% for heroin addicts, 14-81% for MMT, 36-83% for BMT, and 90% for naltrexone maintenance. The rates of SD in alcohol-dependent population have ranged 40-95.2%, with rates being consistently much higher in alcohol-dependent population than in the healthy controls or social drinkers. The common SDs reported have been erectile dysfunction followed by premature ejaculation, retarded ejaculation and decreased sexual desire among men, and dyspareunia and vaginal dryness among women. This review suggests that long-term use of alcohol and opioids are associated with SD in almost all domains of sexual functioning. There is a need to increase the awareness of clinicians about this association as many times SD in patients with substance abuse lead to poor treatment compliance and relapse. Further, there is a need to carry out more number of studies to understand the relationship in a better way.

  6. COMORBIDITY DIAGNOSES IN ALCOHOL DEPENDENT PATIENTS: DIFFERENCES AND DILEMMAS

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    Maja Rus-Makovec

    2002-11-01

    Full Text Available Background. In the presented study we followed the diagnostic procedures of comorbidity in alcohol dependent patients of in-patient treatment. The aim of the study was to evaluate the incidence of dual/triple diagnoses with alcohol dependent patients and to incorporate the diagnostic procedures in rutine work and in treatment planning.Material and methods. We were following the basic parameters of treatment of 469 patients (366 male, 102 female from July 1999 to July 2001. The diagnostic criteria according to ICD-10 were applied after at least four weeks of sobriety.Results. The most frequent additional diagnoses found were nicotine dependency, depressive and personal disorders. Main gender differences were found in diagnosis of depressive disorders and in dependency or abuse of prescripted drugs. Comparison of our results with literature data showed the greatest differences in diagnoses of cognitive, depressive, anxious data and dependency of other psychoactive substances.Conclusions. The comparison between the two time periods shows that stuff sensibility to diagnostic procedures of comorbidity states influences the frequency of diagnostic categories. The literature data review leads to impression of inconsistent diagnosing regarding the context and phylosophy of treatment context, stuff education and patient population.

  7. Clinical management methods for out-patients with alcohol dependence

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    Boulze Isabelle

    2006-02-01

    Full Text Available Abstract Background In France outpatient centres for the care of alcoholics are healthcare establishments providing medical, psychological and social support. Although they meet the practical needs of these patients, their degree of use in each of these domains and the respective mobilisation of different skills by the care team are not well understood. Our aim was therefore to determine in detail the management involved as a function of the severity of alcohol dependence. For this purpose, all the procedures involved were compiled in a thesaurus describing its type (psychological, medical, social, reception, its scheduled or unscheduled nature, its method (face-to-face, telephone, letter and its duration. The severity of dependence was evaluated using the Addiction Severity Index (ASI. Results 45 patients were included and followed-up during 291 ± 114 days. The mean initial ASI scores (± SD were: medical (M = 0.39 ± 0.3, working-income (ER = 0.5 ± 0.3, alcohol (A = 0.51 ± 0.2, illicit drugs (D = 0.07 ± 0.08, legal (L = 0.06 ± 0.13, familial and social environment (FS = 0.34 ± 0.26, psychological (P = 0.39 ± 0.22. The total number of procedures was 1341 (29.8 per patient corresponding to 754.4 hours (16.7 per patient. The intensity of management peaked during the first month of treatment, and then declined rapidly; the maximum incidence of abstinence was observed during the 3rd month of management. Interviews with patients, group therapy and staff meetings represented 68.7%, 9.9% and 13.9% of all procedures, respectively. In patients with severe dependence, as compared to moderate, management was twice as intense in the psychological and social domains, but not in the medical domain. The ASI questionnaire was completed a second time by 24 patients, after an average of 3.2 months. The improvement was significant in the M, A, D and P domains only. Conclusion This study provided an overview of the methods employed in managing a sample of

  8. Object alternation in alcohol dependent patients without amnesic syndrome

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    Brokate, B.; Bernsdorff, K.; Braamhorst, W.; Eling, P.A.T.M.; Hildebrandt, H.

    2008-01-01

    Several studies indicate that the frontal cortex is sensitive to the toxic effects of alcohol. Recent studies of our group revealed all impairment of alcohol dependent subjects in object alternation. One major problem of these studies is that they all used object alternation embedded in a spatial pr

  9. Gender Differences in Interpersonal Problems of Alcohol-Dependent Patients and Healthy Controls

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    Marc Walter

    2009-12-01

    Full Text Available Alcohol dependence is a heavy burden on patients, their families, and society. Epidemiological studies indicate that alcohol dependence will affect many individuals at some time in their lives, with men affected more frequently than women. Since alcohol-dependent patients often exhibit a lack of social skills and suffer from interpersonal problems, the aim of this study is to elucidate whether men and women experience the same interpersonal problems. Eighty-five alcohol-dependent patients (48 men; 37 women after detoxification and 62 healthy controls (35 men; 27 women were recruited. Interpersonal problems were measured with the Inventory of Interpersonal Problems (IIP-64. Additionally, alcohol-dependent patients were interviewed with the Alcohol Use Disorders Identification Test (AUDIT and were subtyped according to Lesch’s Alcohol Typology (LAT. There were no significant gender differences in the AUDIT and LAT between alcohol-dependent men and women. Interpersonal problems of alcohol-dependent men differed significantly in one out of eight dimensions from controls; alcohol-dependent men perceive themselves as colder than male controls. Alcohol-dependent women differed in four out of eight interpersonal dimensions from female controls. Alcohol-dependent women rated themselves as significantly more vindictive, more introverted, more overly accommodating and more intrusive than female controls. Results suggest that alcohol-dependent men and women suffer from different interpersonal problems and furthermore alcohol-dependent women perceive more interpersonal problems, whereas the severity of alcohol dependence did not differ between the groups. Our findings indicate that alcohol-dependent women may profit more from a gender-specific treatment approach aimed at improving treatment outcome than alcohol-dependent men.

  10. The metabolic syndrome in patients with alcohol dependency: Current research and clinical implications.

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    Kahl, Kai G; Hillemacher, Thomas

    2016-10-01

    The relationship between alcohol dependency and disorders such as liver disease and cancer has been thoroughly researched. However, the effects of alcohol on cardiometabolic health remain controversial. Several reports found low to moderate alcohol consumption to be associated with a lower risk for cardiometabolic disorders. In contrast, excessive alcohol consumption has been related to an increased risk. Most of these studies were performed in non-clinical populations, therefore limiting the explanatory power to non-dependent patients. Only a few studies examined cardiovascular disorders and cardiovascular risk factors, in particular the metabolic syndrome (MetS), in alcohol dependent patients. We here present a narrative review of studies performed so far on the MetS in alcohol dependency, and provide current hypotheses on the association of alcohol dependency, appetite regulation and the development of the MetS.

  11. Changes in nutrition-related behaviors in alcohol-dependent patients after outpatient detoxification

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    Rohdemann, Maren E. H.

    2016-01-01

    Background: Previous studies have reported changes in nutrition-related behaviors in alcohol-dependent patients after alcohol detoxification, but prospective studies assessing the effects of these changes on maintaining abstinence are lacking. Aim: To assess changes in craving and consumption of coffee, cigarettes, chocolate and other sweets over time up to six months after outpatient alcohol detoxification treatment and to detect differences in abstinent versus non-abstinent patients. ...

  12. Reduced Dopamine Transporter Availability and Neurocognitive Deficits in Male Patients with Alcohol Dependence.

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    Che-Hung Yen

    Full Text Available Dopamine plays an important role in the development of alcohol dependence, cognitive dysfunction, and is regulated via dopamine transporter activity. Although dopamine transporter activity is critically involved in alcohol dependence, studies observing this relationship are limited. Thus the current study examined whether dopamine transporter availability is associated with developing of alcohol dependence and cognitive dysfunction. Brain imaging with 99mTc-TRODAT-1 as a ligand was used to measure dopamine transporter availability among 26 male patients with pure alcohol dependence and 22 age- and sex- matched healthy volunteers. The Wisconsin Card Sorting Test (WCST and Tridimensional Personality Questionnaire (TPQ were administered to assess neurocognitive functioning and personality traits, respectively. Compared to healthy controls, patients with alcohol dependence showed a significant reduction in dopamine transporter availability (p < 0.001, as well as diminished performance on the WCST (p < 0.001. Dopamine transporter availability was negatively correlated with both total and perseverative WCST errors among healthy controls, but only patients with alcohol dependence showed a positive correlation between dopamine transporter availability and a harm avoidance personality profile. Thus, reductions in dopamine transporter availability may play a pathophysiological role in the development of pure alcohol dependence, given its association with neurocognitive deficits. Moreover, personality may influence the development of pure alcohol dependence; however, additional clinical subgroups should be examined to confirm this possibility.

  13. The clinical and demographic profile of male patients with alcohol dependence syndrome

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    M Pramod Kumar Reddy

    2014-01-01

    Full Text Available Aims: To study the demographic factors associated with alcohol dependence syndrome so that the problems of alcohol related co morbidities can be prevented with appropriate preventive measures. Materials and Methods: The study was conducted in De-Addiction Clinic of the Department of Psychiatry, Mamata Medical College, Khammam, Andhra Pradesh from July 2008 to February 2009. Patient who fulfills criteria for alcohol dependence, according to diagnostic and statistical manual of mental disorders, fourth edition were included. Results: Mean age (standard deviation at first drink was 18.93 (3.81 years and at onset of Alcohol dependence was 28.28 (6.55 years. The most common reason being given by the patients was financial strain (70% of the patients due to alcohol use and its consequences. Educational qualification of 12th standard or above was seen only in 7.5%. Alcohol dependence syndrome was more common in unemployed, unskilled and semi-skilled patients. Majority of patients (80% belonged to lower socio-economic class. Conclusion: Alcohol dependence syndrome and its related co morbidities can be minimized to a great extent if the educational and socio-economic standards are improved in countries like India where there is increase in alcohol consumption as a life style choice.

  14. SNP- and haplotype analysis of the tryptophan hydroxylase 2 gene in alcohol-dependent patients and alcohol-related suicide.

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    Zill, Peter; Preuss, Ulrich W; Koller, Gabrielle; Bondy, Brigitta; Soyka, Michael

    2007-08-01

    Several lines of evidence indicate that disturbances of the central serotonergic system are involved in the pathophysiology of alcohol dependence and suicidal behavior. Recent studies have indicated that a newly identified second isoform of the tryptophan hydroxylase gene (TPH2) is preferentially involved in the rate limiting synthesis of neuronal serotonin. Genetic variations in the TPH2 gene have been associated with an increased risk for major depression and suicidal behavior. We performed single SNP (single nucleotide polymorphism), linkage disequilibrium and haplotype studies on 353 alcohol-dependent patients of whom 102 individuals had a history of at least one suicide attempt and 305 healthy controls with 20 SNPs covering the entire gene region of TPH2. Neither single SNP-, nor haplotype analysis could detect significant associations with alcohol dependence and/or suicidal behavior among alcohol-dependent patients. One major haplotype block of strong linkage disequilibrium between introns 5 and 8 of the TPH2 gene has been found in alcoholics and controls, which is in concordance with recent reports. In conclusion, our results suggest that single SNPs, respectively, haplotypes of the TPH2 gene are unlikely to play a major role in the pathophysiology of alcohol dependence or the alcoholism-related phenotype suicidal behavior. Further analysis are needed to confirm these results.

  15. Low digit ratio 2D:4D in alcohol dependent patients.

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    Johannes Kornhuber

    Full Text Available The ratio of the lengths of the second and fourth finger (2D∶4D has been described as reflecting the degree of prenatal androgen exposure in humans. 2D∶4D is smaller for males than females and is associated with traits such as left-handedness, physical aggression, attention-deficit-hyperactivity disorder and a genetic polymorphism of the androgen receptor. All of these traits are known to be correlated to the vulnerability for alcohol dependency. We therefore hypothesized low 2D∶4D in patients with alcohol dependency. In the present study on 131 patients suffering from alcohol dependency and 185 healthy volunteers, we found that alcohol dependent patients had smaller 2D∶4D ratios compared to controls with preserved sexual dimorphism but with reduced right-left differences. The detection of alcohol dependency based on 2D∶4D ratios was most accurate using the right hand of males (ROC-analysis: AUC 0.725, sensitivity 0.667, specificity 0.723. These findings provide novel insights into the role of prenatal androgen exposure in the development of alcohol dependency and for the use of 2D∶4D as a possible trait marker in identifying patients with alcohol dependency.

  16. Computerized tomographic study on the brain of patients with alcohol dependence

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    Kato, Akira (Biwako Hospital, Otsu, Shiga (Japan)); Tsuji, Motohiro; Nakamura, Michihiko; Nakajima, Teruo

    1991-03-01

    One hundred ten patients with alcohol dependence and 56 psychiatric patients with either senile dementia, amphetamine psychosis, epilepsy or chronic schizophrenia were investigated with a CT scan of the brain. The maximum width of the 3rd ventricle was measured, and the presence/absence of enlargement of the lateral ventricle and of atrophy of the frontal lobe was determined independently by 3 physicians. The width of the 3rd ventricle in alcoholic and the other patients examined was gradually enlarged with aging, and the width in these patients was significantly larger than that in the age-matched control patients who were selected from the patients with amphetamine psychosis, epilepsy or schizophrenia. The enlargement of the lateral ventricles observed in the alcoholic patients always accompanied the enlargement of the 3rd ventricle, but not vice versa. The alcoholic patients with frontal lobe atrophy showed a higher incidence of withdrawal delirium than the patients without atrophy. These findings suggest that the chronic intake of alcohol might affect primarily the area around the 3rd ventricle, resulting in enlargement of this ventricle and consequential enlargement of the lateral ventricles and also that the alcoholic patients with frontal lobe atrophy could have a high risk for a manifestation of alcoholic withdrawal delirium. (author).

  17. The impact of atrial natriuretic peptide on anxiety, stress and craving in patients with alcohol dependence.

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    Koopmann, Anne; Leménager, Tagrid; Wolf, Nadine Donata; Reinhard, Iris; Hermann, Derik; Koch, Jan; Wiedemann, Klaus; Kiefer, Falk

    2014-01-01

    Atrial natriuretic peptide (ANP) is well known to modulate fluid and electrolyte homeostasis but also to counter-regulate hypothalamic-pituitary-adrenal (HPA) axis activity. Correspondingly, recent studies suggest an important role of ANP in the neurobiology of anxiety. Preclinical and clinical data now provide evidence for an involvement of ANP in the pathophysiology of addictive behavior. The present study aims to elucidate the effects of ANP on alcohol-dependent patients' anxiety, perceived stress and craving during alcohol withdrawal. A sample of 59 alcohol-dependent inpatients was included in the analysis. A blood sample was taken at day 14 of detoxification in order to assess the concentrations of ANP and cortisol in plasma. In parallel, we assessed patients' alcohol craving, using the Obsessive Compulsive Drinking Scale, as well as anxiety (State-Trait Anxiety Inventory). Patients' stress levels were assessed using the Perceived Stress Scale. We found a significant negative association between patients' ANP plasma concentrations and anxiety, craving for alcohol and perceived stress. Regression analyses suggest that ANP is a significant predictor both for patients' perceived stress and for the severity of anxiety during early abstinence. The association of patients' ANP plasma levels and craving is suggested to be mediated by perceived stress. Our results suggest that the association of patients' ANP plasma levels and craving is mediated by their perceived stress. For this reason, intranasal application of ANP may prove to be a new avenue for the treatment of alcohol dependence in patients exhibiting high levels of perceived stress.

  18. Self-mutilation among male patients with alcohol dependency: the role of dissociation.

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    Evren, Cuneyt; Sar, Vedat; Evren, Bilge; Dalbudak, Ercan

    2008-01-01

    The aim of this study was to investigate the relationship of self-mutilative behavior with dissociative experiences among men who are alcohol dependent. Participants were 176 inpatients consecutively admitted to an alcohol dependency treatment center. Dissociative Experiences Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, Symptom Checklist-Revised, and Michigan Alcoholism Screening Test were conducted to all participants. A sizable proportion of patients (29.0%) reported self-mutilation (SM). Childhood abuse, younger age, early onset of alcoholism, and dissociative taxon membership predicted SM. The overall severity of clinical condition and the frequency of suicide attempts among those who reported SM were higher than those of the remaining patients. The Dissociative Experiences Scale-Taxon item "auditory verbal hallucinations" and the Symptom Checklist-Revised dimension "hostility" were predictors of SM. There is a complex relationship between dissociation, alcohol use, and SM. Increased awareness among clinicians on this relationship may increase the effectiveness of treatment interventions.

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

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    Rebecca O'Connell

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

  20. The outcome of patients sustaining a proximal femur fracture who suffer from alcohol dependency.

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    Faroug, R; Amanat, S; Ockendon, M; Shah, S V; Gregory, J J

    2014-07-01

    There are many negative health consequences associated with alcohol dependency. Fractures of the proximal femur carry significant morbidity and mortality. This study examines the outcomes in patients with alcohol dependency, who sustain a fracture of the proximal femur. Twenty-eight consecutive alcohol dependent patients who suffered a fracture of the proximal femur were identified over a three year period. Data were collected on demographics, co-morbidity, surgical factors, mobility and mortality. The median age of patients was 61 years. The median weekly alcohol intake was 158 units. Thirteen patients sustained an extra-capsular fracture and 15 an intra-capsular proximal femoral fracture. Twenty-two fractures were treated with internal fixation and six with arthroplasty. The overall mortality rate was 29% at a median of 15 months post fracture. The failure rate of intra-capsular fractures fixed with cannulated screws was 56% at a median time of 43 days. All patients had a reduction in mobility compared to their pre-operative function. The reduction in mobility was greatest in patients with intra-capsular fractures treated with cannulated screw fixation. Alcohol dependent patients sustaining a fracture of the proximal femur are significantly younger than non-alcohol dependent patients sustaining the same injury. Despite the younger age at presentation the one year mortality rate of this group was high (29%). The high rate of complications with fracture fixation and high one year mortality suggest that hemiarthroplasty may be the best treatment option for intra-capsular fractures in this patient group.

  1. Alcohol Dependence and Alcoholic Liver Disease

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    Karl Mann

    2015-01-01

    Full Text Available Alcohol dependence is a disabling condition that has a high prevalence, but in Europe only a small fraction of the people diagnosed with alcohol abuse and dependence are treated, representing the widest treatment gap, as compared with other mental disorders. Early diagnosis and monitoring of alcoholic liver disease (ALD is still insufficiently solved. Although ALD is the most common cause for liver disease in the Western world, it largely remains underestimated and underdiagnosed for many reasons. The recent introduction of non-invasive elastographic techniques such as transient elastography (TE has significantly improved the early diagnosis of alcoholic liver cirrhosis (ALC. As demonstrated in the literature, inflammation-associated liver stiffness (LS rapidly decreases during alcohol detoxification, and is also directly correlated to change in LS in both abstinent and relapsing patients. Newly published data show that LS could be used to monitor and validate hepatoprotective effects during nalmefene usage. Nalmefene is an opioid system modulator that diminishes the reinforcing effects of alcohol, helping the patient to reduce drinking. Three randomised, multicentre, double-blind, placebo-controlled, parallelgroup Phase III studies were designed to assess the efficacy and safety of nalmefene in reducing alcohol consumption. Patients with a high or very high drinking risk level (DRL at baseline and randomisation show a clinically significant effect from nalmefene treatment, which is generally well tolerated. Moreover, reduced alcohol consumption supported by nalmefene in combination with psychosocial support may indeed help to reduce the alcohol-related burden and the large treatment gap.

  2. [Severity of alcohol dependence and social functioning of male patients with alcoholism. I. Functioning in the sharing of marital roles].

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    Dabkowski, M; Rogiewicz, M; Ziółkowski, M; Rybakowski, J

    1989-01-01

    The relations between social functioning and severity of alcohol dependence of 40 male patients from Dependence Treatment Ward in Bydgoszcz were studied. Using the MAST, CAGE, and self clinical scale the cohort was divided into two groups: less and more severe dependent probands. The demographic and social data of patients from both groups did not differ significantly. Social functiong was evaluated by use the Scale of Social Roles taking into consideration the set of marital roles (with basic roles of sexual partner, friend, guardian, and family support). The disposition to perform the role, privileges, fulfilling the duties, activity, and harmonization of the role were estimated in each of the role mentioned above and in every patient. It was shown that subjects more dependent on alcohol are significantly less active in the role of sexual partner and in support of family, as well as are less effective in performing such roles and are more egoistic in the role of sexual partner than men less dependent on alcohol. No differences were found in other roles among studied groups. The revealed differences were discussed in the aspect of psychologica and interactive hanges in marital couple.

  3. PATTERN OF PSYCHIATRIC MORBIDITY IN SPOUSES OF PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME

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    Ponnu Mary

    2015-09-01

    Full Text Available BACKGROUND : Alcohol use causes harm to the well - being and health of the individual and affects the family as well. Stress of living with an alcoholic, intimate partner violence and poor marital satisfaction has contributed to the psychiatric morbidity in spouses. Addressing the mental health issues of spouses of alcoholics can reduce their burden and improve their quality of life. AIMS: It was done with an aim o f assessing the pattern of psychiatric morbidity in spouses of male patients with alcohol dependence syndrome. The objectives were to determine the most common type of psychiatric disorder among these women, to identify the factors influencing psychiatric morbidity, and to explore the association between psychiatric morbidity in them and severity of alcohol dependence in the male patients. SETTINGS AND DESIGN S : Hospital based, O bservational and cross sectional study conducted among spouses of 100 male patients with a diagnosis of alcohol dependence syndrome reporting to Psychiatry department at Pondicherry Institute of Medical Sciences for a period of 1 year. METHODS AND MATERIALS: Scales used were MINI PLUS and SAD - Q. STATISTICAL ANALYSIS USED: Chi - sq uared test . RESULTS: The sample included 100 spouses, out of which 36 % had psychiatric morbidity. Mood disorders comprised 50 % and anxiety and stress related disorders comprised about 36% of the total morbidity. There was significant association between psychiatric morbidity in the wives and severity of alcohol dependence in husbands. CONCLUSION: It was evident that a major proportion of wives are having psychological morbidities which have clear links to the severity of alcohol use pattern in their husba nds. Therefore identifying the high prevalence of morbidity and treating them would go a long way in improving the quality of life in both spouses.

  4. Epileptiform activity in alcohol dependent patients and possibilities of its indirect measurement.

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    Petr Bob

    Full Text Available BACKGROUND: Alcohol dependence during withdrawal and also in abstinent period in many cases is related to reduced inhibitory functions and kindling that may appear in the form of psychosensory symptoms similar to temporal lobe epilepsy frequently in conditions of normal EEG and without seizures. Because temporal lobe epileptic activity tend to spread between hemispheres, it is possible to suppose that measures reflecting interhemispheric information transfer such as electrodermal activity (EDA might be related to the psychosensory symptoms. METHODS AND FINDINGS: We have performed measurement of bilateral EDA, psychosensory symptoms (LSCL-33 and alcohol craving (ACQ in 34 alcohol dependent patients and 32 healthy controls. The results in alcohol dependent patients show that during rest conditions the psychosensory symptoms (LSCL-33 are related to EDA transinformation (PTI between left and right EDA records (Spearman r = 0.44, p<0.01. CONCLUSIONS: The result may present potentially useful clinical finding suggesting a possibility to indirectly assess epileptiform changes in alcohol dependent patients.

  5. Glycosylation changes in the salivary glycoproteins of alcohol-dependent patients: a pilot study.

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    Kratz, Ewa M; Waszkiewicz, Napoleon; Kaluza, Anna; Szajda, Sławomir D; Zalewska-Szajda, Beata; Szulc, Agata; Zwierz, Krzysztof; Ferens-Sieczkowska, Miroslawa

    2014-01-01

    Glycosylation of serum proteins is affected with prolonged heavy drinking, and carbohydrate deficient transferrin (CDT) is well established and highly specific biomarker of sustained alcohol consumption. However, total amount of sialic acid is not the only glycoepitope that may be altered as a result of the disease. This work is focused on glycan structures altered in salivary glycoproteins of alcoholics, indicating the most efficient carriers of such marker glycoepitopes. Salivary glycoproteins of 31 alcohol-dependent patients and 21 healthy controls were studied by means of lectin ELISA and lectin blotting with the lectins specific for core and antennary fucose, α2,3-bound sialic acid as well as T and Tn antigens in O-glycans. In direct lectin ELISA, core fucosylation, α2,3 sialylation and expression of T-antigen were significantly lowered in the saliva of alcohol-dependent patients. In lectin blotting ten glycoprotein bands were analyzed. The profile of disease-related alterations was found to be complex, but all six lectins studied here were able to detect altered glycan structures. In some glycoproteins the tendency to correct the glycosylation profile was observed after 7 weeks of abstinence. Alterations in the glycosylation profiles in the salivary glycoproteins of alcohol-dependent people were found. Some of salivary glycoproteins, such as α-amylase, clusterin, haptoglobin, heavy and light chains of immunoglobulins, and transferrin, seem to be worthy of detailed glycosylation analysis in the detection of alcohol dependence. Further studies may allow one to estimate if such glycomarkers may also reflect the amount of alcohol intake or the duration of alcohol intake.

  6. Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both-A multi-center study.

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    Schäfer, Ingo; Langeland, Willemien; Hissbach, Johanna; Luedecke, Christel; Ohlmeier, Martin D; Chodzinski, Claudia; Kemper, Ulrich; Keiper, Peter; Wedekind, Dirk; Havemann-Reinecke, Ursula; Teunissen, Sybille; Weirich, Steffen; Driessen, Martin

    2010-06-01

    The aims of this study were to examine the level of dissociative symptoms in patients with different substance related disorders (alcohol dependence, drug dependence, and combined alcohol and drug dependence), and to investigate the influence of potentially traumatic events in childhood, age, gender, and posttraumatic stress disorder on the relationship between dissociative symptoms and type of substance abuse. Of the 459 participants (59.7% male) 182 (39.7%) were alcohol-dependent (A), 154 (33.6%) were drug-dependent (D), and 123 (26.8%) were dependent on both, alcohol and drugs (AD) based on the DSM-IV criteria for a current diagnosis. Participants completed the Childhood Trauma Questionnaire (CTQ) and the Dissociative Experiences Scale (DES). The International Diagnostics Checklist (IDCL) was administered to diagnose PTSD. Higher levels of dissociation were observed in patients with drug dependence as compared to patients with mere alcohol dependence (mean DES group A: 9.9+/-8.8; group D: 12.9+/-11.7; group AD: 15.1+/-11.3). However, when severity of potentially traumatic events in childhood, PTSD, age and gender were included in the analysis, the influence of the type of substance abuse did not prove to be statistically significant. The variable most strongly related to dissociative symptoms was severity of potentially traumatic events in childhood, in particular emotional abuse, even after controlling for PTSD and other potential confounders. It seems appropriate to screen SUD patients for dissociative symptoms, especially those with a more complex risk profile including (additional) drug abuse, female gender, younger age and most importantly a history of childhood trauma. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  7. Decrease in salivary lactoferrin output in chronically intoxicated alcohol-dependent patients.

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    Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Zalewska, Anna; Waszkiewicz, Magdalena; Szajda, Sławomir Dariusz; Repka, Bernadeta; Szulc, Agata; Kępka, Alina; Minarowska, Alina; Chojnowska, Sylwia; Konarzewska, Beata; Ładny, Jerzy Robert; Kowzan, Urszula; Zwierz, Krzysztof

    2012-07-04

    Salivary lactoferrin is a glycoprotein involved in the elimination of pathogens and the prevention of massive overgrowth of microorganisms that affect oral and general health. A high concentration of lactoferrin in saliva is often considered to be a marker of damage to the salivary glands, gingivitis, or leakage through inflamed or damaged oral mucosa, infiltrated particularly by neutrophils. We conducted a study to determine the effect of chronic alcohol intoxication on salivary lactoferrin concentration and output. The study included 30 volunteers consisting of ten non-smoking male patients after chronic alcohol intoxication (group A), and 20 control nonsmoking male social drinkers (group C) with no history of alcohol abuse. Resting whole saliva was collected 24 to 48 hours after a chronic alcohol intoxication period. Lactoferrin was assessed by enzyme-linked immunosorbent assay. For all participants, the DMFT index (decayed, missing, or filled teeth), gingival index (GI) and papilla bleeding index (PBI) were assessed. The differences between groups were evaluated using the Mann-Whitney U test. We noticed significantly decreased salivary flow (SF) in alcohol dependent patients after chronic alcohol intoxication (A), compared to the control group (C). Although there was no significant difference in salivary lactoferrin concentration between the alcohol dependent group A and the control group C, we found significantly decreased lactoferrin output in group A compared to group C. We found a significant correlation between the amount of daily alcohol use and a decrease in lactoferrin output. There was a significant increase in GI and a tendency of PBI to increase in group A compared to group C. We demonstrated that chronic alcohol intoxication decreases SF and lactoferrin output. The decreased lactoferrin output in persons chronically intoxicated by alcohol may be the result of lactoferrin exhaustion during drinking (due to its alcohol-related lower biosynthesis or

  8. Decrease in salivary lactoferrin output in chronically intoxicated alcohol-dependent patients

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    Napoleon Waszkiewicz

    2012-07-01

    Full Text Available

    Salivary lactoferrin is a glycoprotein involved in the elimination of pathogens and the prevention of massive overgrowth of microorganisms that affect oral and general health. A high concentration of lactoferrin in saliva is often considered to be a marker of damage to the salivary glands, gingivitis, or leakage through inflamed or damaged oral mucosa, infiltrated particularly by neutrophils. We conducted a study to determine the effect of chronic alcohol intoxication on salivary lactoferrin concentration and output. The study included 30 volunteers consisting of ten non-smoking male patients after chronic alcohol intoxication (group A, and 20 control nonsmoking male social drinkers (group C with no history of alcohol abuse. Resting whole saliva was collected 24 to 48 hours after a chronic alcohol intoxication period. Lactoferrin was assessed by enzyme-linked immunosorbent assay. For all participants, the DMFT index (decayed, missing, or filled teeth, gingival index (GI and papilla bleeding index (PBI were assessed. The differences between groups were evaluated using the Mann–Whitney U test. We noticed significantly decreased salivary flow (SF in alcohol dependent patients after chronic alcohol intoxication (A, compared to the control group (C. Although there was no significant difference in salivary lactoferrin concentration between the alcohol dependent group A and the control group C, we found significantly decreased lactoferrin output in group A compared to group C. We found a significant correlation between the amount of daily alcohol use and a decrease in lactoferrin output. There was a significant increase in GI and a tendency of PBI to increase in group A compared to group C. We demonstrated that chronic alcohol intoxication decreases SF and lactoferrin output. The decreased lactoferrin output in persons chronically intoxicated by alcohol may be the result of lactoferrin exhaustion during drinking (due to its alcohol-related lower

  9. Profile of nicotine use among alcohol dependent patients visiting a tertiary care center in north India

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    Rizwana Quraishi

    2014-01-01

    Full Text Available Background: Use of tobacco among alcohol dependent population is quite frequent. This co-morbidity increases the risk for various diseases. Understanding the pattern of tobacco use with co-morbid alcohol use may help in planning appropriate prevention/treatment strategies. The study aimed at examining the profile and pattern of nicotine use among alcohol dependent patients visiting a tertiary care treatment center in North India. Materials and Methods: Male patients fulfilling diagnostics and statistical manual of mental disorder fourth edition, criteria for nicotine and alcohol diagnostics and statistical dependence, attending the out-patient department of the tertiary care treatment center were recruited after obtaining informed consent. The socio-demographic profile, drug use history, nicotine associated health problems and general health problem were recorded. Motivation to stop tobacco use was assessed qualitatively using the direct questions about their interest and intentions to quit. Results: A total of 150 subjects were included in the study. The mean age of the study sample was 37.6 ± 10.44 years. Tobacco was reported as the gateway drug in 90% of the cases. Exclusive bidi use reported in 42% of the subjects. Mean duration of bidi and co-morbid alcohol use was higher than cigarette or smokeless tobacco use. Self-reported health problems associated with nicotine use and general health was reported by 41% and 39% of the subjects. Unsuccessful past quit attempts was present in 85% cases. More than 90% of subjects remained interested in quitting the tobacco use. An increased liver enzyme (aspartate transaminase, alanine transaminase and gamma-glutamyl transferase were observed in 43, 32 and 47% of the cases. Conclusion: The results suggest the nicotine and alcohol dependent patients represent a separate population requiring higher attention from the treating physician.

  10. Decreased serum level of NGF in alcohol-dependent patients with declined executive function

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    Bae H

    2014-11-01

    Full Text Available Hwallip Bae,1 Youngsun Ra,1 Changwoo Han,2 Dai-Jin Kim3 1Department of Psychiatry, Myongji Hospital, Goyang, 2Department of Psychiatry, Keyo Hospital, Uiwang, 3Department of Psychiatry, Seoul St Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea Abstract: The role of neurotrophic factors has been highlighted as a cause of decline in the cognitive function of alcohol-dependent patients. It is known that nerve-growth factor (NGF, one of the neurotrophins, is related to the growth and differentiation of nerve cells, as well as to a decline in cognitive function. The purpose of this study was to investigate the relationship between decreased NGF levels and cognitive decline in alcohol-dependent patients. The serum concentration of NGF was measured in 38 patients with chronic alcohol dependence, and several neuropsychological tests were also performed for cognitive function assessment. The results indicated a significant correlation between serum NGF level and the trail-making test part B, which evaluates executive function, but did not show a significant correlation with other cognitive function tests. An increased serum level of NGF was associated with a decreased completion time in the trail-making test B, and this finding indicates that a high serum level of NGF is related to greater executive function. This finding may imply a protective role of NGF in preventing neuron damage among patients with alcohol dependence. Larger controlled studies will be necessary in the future to investigate this issue further. Keywords: nerve-growth factor, alcohol dependence, executive function, trail-making test

  11. PSYCHIATRIC MORBIDITY AND MARITAL QUALITY AMONG WIVES OF PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME

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    Koustubh R

    2015-06-01

    Full Text Available BACKGROUND : Alcohol Dependence syndrome (ADS is one of the most common psychiatric disorders that has deleterious consequences not only on the patient with ADS but also hampers social , financial , and legal matters of his family hence could be considered as a disorder of the family. Spouses of patients with ADS , a key member of such dysfunctional family system , are most vulnerable to have significant psychiatric disorders like adjustment disorders , mood disorders , anxiety disorders and psychosocial problems. Hence we have undertaken this study in order to understand and address such issues which is largely neglected in psychiatric research. AIMS AND OBJECTIVES : To assess the severity of alcohol dependence & its adverse effect on families , the prevalence and pattern of psychiatric morbidity and marital quality in spouses of men with ADS and to explore the association between them. MATERIALS AND METHODS: 60 spouses of males with ADS according to Diagnostic and Statistical Manual of Mental Disorders ‑ IV (DSM IV - TR Criteria were screened for psychiatric morbidity using General Health Questionnaire and the presence of specific psychiatric disorders using Structured Cli nical Interview for DSM - IV AXIS - I & AXIS - II (SCID - I & SCID - II. Severity of alcohol dependence in males and its adverse consequences was assessed using Short Alcohol Dependence Data and Drinkers Inventory of Consequences, respectively. Marital quality was assessed using the marital quality scale. Data obtained was analyzed statistically. RESULTS : High prevalence of Psychiatric morbidity (63.33% among spouses of alcohol dependent men , with majority having Axis I diagnosis of Major Depression (35% , Anxiety and Adjustment Disorder. None of them had personality disorders on SCID II. Psychiatric morbidity , poor marital quality in spouses and high alcohol dependence in their husbands and its adverse consequences were found to be significantly correlated with each

  12. Psychological changes in alcohol-dependent patients during a residential rehabilitation program

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    Giorgi I

    2015-12-01

    Full Text Available Ines Giorgi,1 Marcella Ottonello,2,3 Giovanni Vittadini,4 Giorgio Bertolotti5 1Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, 2Department of Physical & Rehabilitation Medicine, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Genoa, 3Department of Medicine, PhD Program in Advanced Sciences and Technologies in Rehabilitation Medicine and Sport, Università di Tor Vergata, Rome, 4Alcohol Rehabilitation Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, 5Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Tradate, Italy Background: Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive–affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse.Materials and methods: The sample included 560 subjects (mean age 46.91±10.2 years who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment – Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome

  13. Treatment in hospital for alcohol-dependent patients decreases attentional bias

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    Flaudias V

    2013-05-01

    Full Text Available Valentin Flaudias,1,2 Georges Brousse,1,2 Ingrid De Chazeron,1,2 François Planche,2 Julien Brun,2 Pierre-Michel Llorca1,2 1Clermont Université, EA 7280 NPsy-Sydo, Clermont-Ferrand, France; 2Pôle Psychiatrie B, CHU Gabriel-Montpied, Clermont-Ferrand, France Background and objectives: Previous studies in alcohol-dependent patients have shown an attentional bias (AB under related substance cues, which can lead to relapse. This AB can be evaluated by the alcohol Stroop test (AST. The AST is a modified Stroop task in which participants have to name the color of an alcohol-related word or a neutral word. AB is the response-time difference between these two types of words. The goal of the current study was to examine modification of AB during specialized hospitalization for alcohol dependence, with the suppression of a training bias that could be present in within-subject design. Methods: Individuals with alcohol-dependence disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th edition and admitted for withdrawal in the addiction unit of the University Hospital of Clermont-Ferrand (test group, n = 42 and persons with no alcohol or psychiatric disorder (control group, n = 16, recruited among colleagues and friends of the staff, performed the AST. A subgroup of the test group performed the AST in admission (admission group, n = 19, and another subgroup undertook the test immediately before discharge (discharge group, n = 23. Results: Results showed an AB only for patients seen at admission (F[1,55] = 3.283, P = 0.075. Moreover, we observed that the AB in the admission group (mean = 34 ms, standard deviation [SD] = 70.06 was greater than the AB in the control group (mean = 23 ms, SD = 93.42, itself greater than the AB in the discharge group (mean = −12 ms, SD = 93.55 (t[55] = −1.71; P = 0.09. Conclusion: Although the results are preliminary, the present study provides evidence for changes in the AB during alcohol-addiction treatment

  14. [Pharmacological treatment in alcohol-, drug- and benzodiazepine-dependent patients - the significance of trazodone].

    Science.gov (United States)

    Funk, Sándor

    2013-06-01

    Currently detoxification of drug and alcohol dependent patients is pharmacologically unresolved, and long-term treatment following the acute phase is also not very successful including a high number of relapses. We would need medications that on the short term cease: the severe vegetative symptoms, the pain, the extremely distressing psychosyndrome characterised by restlessness, anxiety or acute depressive symptoms, and the craving. The optimal would be if there was one medication capable of simultaneously alleviating or diminishing all the above symptoms without causing dependency and preventing relapse in the long-term. Dependency is almost all cases accompanied by primary and/or secondary mood disorder or sleep disorder which should also be treated. It should be considered, however, that following withdrawal of the agent benzodiazepine dependency often develops. The serotonin antagonist and reuptake inhibitor (SARI) trazodone is effective in the treatment of depression accompanied by sleeping disorder and it has also shown efficacy in alcohol and benzodiazepine-dependency. Its administration may improve the efficacy of detoxification and treatment of following conditions, may decrease medication load and the risk of the development of benzodiazepine dependency. In our clinical practice we frequently use this agent to treat our patients simultaneously suffering from depression and addiction problems, gaining experience comparing it to other pharmacotherapies (benzodiazepines or other antidepressants). The medication is not approved for alcohol and drug dependence, however, treatment t of comorbid conditions is not against to the official recommendations. Our aim was, in addition to reviewing the literature, to share our experience which, although cannot be considered an evidence based study, we deemed worthy of publishing. We cannot, at this point, put forward a protocol addressing all related scientific problems and problems of off-label treatment, and we could

  15. Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients

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    Zhenhe eZhou

    2014-08-01

    Full Text Available Internet addiction disorder (IAD should belong to a kind of behavioral addiction. Previous studies indicated that there are many similarities in the neurobiology of behavior and substance addictions. Up to date, although individuals with IAD have difficulty suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for IAD. Neuropsychological test studies have contributed significantly to our understanding of the effect of IAD on the cognitive function. The purpose of the present study was to examine whether Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent individuals. Participants include 22 Internet addictive individuals, 22 alcohol-dependent patients (AD and 22 normal controls (NC. All participants were measured with BIS- 11, go/no-go task, WCST and Digit span task under the same experimental condition. Results showed that BIS-11 scores, false alarm rate, the total response errors, perseverative errors, failure to maintain set of IAD and AD group were significantly higher than that of NC group, and hit rate, percentage of conceptual level responses, the number of categories completed, forwards scores and backwards scores of IAD and AD group were significantly lower than that of NC group, however, no differences in above variables between IAD group and AD group were observed. These results revealed that the existence of impulsivity, deficiencies in executive function and working memory in an IAD and an AD sample, namely, Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients.

  16. Acamprosate for alcohol dependence

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    Susanne Rösner

    Full Text Available BACKGROUND: Alcohol dependence is among the main leading health risk factors in most developed and developing countries. Therapeutic success of psychosocial programs for relapse prevention is moderate, but could potentially be increased by an adjuvant treatment with the glutamate antagonist acamprosate. OBJECTIVE: To determine the effectiveness and tolerability of acamprosate in comparison to placebo and other pharmacological agents. CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: We searched the Cochrane Drugs and Alcohol Group (CDAG Specialized Register, PubMed, Embase and CINAHL in January 2009 and inquired manufacturers and researchers for unpublished trials. SELECTION CRITERIA: All double-blind randomised controlled trials (RCTs which compare the effects of acamprosate with placebo or active control on drinking-related outcomes. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data. Trial quality was assessed by one author and cross-checked by a second author. Individual patient data (IPD meta-analyses were used to verify the primary effectiveness outcomes. MAIN RESULTS: 24 RCTs with 6915 participants fulfilled the criteria of inclusion and were included in the review. Compared to placebo, acamprosate was shown to significantly reduce the risk of any drinking RR 0.86 (95% CI 0.81 to 0.91; NNT 9.09 (95% CI 6.66 to 14.28 and to significantly increase the cumulative abstinence duration MD 10.94 (95% CI 5.08 to 16.81, while secondary outcomes (gamma-glutamyltransferase, heavy drinking did not reach statistical significance. Diarrhea was the only side effect that was more frequently reported under acamprosate than placebo RD 0.11 (95% 0.09 to 0.13; NNTB 9.09 (95% CI 7.69 to 11.11. Effects of industry-sponsored trials RR 0.88 (95% 0.80 to 0.97 did not significantly differ from those of non-profit funded trials RR 0.88 (95% CI 0.81 to 0.96. In addition, the linear regression test did not indicate a significant risk of

  17. Transcranial direct current stimulation of the prefrontal cortex reduces cue-reactivity in alcohol-dependent patients.

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    Wietschorke, Katharina; Lippold, Julian; Jacob, Christian; Polak, Thomas; Herrmann, Martin J

    2016-10-01

    Alcohol craving has been shown to be an important factor for relapses in alcohol-dependent patients. Furthermore, brain activity in reward-related areas in response to alcohol-related cues is positively related to the amount of post-relapse alcohol consumption. On the other hand, it has been shown that cue-exposure based extinction training (CET) leads to larger decrease of striatal and left dorsolateral prefrontal cortex (dLPFC) cue-induced activation compared to standard clinical day-care treatment, but the effect sizes are relatively small. The question of this study was, whether it is possible to change cue-reactivity and subjective craving by applying bilateral prefrontal transcranial direct current stimulation (tDCS). We stimulated 30 detoxified alcohol-dependent patients (50 % with a sham and 50 % with left cathodal/right anodal stimulation) and presented emotional as well as alcohol-related pictures. We measured the emotional startle modulation and found significantly increased startle amplitudes in the verum stimulation condition for alcohol-related cues, indicating a more negative processing of this cues in alcohol-dependent patients after verum tDCS stimulation. Additionally we found tendencies for stronger reduction in subjective craving in verum-stimulated patients. Therefore our study underscores the positive value of DCS in reducing craving and might help to improve the understanding and therapy of alcohol dependence.

  18. Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence

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    2013-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD, and alcohol dependence . Objective: The objective of this study is to evaluate the efficacy of

  19. A randomised controlled trial of extended brief intervention for alcohol dependent patients in an acute hospital setting (ADPAC

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    Williamson Paula

    2011-07-01

    Full Text Available Abstract Background Alcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity. Only 5.6% of alcohol-dependent individuals ever access specialist treatment and only a small percentage ever seek treatment. As people who are alcohol dependent are more likely to have experienced health problems leading to frequent attendance at acute hospitals it would seem both sensible and practical to ensure that this setting is utilised as a major access point for treatment, and to test the effectiveness of these treatments. Methods/Design This is a randomised controlled trial with a primary hypothesis that extended brief interventions (EBI delivered to alcohol-dependent patients in a hospital setting by an Alcohol Specialist Nurse (ASN will be effective when compared to usual care in reducing overall alcohol consumption and improving on the standard measures of alcohol dependence. Consecutive patients will be screened for alcohol misuse in the Emergency Department (ED of a district general hospital. On identification of an alcohol-related problem, following informed written consent, we aim to randomize 130 patients per group. The ASN will discharge to usual clinical care all control group patients, and plan a programme of EBI for treatment group patients. Follow-up interview will be undertaken by a researcher blinded to the intervention at 12 and 24 weeks. The primary outcome measure is level of alcohol dependence as determined by the Severity of Alcohol Dependence Questionnaire (SADQ score. Secondary outcome measures include; Alcohol Use Disorders Identification Test (AUDIT score, quantity and frequency of alcohol consumption, health-related quality of life measures, service utilisation, and patient experience. The trial will also allow an assessment of the cost-effectiveness of EBI in an acute hospital setting. In addition, patient experience will be assessed using qualitative methods

  20. Assessment of the effectiveness of yoga therapy as an adjunct in patients with alcohol dependence syndrome

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    Dipesh Bhagabati

    2017-01-01

    was significant only till two weeks (p<0.05. Conclusion: Yoga therapy significantly reduced anxiety symptoms and craving in patients of alcohol dependence but not depressive symptoms. Secondly, practicing yoga for a longer period of time has progressive benefits.

  1. Intangible costs of alcohol dependence from the perspective of patients and their relatives: A contingent valuation study.

    Science.gov (United States)

    Mosquera Nogueira, Jacinto; Rodríguez-Míguez, Eva

    2016-09-29

    Alcohol dependence causes multiple problems not only for the person suffering dependence but also for others. In this study, the contingent valuation method is proposed to measure the intangible effects of alcohol dependence from the perspective of the persons directly involved: the patients and their relatives. Interviews were conducted with 145 patients and 61 relatives. Intangible effects of alcohol dependence were determined based on willingness to pay for a hypothetical treatment for dependence, with different success scenarios (100% and 50%). The mean monthly willingness to pay among the alcohol-dependent population was €129 and €168, respectively, for the treatments with 100% and 50% success. The willingness to pay of relatives was greater in both scenarios (€307 and €420, respectively), which could be explained by their greater perception of the family, labour, and health problems resulting from alcohol dependence. Regression analysis showed that patients' willingness to pay is positively related to treatment efficacy, personal income and moderate health deterioration, and negatively related to feeling discouraged and depressed. The results from this study can be applied to economic valuation studies that aim to measure the benefits of programs intended to reduce the prevalence of alcohol dependence. The intangible costs estimated can be added to the direct and indirect costs commonly used.

  2. Changes in Nutrition-Related Behaviors in Alcohol-Dependent Patients After Outpatient Detoxification: The Role of Chocolate.

    Science.gov (United States)

    Stickel, Anna; Rohdemann, Maren; Landes, Tom; Engel, Katharina; Banas, Roman; Heinz, Andreas; Müller, Christian A

    2016-01-01

    Previous studies have reported changes in nutrition-related behaviors in alcohol-dependent patients after alcohol detoxification, but prospective studies assessing the effects of these changes on maintaining abstinence are lacking. To assess changes in craving and consumption of chocolate and other sweets over time up to six months after outpatient alcohol detoxification treatment and to detect differences in abstinent versus nonabstinent patients. One hundred and fifty alcohol-dependent patients were included in this prospective observational study. Participants completed self-report questionnaires on nutrition-related behaviors and craving before detoxification treatment (baseline, t1), one week (t2), one month (t3), and six months later (t4). Significant changes in craving for and consumption of chocolate as well as in craving for other sweets were observed over time. Increases were most prominent within the first month. Patients who remained abstinent until t3 consumed three times more chocolate than nonabstainers. One quarter of the patients switched from being rare (t1) to frequent (t3) chocolate eaters, and 84% of these remained abstinent until t3. No significant correlations were found between craving for alcohol and craving for or consumption of chocolate or other sweets. In the first month after outpatient alcohol detoxification treatment, significant changes in nutrition-related behaviors were observed. These changes were not associated with alcohol craving. For a subgroup, increasing the frequency of chocolate consumption might be a temporary protective factor with respect to alcohol relapse.

  3. Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: a randomized controlled study

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    Khan Riaz

    2011-08-01

    Full Text Available Abstract Background Despite the importance of heavy drinking and alcohol dependence among patients with opiate and cocaine dependence, few studies have evaluated specific interventions within this group. The aim of the present study was to evaluate the impact of screening with the Alcohol Use Disorders Identification Test (AUDIT and of brief intervention (BI on alcohol use in a sample of patients treated for opioid or cocaine dependence in a specialized outpatient clinic. Methods Adult outpatients treated for opioid or cocaine dependence in Switzerland were screened for excessive alcohol drinking and dependence with the AUDIT. Patients with AUDIT scores that indicated excessive drinking or dependence were randomized into two groups--treatment as usual or treatment as usual together with BI--and assessed at 3 months and 9 months. Results Findings revealed a high rate (44% of problematic alcohol use (excessive drinking and dependence among patients with opiate and cocaine dependence. The number of drinks per week decreased significantly between T0 (inclusion and T3 (month 3. A decrease in average AUDIT scores was observed between T0 and T3 and between T0 and T9 (month 9. No statistically significant difference between treatment groups was observed. Conclusions In a substance abuse specialized setting, screening for alcohol use with the AUDIT, followed by feedback on the score, and use of alcohol BI are both possibly useful strategies to induce changes in problematic alcohol use. Definitive conclusions cannot, however, be drawn from the study because of limitations such as lack of a naturalistic group. An important result of the study is the excellent internal consistency of AUDIT in a population treated for opiate or cocaine dependence.

  4. Autobiographical Memory Deficits in Alcohol-Dependent Patients with Short- and Long-Term Abstinence.

    Science.gov (United States)

    Nandrino, Jean-Louis; El Haj, Mohamad; Torre, Julie; Naye, Delphine; Douchet, Helyette; Danel, Thierry; Cottençin, Oliver

    2016-04-01

    Autobiographical memory (AM) enables the storage and retrieval of life experiences that allow individuals to build their sense of identity. Several AM impairments have been described in patients with alcohol abuse disorders without assessing whether such deficits can be recovered. This cross-sectional study aimed to identify whether the semantic (SAM) and episodic (EAM) dimensions of AM are affected in individuals with alcohol dependence after short-term abstinence (STA) or long-term abstinence (LTA). A second aim of this study was to examine the factors that could disrupt the efficiency of semantic and episodic AM (the impact of depression severity, cognitive functions, recent or early traumatic events, and drinking history variables). After clinical and cognitive evaluations (alcohol consumption, depression, anxiety, IQ, memory performance), AM was assessed with the Autobiographical Memory Interview in patients with recent (between 4 and 6 weeks) and longer (at least 6 months) abstinence. Participants were asked to retrieve the number and nature of traumatic or painful life experiences in recent or early life periods (using the Childhood Traumatic Events Scale). The 2 abstinent groups had lower global EAM and SAM scores than the control group. These scores were comparable for both abstinent groups. For childhood events, no significant differences were observed in SAM for both groups compared with control participants. For early adulthood and recent events, both STA and LTA groups had lower scores on both SAM and EAM. Moreover, there was a negative correlation between the length of substance consumption and SAM scores. This study highlighted a specific AM disorder in both episodic and semantic dimensions. These deficits remained after 6 months of abstinence. This AM impairment may be explained by compromised encoding and consolidation of memories during bouts of drinking. Copyright © 2016 by the Research Society on Alcoholism.

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

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    Om Prakash

    2015-01-01

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

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

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

    2002-01-01

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

  7. Baclofen for alcohol dependence in France: incidence of treated patients and prescription patterns--a cohort study.

    Science.gov (United States)

    Dupouy, Julie; Fournier, Jean-Pascal; Jouanjus, Émilie; Palmaro, Aurore; Poutrain, Jean-Christophe; Oustric, Stéphane; Lapeyre-Mestre, Maryse

    2014-02-01

    Recently, baclofen has been widely promoted for treatment of alcohol dependence in France. Our aim was firstly to describe the incidence of patients newly treated with baclofen for alcohol dependence in France from 2007 to 2011, and secondly to describe baclofen prescription patterns and prescribers. A retrospective cohort study of patients newly treated with baclofen was conducted using the "Echantillon Généraliste des Bénéficiaires" database (EGB). Patients with a first dispensation of baclofen between 01/01/2007 and 31/12/2011, followed by a second in the next 120 days, were included. Patients were considered treated with baclofen for neurological conditions if at least one of the following conditions was found to be true: (1) presence of a neurological condition for which baclofen could be prescribed, (2) dispensation of dantrolene, another anti-spastic drug, or (3) hospitalization for a neurological condition for which baclofen could be prescribed. We assumed that all the remaining patients were treated for alcohol dependence. During the 5-year period, 676 patients were incident users. While the annual incidence rate of patients newly treated with baclofen for neurological conditions remained stable, the annual incidence rate of patients newly treated with baclofen for alcohol dependence increased by a factor of 2.9 between 2007 (0.09/1000 person-years) and 2011 (0.26/1000 person-years). In the alcohol dependence group, median duration of baclofen treatment was 143.5 [74.0; 377.0] days; median daily dose was 24.4 [14.8; 39.5] mg. This study demonstrated the rapidly increasing use of baclofen in France for treatment of alcohol dependence.

  8. [Dimensions of personality, attachment style and early maladaptive schemas in alcohol-dependent patients: Are there gender-specific differences?

    Science.gov (United States)

    Camart, N; Cotte, M; Leignel, S; Bouvet, C; Limosin, F

    2016-12-01

    Literature reports particularities in certain psychological dimensions, such as personality traits, early maladaptive schemas and attachment styles among patients dependent on alcohol. Several international studies have also emphasized significant gender differences in psychological profiles. However, in France, only a few studies have dealt with this subject. Our aim was on the one hand to study the characteristics of alcohol-dependent patients in these variables, and on the other hand to search for gender differences. The personality dimensions were assessed with the French Big Five Inventory (Fr-BFI), the attachment style with Bartholomew's Relationship Scales Questionnaire (RSQ), and early maladaptive schemas with the short version of Young's questionnaire (YSQ-S1). Seventy-three subjects were included: 39 alcohol-dependent patients (19 men and 20 women) and 34 healthy control subjects (17 men and 17 women). The scores of alcohol-dependent patients were compared with those of a healthy control group (n=34, 17 men, 17 women) and available standards. We also compared the scores of men and women with alcohol dependence between them, and we compared the scores of men and women to those of the control group and those of the reference sample of the same sex. This is an ongoing study and we publish here the first results. Compared with control subjects, and the reference sample, alcohol-dependent patients showed significantly higher levels of neuroticism and lower levels of extraversion. Furthermore, differences in attachment styles were observed compared to the control group: alcohol-dependent patients presented a less secure attachment, seemed more fearful and detached, but the results remained within the normal standards. Compared to the control subjects, alcohol-dependent patients showed a significant increase in scores regarding many schemas: emotional deprivation, abandonment, abuse/mistrust, isolation, imperfection, dependence, symbiotic relationship

  9. Analysis of extreme drinking in patients with alcohol dependence using Pareto regression.

    Science.gov (United States)

    Das, Sourish; Harel, Ofer; Dey, Dipak K; Covault, Jonathan; Kranzler, Henry R

    2010-05-20

    We developed a novel Pareto regression model with an unknown shape parameter to analyze extreme drinking in patients with Alcohol Dependence (AD). We used the generalized linear model (GLM) framework and the log-link to include the covariate information through the scale parameter of the generalized Pareto distribution. We proposed a Bayesian method based on Ridge prior and Zellner's g-prior for the regression coefficients. Simulation study indicated that the proposed Bayesian method performs better than the existing likelihood-based inference for the Pareto regression.We examined two issues of importance in the study of AD. First, we tested whether a single nucleotide polymorphism within GABRA2 gene, which encodes a subunit of the GABA(A) receptor, and that has been associated with AD, influences 'extreme' alcohol intake and second, the efficacy of three psychotherapies for alcoholism in treating extreme drinking behavior. We found an association between extreme drinking behavior and GABRA2. We also found that, at baseline, men with a high-risk GABRA2 allele had a significantly higher probability of extreme drinking than men with no high-risk allele. However, men with a high-risk allele responded to the therapy better than those with two copies of the low-risk allele. Women with high-risk alleles also responded to the therapy better than those with two copies of the low-risk allele, while women who received the cognitive behavioral therapy had better outcomes than those receiving either of the other two therapies. Among men, motivational enhancement therapy was the best for the treatment of the extreme drinking behavior.

  10. Influence of repeated permanent coloring and bleaching on ethyl glucuronide concentrations in hair from alcohol-dependent patients.

    Science.gov (United States)

    Crunelle, Cleo L; Yegles, Michel; De Doncker, Mireille; Dom, Geert; Cappelle, Delphine; Maudens, Kristof E; van Nuijs, Alexander L N; Covaci, Adrian; Neels, Hugo

    2015-02-01

    Ethyl glucuronide (EtG), a minor metabolite of alcohol, is used as a sensitive marker in hair to detect the retrospective consumption of alcohol. The proximal 0-3 cm hair segment is often used for analysis, providing information on alcohol consumption over the past 3 months. Using more distal segments would allow the detection of alcohol consumption over longer time periods, thereby addressing the chronicity of the consumption. In view of this, permanent coloring and bleaching were shown in vitro to alter EtG concentrations in hair, but no in vivo studies are available to prove or disprove this. To investigate the influence of repeated bleaching and permanent coloring on EtG concentrations in vivo and to assess the stability of EtG concentrations in distal compared to proximal hair segments. Hair samples from alcohol-dependent patients with uncolored/unbleached (N=4), permanent coloration (N=5) and bleached hair (N=5) were analyzed in two to six 3 cm long segments for EtG concentrations, and alcohol consumption and hair cosmetic treatments were assessed. We observed that hair bleaching and permanent coloring reduces EtG concentrations by 82±11% and 65±24%, respectively, with correlations between the number of cosmetic treatments and the decrease in EtG concentrations. EtG remained stable in untreated hair samples up to 18 cm. EtG is a sensitive marker to assess chronic alcohol consumption up to 18 months in alcohol-dependent patients with no cosmetic hair treatments. However, in alcohol-dependent patients who color or bleach their hair, care should be taken when interpreting EtG measurements. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Do alcohol-dependent patients show different neural activation during response inhibition than healthy controls in an alcohol-related fMRI go/no-go-task?

    Science.gov (United States)

    Czapla, Marta; Baeuchl, Christian; Simon, Joe J; Richter, Barbara; Kluge, Matthias; Friederich, Hans-Christoph; Mann, Karl; Herpertz, Sabine C; Loeber, Sabine

    2017-03-01

    Alcohol dependence is associated with impaired response inhibition and heightened cue reactivity towards alcohol-related stimuli. Several brain areas, but mainly prefrontal structures, have been linked to response inhibition in addiction. This study aimed at combining both aspects: salience of drug-associated cues and response inhibition using a go/no-go task with alcohol-associated stimuli during functional magnetic resonance imaging (fMRI). Nineteen abstinent alcohol-dependent patients (ADP) and 21 healthy control subjects (HC) were compared on blood oxygen level-dependent (BOLD) responses during successful inhibition of no-go stimuli and successful reactions to go stimuli. ADP and HC did not significantly differ in their behavioural performance in the task. However, both groups performed worse during the inhibition of alcoholic-associated stimuli compared to neutral stimuli. On the neural level, ADP displayed enhanced BOLD activity relative to HC during successful response inhibition in several areas involved in visual processing, cognitive and impulse control, including occipital structures, anterior cingulate gyrus, medial frontal gyrus and medial orbitofrontal cortex. We interpret these findings as a possible compensation strategy for impaired cognitive processing. Furthermore, the results underline the impact of salience of alcohol-related stimuli on response inhibition, which seems to affect both ADP and HC.

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

    Science.gov (United States)

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

    2012-05-01

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

  13. Lack of association between SNPs in the NEUROD2 gene and alcohol dependence in a German patient sample.

    Science.gov (United States)

    Zill, Peter; Preuss, Ulrich W; Koller, Gabrielle; Bondy, Brigitta; Soyka, Michael

    2011-05-15

    Results of a human post mortem study performed by our own group have suggested that the transcription factor NEUROD2, which plays a role in neuronal development, as well as in the development of anxiety and risk behavior in mice, might be a susceptibility factor for addictive disorders. Therefore the aim of the present study was to analyze a possible relation between genetic variants in the NEUROD2 gene and alcohol dependence in a sample of the Munich Gene Bank of Alcoholism (MGBA). We performed single SNP (single nucleotide polymorphism) and haplotype studies in 430 alcohol-dependent patients and 365 healthy controls with four SNPs covering the gene region of NEUROD2. Neither single SNP nor haplotype analysis could detect significant associations with alcohol dependence. Additionally we could not detect any relation of the analyzed genetic variants to Cloninger's Type 1/2 or Babor's Type A/B classification, to the age of onset or to the amount of alcohol intake. Our results do not provide evidence for an involvement of NEUROD2 polymorphisms in the pathophysiology of alcohol dependence. Further association studies are needed to confirm our findings.

  14. Successful treatment of polydipsia, water intoxication, and delusional jealousy in an alcohol dependent patient with clozapine.

    Science.gov (United States)

    Margetić, Branimir; Aukst-Margetić, Branka; Zarković-Palijan, Tija

    2006-09-30

    The beneficial effect of clozapine on polydipsia and water intoxication in patients with schizophrenia has been demonstrated many times. The authors report a successful clozapine treatment of polydipsia, intermittent water intoxication, and delusional jealousy of an alcoholic. This is a rare case of clozapine treatment of a non-schizophrenic patient affected by polydipsia.

  15. Alcohol dependence--classificatory considerations.

    Science.gov (United States)

    Lesch, O M; Ades, J; Badawy, A; Pelc, I; Sasz, H

    1993-01-01

    The term alcoholism or alcohol dependence has acquired a broad range of meanings. The Plinius Maior Society herewith presents new classificatory considerations and suggests additional recording of special dimensions according to the individual hypothesis and design of a study.

  16. Prazosin for Treatment of Patients with PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2014-12-01

    as high as those in the general population. In addition, alcohol dependence is the most ommon comorbid condition in men with PTSD. Despite this...participants with a current iagnosis of AD and PTSD will be enrolled in a 13-week trial. They will be assigned, in a double-blind fashion , to either

  17. Interpersonal Self-Perception and Memories on Parental Rearing in Alcohol Dependent Patients and Outpatient Controls

    NARCIS (Netherlands)

    Jong, C.A.J. de; Jacobs, P.

    2010-01-01

    The aim of the present study is to explore the relation between interpersonal self-perceptions and memories on parental rearing taking into account the influence of alcohol dependence. Based on interpersonal and object relation theories, the existence and the directions of this relation are hypothes

  18. Heart rate variability biofeedback in patients with alcohol dependence: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Penzlin AI

    2015-10-01

    Full Text Available Ana Isabel Penzlin,1 Timo Siepmann,2 Ben Min-Woo Illigens,3 Kerstin Weidner,4 Martin Siepmann4 1Institute of Clinical Pharmacology, 2Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany; 3Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 4Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany Background and objective: In patients with alcohol dependence, ethyl-toxic damage of vasomotor and cardiac autonomic nerve fibers leads to autonomic imbalance with neurovascular and cardiac dysfunction, the latter resulting in reduced heart rate variability (HRV. Autonomic imbalance is linked to increased craving and cardiovascular mortality. In this study, we sought to assess the effects of HRV biofeedback training on HRV, vasomotor function, craving, and anxiety. Methods: We conducted a randomized controlled study in 48 patients (14 females, ages 25–59 years undergoing inpatient rehabilitation treatment. In the treatment group, patients (n=24 attended six sessions of HRV biofeedback over 2 weeks in addition to standard rehabilitative care, whereas, in the control group, subjects received standard care only. Psychometric testing for craving (Obsessive Compulsive Drinking Scale, anxiety (Symptom Checklist-90-Revised, HRV assessment using coefficient of variation of R-R intervals (CVNN analysis, and vasomotor function assessment using laser Doppler flowmetry were performed at baseline, immediately after completion of treatment or control period, and 3 and 6 weeks afterward (follow-ups 1 and 2. Results: Psychometric testing showed decreased craving in the biofeedback group immediately postintervention (OCDS scores: 8.6±7.9 post-biofeedback versus 13.7±11.0 baseline [mean ± standard deviation], P<0.05, whereas craving was unchanged at

  19. Reliability and Validity of Beliefs about Substance Use (BSU Questionnaire in Alcohol Dependent Patients.

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    Selçuk ASLAN

    2012-11-01

    Full Text Available Objective: In this study, it is aimed to evaluate the validity and reliability of the Beliefs About Substance Use Questionnaire (BSU which was originally developed by Wright (1993. Method: Seventy alcohol addicted inpatients, who were admitted to Ankara Dışkapı Yıldırım Beyazıt Education and Research Hospital Psychiatry Clinic, 31 healthy volunteers who had never used alcohol and 33 social drinkers were evaluated. For all groups, BSU and Craving Beliefs Questionnaire (CBQ, for the patient groups, Beck Anxiety Inventory (BAI, Clinical Institute Withdrawal Assessment (CIWA, Dysfunctional Attitudes Questionnaire (DAS and Automatic Thoughts Questionnaire (ATQ were used as the assessment tools. The correlations and differences between the questionnaires were studied. Results: Mean age of the addicted patients, healthy controls and social drinkers were 42,3± 7,0, 33,5± 9,9 and 33,2± 8,9, respectively. In patient group, mean BSU score was 46,4 ± 21,2. For alcohol addicts, internal reliability of BSU was found to be adequate (Cronbach alfa=0.91 and item-total score correlations were between 0.33 and 0.69. Basic component analysis showed one basic factor. A positive correlation has been found between BSU and CBQ, and ATQ scores. No correlations have been found between total and subscale scores of DAS and total scores of CIWA, BAI and BSU. In evaluation of validity, BSU mean scores of alcohol addicts were found to be significantly higher than healthy controls and social drinkers. Conclusion: Our findings support that Turkish version of BSU is an adequate tool that can be used to evaluate alcohol addicted patients` cognitive believes about alcohol use

  20. The level of alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment.

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    BACKGROUND: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was hyp

  1. The Level of Alexithymia in Alcohol-Dependent Patients Does Not Influence Outcomes after Inpatient Treatment

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was hyp

  2. The level of alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment.

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    BACKGROUND: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  3. The level of Alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment

    NARCIS (Netherlands)

    de Haan, Hein A.; Schellekens, Arnt F.A.; van der Palen, Jacobus Adrianus Maria; Verkes, Robbert-Jan; Buitelaar, Jan K.; de Jong, Cor A.J.

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  4. The Level of Alexithymia in Alcohol-Dependent Patients Does Not Influence Outcomes after Inpatient Treatment

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  5. The level of Alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment

    NARCIS (Netherlands)

    Haan, de Hein A.; Schellekens, Arnt F.A.; Palen, van der Job; Verkes, Robbert-Jan; Buitelaar, Jan K.; Jong, de Cor A.J.

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was hyp

  6. Predicting the effect of naltrexone and acamprosate in alcohol-dependent patients using genetic indicators

    NARCIS (Netherlands)

    Ooteman, W.; Naassila, M.; Koeter, M.W.J.; Verheul, R.; Schippers, G.M.; Houchi, H.; Daoust, M.; van den Brink, W.

    2009-01-01

    Acamprosate and naltrexone are effective medications in the treatment of alcoholism. However. effect sizes are modest. Pharmacogenomics may improve patient-treatment-matching and effect sizes. It is hypothesized that naltrexone exerts its effect through genetic characteristics associated with the do

  7. Pathways to Care of Alcohol -Dependent Patients: An Exploratory Study From a Tertiary Care Substance Use Disorder Treatment Center

    Directory of Open Access Journals (Sweden)

    Pal Singh Balhara

    2016-02-01

    Full Text Available Background No study from India has examined pathways to care in alcohol using population systematically. Objectives The present study aimed to understand the pathways to care among alcohol-dependent individuals seeking help at a tertiary care center. Patients and Methods It was a cross-sectional, observational study. A total of 58 subjects diagnosed with alcohol- dependence syndrome as per DSM-IV-TR were included in the study. Pathways to care were assessed using the world health organization encounter form. Results For 56.9% of the subjects, first point of contact was with a tertiary care addiction psychiatrist. Traditional healers were consulted by about 5.2% of the patients seeking help for the first time. The mean duration of main problems due to alcohol use was 5.82 ± 4.95 years. The first contact tended to be at place nearer to the patient’s residence while further contacts tended to be farther away. Family, friends and neighbours together constituted the single largest group suggesting patients to seek care. Conclusions There is a long time lag between the onset of alcohol use related problems and the first help seeking attempt. Of those who do decide to seek help, the proportion of those obtaining specialist help is higher than commonly believed.

  8. Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

    Science.gov (United States)

    Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

    2016-03-02

    primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD.

  9. Anticonvulsants for alcohol dependence.

    Science.gov (United States)

    Pani, Pier Paolo; Trogu, Emanuela; Pacini, Matteo; Maremmani, Icro

    2014-02-13

    Alcohol dependence is a major public health problem that is characterised by recidivism and a host of medical and psychosocial complications. Besides psychosocial interventions, different pharmacological interventions have been or currently are under investigation through Cochrane systematic reviews. The primary aim of the review is to assess the benefits/risks of anticonvulsants for the treatment of alcohol dependence. We searched the Cochrane Drugs and Alcohol Group Trials Register (October 2013), PubMed (1966 to October 2013), EMBASE (1974 to October 2013) and CINAHL (1982 to October 2013). Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing anticonvulsants alone or in association with other drugs and/or psychosocial interventions versus placebo, no treatment and other pharmacological or psychosocial interventions. We used standard methodological procedures as expected by The Cochrane Collaboration. A total of 25 studies were included in the review (2641 participants). Most participants were male, with an average age of 44 years. Anticonvulsants were compared with placebo (17 studies), other medications (seven studies) and no medication (two studies). The mean duration of the trials was 17 weeks (range four to 52 weeks). The studies took place in the USA, Europe, South America, India and Thailand. Variation was reported in the characteristics of the studies, including their design and the rating instruments used. For many key outcomes, the risk of bias associated with unclear or unconcealed allocation and lack of blinding affected the quality of the evidence.Anticonvulsants versus placebo: For dropouts (16 studies, 1675 participants, risk ratio (RR) 0.94, 95% confidence interval (Cl) 0.74 to 1.19, moderate-quality evidence) and continuous abstinence (eight studies, 634 participants, RR 1.21, 95% Cl 95% 0.97 to 1.52, moderate-quality evidence), results showed no evidence of differences. Moderate-quality evidence suggested that

  10. The predictive validity of the Drinking-Related Cognitions Scale in alcohol-dependent patients under abstinence-oriented treatment

    Directory of Open Access Journals (Sweden)

    Sawayama Toru

    2012-05-01

    Full Text Available Abstract Background Cognitive factors associated with drinking behavior such as positive alcohol expectancies, self-efficacy, perception of impaired control over drinking and perception of drinking problems are considered to have a significant influence on treatment effects and outcome in alcohol-dependent patients. However, the development of a rating scale on lack of perception or denial of drinking problems and impaired control over drinking has not been substantial, even though these are important factors in patients under abstinence-oriented treatment as well as participants in self-help groups such as Alcoholics Anonymous (AA. The Drinking-Related Cognitions Scale (DRCS is a new self-reported rating scale developed to briefly measure cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment, including positive alcohol expectancies, abstinence self-efficacy, perception of impaired control over drinking, and perception of drinking problems. Here, we conducted a prospective cohort study to explore the predictive validity of DRCS. Methods Participants in this study were 175 middle-aged and elderly Japanese male patients who met the DSM-IV Diagnostic Criteria for Alcohol Dependence. DRCS scores were recorded before and after the inpatient abstinence-oriented treatment program, and treatment outcome was evaluated one year after discharge. Results Of the 175 participants, 30 were not available for follow-up; thus the number of subjects for analysis in this study was 145. When the total DRCS score and subscale scores were compared before and after inpatient treatment, a significant increase was seen for both scores. Both the total DRCS score and each subscale score were significantly related to total abstinence, percentage of abstinent days, and the first drinking occasion during the one-year post-treatment period. Therefore, good treatment outcome was significantly predicted by low

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

    Science.gov (United States)

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

    2015-08-01

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

  12. Pharmacogenomics of alcohol addiction: Personalizing pharmacologic treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Ragia Georgia

    2014-01-01

    Full Text Available Alcohol dependence is a serious psychiatric disorder with harmful physical, mental and social consequences, and a high probability of a chronic relapsing course. The field of pharmacologic treatment of alcohol dependence and craving is expanding rapidly; the drugs that have been found to reduce relapse rates or drinking in alcohol-dependent patients and are approved for treatment of alcohol dependence are naltrexone, acamprosate and disulfiram, whereas also topiramate appears as a promising therapy. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that genetic variation is a significant contributor to interindividual variation of clinical presentation of alcohol problems and response to a given treatment. The aim of the present review is to summarize and discuss the findings on the association between gene polymorphisms and the response to alcohol dependence treatment medications. It is anticipated that future implementation of pharmacogenomics in clinical practice will help personalize alcohol dependence drug treatment, and development personalized hospital pharmacology.

  13. Psychological survey of alcohol dependent patients%酒依赖患者的心理调查

    Institute of Scientific and Technical Information of China (English)

    方彩霞

    2012-01-01

      目的:调查分析酒依赖患者心理状态,提供相应的心理干预措施.方法:采用 SCL-90症状自评量表,对41例酒依赖患者进行心理调查,并将调查结果与常模对照分析研究.结果:在因子分析中,酒依赖患者在躯体化、人际关系、抑郁、焦虑、恐怖等因子分显著高于常模( t <0.05).结论:酒依赖患者存在明显的心理问题,应对其进行必要的心理干预.%  Objective: Investigation of patients with alcohol dependence psychological state, to provide appropriate psychological interventions. Methods: SCL-90 Symptom Checklist dependent patients psychological investigation of 41 cases of wine, and the findings norm control analysis. Results:Factor analysis, alcohol-dependent patients was significantly higher than the norm (t <0.05) in the factor scores of somatization, interpersonal sensitivity, depression, anxiety, and terror. Conclusion: The alcohol dependence in patients with obvious mental problems, should carry out the necessary psychological intervention.

  14. 酒精依赖患者的护理%Research on Nursing of Patients with Alcohol Dependence

    Institute of Scientific and Technical Information of China (English)

    谢青莲; 曹秉蓉; 胡丽; 欧颖

    2011-01-01

    目的 总结酒精依赖患者的护理特点和经验.方法 2008年1月- 2009年10月,对收治的60例酒精依赖患者,依据其临床特点采取针对性的护理措施,重点加强心理护理.结果 60例患者症状明显改善,痊愈40例,无并发症发生.结论 在药物治疗的基础上,配合施行各项有效的护理措施,特别是心理护理,可帮助患者减轻对酒品的依赖程度,恢复健康和正常生活.%Objective To summarize the characteristics and experiences of nursing for patients with alcohol dependence. Method From January 2008 to October 2009, 60 patients with alcohol dependence were admitted to our department According to the clinical characteristics of those patients, corresponding nursing measures were applied. Mental nursing was enhanced. Results The symptoms of 60 inpatients were obviously improved without complications. The evaluation of treatment showed that 40 patients were cured. Conclusion On the base of medicine treatment, patients can lower their alcohol dependence and go back to normal life by effective measures of nursing, especially mental nursing.

  15. Comparative study of marital adjustment and life satisfaction among spouses of patients with alcohol dependence and normal healthy control: a case control study

    Directory of Open Access Journals (Sweden)

    Nazish Fatima

    2015-09-01

    Results: There was significant difference in respect to life satisfaction among the spouses of individual with alcohol dependence syndrome and normal healthy control. Life satisfaction as well as marital adjustment was better in spouses of normal healthy control as compared to spouses of patients of alcohol dependence. Conclusions: There is significant difference in respect to life satisfaction among the spouses of individual with alcohol dependence syndrome and normal healthy control. Wives of normal healthy control had better marital adjustment as compared to spouses of alcohol dependence syndrome. There was positive co-relation between life satisfaction and marital adjustment. [Int J Res Med Sci 2015; 3(9.000: 2246-2251

  16. 酒精依赖患者注意网络研究%Attention networks in patients with alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    孔晓明; 孙艳; 谢成娟; 汪凯; 张许来

    2012-01-01

    Objective To investigate the characteristics of attention networks impairment in the patients with alcohol dependence and the impossible mechanism that the brain was harmed by the alcohol. Methods Mini - mental state examination and the attention network test were used in 21 patients with alcohol dependence and 21 normal controls. Results The orienting network function was significantly lower(P 0.05). Conclusion The orienting and executive network impairment was found in 21 patients with alcohol dependence,which suggests the frontal lobe and parietal lobe may be more significantly affected by the alcohol.%目的 探索酒精依赖患者注意缺陷的特征以及可能机制.方法 对确诊的21例酒精依赖患者进行简易精神状态量表(MMSE)测试和注意网络测试,并与21名正常对照组相比较.结果 酒精依赖患者组定向网络时间[(30.4±36.9) ms]较对照组[(56.8±22.0)m]明显缩短;执行控制网络时间[(160.6±78.8)ms]较对照组[(103.9±47.6)ms]明显延长,差异有统计学意义(P<0.05).而警觉网络效率与对照组的差异无统计学意义.结论酒精依赖患者定向网络和执行网络受损,提示酒精可能对额叶、顶叶等脑区有更为显著的影响.

  17. The associations between self-consciousness, depressive state and craving to drink among alcohol dependent patients undergoing protracted withdrawal.

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    Philippe de Timary

    Full Text Available CONTEXT: In order to understand how certain personality traits influence the relation between depression symptoms and craving for alcohol, trait self-consciousness (trait SC was examined during a withdrawal and detoxification program. METHODS: Craving (Obsessive and Compulsive Drinking Scale, depressive state (Beck Depression Inventory and trait SC (Revised Self-Consciousness Scale were assessed in alcohol-dependent inpatients (DSM-IV, N = 30 both at the beginning (T1: day 1 or 2 and at the end (T2: day 14 to18 of protracted withdrawal during rehabilitation. RESULTS: A significant decrease in craving and depressive symptoms was observed from T1 to T2, while SC scores remained stable. At both times, strong positive correlations were observed between craving and depression. Moreover, regression analyses indicated that trait SC significantly moderated the impact of depression on cravings for alcohol. LIMITATIONS: This study was performed on a relatively small sample size. Administration of medications during detoxification treatment can also be a confounding factor. Finally, craving could have been evaluated through other types of measurements. CONCLUSIONS: During protracted withdrawal, alcohol craving decreased with the same magnitude as depressive mood. Depressive symptoms were related to alcohol craving but only among patients with high trait SC scores. Our results suggest that metacognitive approaches targeting SC could decrease craving and, in turn, prevent future relapses.

  18. The Cloninger Type I/Type II Typology: Configurations and Personality Profiles in Socially Stable Alcohol Dependent Patients

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    Peter Wennberg

    2014-01-01

    Full Text Available Many attempts have been made to derive alcohol use typologies or subtypes of alcohol dependence and this study aimed at validating the type I/type II typology in a treatment sample of socially stable alcohol dependent males and females. A second aim was to compare the two types with respect to their temperament profiles. Data was part of a larger ongoing longitudinal study, the Gothenburg Alcohol Research Project, and included 269 alcohol dependent males and females recruited from three treatment centers. The results showed that type II alcoholism occurred as a more homogenous type than type I alcoholism, and type I alcoholism seemed too heterogeneous to be summarized into one single type. When adapting a strict classification, less than a third of the study population could be classified in accordance with the typology, suggesting that the typology is not applicable, at least in socially stable individuals with alcohol dependence. The results also showed that type II alcoholics showed higher levels of novelty seeking than did the individuals that were classified as type I alcoholics. Quite surprisingly, the individuals classified as type II alcoholics also showed higher levels of harm avoidance than did the individuals that were classified as type I alcoholics.

  19. Alcohol homograph priming in alcohol-dependent inpatients

    NARCIS (Netherlands)

    Woud, M.L.; Salemink, E.; Gladwin, T.E.; Wiers, R.W.H.J.; Becker, E.S.; Lindenmeyer, J.; Rinck, M.

    2016-01-01

    Aim: Alcohol dependency is characterized by alcohol-related interpretation biases (IBs): Individuals with high levels of alcohol consumption generate more alcohol-related than alcohol-unrelated interpretations in response to ambiguous alcohol-related cues. However, a response bias could be an altern

  20. Alcohol abuse and related disorders treatment of alcohol dependence

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    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

  1. Serum levels of brain-derived neurotrophic factor in alcohol-dependent patients receiving high-dose baclofen.

    Science.gov (United States)

    Geisel, Olga; Hellweg, Rainer; Müller, Christian A

    2016-06-30

    The neurotrophin brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the development and maintenance of addictive and other psychiatric disorders. Also, interactions of γ-aminobutyric acid (GABA)-ergic compounds and BDNF have been reported. The objective of this study was to investigate serum levels of BDNF over time in alcohol-dependent patients receiving individually titrated high-dose treatment (30-270mg/d) with the GABA-B receptor agonist baclofen or placebo for up to 20 weeks. Serum levels of BDNF were measured in patients of the baclofen/placebo group at baseline (t0), 2 weeks after reaching individual high-dose of baclofen/placebo treatment (t1) and after termination of study medication (t2) in comparison to carefully matched healthy controls. No significant differences in serum levels of BDNF between the baclofen and the placebo group or healthy controls were found at t0, t1, or at t2. Based on these findings, it seems unlikely that baclofen exerts a direct effect on serum levels of BDNF in alcohol-dependent patients. Future studies are needed to further explore the mechanism of action of baclofen and its possible relationship to BDNF in alcohol use disorders.

  2. Predicting Inpatient Detoxification Outcome of Alcohol and Drug Dependent Patients: The Influence of Sociodemographic Environment, Motivation, Impulsivity, and Medical Comorbidities

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    Yvonne Sofin

    2017-01-01

    Full Text Available Aims. This prospective study aims to identify patient characteristics as predictors for treatment outcome during inpatient detoxification treatment for drug and alcohol dependent patients. Methods. A mixed gender sample of 832 consecutively admitted drug and alcohol dependent patients were interviewed by an experienced physician. The impact of a variety of factors concerning social environment, therapy motivation, impulsivity related variables, medical history, and addiction severity on treatment outcome was examined. Results. 525 (63.1% of the patients completed detoxification treatment whereas 307 (36.9% dropped out prematurely. Being female, living in a partnership, having children, being employed, and having good education were predictive for a positive outcome. Family, health, the fear of losing the job, prosecution, and emergency admission were significant motivational predictors for treatment outcome. Being younger, history of imprisonment, and the number of previous drop-outs were predictive for a negative outcome. Conclusions. Variables concerning social environment and the number of previous drop-outs have been identified as best predictors for treatment outcome. Socially stable patients benefit from the current treatment setting and treatment shall be adapted for patients with negative predictors. Treatment may consequently be tailored with respect to intervention type, duration, and intensity to improve the outcome for those patients that fulfil criteria with negative impact on treatment retention.

  3. Predicting Inpatient Detoxification Outcome of Alcohol and Drug Dependent Patients: The Influence of Sociodemographic Environment, Motivation, Impulsivity, and Medical Comorbidities

    Science.gov (United States)

    Danker-Hopfe, Heidi; Gooren, Tina

    2017-01-01

    Aims. This prospective study aims to identify patient characteristics as predictors for treatment outcome during inpatient detoxification treatment for drug and alcohol dependent patients. Methods. A mixed gender sample of 832 consecutively admitted drug and alcohol dependent patients were interviewed by an experienced physician. The impact of a variety of factors concerning social environment, therapy motivation, impulsivity related variables, medical history, and addiction severity on treatment outcome was examined. Results. 525 (63.1%) of the patients completed detoxification treatment whereas 307 (36.9%) dropped out prematurely. Being female, living in a partnership, having children, being employed, and having good education were predictive for a positive outcome. Family, health, the fear of losing the job, prosecution, and emergency admission were significant motivational predictors for treatment outcome. Being younger, history of imprisonment, and the number of previous drop-outs were predictive for a negative outcome. Conclusions. Variables concerning social environment and the number of previous drop-outs have been identified as best predictors for treatment outcome. Socially stable patients benefit from the current treatment setting and treatment shall be adapted for patients with negative predictors. Treatment may consequently be tailored with respect to intervention type, duration, and intensity to improve the outcome for those patients that fulfil criteria with negative impact on treatment retention.

  4. [Alcohol tolerance in patients with non-insulin-dependent diabetes (type 2) treated orally with drugs--derivatives of sulphonylurea].

    Science.gov (United States)

    Lao, B; Czyzyk, A; Szutowski, M; Szczepanik, Z

    1993-06-01

    The oral ethanol loading test (0.5 g per kg b.m. given as 40% solution) was carried out in 5 groups, each of 10 patients with non-insulin-dependent (type 2) diabetes before and after 10 days of treatment with one of the following sulphonylurea derivatives: tolbutamide 0.5 t.i.d., chlorpropamide 0.5 once daily morning, glibornuride 0.025 t.i.d, glibenclamide 0.005 t.i.d. and glipizide 0.005 t.i.d. The response to alcohol (facial flush, heart rate, blood pressure) were compared, and blood concentration of ethanol, acetaldehyde, pyruvate, lactate, carbonates as well as blood pH, pO2 and pCO2 were determined in fasting state and during 6 hours after alcohol ingestion. In all patients the family history of diabetes and the presence and degree of vascular complications were registered. Evident flushing phenomenon was observed in 6 patients treated with chlorpropamide, in 3 treated with tolbutamide, in 2 treated with glibenclamide, in one receiving glibornuride and in none treated with glipizide. All drugs caused a greater rise of blood ethanol and acetaldehyde levels in relation to the control tests, but the difference reached statistical significance only in the group receiving chlorpropamide. Moreover, patients (pooled) with positive thermographic response had also significantly higher blood levels of ethanol and acetaldehyde during the second test. The ratio of acetaldehyde to ethanol concentration in blood (mumol:mmol) was not significantly changed in any group indicating parallel impairment of both steps of ethanol metabolism. All studied drugs intensified to a similar degree the alcohol-induced hypoglycaemia, but had no significant effect on the decrease of blood pyruvate level neither on the increase of blood lactate level. They didn't change the post-alcohol decrease of blood bicarbonate and pH, and didn't modify the behaviour of partial gas pressure. There was also no difference between pooled groups of patients with positive and negative thermographic reaction

  5. A possible contribution to improving the therapeutic potentials of Babor's Typology of Alcohol Dependent Patients

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    Mário Sérgio Ribeiro

    2015-09-01

    Full Text Available ABSTRACT Objective The objective of this study was to replicate Babor's Typology and to explore clinical features related to personality traits that may underlie this classification, in order to improve its therapeutic possibilities. Methods Observational prospective study on a group of 273 male alcoholics. After a replication of Babor's variables, Cluster Analysis, Chi-Square – applied on clinical variables related to a Lappda Tipology – and Kappa tests were performed. Results The study identified two distinct clusters that held similar features to those described for the Type A/Type B classification. Besides presenting a lower socio-economic situation, Cluster 2 patients were associated with higher vulnerability and severe clinical features and also differed from Cluster 1 in their response to treatment. These replicated clusters retained connections and also differences in relation to the variables derived from the Lappda Typology. Conclusion Considering that each of the two replicated clusters seem to be associated to different personality traits – according to their correlations to the affective, cognitive and behavioral dimensions brought forward by the Lappda Typology – it is acceptable that this study may contribute to the development of more comprehensive and effective therapeutic strategies specifically tailored to target more specific personality traits of these subgroups of alcoholic patients.

  6. Differences between cravings and health-related quality of life in patients with alcohol dependence with or without dual pathology in outpatient treatment: A descriptive study.

    Science.gov (United States)

    Robles-Martínez, María; García-Carretero, Miguel Ángel; Gibert, Juan; Palma-Álvarez, Raúl Felipe; Abad, Alfonso Carlos; Sorribes, Marta; Roncero, Carlos

    2017-07-20

    Dual diagnosis is the coexistence of an addictive disorder and another mental disorder. The objective is to estimate cravings and self-reported quality of life in a sample of patients with alcoholic dependence, with or without dual pathology, who attend an outpatient treatment centre. A cross-sectional study of 112 patients (56 dual and 56 non-dual), diagnosed with alcohol dependence according to DSM-IV-TR. The presence of cravings is determined by the Multidimensional Alcohol Craving Scale and quality of life through the SF-36 Health Questionnaire. There are no statistically significant differences in cravings in either subgroup; the latter tend to refer to lower alcohol cravings than non-dual patients. The dual patients have a worse quality of life in all categories evaluated, highlighting a worse quality of life in the categories: social function, emotional role, vitality and general health. Females present a lower quality of life emphasising those of social function and emotional role. No differences were detected in relation to cravings between the 2 groups. In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, we should consider focusing on the evaluation of cravings and quality of life. In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, it is necessary to consider cravings and quality of life, since these parameters are important for the evaluation of patients with alcohol dependence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  7. Problemas laborales en pacientes dependientes del alcohol: Evolución en un año de tratamiento Work-related problems among alcohol-dependent patients: Development a year of alcohol treatment

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    Mª Trinidad Gómez-Talegón

    2009-09-01

    Full Text Available Objetivo: El objetivo de este estudio es analizar la prevalencia de problemas laborales debidos al consumo de alcohol en una muestra de dependientes del alcohol y su evolución durante un año de tratamiento. Material y Método: Se realizó un estudio prospectivo de una cohorte de 93 pacientes, que realizaron tratamiento durante un año, diagnosticados de dependencia del alcohol según criterios DSM-IV. Se obtuvo información de los siguientes problemas laborales debidos al consumo de alcohol: absentismo, llamadas de atención, sanciones, accidentes laborales, despidos, desempleo o paro, ocurridos en tres momentos: durante toda la vida, el año anterior al inicio del tratamiento y durante un año de tratamiento. Resultados: El 57% tuvieron problemas laborales a lo largo de su vida, el 35,5% el año anterior al inicio del tratamiento, y el 23,7% durante el año de tratamiento. Los problemas mas frecuentes fueron el absentismo y el desempleo. Los problemas laborales disminuyeron (pObjetive: The aim of this study is to analyse the prevalence of work-related problems due to the consumption of alcohol in a sample of alcohol-dependent patients and their evolution over twelve months of treatment. Method: A prospective study was carried out on a cohort of 93 patients diagnosed as alcohol-dependent according to DSM-IV criteria, who underwent treatment over a 12 month period. Information concerning the following work-related problems due to the consumption of alcohol was obtained: absenteeism, warnings, sanctions, accidents at work, dismissals and unemployment, that occurred within three different time scales: the patient's lifetime, the 12 months prior to the start of the treatment and during the 12 months of the treatment. Results: 57% had had work-related problems during their lifetime, 35.5% in the 12 months prior to starting treatment and 23,7% during the year of treatment. The most frequent problems during the year of treatment were absenteeism and

  8. Assessment of motivation for treatment in alcohol dependent patients who sought treatment at a specialized medical service

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    Oliveira Júnior Hercílio Pereira de

    2003-01-01

    Full Text Available INTRODUCTION: Motivation is deemed a critical component for interventions intended to change behaviors related to the use of alcohol and other drugs. The classification of patients in 'stages of change' can be a useful tool for the organization and improvement of treating programs. METHODS: This study assessed the stages of change using the scales URICA and SOCRATES in patients who attended two different treating programs for alcohol dependence in a specialized medical service. We performed an analysis of the association between stages of change and demographic aspects. After three months of treatment, patients were reassessed to evaluate their outcome. RESULTS: In the assessments using URICA, there was an association between stages of change and monthly income and age. There was no evidence that patients move across the stages of change. Using the scale SOCRATES, we found an association between stages of change and monthly income. In the reassessment, there was a significant movement across the stages of change. CONCLUSION: Patients who attend two different treating programs may have different motivation profiles. There was no movement congruent with the stage of change model, suggesting that patients may need more than 3 months to obtain significant changes in their motivation.

  9. Dissociative disorders among alcohol-dependent inpatients.

    Science.gov (United States)

    Evren, Cuneyt; Sar, Vedat; Karadag, Figen; Tamar Gurol, Defne; Karagoz, Mustafa

    2007-08-30

    The aim of this study was to determine the prevalence of dissociative disorders among inpatients with alcohol dependency. The Dissociative Experiences Scale was used to screen 111 alcohol-dependent patients consecutively admitted to the inpatient unit of a dependency treatment center. Subgroups of 29 patients who scored 30.0 or above and 25 patients who scored below 10.0 were then evaluated with the Dissociative Disorders Interview Schedule and the Structured Interview for DSM-IV Dissociative Disorders. The interviewers were blind to the Dissociative Experiences Scale scores. Of the 54 patients evaluated, 10 (9.0% of the original 111) patients had a dissociative disorder. A considerable number of the remaining patients reported a high level of dissociative experiences. Among the dissociative disorder group, nine patients had dissociative disorder not otherwise specified and one patient had depersonalization disorder. Female gender, younger age, history of suicide attempt, childhood emotional and sexual abuse, and neglect were more frequent in the dissociative disorder group than among non-dissociative patients. The dissociative disorder group also had somatization disorder, borderline personality disorder, and lifetime major depression more frequently. For 9 of the 10 dissociative patients, dissociative symptoms started before the onset of alcohol use. Although the probability of having a comorbid dissociative disorder was not higher among alcohol-dependent inpatients than among the general psychiatric inpatients, the dissociative subgroup had distinct features. Many patients without a dissociative disorder diagnosis (predominantly men) provided hints of subtle dissociative psychopathology. Implications of comorbid dissociative disorders and dissociative experiences on prevention and treatment of alcohol dependency and the importance of gender-specific characteristics in this relationship require further study.

  10. Suicidal behaviour among alcohol-dependent Danes attending outpatient treatment

    DEFF Research Database (Denmark)

    Bjørk Petersen, Christina; Grønbæk, Morten; Bussey Rask, Marie;

    2009-01-01

    . Characteristics of, predictors for and outcome among suicidal patients were studied. Alcohol-dependent patients with a history of suicide attempts were found to constitute a highly selected group in alcohol abuse treatment as they often had a more severe course of alcohol dependence, were unemployed, younger......, were more often lowly educated, and had more physical and psychiatric problems. Traumatic childhood experience related to physical or sexual abuse was found as a major predictor for suicidal behaviour among alcohol-dependent patients. We found no significant difference in the effect of treatment...... that suicidal patients in treatment for alcohol abuse are treated effectively within the present treatment settings....

  11. Salivary lysozyme in smoking alcohol dependent persons.

    Science.gov (United States)

    Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Zalewska, Anna; Waszkiewicz, Magdalena; Szajda, Slawomir Dariusz; Repka, Bernadeta; Szulc, Agata; Kepka, Alina; Minarowska, Alina; Ladny, Jerzy Robert; Zwierz, Krzysztof

    2012-01-01

    The purpose of this study was to evaluate the effect of chronic alcohol intoxication and smoking on the concentration and output of salivary lysozyme. Thirty seven men participated in the study, including 17 male smoking alcohol-dependent patients after chronic alcohol intoxication (AS), and 20 control non-smoking male social drinkers (CNS) with no history of alcohol abuse or smoking. The level of lysozyme was assessed by the radial immunodiffusion method. Significantly lower lysozyme output in the AS group compared to the CNS group was found. Moreover, gingival index was significantly higher in AS than in the CNS group. It appeared that the reduced salivary lysozyme output was more likely the result of ethanol action than smoking. In conclusion, persons addicted to alcohol and nicotine have a poorer periodontal status than non-smoking social drinkers, which may partially be due to the diminished protective effects of lysozyme present in the saliva.

  12. Cost-effectiveness of home visits in the outpatient treatment of patients with alcohol dependence.

    Science.gov (United States)

    Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos B

    2010-01-01

    The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure - abstinent cases at the end of treatment. There were 51.8% abstinent cases for HV and 43.1% for CT, a clinically relevant finding. Other outcome measures, such as quality of life, also showed significant improvements that favored HV. The baseline scenario presented an ICER of USD 1,852. Sensitivity analysis showed an ICER of USD 689 (scenario favoring HV) and USD 2,334 (scenario favoring CT). The HV treatment was found to be cost-effective according to the WHO Commission on Macroeconomics and Health. 2009 S. Karger AG, Basel.

  13. Interpersonal dependency in alcoholic and obese men.

    Science.gov (United States)

    Mills, J K

    1995-06-01

    While psychological conflict about dependency needs of alcoholic and obese persons has been widely observed, few studies have examined differences in dependency characteristics between these clinical groups. The Interpersonal Dependency Inventory was administered to 22 alcoholic and 8 morbidly obese men in intensive treatment for alcohol and obesity. The original hypothesis that alcoholic and obese men would show similar dependency needs was supported. Dependency correlates of personality may serve as useful predictor variables in the clinical treatment of alcoholic and obese persons.

  14. Two-year prognosis after residential treatment for patients with alcohol dependence: three chief guidelines for sobriety in Japan

    Science.gov (United States)

    Cho, Tetsuji; Negoro, Hideki; Saka, Yasuhiro; Morikawa, Masayuki; Kishimoto, Toshifumi

    2016-01-01

    Background In Japan, the three chief traditional guidelines for sobriety (3CGS) are regular medical checkups, participation in self-help groups, and pharmacotherapy with antidipsotropics. However, the official record of the origins of 3CGS is not clear. The aim of this current study was to assess 3CGS by an examination of the prognosis of patients with alcohol dependence 2 years after their discharge from a residential treatment program. Subjects and methods The association between subjects’ abstinence from alcohol and their regular medical checkups, participation in self-help groups, and treatment with antidipsotropics were prospectively examined. Two years after discharge, the relationship between the 3CGS compliance and abstinence rates was investigated as the primary outcome. In addition, the following were examined as secondary outcomes: the time taken till the first drink after discharge, whether the participants were readmitted to residential treatment, the number of days to readmission, the number of heavy drinking days, and recovery. Results A total of 98 patients participated. The perfect and partial abstinence rates for patients who followed all the principles of 3CGS were significantly higher than those for patients who followed no guidelines (P<0.05 and P<0.01, respectively). The perfect abstinence rates for patients who had continued attending checkup sessions (P<0.001) and who were taking antidipsotropics (P<0.05) were significantly higher than those for patients who did not follow these components of 3CGS. However, the perfect abstinence rates were not higher for patients who had continued to participate in self-help groups. In addition, the perfect abstinence rate was statistically associated with regular medical checkups (adjusted odds ratio =5.33, 95% confidence interval =1.35–21.0) and participation in self-help groups (adjusted odds ratio =3.79, 95% confidence interval =1.17–12.3). Conclusion This study, reports the effectiveness of 3CGS

  15. [Treatment processes of pre-alcoholism and alcohol dependence targeted towards drinking reduction].

    Science.gov (United States)

    Yoshimura, Atsushi; Maesato, Hitoshi; Hisatomi, Nobuko; Higuchi, Susumu

    2013-02-01

    Since the 1990s, we have suggested the concept of pre-alcoholism which encompasses patients who have drunk a great deal of alcohol leading to alcohol related problems such as health issues, domestic violence, drunken driving and black-outs. Pre-alcoholism excludes alcohol-dependent patients who have experienced continuous drinking or withdrawal symptoms. We have treated many outpatients with pre-alcoholism for several years. Our regimen demands that the patients must be abstinent for half a year at the beginning of their treatment. After half a year they can choose whether they will continue to be abstinent or they will resume drinking with the aim of reducing their total alcohol consumption. The study clarified the character of pre-alcoholism by investigation of the patients' background and re-diagnosis of the patients based on the International Classification of Diseases, 10th Revision (ICD-10). A remarkable ratio of pre-alcoholic patients was diagnosed with alcohol dependence under ICD-10. We classified pre-alcoholic patients into two groups, one diagnosed as having ICD-10-classed alcohol dependence and the other which did not fulfill the ICD-10 diagnostic criteria of alcohol dependence, and examined the therapeutic processes of the two groups. It was shown that most pre-alcoholic patients could finally take required courses of treatment by themselves without regard to diagnosis under ICD-10, even if they chose any treatment and made alcohol related mistakes on the way. Our findings suggested that pre-alcoholic patients, a portion of whom may have exhibited mild alcohol dependence, could select drinking reduction as a primary goal of treatment after a certain period of abstinence.

  16. Smaller right amygdala in Caucasian alcohol-dependent male patients with a history of intimate partner violence: a volumetric imaging study.

    Science.gov (United States)

    Zhang, Lishu; Kerich, Mike; Schwandt, Melanie L; Rawlings, Robert R; McKellar, Joshua D; Momenan, Reza; Hommer, Daniel W; George, David T

    2013-05-01

    Studies have shown that various brain structure abnormalities are associated with chronic alcohol abuse and impulsive aggression. However, few imaging studies have focused on violent individuals with a diagnosis of alcohol dependence. The present study used volumetric magnetic resonance imaging (MRI) to compare the volumes of different structural components of prefrontal cortex and six subcortical structures in perpetrators of intimate partner violence with alcohol dependence (IPV-ADs), non-violent alcohol-dependent patients (non-violent ADs) and healthy controls (HCs). Caucasian men (n = 54), ages 24-55, who had participated in National Institutes of Alcohol Abuse and Alcoholism treatment programs, were grouped together as IPV-ADs (n = 27), non-violent ADs (n = 14) and HCs (n = 13). The MRI scan was performed at least 3 weeks from the participant's last alcohol use. T1-weighted images were used to measure the volumes of intracranial space, gray and white matter, orbitofrontal cortex, medial prefrontal cortex, lateral prefrontal cortex, and six subcortical structures. Results revealed that IPV-ADs, compared with non-violent ADs and HCs, had a significant volume reduction in the right amygdala. No significant volumetric difference was found in other structures. This finding suggests that structural deficits in the right amygdala may underlie impulsive types of aggression often seen in alcohol-dependent patients with a history of IPV. It adds to a growing literature suggesting that there are fundamental differences between alcohol-dependent patients with and without IPV. © 2011 The Authors, Addiction Biology © 2011 Society for the Study of Addiction.

  17. Linkage analysis in alcohol dependence.

    Science.gov (United States)

    Windemuth, C; Hahn, A; Strauch, K; Baur, M P; Wienker, T F

    1999-01-01

    Alcohol dependence often is a familial disorder and has a genetic component. Research in causative factors of alcoholism is coordinated by a multi-center program, COGA [The Collaborative Study on the Genetics of Alcoholism, Begleiter et al., 1995]. We analyzed a subset of the COGA family sample, 84 pedigrees of Caucasian ancestry comprising 745 persons, 339 of whom are affected according to DSM-III-R and Feighner criteria. Using parametric and nonparametric methods, evidence for linkage was found on chromosome 1 (near markers D1S532, D1S1588, and D1S534), as well as on chromosome 15 (near marker D15S642). Other regions of the genome showed suggestive evidence for contributing loci. Related findings are discussed in recent publications investigating linkage in humans [Reich et al., 1998] and mice [Melo et al., 1996].

  18. The activity of serum beta-galactosidase in colon cancer patients with a history of alcohol and nicotine dependence: preliminary data

    Directory of Open Access Journals (Sweden)

    Napoleon Waszkiewicz

    2013-08-01

    Full Text Available Introduction: Beta-galactosidase (GAL is a lysosomal exoglycosidase involved in the catabolism of glycoconjugates through the sequential release of beta-linked terminal galactosyl residues. The stimulation of activity of exoglycosidases and other degradative enzymes has been noted in cancers as well as in alcohol and nicotine addiction separately. This is the first study to evaluate the activity of the serum senescence marker GAL in colon cancer patients with a history of alcohol and nicotine dependence, as a potential factor of worse cancer prognosis.Material and Methods: The material was serum of 18 colon cancer patients and 10 healthy volunteers. Ten colon cancer patients met alcohol and nicotine dependence criteria. The activity of beta-galactosidase (pkat/ml was determined by the colorimetric method. Comparisons between groups were made using the Kruskal-Wallis analysis and differences evaluated using the Mann-Whitney U test. Spearman’s rank correlation coefficient was used to measure the statistical dependence between two variables.Results: The activity of serum GAL was significantly higher in colon cancer patients with a history of alcohol and nicotine dependence, in comparison to colon cancer patients without a history of drinking/smoking (p=0.015; 46�0increase, and the controls (p=0.0002; 81�0increase. The activity of serum GAL in colon cancer patients without a history of alcohol/nicotine dependence was higher than the activity in the controls (p = 0.043; 24�0increase.Discussion/Conclusion: Higher activity of beta-galactosidase may potentially reflect the accelerated growth of the cancer, invasion, metastases, and maturation, when alcohol and nicotine dependence coincide with colon cancer. For a better prognosis of colon cancer, alcohol and nicotine withdrawal seems to be required.

  19. The activity of serum beta-galactosidase in colon cancer patients with a history of alcohol and nicotine dependence: preliminary data.

    Science.gov (United States)

    Waszkiewicz, Napoleon; Szajda, Sławomir Dariusz; Waszkiewicz, Magdalena; Wojtulewska-Supron, Aleksandra; Szulc, Agata; Kępka, Alina; Chojnowska, Sylwia; Dadan, Jacek; Ładny, Jerzy Robert; Zwierz, Krzysztof; Zalewska-Szajda, Beata

    2013-08-26

    Beta-galactosidase (GAL) is a lysosomal exoglycosidase involved in the catabolism of glycoconjugates through the sequential release of beta-linked terminal galactosyl residues. The stimulation of activity of exoglycosidases and other degradative enzymes has been noted in cancers as well as in alcohol and nicotine addiction separately. This is the first study to evaluate the activity of the serum senescence marker GAL in colon cancer patients with a history of alcohol and nicotine dependence, as a potential factor of worse cancer prognosis. The material was serum of 18 colon cancer patients and 10 healthy volunteers. Ten colon cancer patients met alcohol and nicotine dependence criteria. The activity of beta-galactosidase (pkat/ml) was determined by the colorimetric method. Comparisons between groups were made using the Kruskal-Wallis analysis and differences evaluated using the Mann-Whitney U test. Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables. The activity of serum GAL was significantly higher in colon cancer patients with a history of alcohol and nicotine dependence, in comparison to colon cancer patients without a history of drinking/smoking (p=0.015; 46% increase), and the controls (p=0.0002; 81% increase). The activity of serum GAL in colon cancer patients without a history of alcohol/nicotine dependence was higher than the activity in the controls (p = 0.043; 24% increase). Higher activity of beta-galactosidase may potentially reflect the accelerated growth of the cancer, invasion, metastases, and maturation, when alcohol and nicotine dependence coincide with colon cancer. For a better prognosis of colon cancer, alcohol and nicotine withdrawal seems to be required.

  20. Doctors’ views of disulfiram and their response to relapse in alcohol-dependent patients, Free State, 2009

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    Paulina M. van Zyl

    2016-03-01

    Full Text Available Background: Disulfiram is the oldest and best known drug to prevent relapse after detoxification from alcohol. Effective use of the drug is dependent on stringent monitoring and high levels of external motivation. Doctors’ perceptions about the drug have not been investigated extensively.Aim: We investigated the perceptions and practices of doctors involved in relapse prevention in alcoholics with regard to disulfiram and their response to relapse.Setting: The study population consisted of 60 doctors from the Free State Province, involved in the follow-up of alcoholics across various work settings.Methods: A cross-sectional descriptive study design was used, and data collection involved the use of a questionnaire and semi-structured interviews. Quantitative results are presented in figures and percentages to provide a background for the qualitative findings that are clustered in themes.Results: A quarter of participants did not prescribe disulfiram, another quarter prescribed disulfiram routinely after detoxification, and half of them prescribed it for selected cases only. Subject to affordability, selection of disulfiram was mainly determined by the perceived level of the patient’s motivation. External motivation sometimes took the form of threats of bodily harm or death caused by drinking. Some participants regarded relapse as confirmation of poor motivation and even a valid reason for terminating the doctor-patient relationship.Conclusion: Doctors perceive disulfiram as a psychological tool to induce motivation through creating fear of drinking. Failure and success are perceived as related to the level of motivation. These perceptions could be unfair as biological factors in inter-patient variability in response are ignored.

  1. Doctors’ views of disulfiram and their response to relapse in alcohol-dependent patients, Free State, 2009

    Science.gov (United States)

    2016-01-01

    Background Disulfiram is the oldest and best known drug to prevent relapse after detoxification from alcohol. Effective use of the drug is dependent on stringent monitoring and high levels of external motivation. Doctors’ perceptions about the drug have not been investigated extensively. Aim We investigated the perceptions and practices of doctors involved in relapse prevention in alcoholics with regard to disulfiram and their response to relapse. Setting The study population consisted of 60 doctors from the Free State Province, involved in the follow-up of alcoholics across various work settings. Methods A cross-sectional descriptive study design was used, and data collection involved the use of a questionnaire and semi-structured interviews. Quantitative results are presented in figures and percentages to provide a background for the qualitative findings that are clustered in themes. Results A quarter of participants did not prescribe disulfiram, another quarter prescribed disulfiram routinely after detoxification, and half of them prescribed it for selected cases only. Subject to affordability, selection of disulfiram was mainly determined by the perceived level of the patient’s motivation. External motivation sometimes took the form of threats of bodily harm or death caused by drinking. Some participants regarded relapse as confirmation of poor motivation and even a valid reason for terminating the doctor-patient relationship. Conclusion Doctors perceive disulfiram as a psychological tool to induce motivation through creating fear of drinking. Failure and success are perceived as related to the level of motivation. These perceptions could be unfair as biological factors in inter-patient variability in response are ignored. PMID:27380787

  2. 认知功能的变化在酒依赖患者里的影响%Effect of cognitive function changes for alcohol dependent patients

    Institute of Scientific and Technical Information of China (English)

    宁夔; 孙伟力

    2016-01-01

    Objective to analyze cognitive function changes of alcohol dependent patients to further solve alcohol dependence problem.Methods evaluate cognitive function of 40 cases male alcohol dependent patients finished withdrawal therapy and 40 cases controlled normal male by Wisconsin Card Sorting Test (WCST), analyze difference between two groups.Results Comparison of WCST responses of various types between two groups showed, scores of alcohol dependence group were inferior than non-dependent group (P<0.01).Conclusion alcohol dependent patients have cognitive impairment.%目的:分析酒依赖患者的认知功能的变化情况来进一步解决酒依赖的问题。方法使用威斯康星卡片分类测验(WCST)对40例已完成戒断治疗的男性酒依赖患者和40例正常男性对照者做认知功能的评定,分析两组间的差异。结果 Wisconsin卡片分类测验(WCST)两组间各类应答数的比较,酒依赖组的成绩较非依赖组差(P<0.01)。结论酒依赖者有认知功能损伤。

  3. Treatment of alcohol dependence in patients with co-morbid major depressive disorder – predictors for the outcomes with memantine and escitalopram medication

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    Lönnqvist Jouko

    2008-10-01

    Full Text Available Abstract Background Alcohol dependence comorbid with major depressive disorder poses a major challenge in the clinical setting. The results in the treatment with selective serotonin re-uptake inhibitors have been conflicting. Thus, we compared in alcohol-dependent patients with co-morbid major depressive disorder the selective serotonin re-uptake inhibitor escitalopram to a compound that acts on different transporter system and may reduce craving, the glutamate receptor antagonist memantine. Methods Eighty alcohol-dependent patients comorbid with major depressive disorder in municipal alcohol clinics were randomized 1:1 to receive memantine 20 mg or escitalopram 20 mg in a double-blind manner. During the 26-week study period patients continued their routine treatment at the clinics. Abstinence was not required but encouraged. The patients attended visits weekly during the first month, and then at 3 and at 6 months. Outcome measures were Alcohol Use Disorders Identification Test (AUDIT, Obsessive Compulsive Drinking Scale (OCDS and Drinking Diary. Results The completion rate was high in both groups, especially among the patients who had been abstinent at the beginning of the study. However, among those patients who were not abstinent at baseline, 47% in both groups discontinued the study. Numbers of abstinent days were high in both groups throughout the study. Alcohol consumption measured by the AUDIT QF (quantity-frequency score was significantly reduced in both groups, as was the craving for alcohol measured by the OCDS. Early age at first alcohol intoxication predicted poor treatment outcomes in patients treated with escitalopram, and the same was seen with the early onset of the first depressive episode. The same predictive effects were not found in patients treated with memantine. Conclusion Our results indicate that both memantine and escitalopram are useful adjunct medications for the treatment of alcohol dependence co-morbid with major

  4. 酒依赖患者病情观察及护理干预%Observations of patient's condition and nursing intervention for patients with alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    黄小振; 余丹; 张爽

    2015-01-01

    通过对56例酒依赖患者进行病情观察,制定相应的护理措施并实施,可以帮助患者减轻戒断症状及并发症,安全度过戒断期,从心理及生理上缓解或消除对酒的依赖,提高患者生活质量。%Appropriate nursing interventions were made and carried out through the observation of 56 patients with alcohol dependence ,could lessen patients’ withdrawal symptoms and complications ,make them to tide over withdrawal period safely and to alleviate or eliminate psychological and physiological dependence on alcohol ,and improve patients’ quality of life .

  5. Alcoholics Anonymous and other 12-step programmes for alcohol dependence.

    Science.gov (United States)

    Ferri, M; Amato, L; Davoli, M

    2006-07-19

    Alcoholics Anonymous (AA) is an international organization of recovering alcoholics that offers emotional support through self-help groups and a model of abstinence for people recovering from alcohol dependence, using a 12-step approach. Although it is the most common, AA is not the only 12-step intervention available there are other 12-step approaches (labelled Twelve Step Facilitation (TSF)). To assess the effectiveness of AA or TSF programmes compared to other psychosocial interventions in reducing alcohol intake, achieving abstinence, maintaining abstinence, improving the quality of life of affected people and their families, and reducing alcohol associated accidents and health problems. We searched the Specialized Register of Trials of the Cochrane Group on Drugs and Alcohol, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE from 1966, EMBASE from 1980, CINAHL from 1982, PsychINFO from 1967. Searches were updated in February 2005. We also inspected lists of references for relevant studies. Studies involving adults (alcohol dependence attending on a voluntary or coerced basis AA or TSF programmes comparing no treatment, other psychological interventions, 12-step variants. One reviewer (MF) assessed studies for inclusion and extracted data using a pre-defined data extraction form. Studies were evaluated for methodological quality and discussed by all reviewers. Eight trials involving 3417 people were included. AA may help patients to accept treatment and keep patients in treatment more than alternative treatments, though the evidence for this is from one small study that combined AA with other interventions and should not be regarded as conclusive. Other studies reported similar retention rates regardless of treatment group. Three studies compared AA combined with other interventions against other treatments and found few differences in the amount of drinks and percentage of drinking days. Severity of addiction and drinking consequence did

  6. Using the Theory of Planned Behaviour to examine enrolled nursing students' intention to care for patients with alcohol dependence: A survey study.

    Science.gov (United States)

    Talbot, Anna-Lisa; Dorrian, Jillian; Chapman, Janine

    2015-11-01

    Nurses are often the first point of contact for patients hospitalized due to alcohol-related causes. Alcohol dependence is highly stigmatized and as a result healthcare professionals often have low behavioural intentions, meaning low willingness to care for these patients. This can have a direct influence on quality of care. The purpose of this study was to explore enrolled nursing students' intention to care for patients with alcohol dependence and the antecedents, preliminary factors, that predict this within the Theory of Planned Behaviour; specifically attitudes, subjective norms, self-efficacy and controllability. The study was a cross-sectional survey using the Theory of Planned Behaviour. Two Technical and Further Education South Australia campuses across metropolitan Adelaide. n=86 enrolled nursing students completed the survey (62% response rate). Enrolled nursing students' intention, attitudes, subjective norms, self-efficacy and controllability were measured using a Theory of Planned Behaviour Questionnaire. The Short Alcohol and Alcohol Problems Perception Questionnaire investigated attitudes in more detail and a short knowledge scale assessed alcohol-related knowledge. Subjective norms and attitudes had a significant, positive effect on intention to care within the final model, accounting for 22.6% of the variance, F2,83=12.12, pbehavioural change, in order to improve the quality of care for these patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Dihydrocodeine / Agonists for Alcohol Dependents

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    Albrecht eUlmer

    2012-03-01

    Full Text Available Objective: Alcohol addiction too often remains insufficiently treated. It shows the same profile as severe chronic diseases, but no comparable, effective basic treatment has been established up to now. Especially patients with repeated relapses, despite all therapeutic approaches, and patients who are not able to attain an essential abstinence to alcohol, need a basic medication. It seems necessary to acknowledge that parts of them need any agonistic substance, for years, possibly lifelong. For >14 years, we have prescribed such substances with own addictive character for these patients.Methods: We present a documented best possible practice, no designed study. Since 1997, we prescribed Dihydrocodeine (DHC to 102 heavily alcohol addict-ed patients, later, also Buprenorphine, Clomethiazole (>6 weeks, Baclofen and in one case Amphetamine, each on individual indication. This paper focuses on the data with DH, especially. The Clomethiazole-data has been submitted to a German journal. The number of treatments with the other substances is still low. Results: The 102 patients with the DHC-treatment had 1367 medically assisted detoxifications and specialized therapies before! The 4 years-retention rate was 26.4%, including 2.8% successfully terminated treatments. In our 12-step scale on clinical impression, we noticed a significant improvement from mean 3.7 to 8.4 after 2 years. The demand for medically assisted detoxifications in the 2 years remaining patients was reduced by 65.5%. Mean GGT improved from 206.6 U/l at baseline to 66.8 U/l after 2 years. Experiences with the other substances are similar but different in details.Conclusions: Similar to the Italian studies with GHB and Baclofen, we present a new approach, not only with new substances, but also with a new setting and much more trusting attitude. We observe a huge improvement, reaching an almost optimal, stable, long term status in around ¼ of the patients already. Many further

  8. Relationship of coping and patterns of dependent behavior in patients with chronic pancreatitis of biliary and alcoholic etiology in aspect of differentiation of its medical and psychological support

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    Маріанна Владиславівна Маркова

    2015-08-01

    Full Text Available Choric pancreatitis is an actual medical and psychological problem in Ukraine. The aim of the work was to study the features of coping in patients with chronic pancreatitis of alcoholic and biliary etiology.Methods. For detecting coping-mechanisms the standard method WCQ Р of Lazarus was used. The study of addictive tendencies was carried out with the help of questionnaire AUDIT and UDIT-tests oriented on patterns of dependent behavior.Results. The study of features of coping-mechanisms and an addiction to dependent behavior in patients with chronic pancreatitis revealed intergroup and intragroup differences. Confrontation and low levels of self-control, responsibility and positive assessment were intrinsic for respondents with alcoholic etiology of pancreatitis. Women demonstrated the high addiction to the search of social support, men – to distancing. As to an addictive behavior there was revealed that the typical common tendencies were the consumption of coffee, alcohol, internet-dependence, the specific ones for women – TV, shopping-dependencies, for men – workaholism in patients with biliary and computer-addiction in patients with alcoholic chronic pancreatitis. Intergroup differences were demonstrated by an addiction to disorder of food behavior in patients with biliary and consumption of alcohol and smoking in respondents with alcoholic etiology of pancreatitis.Conclusions. The revealed differences in coping-strategies of patients with different nosological forms of chronic pancreatitis give important information for detecting the targets of medical and psychological influence and constructing of differentiated program of medical and psychological help to patients of this type

  9. Correlates of baclofen effectiveness in alcohol dependence

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    Lekhansh Shukla

    2015-01-01

    Full Text Available Alcohol dependence is a global concern. Baclofen has shown promise as an anti-craving agent but its efficiency remains to be settled. We reviewed 549 male cases diagnosed with alcohol dependence who received Acamprosate (201 or Baclofen (348. ′Time to first drink′ was compared between two groups and multiple regression analysis was done in baclofen group to identify correlates of effectiveness. There was a significant difference in outcome measure between Baclofen (M = 4.44, SD = 3.75 and Acamprosate group (M = 3.73, SD = 2.19; t (547 = 2.45, P = 0.01. Initial regression analysis with six predictor variables (average daily alcohol units, current age, age at onset of dependence, family history, duration of dependence and dose of baclofen in mg/day showed significant correlation of outcome variable with only two predictor variables - dose of baclofen and average daily intake. Using the hierarchical method it was found that ′dose of baclofen′ and ′average alcohol intake′ explain a significant amount of variance in ′time to first drink′. [F (1, 345 = 182.8, P < 0.001, R2 = 0.52, R2 adjusted = 0.51]. This information can be used to select patients in long term longitudinal studies and may explain variable results seen in clinical trials of baclofen done earlier.

  10. Alcoholism, Field Dependency and Organic Impairment.

    Science.gov (United States)

    Lafferty, Patricia; Kahn, Marvin W.

    Although research has suggested that field dependency is a relatively stable characteristic of alcoholics, the results have been confounded by the use of different measures and different time intervals. To investigate the degree of organic brain impairment and its association with measured field dependency amongst alcoholics, 41 male alcoholics,…

  11. [MAST and AUDIT. Evaluation of psychometric characteristics in patients with alcohol dependence].

    Science.gov (United States)

    Fonte, Aníbal; Mota-Cardoso, Rui

    2013-01-01

    Introdução/Objectivo: Avaliar a correlação entre a pontuação no MAST e no AUDIT em doentes internados para desintoxicaçãopor dependência de álcool e analisar a possibilidade destas pontuações refletirem a intensidade da gravidade da dependência e dos problemas relacionados com o uso do álcool.Material e Métodos: Estudo correlacional. Doentes internados pela primeira vez, para tratamento por dependência de álcool. Além de uma entrevista estruturada, do MAST e do AUDIT, foi utilizado o SADD para avaliação do grau de dependência do álcool e o APQ para os problemas relacionados com o consumo de álcool.Resultados: A consistência interna (α de Cronbach) do MAST foi 0,77 e a do AUDIT foi 0,73. A correlação entre os dois instrumentos foi moderada (R = 0,497, p < 0,001). Ambos apresentam correlação moderada e significativa (p < 0,001) com o SADD e o APQ. O conjunto de itens do AUDIT dirigidos para a dependência têm maior correlação com o SADD do que com o APQ, sucedendo o inverso com o conjunto de itens pertencentes à dimensão problemas/consequências adversas. Os dois instrumentos apresentam correlação baixa com o volume de álcool consumido avaliado em g/d.Conclusão: Tanto o MAST como o AUDIT apresentam uma pontuação total que reflete a gravidade da dependência e das perturbações induzidas pelo álcool. Em populações clínicas estes instrumentos podem ser utilizados como variável contínua, para registo quantitativo da magnitude dos problemas. O AUDIT, relativamente ao MAST, tem a vantagem de apresentar um número menor de itens, ser mais fácil de responder e de cotar. O AUDIT tem ainda a vantagem de apresentar conjuntos de itens pertencentes a três dimensões (quantidade/frequência, dependência, problemas/consequências adversas) que podem ser analisados separadamente permitindo uma caracterização mais especificação das situações em estudo.

  12. Socio-emotional factors in alcohol dependence

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    Deyashini Lahiri Tikka

    2014-01-01

    Full Text Available Background: Alcohol-dependent patients are traditionally believed to have insecure attachment styles, higher anger expression, and lower self-esteem. There is a need to study them together. Aim: To understand the relationships amongst various of the socio-emotional factors. Materials and Methods: Forty male patients with Alcohol dependence syndrome and 40 matched healthy controls (General Health Questionnaire-12 score <3 were compared on attachment styles (on Relationship Scale Questionnaire, anger domains (on State Trait Anger Expression Inventory, and self-esteem (on Rosenberg Self-esteem Scale. Statistics and Analysis: Comparison using independent samples t test and chi square test; correlation using Pearson′s correlation coefficient. Results: Patients had significantly higher anger expression, ′anger in′ and ′anger out,′ and lower self-esteem than healthy controls. Severity of alcohol dependence had significant correlation with ′anger out,′ and self-esteem had significant negative correlation with anger expression. Conclusion: The present study suggests that the socio-emotional factors studied are developmentally linked to each other.

  13. [Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part I: Screening, Early Detection and Risk Factors in Patients with Alcohol Abuse or Dependence].

    Science.gov (United States)

    de la Espriella Guerrero, Ricardo; de la Hoz Bradford, Ana María; Gómez-Restrepo, Carlos; Zárate, Alina Uribe-Holguín; Menéndez, Miguel Cote; Barré, Michelle Cortés; Rentería, Ana María Cano; Hernández, Delia Cristina

    2012-12-01

    Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. 70 % of people under risk of having alcohol problems go undetected in medical practice, a fact that underlines the need for specific screening measures allowing early detection leading to timely treatment. This article presents evidence gathered by alcohol abuse and dependence screening as well as by risk factor identification and screening. It also presents evidence concerning withdrawal symptoms, delirium tremens and Wernicke's encephalopathy in order to promote early detection and timely treatment. Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Evidence was found and recommendations were made for the pertinent screening and search of risk factors, in order to perform a diagnosis and carry out a timely management of alcohol abuse, dependence and ensuing complications: withdrawal syndrome, delirium tremens and Wernicke's encephalopathy. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  14. DEVELOPMENT AND VALIDATION OF 'SURE': A PATIENT REPORTED OUTCOME MEASURE (PROM) FOR RECOVERY FROM DRUG AND ALCOHOL DEPENDENCE.

    Science.gov (United States)

    Neale, Joanne; Vitoratou, Silia; Finch, Emily; Lennon, Paul; Mitcheson, Luke; Panebianco, Daria; Rose, Diana; Strang, John; Wykes, Til; Marsden, John

    2016-08-01

    Patient Reported Outcome Measures (PROMs) assess health status and health-related quality of life from the patient/service user perspective. Our study aimed to: i. develop a PROM for recovery from drug and alcohol dependence that has good face and content validity, acceptability and usability for people in recovery; ii. evaluate the psychometric properties and factorial structure of the new PROM ('SURE'). Item development included Delphi groups, focus groups, and service user feedback on draft versions of the new measure. A 30-item beta version was completed by 575 service users (461 in person [IP] and 114 online [OL]). Analyses comprised rating scale evaluation, assessment of psychometric properties, factorial structure, and differential item functioning. The beta measure had good face and content validity. Nine items were removed due to low stability, low factor loading, low construct validity or high complexity. The remaining 21 items were re-scaled (Rasch model analyses). Exploratory and confirmatory factor analyses revealed 5 factors: substance use, material resources, outlook on life, self-care, and relationships. The MIMIC model indicated 95% metric invariance across the IP and OL samples, and 100% metric invariance for gender. Internal consistency and test-retest reliability were granted. The 5 factors correlated positively with the corresponding WHOQOL-BREF and ARC subscales and score differences between participant sub-groups confirmed discriminative validity. 'SURE' is a psychometrically valid, quick and easy-to-complete outcome measure, developed with unprecedented input from people in recovery. It can be used alongside, or instead of, existing outcome tools. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome

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    Justin B. Dickerson

    2011-02-01

    Full Text Available Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358. Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (b=0.31, P=0.001, referral to a hospital by a physician (b=0.35, P=0.014, and increasing age (b= 0.01, P=0.001 were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62. Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  16. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome.

    Science.gov (United States)

    Dickerson, Justin B

    2011-02-22

    Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (β=0.31, P=0.001), referral to a hospital by a physician (β=0.35, P=0.014), and increasing age (β= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  17. Do Drug-Dependent Patients Attending Alcoholics Anonymous Rather than Narcotics Anonymous Do As Well? A Prospective, Lagged, Matching Analysis.

    Science.gov (United States)

    Kelly, John F; Greene, M Claire; Bergman, Brandon G

    2014-11-01

    Alcoholics Anonymous (AA) is the most prevalent 12-step mutual-help organization (MHO), yet debate has persisted clinically regarding whether patients whose primary substance is not alcohol should be referred to AA. Narcotics Anonymous (NA) was created as a more specific fit to enhance recovery from drug addiction; however, compared with AA, NA meetings are not as ubiquitous. Little is known about the effects of a mismatch between individuals' primary substance and MHOs, and whether any incongruence might result in a lower likelihood of continuation and benefit. More research would inform clinical recommendations. Young adults (N = 279, M age 20.4, SD 1.6, 27% female; 95% White) in a treatment effectiveness study completed assessments at intake, and 3, 6, and 12 months post-treatment. A matching variable was created for 'primary drug' patients (i.e. those reporting cannabis, opiates or stimulants as primary substance; n = 198/279), reflecting the proportion of total 12-step meetings attended that were AA. Hierarchical linear models (HLMs) tested this variable's effects on future 12-step participation and percent days abstinent (PDA). The majority of meetings attended by both alcohol and drug patients was AA. Drug patients attending proportionately more AA than NA meetings (i.e. mismatched) were no different than those who were better matched to NA with respect to future 12-step participation or PDA. Drug patients may be at no greater risk of discontinuation or diminished recovery benefit from participation in AA relative to NA. Findings may boost clinical confidence in making AA referrals for drug patients when NA is less available. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  18. Suicidal behavior and haplotypes of the dopamine receptor gene (DRD2 and ANKK1 gene polymorphisms in patients with alcohol dependence--preliminary report.

    Directory of Open Access Journals (Sweden)

    Andrzej Jasiewicz

    Full Text Available Suicide is a significant public health issue and a major cause of death throughout the world. According to WHO it accounts for almost 2% of deaths worldwide. The etiology of suicidal behavior is complex but the results of many studies suggest that genetic determinants are of significant importance. In our study,--we have analyzed selected SNPs polymorphisms in the DRD2 and ANKK1 genes in patients with alcohol dependence syndrome (169 Caucasian subjects including a subgroup of individuals (n = 61 who have experienced at least one suicide attempt. The aim of the study was to verify if various haplotypes of selected genes, comprising Taq1A, Taq1B, and Taq1D single nucleotide polymorphisms (SNP, play any role in the development of alcohol dependence and suicidal behavior. The control group comprised 157 unrelated individuals matched for ethnicity, gender,- and age and included no individuals with mental disorders. All subjects were recruited in the North West region of Poland. The study showed that alcohol dependent subjects with a history of at least one suicidal attempt were characterized by a significantly higher frequency of the T-G-A2 haplotype when compared to individuals in whom alcohol dependence was not associated with suicidal behavior (p = 0.006. It appears that studies based on identifying correlation between SNPs is the future for research on genetic risk factors that contribute to the development of alcohol addiction and other associated disorders. To sum up, there is a necessity to perform further research to explain dependencies between the dopaminergic system, alcohol use disorders and suicidal behavior.

  19. Alcohol Dependency in Indian Dentists

    OpenAIRE

    Gaurav Solanki

    2012-01-01

    Alcohol consumption has widely increased through out the world. This all is due to a stressful life style and emotional load on a person. Dentistry is not excluded from the stress phenomenon. Dentists experience stressful situations every day, and have to deal with these in a very professional manner. The dentists participated were told about the hazard and ill-effect of alcohol consumption. There need to be a reduction in consumption of alcohol in dentistry for the upliftment of general mass...

  20. Functional and Dysfunctional rumination in alcohol dependence

    OpenAIRE

    Grynberg, Delphine; Briane, Yasmine; Timary, Philippe De; Maurage, Pierre; 16th International Society of Addiction Medicine Annual Meeting

    2014-01-01

    Previous findings have shown that rumination predicts alcohol abuse independently of depression. However, the literature does not inform about the relationships between alcohol dependence and functional and dysfunctional rumination. It has indeed been suggested that there exist a functional form of rumination(concrete thinking) and a dysfunctional form of rumination (abstract thinking). In this study, our aim is to evaluate if alcohol dependence is similarly associated with functional/constru...

  1. Analysis of correlation between personality characteristics of patients with alcohol dependence and the severity of alcohol dependence%酒依赖患者人格特征及酒依赖程度的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    艾霞; 刘华清; 杨甫德; 张东; 刘红侠

    2015-01-01

    目的:探索酒依赖患者的人格特征,以及酒依赖程度的影响因素。方法:运用明尼苏达多相人格调查表( MMPI)和酒依赖筛查量表( MAST)测查150例住院酒依赖患者(研究组)进行评估并与正常人(对照组)进行比较。以年龄、受教育年限、病程、发病年龄、饮酒时间、每日饮酒量以及MMPI 10个临床量表分作自变量,依次将酒依赖患者MAST 5个因子分作为因变量,进行多元逐步回归分析。结果:研究组的校正量表分低于对照组,差异具有统计学意义( P<0.05),诈病、疑病、抑郁、癔症、精神病态、偏执、神经衰弱、精神分裂、轻躁狂量表分均高于对照组,差异有统计学意义( P<0.01)。多元逐步回归分析显示,对饮酒问题的认识分与Pa、Pt、饮酒时间、受教育年限存在相关性( P均<0.05);工作社会分与Hy、Pt存在相关性(P均<0.05);肝脏疾患分与D、受教育年限存在相关性(P均<0.05)。结论:酒依赖患者有明显的人格偏离,某些人格特质、受教育时间和持续饮酒时间影响患者酒依赖程度。%Objective:To explore the personality characteristics of patients with alcohol dependence as well as the correlation with the severity of alcohol dependence. Method:Minnesota multiphasic personality inventory( MMPI)and Michigan alcohol screening test( MAST)were administered to 150 patients hospitalized for alcohol dependence( experimental group). The results were compared with those of the control. Age,years of education,course of disease,age of onset,time of drinking,daily alcohol intake and ten clinical scales of MMPI were selected as independent variables. In the meantime,five factors of MAST were treated as dependent variables to perform multiple stepwise regression,respectively. Results:The scores of corrected scales in the experimental group were lower than those of the control with statistical

  2. COMORBID GAMBLING IN PERSONS SUFFERING FROM ALCOHOL DEPENDENCE

    Directory of Open Access Journals (Sweden)

    Jagadeesan M. S

    2016-07-01

    Full Text Available BACKGROUND Gambling has been a part of human behaviour since prehistory. Past global studies show that rates of pathologic gambling are 4 to 10 times higher for substance abusers than for the general population. Alcohol dependence is also more common among parents of pathologic gamblers. Studies from India have been very few on this subject. OBJECTIVES The objectives were to analyse the prevalence of gambling behaviour in alcohol dependent individuals, to assess whether alcohol influence had effect on gambling behaviour, to analyse if gambling behaviour was associated with personality traits, to explore the possibility whether alcohol use & gambling behaviour in parents had influence on the gamblers. METHODS A sample of 100 consecutive male patients attending de-addiction OPD of a Government Tertiary Care Hospital in Chennai was selected. Those who had a diagnosis of alcohol dependence were screened for gambling and assessed using the South Oaks Gambling Screen (SOGS and Eysenck’s Personality Questionnaire. History of gambling behaviour and alcohol use in parents were correlated. RESULTS A high incidence of gambling related problems in alcohol dependent individuals was found. Among them, 24% had gambling related problems, of which 11% amounted to pathologic gambling. Age, Marital status, Residential locality, Economic status, Educational levels, or being under the influence of alcohol did not correlate with the gambling behaviour. Extrovert personality, alcohol dependence in father, and family history of gambling were more common in problem/pathologic gamblers.

  3. Alcohol Dependency in Indian Dentists

    Directory of Open Access Journals (Sweden)

    Gaurav Solanki

    2012-04-01

    Full Text Available Alcohol consumption has widely increased through out the world. This all is due to a stressful life style and emotional load on a person. Dentistry is not excluded from the stress phenomenon. Dentists experience stressful situations every day, and have to deal with these in a very professional manner. The dentists participated were told about the hazard and ill-effect of alcohol consumption. There need to be a reduction in consumption of alcohol in dentistry for the upliftment of general masses as well as the dentist.

  4. Nalmefene: a new approach to the treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Paille F

    2014-08-01

    Full Text Available François Paille, Hervé Martini Department of Addiction Treatment, University Hospital, Vandœuvre-lès-Nancy, France Abstract: Reduction of alcohol consumption is not yet a widely accepted treatment objective for alcohol-dependent patients, as abstinence is often considered to be the only possible objective in this situation. However, various studies have demonstrated the value of proposing these two options to such patients. Firstly, reduction of alcohol consumption very significantly reduces the risk of alcohol-related damage, and also modifies the patient's and the doctor's perception of the disease, resulting in improved access to care and better patient adherence with the proposed treatment objective and consequently better clinical results. Recent studies have shown that some medicinal products can help patients reduce their alcohol consumption. One such product, nalmefene, has been granted European marketing authorization and is now being released onto the market in various countries. The ESENSE 1 and 2 studies in alcohol-dependent patients showed that, in combination with BRENDA, a psychosocial intervention focusing on reinforcement of motivation and treatment adherence, nalmefene significantly reduced the number of heavy drinking days and mean daily total alcohol consumption versus placebo. This reduction was more marked in the marketing authorization target population, ie, patients with a high or very high drinking risk level according to World Health Organization criteria. Another original feature of this molecule is that it can be used as needed if the patient perceives a risk of drinking, which is a more flexible approach and more likely to ensure the patient's active involvement in the treatment of his/her disease. This molecule opens up interesting and original therapeutic prospects in the treatment of alcohol dependence. Keywords: alcohol dependence, reduction, consumption, damage reduction, drug therapy, nalmefene

  5. KPNA3 Variation Is Associated with Schizophrenia, Major Depression, Opiate Dependence and Alcohol Dependence

    Directory of Open Access Journals (Sweden)

    Charles P. Morris

    2012-01-01

    Full Text Available KPNA3 is a gene that has been linked to schizophrenia susceptibility. In this study we investigated the possible association between KPNA3 variation and schizophrenia. To investigate a wider role of KPNA3 across psychiatric disorders we also analysed major depression, PTSD, nicotine dependent, alcohol dependent and opiate dependent cohorts. Using a haplotype block-based gene-tagging approach we genotyped six KPNA3 single nucleotide polymorphisms (SNPs in 157 schizophrenia patients, 121 post-traumatic stress disorder patients, 120 opiate dependent patients, 231 alcohol dependent patients, 147 nicotine dependent patients and 266 major depression patients. One SNP rs2273816 was found to be significantly associated with schizophrenia, opiate dependence and alcohol dependence at the genotype and allele level. Major depression was also associated with rs2273816 but only at the allele level. Our study suggests that KPNA3 may contribute to the genetic susceptibility to schizophrenia as well as other psychiatric disorders.

  6. Association between DRD2, 5-HTTLPR, and ALDH2 genes and specific personality traits in alcohol- and opiate-dependent patients.

    Science.gov (United States)

    Wang, Tzu-Yun; Lee, Sheng-Yu; Chen, Shiou-Lan; Huang, San-Yuan; Chang, Yun-Hsuan; Tzeng, Nian-Sheng; Wang, Chen-Lin; Hui Lee, I; Yeh, Tzung Lieh; Yang, Yen Kuang; Lu, Ru-Band

    2013-08-01

    The vulnerability of developing addictions is associated with genetic factors and personality traits. The predisposing genetic variants and personality traits may be common to all addictions or specific to a particular class of addiction. To investigate the relationship between genetic variances, personality traits, and their interactions in addiction are important. We recruited 175 opiate-dependent patients, 102 alcohol-dependent patients, and 111 healthy controls. All participants were diagnosed using DSM-IV criteria and assessed with Tridimensional Personality Questionnaire (TPQ). The dopamine D2 receptor (DRD2), 5-HTT-linked promoter region (5-HTTLPR), and aldehyde dehydrogenase 2 (ALDH2) genes were genotyped using PCR. The genotype frequency of the 5-HTTLPR and ALDH2 was significantly different between the patients and controls (P=0.013, Ptraits, whereas addicts with ALDH2 *1/*2 or *2/*2 and low-functional group of DRD2 and 5-HTTLPR genes have higher NS traits. We concluded that addicts, both alcohol- and opiate-dependent patients, have common genetic variants in DRD2 and 5-HTTLPR but specific for ALDH2. Higher NS and HA traits were found in both patient groups with the interaction with DRD2, 5-HTTLPR, and ALDH2 genes. The ALDH2 gene variants had different effect in the NS and HA dimension while the DRD2 and 5-HTTLPR genes did not.

  7. Being in a safe haven and struggling against alcohol dependency. The meaning of caring for male patients in advanced addiction nursing.

    Science.gov (United States)

    Thurang, Anna; Rydström, Jens; Bengtsson Tops, Anita

    2011-01-01

    The aim of the present study was to explore and illuminate the meaning of advanced nursing caring for men with alcohol dependency, as narrated by the men themselves. Ten male patients were interviewed in-depth and data were subjected to a phenomenological-hermeneutic analysis. Caring meant having the opportunity to rest in a safe haven together with professional caregivers, to struggle for liberation from dependency, and to expand the life-sphere by starting to accept oneself and broaden social participation. The findings illuminate various patterns of masculinity and point to the importance for caregivers to be open to challenging stereotypical gender assumptions.

  8. The Effects of as-Needed Nalmefene on Patient-Reported Outcomes and Quality of Life in Relation to a Reduction in Alcohol Consumption in Alcohol-Dependent Patients.

    Directory of Open Access Journals (Sweden)

    Clément François

    Full Text Available The objective of this article was to investigate the effect of as-needed nalmefene on health-related quality of life (HRQoL in patients with alcohol dependence, and to relate changes in drinking behavior and status to HRQoL outcomes.This post hoc analysis was conducted on a pooled subgroup of patients with at least a high drinking risk level (men: >60 g/day; women: >40 g/day who participated in one of two randomized controlled 6-month studies, ESENSE 1 and ESENSE 2. Patients received nalmefene 18 mg or placebo on an as-needed basis, in addition to a motivational and adherence-enhancing intervention (BRENDA. At baseline and after 12 and 24 weeks questionnaires for the Medical Outcomes Study (MOS 36-item Short-Form Health Survey (SF-36, European Quality of life-5 Dimensions (EQ-5D and the Drinker Inventory of Consequences (DrInC-2R were completed.The pooled population consisted of 667 patients (nalmefene: 335; placebo: 332, with no notable between-group differences in baseline patient demographics/characteristics. At week 24, nalmefene had a superior effect compared to placebo in improving SF-36 mental component summary scores (mean difference [95% CI], p-value: 3.09 [1.29, 4.89]; p=0.0008, SF-36 physical component summary scores (1.23 [0.15, 2.31]; p=0.026, EQ-5D utility index scores (0.03 [0.00, 0.06]; p=0.045, EQ-5D health state scores (3.46 [0.75, 6.17]; p=0.012, and DrInC-2R scores (-3.22 [-6.12, 0.33]; p=0.029. The improvements in SF-36 mental component summary scores at week 24, and the DrInC-2R total score change from baseline to week 24, were significantly correlated to reductions in heavy drinking days and total alcohol consumption at week 24.As-needed nalmefene significantly improved almost all patient-reported HRQoL measures included in SF-36 and EQ-5D compared with placebo. These HRQoL gains were significantly correlated to reduced drinking behavior, as determined by reductions in heavy drinking days and total alcohol consumption.

  9. Salivary exoglycosidases as markers of alcohol dependence.

    Science.gov (United States)

    Waszkiewicz, Napoleon; Chojnowska, Sylwia; Zalewska, Anna; Zwierz, Krzysztof; Szulc, Agata; Szajda, Sławomir Dariusz

    2014-01-01

    Some salivary markers of alcohol abuse/dependence have been proposed so far: aminotransferases, gamma-glutamyltransferase, ethanol, ethyl glucuronide, ethyl sulfate, sialic acid, β-hexosaminidase A, oral peroxidase, methanol, diethylene/ethylene glycol, α-amylase, clusterin, haptoglobin, heavy/light chains of immunoglobulins and transferrin. To investigate the effect of chronic alcohol drinking and smoking on the activity (pKat/ml) and output (pKat/min) of salivary lysosomal exoglycosidases: α-fucosidase (FUC), α-mannosidase (MAN), β-galactosidase (GAL), and β-glucuronidase (GLU), and their applicability as markers of alcohol dependence. The activity of FUC, MAN, GAL and GLU was measured colorimetrically in the saliva of healthy social drinkers, alcohol-dependent non-smokers and alcohol-dependent smokers. We observed an increased salivary activity of FUC, GAL, GLU and MAN, as well as an increased output of GAL and GLU, in comparison with controls. The highest increase in the activity/output was found in salivary GLU and MAN (GLU, even 7- to 18-fold), and the least in GAL. We found an excellent sensitivity and specificity and a high accuracy (measured by the area under the ROC curve) for salivary FUC, GLU and MAN activities. The salivary GLU activity positively correlated with the number of days of last alcohol intoxication. Salivary activity of FUC, GAL and MAN, but not GLU, positively correlated with the periodontal parameters such as gingival index and papilla bleeding index. Although we found an excellent sensitivity and specificity as well as a high accuracy for the salivary activity of FUC, GLU and MAN, the GLU activity seems to be mostly applicable as a marker of chronic alcohol drinking (alcohol dependence). © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  10. Do premorbid predictors of alcohol dependence also predict the failure to recover from alcoholism?

    DEFF Research Database (Denmark)

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

    2010-01-01

    In a search for viable endophenotypes of alcoholism, this longitudinal study attempted to identify premorbid predictors of alcohol dependence that also predicted the course of alcoholism.......In a search for viable endophenotypes of alcoholism, this longitudinal study attempted to identify premorbid predictors of alcohol dependence that also predicted the course of alcoholism....

  11. Craving and other characteristics of the comorbidity of alcohol and nicotine dependence.

    Science.gov (United States)

    Hertling, Ines; Ramskogler, Katrin; Dvorak, Alexander; Klingler, Anton; Saletu-Zyhlarz, Gerda; Schoberberger, Rudolf; Walter, Henriette; Kunze, Michael; Lesch, Otto Michael

    2005-08-01

    In this cross-sectional study we compared alcohol-dependent smokers and non-alcohol-dependent smokers with respect to intensity of nicotine dependence, craving conditions, sleep disturbances, comorbidity with major depression, reasons for smoking, accompanying somatic diseases and patients' prolonged abstinence from smoking during the 3 years preceding the study. Fifty-one alcohol-dependent smokers and 327 non-alcohol-dependent smokers diagnosed as ICD-10 and DSM-IV-nicotine dependent, were investigated by means of the Fagerström Test for Nicotine Dependence, the Lübeck Craving-Recurrence Risk Questionnaire and the Lesch Alcohol Dependence Typology (both adapted to smoking). The intensity of nicotine dependence was more enhanced in alcohol-dependent smokers compared to non-alcohol-dependent smokers. Several variables of all factors of craving ("depressive mood", "stimulation", "relaxation", "socially triggered tension") were significantly increased in alcohol-dependent patients (Pcraving for nicotine, sleep disturbances and symptoms of depression appear to be enhanced in alcohol-dependent smokers compared with non-alcohol-dependent smokers. Conclusions. - It is hoped that the factors of craving and reasons for smoking identified in this study will contribute to a better understanding of smoking temptation in alcohol-dependent smokers and non-alcohol-dependent smokers in future.

  12. An Exploratory Study Assessing Cognitive Function in Alcohol-dependent Patients%酒精依赖者认知功能评估的探索研究

    Institute of Scientific and Technical Information of China (English)

    阮若云; 熊卉; 郭润; 卢翔; 陈帆; 叶懿; 颜有仪; 廖林川

    2015-01-01

    ABSTRACT:ObjectiveTo assess cognitive function in patients with alcohol dependence syndrome to provide a foundation of clinical diagnosis and treatment for such kind of disease and offer a reference for evaluating whether alcohol-dependent patients are able to take responsibility, either full or partial.Methods27 patients with alcohol dependence syndrome were chosen and received two tests of visual choice reaction time and cancellation efficiency before and after treatment, respectively. 30 healthy volunteers, whose gender, age and education background were matched with the patients, were selected as the control group and received the above same two tests before and after drinking alcohol but with the latter being conducted when no signs of ethanol and acetaldehyde showing in the subject’s blood. Finally the data were processed with the analysis of variance.ResultsCompared with the control group, the patients of alcohol dependence syndrome had statistically significant difference in the two tests either pre- or post- treatment (P0.05).ConclusionsPart of the cognitive function of alcohol-dependent patients is damaged irreversibly no matter whether treatment has been made or not.%目的:评估酒精依赖综合征患者的认知功能状态,为酒精依赖者临床诊疗与评估提供研究基础,为这类患者有无完全或部分责任能力的评判提供参考依据。方法选取27名酒精依赖综合征患者,分别于治疗前后进行视觉选择反应时和划消效率两项测试,同时选取30名性别、年龄、文化程度与酒精依赖综合征患者相匹配的健康志愿者,分别于饮酒前后进行相同测试,所得数据进行方差分析。结果相对于健康人群,酒精依赖患者的视觉反应时和划消效率均存在显著差异(P<0.01),并且治疗前后相比差异也具有统计学意义(P<0.05),而健康人饮酒前后无统计学意义(P>0.05)。结论酒精依赖患者部分认知功能受到了不可逆的损害。

  13. 酒精依赖与MMPI相关因子分析%Correlation analysis of alcohol dependent patients and factors of clinical basical scale of MMPI

    Institute of Scientific and Technical Information of China (English)

    林永

    2014-01-01

    目的:探讨酒精依赖与明尼苏达多相人格测验( MMPI)临床基本量表各因子的相关性。方法研究组系2008年6月-2010年6月在临沂市精神卫生中心就诊的酒精依赖患者。采用MMPI计算机测试软件,对酒精依赖组(n=162)和正常对照组(n=99)进行测试,对两组MMPI的疑病、抑郁、癔症、人格偏离、男子气、偏执、精神衰弱、精神分裂、躁狂、社会内向10个因子标准分进行统计分析,并进行logistic回归分析。结果除男子气因子外,酒精依赖组MMPI临床基本量表各因子标准分均高于对照组(P<0.01);多因素logistic回归分析发现酒精依赖与抑郁、癔症呈正相关,与精神分裂呈负相关(P均<0.05) 。结论酒精依赖患者可能存在心理及躯体症状,尤其与抑郁、癔症关系密切。%Objective To discuss relationship between alcohol dependent patients and factors of clinical basical scale of MMPI. Methods The study group was 162 alcohol dependent patients for treatment in Linyi mental health center from 2008,6 to 2010,6. The control group was 99 physical examination men. The current adopted MMPI computer testing software and measured alcohol de-pendent patients and normal subjects to statistically analyze MMPI coarse marks of ten factors ,which included Hypochondriasis Depres-sion Hysteria Psychopathic deviate Masculinity-femininity Paranoia Psychasthenia Schizophrenia Hypomania and Social introversion ( Hs,D,Hy,Pd,Mf,Pa,Pt,Sc,Ma and Si) between the two groups,then did the logistic regression. Results In addition to male fac-tor,the coarse scores of nine factors in alcohol dependent groups were all significantly higher than those of compare groups (P<0. 01), and it was found that alcohol dependent was relative to Hy,D and Sc positively by logistic regression analysis. Conclusion Alcohol dependent patients probably have psychological and physical symptoms,especially Hysteria and Depression.

  14. The alcohol patient and surgery

    DEFF Research Database (Denmark)

    Tønnesen, H

    1999-01-01

    Alcohol abusers have a threefold increased risk of post-operative morbidity after surgery. The most frequent complications are infections, cardiopulmonary insufficiency, and bleeding episodes. Pathogenesis is suppressed immune capacity, subclinical cardiac dysfunction, and haemostatic imbalance....... The economic implications of alcohol abuse in surgical patients are tremendous. Interventional studies are required to reduce future increases in post-operative morbidity....

  15. Alcohol dependence and risk of somatic diseases and mortality

    DEFF Research Database (Denmark)

    Holst, Charlotte; Tolstrup, Janne Schurmann; Sørensen, Holger Jelling

    2017-01-01

    AIMS: To (1) estimate sex-specific risks of a comprehensive spectrum of somatic diseases in alcohol dependent individuals versus a control population, and in the same population to (2) estimate sex-specific risks of dying from the examined somatic diseases. DESIGN: Register-based matched cohort...... study. Alcohol dependent individuals were identified from an alcohol treatment database. Controls were randomly selected from the Danish Civil Registration System. Information on somatic diseases obtained from the Danish National Patient Registry and causes of death obtained from the Cause of Death...... Registry. Cox proportional hazards model was applied to estimate Hazard ratios (HRs). SETTING: Denmark. PARTICIPANTS: 19,002 alcohol dependent individuals and 186,767 controls. MEASUREMENTS: Outcome variables included 11 disease groups and 29 sub-groups, defined according to the International...

  16. The characteristics of decision-making impairment in alcohol-dependence patients%酒精依赖患者的决策功能障碍

    Institute of Scientific and Technical Information of China (English)

    谢成娟; 袁莉莉; 汪凯

    2012-01-01

    Objective To explore the characteristics of decision-making impairment in alcohol-dependence patients. Methods A total of 18 individuals with alcohol-dependence were compared with matched health controls on the Iowa gambling task ( IGT ). Results In Iowa gambling task, the results showed that alcohol-dependence patients selected more disadvantageous cards than health controls, however without significant difference[ ( 46. 67 ± 6. 72 vs 46. 45 ± 12. 28 respectively ), t = 0. 07 ,P > 0. 05 ]. A 2 ( group ) × 5 ( block ) ANOVA ( analysis of variance ) on the scores of advantageous from the gambling task revealed a significant main effect of block [ F( 0. 529 ) = 3. 929 ,P 0.05].采用2(组)×5(阶段)的方差分析比较两组不同阶段的总有利选择:结果发现不同阶段主效应显著[F(0.529)=3.929,P<0.05];而被试组别主效应[F(0.001)=0.01,P=0.92]和两者的交互作用[(F(0.333)=1.74,P=0.196)]差异无统计学意义.两组被试5个阶段的净得分两两比较显示:对照组在81~100张(block5)的净得分显著高于酒精依赖组(P<0.05).结论 酒精依赖患者IGT表现受损,可能与眶额叶皮质、杏仁核受损以及多巴胺功能障碍有关.

  17. Effects of Depression on Treatment Motivation in Male Alcohol Dependence

    Science.gov (United States)

    CENGİSİZ, Cengiz; DEVECİ, Artuner; YAPICI, Aslıhan

    2015-01-01

    Introduction Treatment motivation in alcohol dependents is usually viewed as a strong predictor of seeking treatment and treatment success. The conditions affecting motivation in alcohol dependence, however, has not been clarified. In this study, it is aimed to determine the effects of depression on treatment motivation in male alcohol dependence. Methods The present study included 34 male alcohol dependents presenting to outpatient clinics in Manisa Hospital of Mental Disorders and Hospital of Celal Bayar University. The patients underwent evaluation using the socio-demographic and clinical information form, DSM-IV SCID-I Clinical Version, Treatment Motivation Questionnaire (TMQ), and Hamilton Depression Rating Scale (HDRS). Results A significant relationship was found between the total score of TMQ and HDRS (p=.039). Conclusion We believe that the present study, in which we examined the relationship between treatment motivation in male alcohol dependence and depression, would provide a significant contribution to literature. It is also important to investigate other factors that may affect treatment motivation in male alcohol dependence. Studies with larger samples are needed on this topic.

  18. Emotional Intelligence Components in Alcohol Dependent and Mentally Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Arash Mohagheghi

    2015-01-01

    Full Text Available Objective. Emotional intelligence might play an important role in the onset and persistence of different psychopathologies. This study investigated the relationship between emotional intelligence and alcohol dependence. Methods. In this case-control study, participants included alcohol dependent individuals and mentally healthy inpatients. Each group consisted of 40 individuals (male/female: 1. The diagnosis was based on the criteria of the DSM-IV-TR using the Structured Clinical Interview for DSM-IV (SCID-IV. All the participants completed Bar-On emotional intelligence test. Results. 20 males and 20 females were included in each group. Mean age of alcohol dependent participants and controls was 31.28 ± 7.82 and 34.93 ± 9.83 years in that order. The analyses showed that the alcohol dependent individuals had a significant difference compared with the control group and received lower scores in empathy, responsibility, impulse control, self-esteem, optimism, emotional consciousness, stress tolerance, autonomy, problem-solving, and total score of emotional intelligence components. Conclusion. Patients with alcohol dependence have deficits in components of emotional intelligence. Identifying and targeted training of the individuals with lower scores in components of emotional intelligence may be effective in prevention of alcohol dependence.

  19. Clinical experience of baclofen in alcohol dependence: A chart review

    Directory of Open Access Journals (Sweden)

    Abhijit R Rozatkar

    2016-01-01

    Full Text Available Introduction: Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. Methodology: The study is retrospective chart review of patients (n = 113 who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. Results: The study sample was predominantly male, mean age of 41.49 (±9.75 years, most having a family history of substance use (70.97%, and many reporting binge use pattern in last year (49.46%. Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20–40 mg/day. Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Conclusion: Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.

  20. [Effect of comorbid depression on the development and course of alcohol dependence].

    Science.gov (United States)

    Rybakova, K V; Rybakova, T G; Neznanov, N G; Eryshev, O F

    2013-01-01

    It was compared 72 patients with alcohol dependence (AD) and endogenous depression (ED) and 30 patients with AD without comorbid affective pathology. It has been shown that the development of alcohol dependence in individuals with ED is slower than in patients without ED. A lack of a family history of addictive pathology was noted to be a predictor of a more favorable course of alcohol dependence in patients with ED.

  1. Sodium oxybate: a review of its use in alcohol withdrawal syndrome and in the maintenance of abstinence in alcohol dependence.

    Science.gov (United States)

    Keating, Gillian M

    2014-01-01

    A liquid formulation of sodium oxybate (Alcover(®)), the sodium salt of γ-hydroxybutyric acid (GHB), is approved in Italy and Austria for use in alcohol withdrawal syndrome and for the maintenance of abstinence in alcohol dependence. This article reviews the efficacy and tolerability of sodium oxybate in alcohol withdrawal syndrome and in the maintenance of abstinence in alcohol dependence, as well as summarizing its pharmacological properties. Results of randomized controlled trials indicate that sodium oxybate was at least as effective as diazepam and clomethiazole in patients with alcohol withdrawal syndrome, rapidly alleviating symptoms, and was at least as effective as naltrexone or disulfiram in the maintenance of abstinence in alcohol-dependent patients. Sodium oxybate was generally well tolerated. The risk of sodium oxybate abuse is generally low when it is administered to alcohol-dependent patients at its approved dosage, under the supervision of a designated family member and with continuous strict medical surveillance. However, certain patient groups, such as patients with alcohol dependence and borderline personality disorder or who are in remission from heroin or cocaine addiction, may not be suitable candidates for sodium oxybate therapy because of an increased risk of abuse. In conclusion, sodium oxybate is a useful option for the treatment of alcohol withdrawal syndrome and for the maintenance of abstinence in alcohol dependence.

  2. Smartphone-based support system (SoberDiary) coupled with a Bluetooth breathalyser for treatment-seeking alcohol-dependent patients.

    Science.gov (United States)

    You, Chuang-Wen; Chen, Yen-Chang; Chen, Chun-Hsin; Lee, Chao-Hui; Kuo, Po-Hsiu; Huang, Ming-Chyi; Chu, Hao-Hua

    2017-02-01

    Relapse prevention in patients with alcohol dependence (AD) has long been a clinical challenge. It is vital to provide services with minial restrictions for patients to have access to continuous after-treatment care. The study was aimed to examine the benefits of a smartphone application (SoberDiary) coupled to a Bluetooth breathalyser to assist patients recovering from alcohol dependence (AD). This study recruited 38 patients that fulfilled the DSM-IV-TR criteria for AD and who were undergoing an outpatient maintenance program for abstinence. The participants were provided a breathalyser and smartphone-equipped SoberDiary and followed for 12weeks. The participants were divided into highly adherent (HA) and less adherent (LA) groups according to the medium number of reward points they were awarded for using the SoberDiary system throughout the follow-up period based on the average amount of time spent on using the application, the number of function modules they accessed, and the number of BrAC tests they completed each day. 19 of the patients were classified as HA and 19 patients were classified as LA group. Members of the HA group recorded fewer drinking days and drinks consumed per week, a higher cumulative number of abstinence days, a higher abstinence rate, less pronounced anxiety, and superior quality of life. The proposed smartphone-assisted support system coupled with a Bluetooth breathalyser might be a feasible supplement to conventional treatment for AD. Higher SoberDiary compliance appears to be associated with better clinical outcomes. Copyright © 2016. Published by Elsevier Ltd.

  3. Cue reactivity is associated with duration and severity of alcohol dependence: an FMRI study.

    Directory of Open Access Journals (Sweden)

    Zsuzsika Sjoerds

    Full Text Available INTRODUCTION: With the progression of substance dependence, drug cue-related brain activation is thought to shift from motivational towards habit pathways. However, a direct association between cue-induced brain activation and dependence duration has not yet been shown. We therefore examined the relationship between alcohol cue-reactivity in the brain, cue-induced subjective craving and alcohol dependence duration and severity. Since alcohol dependence is highly comorbid with depression/anxiety, which may modulate brain responses to alcohol cues, we also examined the relation between comorbid depression/anxiety and cue-reactivity. METHODS: We compared 30 alcohol dependent patients with 15 healthy controls and 15 depression/anxiety patients during a visual alcohol cue-reactivity task using functional magnetic resonance imaging blood oxygenated level-dependent responses and subjective craving as outcomes. Within the alcohol dependent group we correlated cue-reactivity with alcohol dependence severity and duration, with cue-induced craving and with depression/anxiety levels. RESULTS: Alcohol dependent patients showed greater cue-reactivity in motivational brain pathways and stronger subjective craving than depression/anxiety patients and healthy controls. Depression/anxiety was not associated with cue-reactivity, but depression severity in alcohol dependent patients was positively associated with craving. Within alcohol dependence, longer duration of alcohol dependence was associated with stronger cue-related activation of the posterior putamen, a structure involved in habits, whereas higher alcohol dependence severity was associated with lower cue-reactivity in the anterior putamen, an area implicated in goal-directed behavior preceding habit formation. CONCLUSION: Cue-reactivity in alcohol dependence is not modulated by comorbid depression or anxiety. More importantly, the current data confirm the hypothesis of a ventral to dorsal striatal shift

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

    Science.gov (United States)

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

    2011-01-01

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

  5. Baclofen for alcohol dependence: Relationships between baclofen and alcohol dosing and the occurrence of major sedation.

    Science.gov (United States)

    Rolland, Benjamin; Labreuche, Julien; Duhamel, Alain; Deheul, Sylvie; Gautier, Sophie; Auffret, Marine; Pignon, Baptiste; Valin, Thomas; Bordet, Régis; Cottencin, Olivier

    2015-10-01

    High-dose baclofen, i.e., 300 mg/d or more, has recently emerged as a strategy for treating alcohol dependence. The impact that the co-exposure of large amounts of alcohol and baclofen has on sedation is unclear. In a prospective cohort of 253 subjects with alcohol dependence, we collected daily alcohol and baclofen doses across the first year of baclofen treatment and the monthly maximum subjective sedation experienced by each patient (0-10 visual analog scale). For each patient-month, we determined the average weekly alcohol consumption (AWAC; standard-drinks/week) and the maximum daily dose of baclofen (DDB; mg/d). The occurrence of an episode of major sedation (EMS) during a patient-month was defined as a sedation score ≥7. The relationship between the EMS occurrence and the concurrent AWAC and DDB was investigated using a generalized estimating equation model. In total, 1528 patient-months were compiled (70 with an EMS). Univariate analyses demonstrated that the rate of patient-month to EMS increased gradually with AWAC (p35. There was also a significant gradual risk for EMS associated with DDB (35 of 1.22 (95%CI, 1.08-1.38) versus 1.11 (95%CI, 0.96-1.29) in AWAC=1-35, and 0.95 (95%CI, 0.76-1.19) in AWAC=0. The level of sedation observed in patients using baclofen for alcohol dependence appears to directly depend on the immediate doses of both the baclofen and the alcohol.

  6. Association of VMAT2 gene polymorphisms with alcohol dependence.

    Science.gov (United States)

    Fehr, Christoph; Sommerlad, Daniel; Sander, Thomas; Anghelescu, Ion; Dahmen, Norbert; Szegedi, Armin; Mueller, Christiana; Zill, Peter; Soyka, Michael; Preuss, Ulrich W

    2013-08-01

    Alcohol-related diseases cause significant harm in the western world. Up to 65 % of the phenotypic variance is genetically determined. Few candidate genes have been identified, comprising ADH4, ALDH2, COMT, CRHR1, DAT (SLC6A3), GABRA2 and MAOA. While abnormalities in the dopaminergic mesolimbic reward system are considered important mediators of alcoholism, studies analyzing variants of dopamine receptors showed conflicting results. Other modulators of the reward system are synaptosomal genes. Among candidate genes, polygenic variants of the Vesicular Monamine Transporter 2 (VMAT2) gene locus associated with alterations of drinking behavior were published. These variants comprise single nucleotide polymorphisms (SNPs) within the promoter region and the open reading frame. In this study, we confirm the association of VMAT2 SNP rs363387 (allelic association: p = 0.015) with alcohol dependence. This SNP defines several haplotypes including up to four SNPs (minimal p = 0.0045). In addition, numeric effects in the subgroups of males and patients with positive family history were found. We suggest that several rs363387 T-allele containing haplotypes increase the risk of alcohol dependence (OR 1.53), whereas G-allele containing haplotypes confer protection against alcohol dependence. Taken together, there is supporting evidence for a contribution of VMAT2 gene variants to phenotypes of alcohol dependence.

  7. 男性酒依赖患者的决策倾向研究%The study of decision-making biases in male alcohol dependent patients

    Institute of Scientific and Technical Information of China (English)

    尹良爽; 李泽爱; 朱春燕; 庞良俊; 董文文; 汪凯

    2013-01-01

    Objective To investigate the characteristics of decision-making in male patients with alcohol dependence (AD).Methods A total of 32 male patients were compared with matched 32 normal controls on the Iowa Gambling Task.Meanwhile,all of the subjects were evaluated with the Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and Mini-Mental State Examination (MMSE).Results The AD group selected more net disadvantageous cards (number of cards selected from the disadvantageous decks minus number of cards selected from advantageous decks) than normal controls [(1.38 ± 18.01)times vs.(-6.34 ± 12.10) times; t(65) =2.074,P =0.042].The 2(group) ×5(block)ANOVA (analysis of variance) on the cards of net disadvantageous from the gambling task revealed a significant main group effect [F(1,65) =5.357,P =0.024],and a significant main effect of block [F(4,260) =16.252,P < 0.001].The results showed that normal controls and patients with alcohol dependence gradually shifted their selections toward the good decks as the game progresses.The total number of net disadvantageous cards in AD subjects was negatively correlated to the age of initial alcohol use and the age of addiction (r =-0.541,P =0.001 ;r =-0.350,P =0.050;respectively).Conclusion The present study suggests that the decision-making impairment might be in male alcohol dependence patients.%目的 探讨男性酒依赖(alcohol dependence,AD)患者认知能力的风险决策.方法 将32例AD患者(患者组)与其人口学资料相匹配的正常对照(对照组)作为研究对象,采用爱荷华博弈任务(Iowa Gambling Task,IGT)进行决策能力的测试,分别应用焦虑自评量表(SAS)、抑郁自评量表(SDS)和简明智力量表(MMSE)对2组患者进行评定.结果 患者组在IGT中净不利选牌数明显高于对照组[(1.38±18.01)次:(-6.34±12.10)次],2组比较差异有统计学意义[t(65)=2.074,P=0.042].采用2(组)×5(阶段)方差分析比较不同阶段的净

  8. Pharmacotherapeutic Treatment of Alcohol Dependence: An Overview

    Science.gov (United States)

    Graves, Erin; Goodwin, Lloyd R., Jr.

    2008-01-01

    Pharmacotherapy medications can reduce the likelihood of relapse, decrease craving intensity and severity of withdrawal symptoms, and bolster the likelihood of achieving and maintaining recovery goals for many individuals seeking recovery from alcohol dependence. An overview of the benefits and concerns of integrating pharmacotherapeutic…

  9. A heuristic model of alcohol dependence.

    Directory of Open Access Journals (Sweden)

    Zhen Qi

    Full Text Available BACKGROUND: Substance dependence poses a critical health problem. Sadly, its neurobiological mechanisms are still unclear, and this lack of real understanding is reflected in insufficient treatment options. It has been hypothesized that alcohol effects are due to an imbalance between neuroexcitatory and neuroinhibitory amino acids. However, glutamate and GABA interact with other neurotransmitters, which form a complicated network whose functioning evades intuition and should be investigated systemically with methods of biomedical systems analysis. METHODS AND RESULTS: We present a heuristic model of neurotransmitters that combines a neurochemical interaction matrix at the biochemical level with a mobile describing the balances between pairs of neurotransmitters at the physiological and behavioral level. We investigate the effects of alcohol on the integrated neurotransmitter systems at both levels. The model simulation results are consistent with clinical and experimental observations. The model demonstrates that the drug diazepam for symptoms of alcohol withdrawal effectively reduces the imbalances between neurotransmitters. Moreover, the acetylcholine signal is suggested as a novel target for treatment of symptoms associated with alcohol withdrawal. CONCLUSIONS: Efficient means of integrating clinical symptoms across multiple levels are still scarce and difficult to establish. We present a heuristic model of systemic neurotransmitter functionality that permits the assessment of genetic, biochemical, and pharmacological perturbations. The model can serve as a tool to represent clinical and biological observations and explore various scenarios associated with alcohol dependence and its treatments. It also is very well suited for educational purposes.

  10. Nursing of emotional disorder in patients with alcohol dependence%乙醇依赖患者情绪障碍的护理

    Institute of Scientific and Technical Information of China (English)

    童芳; 易元平

    2011-01-01

    Objective To analyze the nursing effect of emotional disorder in patients with alcohol dependence.Methods From January 2009 to February 2010,81 patients in our hospital with emotional disorder of alcohol dependence were randomly divided into the observation group (41 cases)and the control group (40 cases).The control group was given routine nursing care,and the observation group was given enhanced care for emotional disorders on the basis of routine nursing care,the clinical results of two groups were compared.Results In the observation group,the re-drinking rate and readmission rate were19.5 % and 7.3%,significantly lower than 40.0% and 27.5% of the control group,the time interval of re-drinking of the observation group was significantly longer than the control group,the anxiety and depression scores were significantly better than the control group.Conclusions To give enhanced care on the basis of routine nursing care for patients with emotional disorders because of alcohol dependence has better clinical effect,it contributes to the patients′ rehabilitation.%目的 分析乙醇依赖患者情绪障碍的护理效果.方法 将我院2009年1月至2010年2月收治的乙醇依赖患者81例,随机分为观察组41例和对照组40例.对照组给予常规护理,而观察组在对照组的基础上加强对情绪障碍的护理,比较2组的护理效果.结果 观察组的复饮率、再住院率分别为19.5%、7.3%,明显低于对照组的40.0%、27.5%,且观察组的复饮间隔时间明显长于对照组;观察组护理后的焦虑、抑郁评分均明显优于对照组.结论 对乙醇依赖患者在常规护理的基础上加强情绪障碍护理可以取得更好的临床效果,有利于患者的康复.

  11. [Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part II: Evaluation and Management of Patients with Acute Alcohol Intoxication].

    Science.gov (United States)

    de la Espriella Guerrero, Ricardo; de la Hoz Bradford, Ana María; Zárate, Alina Uribe-Holguín; Lee, Patricia Rodríguez; Menéndez, Miguel Cote; Rentería, Ana María Cano; Hernández, Delia Cristina; Cardeño, Carlos; Barré, Michelle Cortés; Kunzel, Gabriel Hernández; Gómez-Restrepo, Carlos

    2012-12-01

    Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. The identification of acute alcohol intoxication is extremely important, as well as the alcohol withdrawal syndrome and its complications, such as delirium tremens and Wernicke's encephalopathy in order to grant a timely treatment for those patients. This article introduces the evidence found so as to face and treat these clinic manifestations. Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Evidence was found and recommendations were made for the diagnosis and treatment of acute alcohol intoxication, withdrawal syndrome, delirium tremens and Wernicke's encephalopathy. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Cognitive impairments in alcohol-dependent subjects

    Directory of Open Access Journals (Sweden)

    Florent eBernardin

    2014-07-01

    Full Text Available Chronic excessive alcohol consumption induces cognitive impairments mainly affecting executive functions, episodic memory, and visuospatial capacities related to multiple brain lesions. These cognitive impairments not only determine everyday management of these patients, but also impact on the efficacy of management and may compromise the abstinence prognosis. Maintenance of lasting abstinence is associated with cognitive recovery in these patients, but some impairments may persist and interfere with the good conduct and the efficacy of management. It therefore appears essential to clearly define neuropsychological management designed to identify and evaluate the type and severity of alcohol-related cognitive impairments. It is also essential to develop cognitive remediation therapy so that the patient can fully benefit from the management proposed in addiction medicine units.

  13. Effects of alcohol intake on brain structure and function in non-alcohol-dependent drinkers

    NARCIS (Netherlands)

    Bruin, Eveline Astrid de

    2005-01-01

    About 85% of the adult population in the Netherlands regularly drinks alcohol. Chronic excessive alcohol intake in alcohol-dependent individuals is known to have damaging effects on brain structure and function. Relatives of alcohol-dependent individuals display differences in brain function that ar

  14. Effects of alcohol intake on brain structure and function in non-alcohol-dependent drinkers

    NARCIS (Netherlands)

    Bruin, Eveline Astrid de

    2005-01-01

    About 85% of the adult population in the Netherlands regularly drinks alcohol. Chronic excessive alcohol intake in alcohol-dependent individuals is known to have damaging effects on brain structure and function. Relatives of alcohol-dependent individuals display differences in brain function that

  15. The activity of serum beta-galactosidase in colon cancer patients with a history of alcohol and nicotine dependence: preliminary data

    OpenAIRE

    Napoleon Waszkiewicz; Sławomir Dariusz Szajda; Magdalena Waszkiewicz; Aleksandra Wojtulewska-Supron; Agata Szulc; Alina Kępka; Sylwia Chojnowska; Jacek Dadan; Jerzy Robert Ładny; Krzysztof Zwierz; Beata Zalewska-Szajda

    2013-01-01

    Introduction: Beta-galactosidase (GAL) is a lysosomal exoglycosidase involved in the catabolism of glycoconjugates through the sequential release of beta-linked terminal galactosyl residues. The stimulation of activity of exoglycosidases and other degradative enzymes has been noted in cancers as well as in alcohol and nicotine addiction separately. This is the first study to evaluate the activity of the serum senescence marker GAL in colon cancer patients with a history of alcohol and nicotin...

  16. Relapse (number of detoxifications) in abstinent male alcohol-dependent patients as related to personality traits and types of tolerance to frustration.

    Science.gov (United States)

    Baars, Melanie Y; Müller, Matthias J; Gallhofer, Bernd; Netter, Petra

    2013-01-01

    Personality traits like depression on the one hand and aggression and impulsivity on the other are assumed to be predisposing factors for different types of alcohol dependence. Both types are associated with sensitivity to frustration, but this may be different for the two types of personality according to whether they are confronted with frustrations caused by withdrawal from positive or infliction of negative events. It has not been shown so far if both types of personality factors and the two different sources of frustration are differently relevant for the propensity of relapse. This was investigated here in a study on 60 abstinent male alcohol-dependent patients. Correlations between the number of previous detoxifications reflecting liability to relapse and questionnaire scores on personality factors and on reactions to frustration were computed. Bonferroni-corrected correlations yielded significant relationships between the number of detoxifications and the personality factor of aggression as well as pronounced depressive reactions to frustrating conditions of non-reward caused by humans. Controlling for impulsivity, aggression and depression revealed that depressive reactions to frustration are genuine predictors for probability of relapse independent of underlying personality factors. Persons particularly sensitive to frustrations from human denial of positive reinforcers are liable to relapse which fits the theory of sensitivity to reward in drug-addicted individuals. Results demonstrate that relapse is clearly more related to aggression than to impulsivity, depression and anxiety and may be facilitated if persons are sensitive to frustrating conditions of non-reward caused by social partners. Copyright © 2013 S. Karger AG, Basel.

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Determination of the effects of alcohol dehydrogenase (ADH) 1B and ADH1C polymorphisms on alcohol dependence in Turkey.

    Science.gov (United States)

    Aktas, Ekin Ozgur; Kocak, Aytaç; Senol, Ender; Celik, Handan Ak; Coskunol, Hakan; Berdeli, Afig; Aydin, Hikmet Hakan

    2012-03-01

    Alcoholism is a complex genetically influenced disorder which refers to alcohol abuse and alcohol dependence. There are controversial results on the role of gene polymorphisms in alcohol dependence in the literature. Differences in population groups and selective inclusion criteria for alcohol dependence may affect results. In this study, we investigated the role of ADH1B Arg48His (rs1229984) and, ADH1C Ile350Val (rs698) gene polymorphisms in Turkish population. 100 healthy volunteers and 75 patients who were admitted to Ege University Alcohol Dependence Unit enrolled in the study. We found significant increase both in ADH1B (Arg48His) polymorphism Arg allele and Arg/Arg genotype frequency in patients. No profound connection between alcohol dependence and ADH1C Ile350Val gene polymorphism was detected. Alcohol dependence is an important health problem that depends on many genetic and environmental factors but we think that it is possible to interpret genetic risk for developing early diagnostic methods and treatment strategies by comprehensive linkage and association studies.

  19. The Impact of Accelerated Right Prefrontal High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Cue-Reactivity: An fMRI Study on Craving in Recently Detoxified Alcohol-Dependent Patients.

    Science.gov (United States)

    Herremans, Sarah C; Van Schuerbeek, Peter; De Raedt, Rudi; Matthys, Frieda; Buyl, Ronald; De Mey, Johan; Baeken, Chris

    2015-01-01

    In alcohol-dependent patients craving is a difficult-to-treat phenomenon. It has been suggested that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) may have beneficial effects. However, exactly how this application exerts its effect on the underlying craving neurocircuit is currently unclear. In an effort to induce alcohol craving and to maximize detection of HF-rTMS effects to cue-induced alcohol craving, patients were exposed to a block and event-related alcohol cue-reactivity paradigm while being scanned with fMRI. Hence, we assessed the effect of right dorsolateral prefrontal cortex (DLPFC) stimulation on cue-induced and general alcohol craving, and the related craving neurocircuit. Twenty-six recently detoxified alcohol-dependent patients were included. First, we evaluated the impact of one sham-controlled stimulation session. Second, we examined the effect of accelerated right DLPFC HF-rTMS treatment: here patients received 15 sessions in an open label accelerated design, spread over 4 consecutive days. General craving significantly decreased after 15 active HF-rTMS sessions. However, cue-induced alcohol craving was not altered. Our brain imaging results did not show that the cue-exposure affected the underlying craving neurocircuit after both one and fifteen active HF-rTMS sessions. Yet, brain activation changes after one and 15 HF-rTMS sessions, respectively, were observed in regions associated with the extended reward system and the default mode network, but only during the presentation of the event-related paradigm. Our findings indicate that accelerated HF-rTMS applied to the right DLPFC does not manifestly affect the craving neurocircuit during an alcohol-related cue-exposure, but instead it may influence the attentional network.

  20. Quantitative electroencephalography analysis in university students with hazardous alcohol consumption, but not alcohol dependence.

    Science.gov (United States)

    Núñez-Jaramillo, Luis; Vega-Perera, Paulo; Ramírez-Lugo, Leticia; Reyes-López, Julián V; Santiago-Rodríguez, Efraín; Herrera-Morales, Wendy V

    2015-07-08

    Hazardous alcohol consumption is a pattern of consumption that leads to a higher risk of harmful consequences either for the user or for others. This pattern of alcohol consumption has been linked to risky behaviors, accidents, and injuries. Individuals with hazardous alcohol consumption do not necessarily present alcohol dependence; thus, a study of particular neurophysiological correlates of this alcohol consumption pattern needs to be carried out in nondependent individuals. Here, we carried out a quantitative electroencephalography analysis in health sciences university students with hazardous alcohol consumption, but not alcohol dependence (HAC), and control participants without hazardous alcohol consumption or alcohol dependence (NHAC). We analyzed Absolute Power (AP), Relative Power (RP), and Mean Frequency (MF) for beta and theta frequency bands under both eyes closed and eyes open conditions. We found that participants in the HAC group presented higher beta AP at centroparietal region, as well as lower beta MF at frontal and centroparietal regions in the eyes closed condition. Interestingly, participants did not present any change in theta activity (AP, RP, or MF), whereas previous reports indicate an increase in theta AP in alcohol-dependent individuals. Our results partially resemble those found in alcohol-dependent individuals, although are not completely identical, suggesting a possible difference in the underlying neuronal mechanism behind alcohol dependence and hazardous alcohol consumption. Similarities could be explained considering that both hazardous alcohol consumption and alcohol dependence are manifestations of behavioral disinhibition.

  1. Relay model for recruiting alcohol dependent patients in general hospitals--a single-blind pragmatic randomized trial

    DEFF Research Database (Denmark)

    Schwarz, Anne-Sophie; Bilberg, Randi; Bjerregaard, Lene Berit Skov;

    2016-01-01

    - The Relay Model. METHOD/DESIGN: The study is a single-blind pragmatic randomized controlled trial including patients admitted to the hospital. The study group (n = 500) will receive an intervention, and the control group (n = 500) will be referred to treatment by usual procedures. All patients complete...

  2. Alcohol Dependence in Adult Children of Alcoholics: Longitudinal Evidence of Early Risk.

    Science.gov (United States)

    Jennison, Karen M.; Johnson, Kenneth A.

    1998-01-01

    Investigates familial alcoholism effects and the comparative probability of risk that adult children of alcoholics have for alcohol dependence. Results, based on a national survey of 12,686 young adults over a five-year period, show that the risk for alcoholism is relatively greater for males than females. (MKA)

  3. In silico models of alcohol dependence and treatment

    Directory of Open Access Journals (Sweden)

    Boris eKovatchev

    2012-02-01

    Full Text Available In this paper we view alcohol dependence and the response to treatment as a recurrent bio-behavioral process developing in time and propose formal models of this process combining behavior and biology in silico. The behavioral components of alcohol dependence and treatment are formally described by a stochastic process of human behavior, which serves as an event generator challenging the metabolic system. The biological component is driven by the biochemistry of alcohol intoxication described by deterministic models of ethanol pharmacodynamics and pharmacokintetics to enable simulation of drinking addiction in humans. Derived from the known physiology of ethanol and the literature of both ethanol intoxication and ethanol absorption, the different models are distilled into a minimal model (as simple as the complexity of the data allows that can represent any specific patient. We use these modeling and simulation techniques to explain responses to placebo and ondansetron treatment observed in clinical studies. Specifically, the response to placebo was explained by a reduction of the probability of environmental reinforcement, while the effect of ondansetron was explained by a gradual decline in the degree of ethanol-induced neuromodulation. Further, we use in silico experiments to study critical transitions in blood alcohol levels after specific average number of drinks per day, and propose the existence of two critical thresholds in the human - one at 5 and another at 11 drinks/day - at which the system shifts from stable to critical and to super critical state indicating a state of alcohol addiction. The advantages of such a model-based investigation are that 1 the process of instigation of alcohol dependence and its treatment can be deconstructed into meaningful steps, which allow for individualized treatment tailoring, and 2 physiology and behavior can be quantified in different (animal or human studies and then the results can be integrated

  4. The efficacy of the dopamine D2/D3 antagonist tiapride in maintaining abstinence: a randomized, double-blind, placebo-controlled trial in 299 alcohol-dependent patients.

    Science.gov (United States)

    Bender, Stefan; Scherbaum, Norbert; Soyka, Michael; Rüther, Eckart; Mann, Karl; Gastpar, Markus

    2007-10-01

    In this investigation, the hypothesis was tested whether the selective dopamine D2/D3 receptor antagonist tiapride is effective in maintaining abstinence after detoxification in alcohol-dependent patients. The rationale of the study was based on the relevance of the dopaminergic system for addictive behaviour as well as some preliminary studies. A multi-centre, randomized, double-blind, placebo-controlled, parallel-group study was conducted. A total of 299 detoxified alcohol-dependent patients (ICD-10: F10.2) received either tiapride (300 mg/d) or placebo over a 24-wk study period. Subjects with severe comorbid psychiatric disorder such as schizophrenia or Wernicke-Korsakoff syndrome were excluded. Primary outcome variable was the time to first relapse with relapse defined as any alcohol consumption after detoxification. Data analysis was done with Kaplan-Meier estimates with log-rank test (one-sided, ptest, p=0.9895). Relapse rate was higher in the intervention group (54.4%) than in the control group (40.7%). Like the dopamine antagonist flupenthixol, tiapride was not effective in maintaining alcohol abstinence. Regarding the high success rate in the placebo group the influence of psychosocial treatment in studies investigating drug effects on the course of alcohol dependence has to be considered.

  5. Suicidal thoughts in persons treated for alcohol dependence: The role of selected demographic and clinical factors.

    Science.gov (United States)

    Ziółkowski, Marcin; Czarnecki, Damian; Chodkiewicz, Jan; Gąsior, Krzysztof; Juczyński, Artur; Biedrzycka, Agata; Gruszczyńska, Ewa; Nowakowska-Domagała, Katarzyna

    2017-09-01

    Greater knowledge is needed of potential predictive factors for suicide in cases of alcohol addiction. Therefore, the aim of the study was to identify the socio-demographic variables and clinical factors associated with alcohol dependence which may have an influence on the occurrence of suicidal thoughts in alcohol-dependent patients. A group of 510 patients (396 male and 114 female) diagnosed with alcohol dependence syndrome were interviewed during the third week of therapy according to the Beck Depression Inventory (BDI), the Penn Alcohol Craving Scale (PACS) and the Short Alcohol Dependence Data Questionnaire (SADD). Socio-demographic data was also collected. The results of a binary logistic regression with suicidal thoughts as a dependent variable show that 63 out of the 510 participants (12% of the sample) reported the presence of suicidal thoughts. Alcohol dependence and alcohol craving appear to increase the likelihood of suicidal thoughts, and participants presenting psychiatric disorders were twice as likely to demonstrate suicidal ideation as those who did not. Alcohol dependence, alcohol craving and psychiatric comorbidity may be regarded as risk factors for suicidal ideation in the studied sample, with the only protective factor being living in a relationship. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Nutritional intake and status in persons with alcohol dependency

    DEFF Research Database (Denmark)

    Wilkens Knudsen, Anne; Jensen, Jens-Erik Beck; Nordgaard-Lassen, Inge

    2014-01-01

    Malnutrition increases the risk of developing alcohol-related complications. The aim of this study was to describe nutrient intake, nutritional status and nutrition-related complications in a Danish population of outpatients with alcohol dependency.......Malnutrition increases the risk of developing alcohol-related complications. The aim of this study was to describe nutrient intake, nutritional status and nutrition-related complications in a Danish population of outpatients with alcohol dependency....

  7. Mechanisms of hyponatraemia in alcohol patients.

    Science.gov (United States)

    Liamis, G L; Milionis, H J; Rizos, E C; Siamopoulos, K C; Elisaf, M S

    2000-01-01

    Hyponatraemia is commonly reported in chronic alcoholic patients. However, the underlying pathogenetic mechanisms are not well delineated. In the current study, we analysed the possible pathophysiological mechanisms of hyponatraemia in a group of alcoholic patients (n = 127) admitted to our hospital for causes related to alcohol misuse. Hyponatraemia (serum sodium potomania' syndrome, while in two others, hyponatraemia was due to reset osmostat or to cerebral salt wasting syndrome, not previously described in alcoholic patients. It is concluded that hyponatraemia is a frequently observed electrolyte disorder in hospitalized alcoholic patients and is related to various pathophysiological mechanisms.

  8. Elevated Linoleic Acid (A Pro-Inflammatory PUFA) and Liver Injury in a Treatment Naive HIV-HCV Co-Infected Alcohol Dependent Patient

    Science.gov (United States)

    Vatsalya, Vatsalya; Barve, Shirish S.; McClain, Craig J.; Ramchandani, Vijay A.

    2016-01-01

    HIV and HCV co-infection is a unique disease condition, and medical management of such condition is difficult due to severity and systemic complications. Added with heavy alcohol drinking, risk of liver injury increases due to several pro-inflammatory responses that subsequently get involved with alcohol metabolism. Elevated levels of fatty acids have been reported both in viral infections as well as alcoholic liver disease though such investigations have not addressed the adverse events with dual viral infection of HIV and HCV along with heavy drinking. This case report is of a patient with excessive alcohol drinking and first time diagnosis of HIV and HCV dual infection, elaborating concurrent alteration in Linoleic Acid (LA) levels and pro-inflammatory shift in ω-6/ω-3 ratio along with the elevations in liver injury markers. Elevated LA has been recently studied extensively for its role in alcoholic liver disease; and in the present case, we also found it to be clinically relevant to liver injury. PMID:27489857

  9. Fractures and alcohol abuse - patient opinion of alcohol intervention

    DEFF Research Database (Denmark)

    Pedersen, Bolette; Alva-Jørgensen, Peter; Raffing, Rie

    2011-01-01

    PURPOSE: To clarify patient opinions about alcohol intervention in relation to surgery before investigating the effect in a Scandinavian multi-centre randomized trial. MATERIAL AND METHODS: A qualitative study. Thirteen consecutive alcohol patients with fractures participated after informed consent....... They were interviewed during their hospital stay. The number of participants was based on the criteria of data-saturation. The analysis followed the applied qualitative framework model aimed at evaluation of specific participant needs within a larger overall project. RESULTS: All patients regarded alcohol...... intervention in relation to surgery as a good idea. They did not consider quit drinking as a major problem during their hospital stay and had all remained abstinent in this period. About half of the patients were ready or partly ready to participate in an alcohol intervention. Patient opinions...

  10. Alcohol and drug misuse, abuse, and dependence in women veterans.

    Science.gov (United States)

    Hoggatt, Katherine J; Jamison, Andrea L; Lehavot, Keren; Cucciare, Michael A; Timko, Christine; Simpson, Tracy L

    2015-01-01

    We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care.

  11. Prevalence of alcohol dependence among excessive drinkers in New Mexico.

    Science.gov (United States)

    Woerle, Sandra; Roeber, Jim; Landen, Michael G

    2007-02-01

    Excessive alcohol consumption claims more than 75,000 lives in the United States each year. The prevalence of alcohol dependence among excessive drinkers is not well known. Data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS) in New Mexico were used to assess the prevalence of excessive drinking, including binge drinking, heavy drinking, alcohol-impaired driving, and alcohol dependence. Of 4,761 respondents, 16.5% were excessive drinkers; 14.4% binge drank and 1.8% were alcohol dependent. While the rates of alcohol dependence were higher among the youngest age group, males, those with some college education, and those of race/ethnicity other than White, non-Hispanic, only differences by age were statistically significant. The prevalence of alcohol dependence was the highest among those who reported alcohol-impaired driving in the past 30 days (15.9%), and was lower among those who reported heavy drinking (13.4%) and binge drinking (8.1%). Although 16.5% of New Mexico adults had at least 1 type of excessive drinking, only 1.8% of all adults met the criteria for alcohol dependence. Furthermore, only a minority of those who reported binge drinking, heavy drinking, or alcohol-impaired driving met the criteria for alcohol dependence. This suggests that most alcohol problems in New Mexico are likely due to excessive drinking among persons who are not alcohol dependent. The adverse health and social consequences associated with excessive drinking are not limited to those who are alcohol dependent, but extend to a broader range of problem drinkers across the population.

  12. Sodium oxybate in maintaining alcohol abstinence in alcoholic patients with and without psychiatric comorbidity.

    Science.gov (United States)

    Caputo, Fabio; Francini, Sara; Brambilla, Romeo; Vigna-Taglianti, Federica; Stoppo, Michela; Del Re, Arfedele; Leggio, Lorenzo; Addolorato, Giovanni; Zoli, Giorgio; Bernardi, Mauro

    2011-06-01

    Sodium oxybate (SMO) is a GABA-ergic drug currently used for the treatment of alcohol-dependence in some European countries. In particular, clinical studies have shown a role of SMO in promoting alcohol abstinence, as well as in relieving withdrawal symptoms. The aim of this study was to describe alcohol abstinence and the onset of craving for and abuse of SMO in alcohol-dependent subjects with and without psychiatric co-morbidity. Forty-eight patients were enrolled and classified into two groups: group A (20 alcoholics without any psychiatric co-morbidity) and group B (28 alcoholics with a psychiatric co-morbidity). All patients were treated with oral SMO (50 mg/kg of body weight t.i.d.) for 12 weeks. Alcohol abstinence as well as alcohol drinking during the 12 weeks of treatment did not differ between the two groups at the end of treatment (p=0.9). In addition, a reduction of alcohol intake in both groups has been observed (pcraving for SMO was significantly more frequent in group B than group A (p=0.001). Cases of SMO abuse were observed in almost 10% of group B patients. In conclusion, alcohol abstinence achieved through SMO administration does not differ in patients with and without psychiatric co-morbidity. However, alcoholics with co-morbid borderline disorders appear to be at high risk of developing craving for and abuse of the drug; therefore, SMO may not be indicated in these patients. Copyright © 2010 Elsevier B.V. All rights reserved.

  13. Depression, alcohol use disorders and nicotine dependence among patients at a general hospital Depressão, transtornos decorrentes do uso de álcool e dependência de nicotina no hospital geral

    Directory of Open Access Journals (Sweden)

    Neury José Botega

    2010-09-01

    Full Text Available OBJECTIVE: To determine prevalence rates and identify patient characteristics associated with depression, alcohol use disorders and nicotine dependence among individuals admitted to a general teaching hospital. METHOD: Using the Hospital Anxiety and Depression Scale and Alcohol Use Disorder Identification Test, we assessed 4,352 consecutive medical and surgical patients admitted over a 13-month period. The patients were also asked to report their daily cigarette smoking habits during the last month. Multiple logistic regression analyses were performed, and odds ratios (ORs were calculated. RESULTS: The mean age of the sample was 49.3 years, and 56.6% were male. Prevalence rates of depression, alcohol use disorders and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis, depression was associated with previous suicide attempts (OR = 8.7, lower level of education (OR = 3.6, prior use of psychotropic medications (OR = 3.1, cancer (OR = 1.7 and pain (OR = 1.7. Alcohol use disorders were associated with male sex (OR = 6.3, smoking (OR = 3.5, admission for an external cause of injury, such as a traffic accident (OR = 2.4, and previous suicide attempts (OR = 2.3. Nicotine dependence was associated with alcohol use disorders (OR = 3.4, young adulthood (OR = 2.3, widowhood (OR = 2.2 and previous suicide attempts (OR = 1.8. CONCLUSION: This is the largest sample of medical and surgical patients ever surveyed with standardized screening instruments in a general hospital in Brazil. The high prevalence rates of psychiatric disorders and the profiles of the patients evaluated in this study underscore the need to develop methods that are more effective for detecting and managing such disorders. Hospital admission should be considered a major opportunity for the detection of psychiatric disorders and the subsequent implementation of the appropriate specific treatment strategies.OBJETIVO: Identificar taxas de prevalência e

  14. Prazosin for Treatment With PTSD And Comorbid Alcohol Dependence

    Science.gov (United States)

    2010-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD and alcohol dependence . The objective of this study is to evaluate the efficacy of prazosis (16mg

  15. Optical Spectra of Hemoglobin Taken from Alcohol Dependent Humans

    OpenAIRE

    Dudok K.; Dudok T.; Vlokh I.; Vlokh R.

    2005-01-01

    Optical spectra of CNMetHb and CNMetHb-Coomassi G-250, taken from the blood of humans with alcohol dependence, are studied in the spectral range of 450–750nm. The shifts in the spectral absorption maxima of CNMetHb-Coomassi G-250 complexes are observed for the diseased persons with alcohol dependence. The obtained results show that the hemoglobin structure of alcohol dependent humans is changed.

  16. Alcohol consumption in patients with primary sclerosing cholangitis

    Institute of Scientific and Technical Information of China (English)

    Hannes Hagstr(o)m; Per St(a)l; Knut Stokkeland; Annika Bergquist

    2012-01-01

    AIM:To assess the alcohol drinking patterns in a cohort of primary sclerosing cholangitis (PSC) patients and the possible influence on the development of fibrosis.METHODS:Ninety-six patients with PSC were evaluated with a validated questionnaire about a patient's lifetime drinking habits:the lifetime drinking history (LDH) questionnaire.In addition,clinical status,transient elastography and biochemistry values were analysed and registered.Patients were defined as having either significant or non-significant fibrosis.Significant fibrosis was defined as either an elastography value of ≥ 17.3 kPa or the presence of clinical signs of cirrhosis.Patients were divided into two groups depending on their alcohol consumption patterns; no/low alcohol consumption (one drink or unit/d) and moderate/high alcohol consumption (≥ 1 drink or unit/d).LDH data were calculated to estimate lifetime alcohol intake (LAI),current alcohol intake,drinks per year before and after diagnosis of PSC.We also calculated the number of episodes of binge-drinking (defined as consuming ≥ 5 drinks per occasion) in total,before and after the diagnosis of PSC.RESULTS:The mean LAI was 3882 units of alcohol,giving a mean intake after onset of alcohol consumption of 2.6 units per week.Only 9% of patients consumed alcohol equal to or more than one unit per day.Current alcohol intake in patients with significant fibrosis (n =26) was less than in patients without significant fibrosis (n =70),as shown by lower values of phosphatidylethanol (B-PEth) (0.1 μmol/L vs 0.33 μmol/L,respectively,P =0.002) and carbohydrate-deficient transferrin (CDT)(0.88% vs 1.06%,respectively,P =0.02).Self-reported LAI was similar between the two groups.Patients with significant fibrosis reduced their alcohol intake after diagnosis from 103 to 88 units per year whereas patients without fibrosis increased their alcohol intake after PSC diagnosis from 111 to 151 units/year.There were no correlations between elastography

  17. Self-mutilative behaviours in male alcohol-dependent inpatients and relationship with posttraumatic stress disorder.

    Science.gov (United States)

    Evren, Cuneyt; Dalbudak, Ercan; Evren, Bilge; Cetin, Rabia; Durkaya, Mine

    2011-03-30

    The aim of this study was to investigate the relationship between self-mutilation (SM) and posttraumatic stress disorder (PTSD) in male alcohol-dependent inpatients, and to examine whether there is something unique about self-mutilaters with the PTSD/alcohol-dependence co-morbidity, compared with self-mutilaters without PTSD in this population. Participants were 156 consecutively admitted male alcohol-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire (SMBQ), the Traumatic Experiences Checklist (TEC), the Clinician Administered PTSD Scale (CAPS), the Symptom Checklist-Revised (SCL-90-R) and the Michigan Alcoholism Screening Test (MAST). Among alcohol-dependent inpatients, 34.0% (n=53) were considered as group with SM. Rate of being unemployed, history of any trauma, history of suicide attempt and lifetime PTSD diagnosis were higher, whereas being married, current age, age at onset of regular alcohol use and duration of education were lower in the group with SM. Mean scores of SCL-90 subscales, TEC and MAST were higher in the SM group. Although SM might be related with PTSD among male alcohol-dependent inpatients, predictors of SM were age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and hostility. Age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and somatisation predicted SM in the subgroup of patients without PTSD, whereas hostility predicted SM alone in the subgroup of patients with PTSD. Results support the anti-suicide and the affect-regulation models of SM in the non-PTSD group, whereas they support the hostility model of SM in the subgroup with PTSD in alcohol-dependent inpatients. Thus, to reduce self-mutilative behaviour (SMB)among alcohol-dependent patients, clinicians must address different subjects in different subgroup patients; that is, focussing hostility in those with PTSD co-morbidity.

  18. Outcome of alcohol dependence: The role of continued care

    Directory of Open Access Journals (Sweden)

    Murthy Pratima

    2009-01-01

    Full Text Available Aims: This study attempted to determine the effects of continued care on subjects with alcohol dependence. Materials and Methods: Study patients were recruited from a slum in Bangalore. The control group comprised individuals from a lower socio-economic status. Both groups received identical treatment from a specialised de-addiction facility. The study group also received weekly continued care in the community, either at a clinic located within the slum or through home visits. Those patients without stable jobs were referred for employment. The control group was given routine hospital follow-up visits. Both groups were evaluated on the Alcohol Problem Questionnaire and quantity/frequency of drinking at baseline and every 3 month interval for one year after discharge. Results: Both groups showed improvement in terms of reduction of drinking at 3 months, with the study group showing a 64% improvement with respect to the number of non drinking days and the control group showed a 50% improvement. However, at 6 months, 9 months, and 12 months, the study group continued to maintain these gains while the control group showed a downward slide (differences significant at P < 0.05. At the end of 12 months, the study group maintained a 53% improvement with respect to the number of non drinking days as compared with baseline, while the control group had an improvement of only 28%. Conclusions: Follow-up support and continued care appear to significantly improve longer-term recovery in alcohol dependents.

  19. An Investigation and Analysis of Family Psychology for 142 Patients with Alcohol Dependence%142例酒精依赖患者的家庭心理调查分析

    Institute of Scientific and Technical Information of China (English)

    马增来; 潘仕常

    2001-01-01

    为了了解酒依赖与家庭心理因素的关系.本文对142例酒依赖患者的家庭心理因素进行了调查。结果显示:142例均为男性,年龄平均52.6士4.8岁,文化程度较低,酒依赖症状的轻重与年龄、个性、饮酒年限以及饮酒量有关。形成酒依赖的因素与家庭地位、经济状况及家庭饮酒史有关。%In order to understand relationship between alcohol dependence and family psychology factor,family psychologic factors of 142 patients with alcohol dependence were investigated. Result is that they are man,average age is 52.6±4.8 years, lower culture level,symptom degree of dependence relate to age,personality drinking nunmber of years and capacity. Forming factor of alcohol dependence relate to family position,economic condition,family drinking alcohol hobby.

  20. 酒精依赖甲基化敏感基因筛选%Screening of gene sensitive to methylation among the patient of alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    赵蓉蓉; 李文强; 王传升; 张瑞岭; 郝伟

    2011-01-01

    Objective To explore the relevance of the methylation status of candidate genes to alcohol dependence and to understand preliminarily the function and significance of epigenetics in the pathological mechanism of alcohol use disorder.Methods Methylation status of candidate genes among 63 male alcohol dependence and 65 male healthy controls were detected and analyzed by genome methylation chip.Results Compared to healthy controls, there existed methylation differences among ADH1A,ALDH3B2,5-HT1F genes,the Delta Beta absolute value of which were separately 0.207 722,0.254 688,0.188 833,with no less than 0.17.Conclusions Alcohol dependence may exist abnormal DNA methylation.The genes of ADH1 A,ALDH3 B2 and 5-HT1 F may participate in epigenetic modification to be relevant to pathological mechanism of alcohol dependence.%目的 探讨候选基因甲基化状态和酒精依赖之间的关联,初步了解表观遗传在酒精依赖病理机制中的作用和意义.方法 运用全基因组甲基化芯片,对63例酒精依赖者(酒精依赖组)及65名年龄、文化程度、地域相匹配的健康对照者(对照组)进行检测和分析.结果 2组基因乙醇脱氢酶1A(ADH1A)、乙醛脱氢酶3B2(ALDH3B2)、5-羟色胺1F(5-HT1F)存在甲基化程度差异性,各基因Delta Beta的绝对值分别为0.207 722,0.254 688,0.188 833,均≥0.17.结论 酒精依赖存在DNA甲基化异常;基因ADH1A、ALDH3 B2、5-HT1F可能参与表观修饰并与酒精依赖的形成相关联.

  1. Family history of alcohol dependence and gray matter abnormalities in non-alcoholic adults

    NARCIS (Netherlands)

    Sjoerds, Zsuzsika; Van Tol, Marie-Jose; van den Brink, Wim; Van der Wee, Nic J. A.; Van Buchem, Mark A.; Aleman, Andre; Penninx, Brenda W. J. H.; Veltman, Dick J.

    2013-01-01

    Objectives. Alcohol-use disorders in adolescents are associated with gray matter (GM) abnormalities suggesting neurotoxicity by alcohol. However, recently similar GM abnormalities were found in non-drinking children with a family history (FH) of alcohol dependence (AD). The question thus rises wheth

  2. Family history of alcohol dependence and gray matter abnormalities in non-alcoholic adults

    NARCIS (Netherlands)

    Sjoerds, Zsuzsika; Van Tol, Marie-Jose; van den Brink, Wim; Van der Wee, Nic J. A.; Van Buchem, Mark A.; Aleman, Andre; Penninx, Brenda W. J. H.; Veltman, Dick J.

    2013-01-01

    Objectives. Alcohol-use disorders in adolescents are associated with gray matter (GM) abnormalities suggesting neurotoxicity by alcohol. However, recently similar GM abnormalities were found in non-drinking children with a family history (FH) of alcohol dependence (AD). The question thus rises

  3. 男性酒依赖患者的社会支持与抑郁情绪的相关性研究%A study of correlates between social support and depression of male patients with alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    冯霞; 张琳

    2015-01-01

    ABSTRACT:Objective To provide psychological intervention , we studied relerance of social support and depression of male patients with alcohol dependence. Methods 44 patients with alcohol dependence and 44 normal persons were measured by assessment of social support and self-rating depression scale. Result SSRI score with patients’ alcohol dependence group was signiifcantly lower than that of the normal group.(P<0.05) SDS score was signiifcantly highter than that of the normal group. The negative correlation between the utilization of support of alcohol dependence group and depression. Conclusion Patients have poor social support in male alcohol dependence, are generally a baddepression, male patients with alcohol dependence on the availability of social support and depression related to show, need to further improve the system of social support, let patientslearn to seek social support, to reduce the patient’s bad mood, reduce relapse.%目的:探讨男性酒依赖患者社会支持与抑郁情绪的相关性,为酒依赖患者进行心理干预提供依据。方法采用社会支持评定量表和抑郁自评量表对44例男性酒依赖和44例正常男性人群进行评定。结果酒依赖组的患者客观支持分、主观支持分、支持利用度及社会支持总分均低于正常人群组(P<0.05);酒依赖组的sds得分高于正常人群组;酒依赖组的支持利用度与抑郁情绪呈负相关,差异具有统计学意义。结论男性酒依赖患者存在不良的社会支持,普遍有不良的抑郁情绪,男性酒依赖患者对社会支持利用度与抑郁情绪呈现出相关向,需要将社会支持系统进一步完善,让患者学会寻找社会支持,以降低患者的不良情绪,减少复饮。

  4. Developmental differences in childhood motor coordination predict adult alcohol dependence

    DEFF Research Database (Denmark)

    Manzardo, Ann M; Penick, Elizabeth C; Knop, Joachim

    2005-01-01

    BACKGROUND: The Danish Longitudinal Study of Alcoholism has identified a number of early biological indicators that predicted alcohol dependence 30 years later. In light of recent evidence linking deficits of the cerebellum to certain neuropsychiatric disorders often comorbid with alcoholism, we...... hypothesized that developmental deficits in the cerebellar vermis may also play a role in the initiation of adult alcohol dependence. The present study evaluated whether measures of motor development in the first year of life predict alcohol dependence three decades later. METHODS: A total of 241 subjects...... after birth as well as at 1 year of age. Muscle tone at birth and day 5 as well as 1-year measures of motor coordination--age to sitting, standing, and walking--were examined. A DSM-III-R diagnosis of alcohol dependence and a measure of lifetime problem drinking served as the 30-year outcome variables...

  5. Evaluation of sexual functions in Turkish alcohol-dependent males.

    Science.gov (United States)

    Dişsiz, Melike; Oskay, Ümran Yeşiltepe

    2011-11-01

    It was reported that long-term and high amount of alcohol consumption cause sexual dysfunction in men. There is a lack of descriptive studies focusing on the sexual dysfunction of alcohol dependent men in Turkey. This study was conducted to evaluate sexual functions of alcohol dependent men. This descriptive study was performed at the Alcohol and Substance Research Treatment and Education Center (ASRTEC). The data was collected between 26 December 2007 and 26 December 2008. As research instruments, an interview form of 30 questions that questioned personal characteristics and was developed by researchers, and IIEF (International Index of Erectile Dysfunction) with 15 items that evaluated sexual dysfunction were used. Mean age of men was 41.22 ± 8.19; 36.5% of participants were graduated from primary school, and 57.5% were unemployed. Average daily alcohol consumption was 16.41 ± 4.90 standard alcohol. We found that 47% of alcohol-dependent men had their first sexual experience before they were 18 years old, 64.4% had multiple partners, 1.7% experienced a sexually transmitted disease, 7.7% had a chronic disease, and 18.3% had pain during intercourse. Mean total IIEF scores of alcohol-dependent men was 57 ± 9.23 (mean ED scores 23.41 ± 3.91). Therefore, 70.3% of participants had a mild (17-25), and 4.4% had a moderate (11-16) erectile dysfunction. With a multivariate analysis, predictors of erectile dysfunction in chronic alcohol dependent male were determined as age of subject, age of onset for alcohol, duration of alcoholism, and cigarette use. Chronic alcoholism affects sexual functions in men. Sexual dysfunction in alcohol addicted males is related with education level and unemployment and starting alcohol consumption at an early age and long-term cigarette smoking. © 2010 International Society for Sexual Medicine.

  6. Allelic variants of ADH, ALDH and the five factor model of personality in alcohol dependence syndrome

    Directory of Open Access Journals (Sweden)

    S K Salujha

    2014-01-01

    Full Text Available Background: The etiology of alcohol dependence is a complex interplay of biopsychosocial factors. The genes for alcohol-metabolizing enzymes: Alcohol dehydrogenase (ADH2 and ADH3 and aldehyde dehydrogenase (ALDH2 exhibit functional polymorphisms. Vulnerability of alcohol dependence may also be in part due to heritable personality traits. Aim: To determine whether any association exists between polymorphisms of ADH2, ADH3 and ALDH2 and alcohol dependence syndrome in a group of Asian Indians. In addition, the personality of these patients was assessed to identify traits predisposing to alcoholism. Materials and Methods: In this study, 100 consecutive males with alcohol dependence syndrome attending the psychiatric outpatient department of a tertiary care service hospital and an equal number of matched healthy controls were included with their consent. Blood samples of all the study cases and controls were collected and genotyped for the ADH2, ADH3 and ALDH2 loci. Personality was evaluated using the neuroticism, extraversion, openness (NEO personality inventory and sensation seeking scale. Results: Allele frequencies of ADH2FNx012 (0.50, ADH3FNx011 (0.67 and ALSH2FNx012 (0.09 were significantly low in the alcohol dependent subjects. Personality traits of NEO personality inventory and sensation seeking were significantly higher when compared to controls. Conclusions: The functional polymorphisms of genes coding for alcohol metabolizing enzymes and personality traits of NEO and sensation seeking may affect the propensity to develop dependence.

  7. Alcohol and Memory: Storage and State Dependency

    Science.gov (United States)

    Parker, Elizabeth S.; And Others

    1976-01-01

    Effects of acute alcohol intoxication on the storage phase of memory were evaluated with two tasks that minimized response retrieval: unpaced paired-associate learning with highly available responses and forced-choice picture recognition. It was concluded that storage processes are sensitive to disruption by alcohol. (CHK)

  8. Pavlovian-to-instrumental transfer effects in the nucleus accumbens relate to relapse in alcohol dependence.

    Science.gov (United States)

    Garbusow, Maria; Schad, Daniel J; Sebold, Miriam; Friedel, Eva; Bernhardt, Nadine; Koch, Stefan P; Steinacher, Bruno; Kathmann, Norbert; Geurts, Dirk E M; Sommer, Christian; Müller, Dirk K; Nebe, Stephan; Paul, Sören; Wittchen, Hans-Ulrich; Zimmermann, Ulrich S; Walter, Henrik; Smolka, Michael N; Sterzer, Philipp; Rapp, Michael A; Huys, Quentin J M; Schlagenhauf, Florian; Heinz, Andreas

    2016-05-01

    In detoxified alcohol-dependent patients, alcohol-related stimuli can promote relapse. However, to date, the mechanisms by which contextual stimuli promote relapse have not been elucidated in detail. One hypothesis is that such contextual stimuli directly stimulate the motivation to drink via associated brain regions like the ventral striatum and thus promote alcohol seeking, intake and relapse. Pavlovian-to-Instrumental-Transfer (PIT) may be one of those behavioral phenomena contributing to relapse, capturing how Pavlovian conditioned (contextual) cues determine instrumental behavior (e.g. alcohol seeking and intake). We used a PIT paradigm during functional magnetic resonance imaging to examine the effects of classically conditioned Pavlovian stimuli on instrumental choices in n = 31 detoxified patients diagnosed with alcohol dependence and n = 24 healthy controls matched for age and gender. Patients were followed up over a period of 3 months. We observed that (1) there was a significant behavioral PIT effect for all participants, which was significantly more pronounced in alcohol-dependent patients; (2) PIT was significantly associated with blood oxygen level-dependent (BOLD) signals in the nucleus accumbens (NAcc) in subsequent relapsers only; and (3) PIT-related NAcc activation was associated with, and predictive of, critical outcomes (amount of alcohol intake and relapse during a 3 months follow-up period) in alcohol-dependent patients. These observations show for the first time that PIT-related BOLD signals, as a measure of the influence of Pavlovian cues on instrumental behavior, predict alcohol intake and relapse in alcohol dependence. © 2015 Society for the Study of Addiction.

  9. Social anxiety symptoms in alcohol-dependent outpatients: prevalence, severity and predictors

    Directory of Open Access Journals (Sweden)

    Nicoli Tamie Yoshimi

    2016-06-01

    Full Text Available ABSTRACT Objectives High rates of comorbidity between social anxiety disorder (SAD and alcohol use disorders have been reported, but the predictors of this comorbidity are poorly known and most studies involve primary SAD samples. The aims were to estimate the prevalence and severity of SAD symptoms among alcohol-dependent patients and to investigate sociodemographic and clinical factors associated with SAD comorbidity, including suicidal behaviors. Methods A cross-sectional study with 53 adults who were in treatment for alcohol dependence at a Brazilian public university outpatient service. Assessment instruments Social Phobia Inventory (SPIN, Short Alcohol Dependence Data and Beck Depression Inventory. Bivariate analyses between the categorical outcome (Probable SAD: SPIN ≥ 19 and explanatory variables were conducted. Correlates of SPIN total and subscales scores (dimensional outcomes were also investigated. Results The diagnosis and treatment of alcohol dependence occurred, on average, 30 years after the onset of alcohol use and 39.6% of the 53 patients (37 men and 16 women reported alleviation of social anxiety symptoms with alcohol use. Twenty-four (45.3% patients presented probable SAD. These patients differed from non-SAD alcohol-dependent individuals by having lower income and higher frequency of depression, suicidal ideation, suicide plans and attempts. The SPIN subscales mostly associated with suicidal behaviors were social inadequacy and social inferiority. Conclusions SAD symptoms are common among help-seeking alcohol-dependent individuals and should be directly investigated and treated, since depression and suicidality are associated with this comorbidity. Prospective studies are needed to assess the impact of SAD treatment on the clinical course of alcohol dependence.

  10. Pharmacotherapy for alcohol addiction in a patient with alcoholic cirrhosis and massive upper gastrointestinal bleed: A case study.

    Science.gov (United States)

    Young, Samantha; Wood, Evan; Ahamad, Keith

    2016-03-01

    Alcohol use causes a substantial burden of morbidity and mortality worldwide. The pharmacologic treatment of alcohol dependence has been increasingly studied and proven to improve outcomes in individuals with alcohol use disorder. However, the treatment of alcohol use disorder is often challenging in the context of patients with hepatic impairment as many medications to treat alcohol use disorder are hepatically metabolised or may cause liver toxicity in some instances. We present a case history of an individual with significant medical complications from alcohol use disorder and explore the dilemma faced in prescribing pharmacologic treatment of alcohol use disorder in patients with significant liver dysfunction. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  11. Alcohol withdrawal syndrome in medical patients.

    Science.gov (United States)

    Gortney, Justine S; Raub, Joshua N; Patel, Pragnesh; Kokoska, Lianne; Hannawa, Mae; Argyris, Amy

    2016-01-01

    The authors provide a critical review focusing on pharmacotherapy of alcohol withdrawal syndrome in hospitalized patients who are not critically ill. They outline recommendations for patient assessment and monitoring. Copyright © 2016 Cleveland Clinic.

  12. Childhood Trauma, Posttraumatic Stress Disorder, and Alcohol Dependence

    OpenAIRE

    Brady, Kathleen T.; Back, Sudie E.

    2012-01-01

    Early-childhood trauma is strongly associated with developing mental health problems, including alcohol dependence, later in life. People with early-life trauma may use alcohol to help cope with trauma-related symptoms. This article reviews the prevalence of early-childhood trauma and its robust association with the development of alcohol use disorders and posttraumatic stress disorder. It also examines the potential biological mechanisms by which early adverse experiences can result in long-...

  13. FAMILIAL CO-DEPENDENCE OF ALCOHOL ABUSING PEOPLE

    OpenAIRE

    Cyrino, Luiz Arthur Rangel; Araujo, Bárbara Bretzke; Santos, Crislainy Camila dos; Baptista, Lilian Vegini

    2017-01-01

    Alcoholism is a collective pathology since it affects all people bonded to the person concerned. Alcohol is actually the main brain depressing psychotropic product and an important cause of morbidity and mortality. Users are called dependent persons, whilst friends and family are co-dependent since they live within the sphere of the dependent person and frequently do not acknowledge their condition. Current analysis, based on a review of the literature on Neuroscience and Psychology, studies ...

  14. Temperament and Character Inventory (TCI) personality profile and sub-typing in alcoholic patients: a controlled study.

    Science.gov (United States)

    Basiaux, P; le Bon, O; Dramaix, M; Massat, I; Souery, D; Mendlewicz, J; Pelc, I; Verbanck, P

    2001-01-01

    Cloninger's Temperament and Character Inventory (TCI) personality profile was used to compare alcohol-dependent patients with non-psychiatric control subjects, and a search made for sub-types of alcoholics with different TCI profiles, using the criteria age of onset of alcohol-related problems, paternal dependence on alcohol and familial antecedents of alcohol dependence. Alcohol-dependent patients (n = 38) were characterized by higher Novelty-Seeking [corresponding to Diagnostic and Statistical Manual of Mental Disorders (4th edition) group B personality type] and lower Self-Directedness than non-psychiatric control subjects (n = 47). Lower Self-Directedness indicates a higher probability of personality disorder in the alcohol-dependent population. Only age of onset of alcohol-related problems delineated the two sub-populations with different TCI profiles: early-onset alcoholics (TCI data add to evidence concerning a higher probability of personality disorder in alcohol-dependent patients, particularly those with early-onset.

  15. The effect of exposure to alcohol-associated cues on the psychological craving and physiological changes after discontinuation of alcohol drinking in alcohol dependence patients%酒环境线索暴露对酒依赖者停止饮酒后心理渴求及生理活动的影响

    Institute of Scientific and Technical Information of China (English)

    王学义; 张云淑; 姚绍敏; 金圭星; 罗金菊; 刘小玉; 陆林

    2008-01-01

    目的 探讨酒环境暴露对酒依赖者心理渴求及生理活动的影响.方法 选择停止饮酒40 d的64例酒依赖患者和32名正常受试者(正常对照组)为研究对象,将患者分为试验组(暴露于酒环境)和患者对照组(暴露于牛奶环境),每组各32例,分别暴露于相关环境线索,于暴露前、暴露后的第1天、第1周和第4周测试三组的心理渴求以及心率、血压、血氢化可的松水平的变化.结果 (1)患者试验组和患者对照组的血浆氢化可的松水平于暴露前[分别为(77±40)μg/L和(75±40)μg/L]、暴露后第1天[分别为(123±56)μg/L和(77±40)μg/L]均高于正常对照组[(47±26)μg/L和(47±31)μg/L;P<0.05].(2)患者试验组暴露于酒环境后,第1天的心理渴求程度及心率、收缩压、舒张压及血氢化可的松水平均较暴露前增高(P<0.05),而第1周和第4周与暴露前比较的差异无统计学意义(P>0.05).结论 酒环境暴露后酒依赖者的心理渴求及心率、血压、血氢化可的松水平增高,减少酒环境线索的暴露是降低复饮的重要因素.%Objective To explore the effects of exposure to alcohol-related environment on the psychologial craving and physiological activities in alcohol dependent patients.Methods The 64 alcohol dependence patients with 40-day discontinuation of alcohol drinking were divided into patient experiment group (exposed to alcohol-related environment)and patient control group(exposed to milk),and 32 healthy adults were involved as normal controls.After exposure to the alcol-related clue,the craving index.heart rate,blood pressure(BP)and serum hydrocortisone level were tested. Results The serum hydrocortisone level in the-Patient experiment group and the patient control group[(77±40)μg/L and,(75±40)μg/L respectively] were higher than that in healthy controls[(47±26)μg/L and(47±31)μg/L respectively]before and on the 1st day after exposure[(123±56)μg/L and(77±40)μg/L;P<0.05].0n

  16. Clinical effectiveness of baclofen for the treatment of alcohol dependence: a review

    Directory of Open Access Journals (Sweden)

    Brennan JL

    2013-07-01

    Full Text Available Jessica L Brennan,2 Jonathan G Leung,1 Jane P Gagliardi,3 Sarah K Rivelli,3 Andrew J Muzyk4 1Department of Hospital Pharmacy Services, Mayo Clinic, Rochester, MN, 2Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 4Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA Abstract: Baclofen, an agonist at the B subunit of gaba-aminobutyric acid receptor, possesses pharmacologic properties that may confer utility for the treatment of alcohol dependence. Research suggests that not only can it be useful in promoting maintenance of alcohol abstinence but also it may play a key role in decreasing alcohol cravings and anxiety often associated with alcohol dependence. To assess the benefit of baclofen for alcohol dependence, a review of the literature was conducted to identify published data investigating this off-label treatment. Four randomized controlled trials to date have been published and were included in this review. Although primary outcomes differ between studies, patients randomized to baclofen experience higher rates of abstinence from alcohol than those taking placebo in two of the trials. Secondary analyses indicate that baclofen is safe in patients with alcohol dependence, including those with moderate to severe liver cirrhosis, and may provide beneficial anxiolytic effects. Despite some positive data, the largest available randomized controlled trial failed to find any differences between baclofen and placebo. In all studies, individuals with severe medical comorbidities, seizure disorders, and psychiatric disorders were excluded from trials, which may limit external validity. In summary, there may be beneficial effects from using baclofen for the treatment of alcohol dependence; however, limited conclusions can be drawn from the small number of studies

  17. Rare ADH Variant Constellations are Specific for Alcohol Dependence

    OpenAIRE

    Zuo, Lingjun; Zhang, Heping; Malison, Robert T; Li, Chiang-shan R.; Zhang, Xiang-Yang; Wang, Fei; Lu, Lingeng; Lu, Lin; Wang, Xiaoping; Krystal, John H.; Zhang, Fengyu; Deng, Hong-Wen; Luo, Xingguang

    2012-01-01

    Aims: Some of the well-known functional alcohol dehydrogenase (ADH) gene variants (e.g. ADH1B*2, ADH1B*3 and ADH1C*2) that significantly affect the risk of alcohol dependence are rare variants in most populations. In the present study, we comprehensively examined the associations between rare ADH variants [minor allele frequency (MAF)

  18. Energy drink consumption and increased risk for alcohol dependence

    Science.gov (United States)

    Arria, Amelia M.; Caldeira, Kimberly M.; Kasperski, Sarah J.; Vincent, Kathryn B.; Griffiths, Roland R.; O'Grady, Kevin E.

    2010-01-01

    Background Energy drinks are highly caffeinated beverages that are increasingly consumed by young adults. Prior research has established associations between energy drink use and heavier drinking and alcohol-related problems among college students. This study investigated the extent to which energy drink use might pose additional risk for alcohol dependence over and above that from known risk factors. Methods Data were collected via personal interview from 1,097 fourth-year college students sampled from one large public university as part of an ongoing longitudinal study. Alcohol dependence was measured with DSM-IV criteria. Results After adjustment for the sampling design, 51.3%wt of students were classified as “low-frequency” energy drink users (1 to 51 days in the past year) and 10.1%wt as “high-frequency” users (≥52 days). Typical caffeine consumption varied widely depending on the brand consumed. Compared to the low-frequency group, high-frequency users drank alcohol more frequently (141.6 vs. 103.1 days) and in higher quantities (6.15 vs. 4.64 drinks/typical drinking day). High-frequency users were at significantly greater risk for alcohol dependence relative to both non-users (AOR=2.40, 95% CI=1.27-4.56, p=.007) and low-frequency users (AOR=1.86, 95% CI=1.10, 3.14, p=.020), even after holding constant demographics, typical alcohol consumption, fraternity/sorority involvement, depressive symptoms, parental history of alcohol/drug problems, and childhood conduct problems. Low-frequency energy drink users did not differ from non-users on their risk for alcohol dependence. Conclusions Weekly or daily energy drink consumption is strongly associated with alcohol dependence. Further research is warranted to understand the possible mechanisms underlying this association. College students who frequently consume energy drinks represent an important target population for alcohol prevention. PMID:21073486

  19. Family Dysfunction Differentially Affects Alcohol and Methamphetamine Dependence: A View from the Addiction Severity Index in Japan

    OpenAIRE

    Kazutaka Ikeda; Yuzo Aikawa; Mitsuru Umeno; Susumu Higuchi; Eiichi Senoo; Ayako Haraguchi; Yasukazu Ogai; Nagisa Sugaya

    2011-01-01

    We investigated the differential influence of family dysfunction on alcohol and methamphetamine dependence in Japan using the Addiction Severity Index (ASI), a useful instrument that multilaterally measures the severity of substance dependence. The participants in this study were 321 male patients with alcohol dependence and 68 male patients with methamphetamine dependence. We conducted semi-structured interviews with each patient using the ASI, which is designed to assess problem severity in...

  20. Pharmacological aversion treatment of alcohol dependence. I. Production and prediction of conditioned alcohol aversion.

    Science.gov (United States)

    Howard, M O

    2001-08-01

    Eighty-two hospitalized alcoholics receiving pharmacological aversion therapy (PAT) over a 10-day treatment interval completed cognitive, behavioral, and psychophysiological measures evaluating conditioned aversion to alcohol. Pre-post assessments provided convergent support for the efficacy of PAT vis-à-vis production of conditioned aversion to alcohol. Positive alcohol-related outcome expectancies were significantly reduced, whereas confidence that drinking could be avoided in various high-risk situations for consumption was increased following PAT. Behavioral and cardiac rate assessments revealed significant changes following PAT that were specific to alcoholic beverages and potentially reflective of conditioned alcohol aversion. Patients with more extensive pretreatment experiences with alcohol-associated nausea and greater involvement in antisocial conduct appeared to be less susceptible to the PAT conditioning protocol.

  1. Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism.

    Science.gov (United States)

    Schwandt, Melanie L; Heilig, Markus; Hommer, Daniel W; George, David T; Ramchandani, Vijay A

    2013-06-01

    Childhood trauma has been linked with a number of negative outcomes later in life, including alcohol dependence (AD). Previous studies have suggested a mediating role for neuroticism in the relationship between childhood trauma and psychopathology. In this study, we investigate the prevalence of multiple types of childhood trauma in treatment-seeking alcohol-dependent patients, and the associations between childhood trauma and AD severity using multiple mediation analysis. The prevalence of 5 types of childhood trauma-emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect-was assessed in treatment-seeking alcohol-dependent patients (n = 280) and healthy controls (n = 137) using the Childhood Trauma Questionnaire. Multiple mediation analyses were used to model associations between childhood trauma measures and alcohol-related outcomes, primarily the severity of AD in the alcohol-dependent sample. Childhood trauma was significantly more prevalent and more severe in the alcohol-dependent subjects. In addition, childhood trauma was found to influence AD severity, an effect that was mediated by neuroticism. When individual trauma types were examined, emotional abuse was found to be the primary predictor of AD severity, both directly and through the mediating effects of the impulsivity subfacet of neuroticism. Physical abuse also had a moderate direct effect on AD severity. Mediation analysis did not reveal any association between childhood trauma and Alcohol Use Disorders Identification Test score in the nondependent control sample. Childhood trauma is highly prevalent in treatment-seeking alcoholics and may play a significant role in the development and severity of AD through an internalizing pathway involving negative affect. Our findings suggest that alcoholics with a history of childhood emotional abuse may be particularly vulnerable to severe dependence. Copyright © 2012 by the Research Society on Alcoholism.

  2. Influence of Naikan cognitive therapy on the compliance of patients with alcohol dependence%内观认知疗法对酒依赖患者治疗依从性的影响

    Institute of Scientific and Technical Information of China (English)

    邹丽君

    2014-01-01

    Objective:To explore the influence of Naikan cognitive therapy?on the compliance of patients with alcohol dependence.Methods:60 alcohol dependent male patients were selected.They were divided into the study group and the control group with 30 cases in each.Two groups of patients were given drug treatment and nursing,while the study group received Naikan cognitive therapy for 8 weeks on the basis of conventional treatment.At the end of the 8 week,the symptom checklist 90(SCL-90) and patient satisfaction and compliance of treatment of the two groups were compared.Results:After treatment,the factors of SCL-90 in study group were significantly lower than those in the control group(P<0.01).Patient satisfaction and compliance to treatment were higher than the control group(P<0.01).Conclusion: Naikan cognitive therapy can reduce alcohol craving of patients with alcohol dependence,improve the satisfaction of patients and treatment compliance and reduce the recurrence rate.%目的:探讨内观认知疗法对酒依赖患者治疗依从性的影响。方法:收治酒依赖男性患者60例,随机分为研究组和对照组,各30例。两组患者均给予药物治疗及护理,研究组在此基础上接受内观认知疗法8周,于8周末对两组患者症状自评量表(SCL-90)、患者满意度及治疗依从性进行比较。结果:治疗后研究组SCL-90各因子分均显著低于对照组(P<0.01),患者满意度及治疗依从性均显著高于对照组(P<0.01)。结论:内观认知疗法能降低酒依赖患者的饮酒渴求,提高患者满意度及治疗依从性,降低复发率。

  3. Impulsivity and sensation seeking in alcohol abusing patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Alain Dervaux

    2010-09-01

    Full Text Available Objective: Some studies have found that high levels of impulsivity and sensation seeking, particularly disinhibition are associated with substance abuse in patients with schizophrenia, as in the general population. However, no study has assessed impulsivity and sensation seeking specifically in schizophrenia patients with alcohol abuse or dependence. Material and Methods: We compared impulsivity and sensation seeking in a group of schizophrenia patients (DSM-III-R criteria with lifetime alcohol abuse or dependence (n=34 and in a group without lifetime substance abuse or dependence (n=66. The patients were assessed using the Composite International Diagnostic Interview (CIDI for DSM-III-R disorders, the Positive and Negative Syndrome Scale, the Barratt Impulsivity Scale (BIS, the Zuckerman Seeking Sensation Scale (SSS, and the Physical Anhedonia Scale (PAS. Results: The mean scores for impulsivity and sensation seeking were higher in the group with lifetime alcohol abuse or dependence than in the group without substance abuse or dependence (BIS: 63.4 SD: 18,7 vs 51.3 SD: 14.2 respectively, ANOVA: F=11.12, p=0.001; SSS: 17.6 SD: 5.9 vs 13.5 SD: 6.7 respectively, ANOVA: F=7.45, p=0.008. There was no significant differences between the two groups on PAS score. Conclusion: Increased impulsivity or sensation seeking may be a link between schizophrenia and alcohol abuse or dependence.

  4. Temperament and character model of personality profile of alcohol- and drug-dependent inpatients.

    Science.gov (United States)

    Evren, Cuneyt; Evren, Bilge; Yancar, Cenk; Erkiran, Murat

    2007-01-01

    The aims of this study were to evaluate the differences in dimensions of temperament and character in Turkish alcohol- and drug-dependent inpatients, and to examine which dimensions would predict drug dependency. The subjects consisted of 111 alcohol-dependent and 93 drug-dependent inpatients according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Subjects were tested using Cloninger's Temperament and Character Inventory (TCI). Among the temperament dimensions, novelty seeking score was higher and reward dependency score was lower in drug-dependent patients than in alcohol-dependent patients. Among the character dimensions, self-directedness and cooperativeness scores were lower in drug-dependent patients. Low age and novelty seeking predicted drug dependency in forward logistic regression model. Subscales that predicted drug dependency other than young age were lower scores on compassion vs revengefulness (C4) and helpfulness (C3), and higher score on spiritual acceptance vs rational materialism (ST3). As in previous studies, which indicate an association between personality and substance choice, in the present study, TCI was shown to be an efficient tool in discriminating alcohol and drug dependents; thus, it seems to be important to consider TCI dimensions in planning the treatment of substance dependency.

  5. The alcohol patient and surgery

    DEFF Research Database (Denmark)

    Tønnesen, H

    1999-01-01

    Alcohol abusers have a threefold increased risk of post-operative morbidity after surgery. The most frequent complications are infections, cardiopulmonary insufficiency, and bleeding episodes. Pathogenesis is suppressed immune capacity, subclinical cardiac dysfunction, and haemostatic imbalance...

  6. Disrupted regulation of social exclusion in alcohol-dependence: an fMRI study.

    Science.gov (United States)

    Maurage, Pierre; Joassin, Frédéric; Philippot, Pierre; Heeren, Alexandre; Vermeulen, Nicolas; Mahau, Pierre; Delperdange, Christel; Corneille, Olivier; Luminet, Olivier; de Timary, Philippe

    2012-08-01

    Alcohol-dependence is associated with cognitive and biological alterations, and also with interpersonal impairments. Although overwhelming in clinical settings and involved in relapse, these social impairments have received little attention from researchers. Particularly, brain alterations related to social exclusion have not been explored in alcohol-dependence. Our primary purpose was to determine the neural correlates of social exclusion feelings in this population. In all, 44 participants (22 abstinent alcohol-dependent patients and 22 paired controls) played a virtual game ('cyberball') during fMRI recording. They were first included by other players, then excluded, and finally re-included. Brain areas involved in social exclusion were identified and the functional connectivity between these areas was explored using psycho-physiological interactions (PPI). Results showed that while both groups presented dorsal anterior cingulate cortex (dACC) activations during social exclusion, alcohol-dependent participants exhibited increased insula and reduced frontal activations (in ventrolateral prefrontal cortex) as compared with controls. Alcohol-dependence was also associated with persistent dACC and parahippocampal gyrus activations in re-inclusion. PPI analyses showed reduced frontocingulate connectivity during social exclusion in alcohol-dependence. Alcohol-dependence is thus linked with increased activation in areas eliciting social exclusion feelings (dACC-insula), and with impaired ability to inhibit these feelings (indexed by reduced frontal activations). Altered frontal regulation thus appears implied in the interpersonal alterations observed in alcohol-dependence, which seem reinforced by impaired frontocingulate connectivity. This first exploration of the neural correlates of interpersonal problems in alcohol-dependence could initiate the development of a social neuroscience of addictive states.

  7. 酒依赖患者配偶康复知识知晓现状的调查研究%Investigation of the rehabilitation knowledge of spouses of patients with alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    柳学华; 骆蕾; 马莉

    2012-01-01

    Objective To investigate the rehabilitation knowledge of spouses of patients with alcohol dependence,so as to provide effective health education and nursing intervention for alcohol dependence palienis'families,to improve the rehabilitation of patients. Methods A self - designed questionnaire was used to investigate 96 ambulatory hopitalized spouses of patients with alcohol dependence. Results In the aspect of the re - drink risk of alcohol dependence patients, 34.38% of the spouses understood fully and 38.54% understood partly. In the aspect of clinical manifestation and coping style of alcohol desire,23.96% of the spouses understood fully and 46. 88% understood partly. About the other twelve aspects of rehabilitation related knowledge, the rate of understanding was low ( <40.00% ),especially the aspects of interest replace training,family psychological therapy,long- term family coping mode and social adaptation of family and patients , whose rates of understanding were below 20.00%. Conclusion The rehabilitation knowledge of spouses of patients with alcohol dependence is poor. It is necessary to provide health education and family nursing intervention to improve the rehabilitation of patients.%目的 调查酒依赖患者配偶对酒依赖康复知识的知晓情况,为酒依赖患者家庭提供有效的健康教育及护理干预,促进酒依赖患者的康复.方法 采用自行设计的调查问卷,对96名门诊及住院酒依赖患者的配偶进行调查.结果 对酒依赖复饮危险总的态度认识方面,完全了解的占34.38%,了解一些的占38.54%;对酒的渴求和欲望来临时的表现及应对策略方面,完全了解的占23.96%,了解一些的占46.88%;对其他12个方面的康复相关知识知晓率均较低(知晓率<40.00%),特别是在替代兴趣发展训练、家庭心理治疗、家庭长期应对模式和家庭及患者的社会适应方面(知晓率<20.00%).结论 洒依赖患者配偶对酒依赖康复相

  8. Assessment of alcohol use patterns among spanish-speaking patients.

    Science.gov (United States)

    Lotfipour, Shahram; Cisneros, Victor; Anderson, Craig L; Roumani, Samer; Hoonpongsimanont, Wirachin; Weiss, Jie; Chakravarthy, Bharath; Dykzeul, Brad; Vaca, Federico

    2013-01-01

    The objective of this study was to assess drinking patterns of Spanish-speaking patients using a bilingual computerized alcohol screening and brief intervention (CASI) tablet computer equipped with the Alcohol Use Disorders Identification Test (AUDIT). This retrospective study was conducted in a tertiary university hospital emergency department (ED) between 2006 and 2010. Data from 1816 Spanish-speaking ED patients were analyzed using descriptive statistics, the chi-square test for independence, and the Kruskal-Wallis rank sum test for comparisons using quantitative variables. Overall, 15% of Spanish-speaking patients were at-risk drinkers, and 5% had an AUDIT score consistent with alcohol dependency (≥20). A higher percentage of Spanish-speaking males than females were at-risk drinkers or likely dependent. Spanish-speaking males exhibited higher frequency of drinking days per week and higher number of drinks per day compared with females. Among older patients, nondrinking behavior increased and at-risk drinkers decreased. The majority of males and females were ready to change their behavior after the CASI intervention; 61% and 69%, respectively, scored 8-10. This study indicated that CASI was an effective tool for detecting at-risk and likely dependent drinking behavior in Spanish-speaking ED patients. The majority of patients were ready to change their drinking behavior. More alcohol screening and brief intervention tools should be tested and become readily accessible for Spanish-speaking patients.

  9. The positive effects of high-frequency right dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation on memory, correlated with increases in brain metabolites detected by proton magnetic resonance spectroscopy in recently detoxified alcohol-dependent patients

    Directory of Open Access Journals (Sweden)

    Qiao J

    2016-09-01

    Full Text Available Jun Qiao,1,2 Guixing Jin,1,2 Licun Lei,3 Lan Wang,1,2 Yaqiang Du,3 Xueyi Wang1,2 1Institute of Mental Health, The First Hospital of Hebei Medical University, 2Brain Ageing and Cognitive Neuroscience Laboratory, Hebei Medical University, 3Department of Radiology, The First Hospital of Hebei Medical University, Hebei, People’s Republic of China Objective: To explore the effect of right dorsolateral prefrontal cortex (DLPFC repetitive transcranial magnetic stimulation (rTMS on memory, and its correlation with levels of hippocampal brain metabolites detected by proton magnetic resonance spectroscopy (1H-MRS in recently detoxified alcohol-dependent patients. Materials and methods: In this randomized, double-blind sham-controlled trial, alcohol-dependent patients were enrolled and randomized into two groups: the experimental group (rTMS, 10 Hz, on right DLPFC, 20 sessions and the control group (sham stimulation. Memory function was assessed using Hopkins Verbal Learning Test-Revised (HVLT-R and Brief Visuospatial Memory Test-Revised (BVMT-R before and after treatment. 1H-MRS was used to detect the levels of N-acetyl aspartic acid (NAA, choline (Cho, and creatine (Cr in bilateral hippocampi before and after treatment. Results: Thirty-eight patients (18 in the experimental group and 20 in the control group were included in the analyses. The experimental group showed significantly greater changes in HVLT-R, BVMT-R, NAA/Cr, and Cho/Cr after rTMS from baseline than the control group. The percentage change in BVMT-R and HVLT-R correlated with the percentage change in NAA/Cr and Cho/Cr in the right brain. Conclusion: High-frequency right DLPFC rTMS was associated with improvement in memory dysfunction, which is correlated with levels of hippocampal brain metabolites detected by 1H-MRS in recently detoxified alcohol-dependent patients. Keywords: alcohol dependence, memory, repetitive transcranial magnetic stimulation, MR spectroscopy

  10. Cingulate cortex functional connectivity predicts future relapse in alcohol dependent individuals

    Directory of Open Access Journals (Sweden)

    Yasmin Zakiniaeiz

    2017-01-01

    Full Text Available Alcohol dependence is a chronic relapsing illness. Alcohol and stress cues have consistently been shown to increase craving and relapse risk in recovering alcohol dependent (AUD patients. However, differences in functional connectivity in response to these cues have not been studied using data-driven approaches. Here, voxel-wise connectivity is used in a whole-brain investigation of functional connectivity differences associated with alcohol and stress cues and to examine whether these differences are related to subsequent relapse. In Study 1, 45, 4- to 8-week abstinent, recovering AUD patients underwent functional magnetic resonance imaging during individualized imagery of alcohol, stress, and neutral cues. Relapse measures were collected prospectively for 90 days post-discharge from inpatient treatment. AUD patients showed blunted anterior (ACC, mid (MCC and posterior cingulate cortex (PCC, voxel-wise connectivity responses to stress compared to neutral cues and blunted PCC response to alcohol compared to neutral cues. Using Cox proportional hazard regression, weaker connectivity in ACC and MCC during neutral exposure was associated with longer time to relapse (better recovery outcome. Similarly, greater connectivity in PCC during alcohol-cue compared to stress cue was associated with longer time to relapse. In Study 2, a sub-group of 30 AUD patients were demographically-matched to 30 healthy control (HC participants for group comparisons. AUD compared to HC participants showed reduced cingulate connectivity during alcohol and stress cues. Using novel data-driven approaches, the cingulate cortex emerged as a key region in the disruption of functional connectivity during alcohol and stress-cue processing in AUD patients and as a marker of subsequent alcohol relapse.

  11. Alcohol-dependent patients receiving specialised outpatient care: an overview of gender issues Dependentes do álcool atendidos em ambulatório especializado: um olhar na questão do gênero

    Directory of Open Access Journals (Sweden)

    Márcia Fonsi Elbreder

    2010-01-01

    Full Text Available OBJECTIVE: The objective of the present study, with focus on gender, was aimed at evaluating alcohol-dependent individual in terms of socio-demographic variables related to alcohol consumption and therapeutic interventions. METHODS: This is a retrospective cross-sectional study of 1,051 patients (833 men and 218 women, with diagnosis of alcohol dependence syndrome, according to ICD-10 criteria, who had sought treatment for the first time at a specialised health centre between 2000 and 2006. RESULTS: The results showed that women, compared to men, are more likely to be unemployed and without partner, in addition to having higher educational level, latter age of alcohol initiation, needing less outpatient alcohol detoxification program, consuming more fermented beverage, presenting less psychiatric comorbidities, and using less coadjutant medications during treatment. CONCLUSION: We can state that some peculiarities exist permeating both gender and alcohol consumption. A further focus on the characteristics of each population is needed to facilitate the adequate use of therapeutic interventions according to gender specificities.OBJETIVO: O objetivo do presente estudo, com foco no gênero, foi avaliar dependentes de álcool em termos de variáveis sociodemográficas, relacionadas ao consumo de álcool e intervenções terapêuticas. MÉTODOS: Este é um estudo retrospectivo transversal com 1.051 pacientes (833 homens e 218 mulheres, com diagnóstico de síndrome de dependência do álcool, de acordo com o CID-10, que procuraram tratamento pela primeira vez em um serviço especializado, entre 2000 e 2006. RESULTADOS: Os resultados mostraram que as mulheres, comparadas aos homens, eram desempregadas e sem companheiro, além de ter melhor nível educacional, iniciarem o consumo alcoólico mais tardiamente, necessitarem menos do programa de desintoxicação alcoólica ambulatorial, consumirem mais bebidas fermentadas, apresentarem menos comorbidades

  12. Comorbid psychiatric diagnoses among individuals presenting to an addiction treatment program for alcohol dependence.

    LENUS (Irish Health Repository)

    Lyne, John Paul

    2011-01-01

    A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.

  13. Observing nurses has improved my alcohol dependency care.

    Science.gov (United States)

    Jaques, Ellise

    2016-09-21

    My first placement in my first year of nursing training was on a gastrointestinal/hepatology ward. Alongside my mentor, I was caring for a patient who had been withdrawing from alcohol since admission to hospital the previous evening.

  14. Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility

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    Witkiewitz K

    2012-02-01

    Full Text Available Katie Witkiewitz, Kimber Saville, Kacie HamreusDepartment of Psychology, Washington State University Vancouver, Vancouver, WA, USAAbstract: Acamprosate, or N-acetyl homotaurine, is an N-methyl-D-aspartate receptor modulator approved by the Food and Drug Administration (FDA as a pharmacological treatment for alcohol dependence. The exact mechanism of action of acamprosate is still under investigation, but the drug appears to work by promoting a balance between the excitatory and inhibitory neurotransmitters, glutamate and gamma-aminobutyric acid, respectively, and it may help individuals with alcohol dependence by reducing withdrawal-associated distress. Acamprosate has low bioavailability, but also has an excellent tolerability and safety profile. In comparison with naltrexone and disulfiram, which are the other FDA-approved treatments for alcohol dependence, acamprosate is unique in that it is not metabolized by the liver and is also not impacted by alcohol use, so can be administered to patients with hepatitis or liver disease (a common comorbid condition among individuals with alcohol dependence and to patients who continue drinking alcohol. Acamprosate has demonstrated its efficacy in more than 25 placebo-controlled, double-blind trials for individuals with alcohol dependence, and has generally been found to be more efficacious than placebo in significantly reducing the risk of returning to any drinking and increasing the cumulative duration of abstinence. However, acamprosate appears to be no more efficacious than placebo in reducing heavy drinking days. Numerous trials have found that acamprosate is not significantly more efficacious than naltrexone or disulfiram, and the efficacy of acamprosate does not appear to be improved by combining acamprosate with other active medications (eg, naltrexone or with psychosocial treatment (eg, cognitive-behavioral therapy. In this review, we present the data on acamprosate, including its pharmacology

  15. 中药常山治疗酒精依赖患者30例临床研究%Clinical Research on Changshan(Radix Dichroae)in Treatment of 30 Alcohol Dependence Patients

    Institute of Scientific and Technical Information of China (English)

    卢桂华; 王世锴; 郭萍

    2011-01-01

    Objective To explore the therapeutic effect and safety of Changshan (Radix Dichroae) on the patients with alcohol dependence. Methods Sixty alcohol dependence patients were randomly assigned to the study group treated with raw Changshan powder and the control group treated with furazolidone for 12 weeks of aversion therapy and 1-year follow-up. The short-term effect was valued by alcohol consumption and the visual analog scale (VAS), while the long-term outcome was measured by withdrawal rate and re-drinking rate. The differences between groups as well as pre- and post-treatment were compared, and the adverse reactions of both groups were also observed. Results After treatment, the alcohol consumption and the severity of craving for alcohol of both groups were significantly decreased (P<0. 01 ), whilst the alcohol consumption of the study group was less than that of the control group (P<0. 01). The long-term effective rate of the study group (93. 3%) was superior to that of the control group (90%) without significant difference. Compared with the control group, the total adverse effect of the study group was relatively rare and tolerable. Conclusion Chinese medicine Changshan (Radix Dichroae) is effective and tolerable for treating alcohol dependence. It can be considered an option in the aversion therapy of alcohol dependence.%目的:探讨中药常山治疗酒精依赖的临床疗效和安全性.方法:将符合诊断标准的60例酒依赖患者随机分为生品常山粉组(研究组)和呋喃唑酮对照组(对照组)各30例,进行12周的厌恶治疗和1年随访调查,近期疗效以每周实际饮酒量和可视渴求量表(VAS)进行评估,远期疗效以戒断率和复饮率进行评价,并观察两组不良反应发生情况.结果:两组患者治疗后实际饮酒量和VAS评分均有明显下降(P<0.01),而研究组实际饮酒量低于对照组(P<0.01).研究组的远期有效率略优于对照组(分别为93.3%和90.0%),

  16. Variation in gastric alcohol dehydrogenase and the risk of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Paulina Całka

    2017-03-01

    Full Text Available Alcohol dependence is both a medical and socioeconomic problem. The disease is multifactorial, i.e. its development is attributable to gene-gene and gene-environment interactions. Multi-centre studies investigating the genetic background of alcoholism stress the role of genes encoding enzymes of the ethanol decomposition pathway in the human body, particularly alcohol dehydrogenase (ADH, in the development of alcohol dependence. Among five classes of alcohol dehydrogenases, class I and IV isoenzymes have been found to be associated with alcohol dependence. Class IV is of particular interest due to its occurrence in the upper gastrointestinal tract, mainly in the stomach. No activity of the enzyme has been demonstrated in the liver. Single nucleotide polymorphism (SNP of the gene encoding ADH class IV (ADH7 affects its ethanol-oxidizing activity in the gastric lumen, thereby influencing the first-pass metabolism (FPM of the substance. The findings published by various research centres have demonstrated that specific SNP changes in the ADH7 gene are of different significance for the risk of alcohol dependence according to the population studied.

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

    Science.gov (United States)

    Kravos, Matej; Malesic, Ivan; Levanic, Suzana

    2005-11-01

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

  18. 戒毒片合并电厌恶疗法治疗酒依赖68例疗效观察%A Study of Rapid Detoxification Tablets and Electric Aversion Therapy in Treatiny 68 Alcohol Dependence Patients

    Institute of Scientific and Technical Information of China (English)

    胡福生; 刘庆梅

    2001-01-01

    目的观察戒毒片合并电厌恶疗法对酒依赖的治疗效果。方法选择符合CCMD-2-R酒依赖诊断标准的68例男性患者,入院后先给予促大脑代谢药物和戒毒片治疗一周,然后进行电厌恶治疗,每日或隔日一次,连续7~10次。结果 68例患者经上述方法治疗均达痊愈。一年后随访戒酒成功率为92.79%。结论戒毒片合并电厌恶疗法治疗酒依赖可加速体内酒精代谢产物排泄,改善营养状况,建立厌恶条件反射,方法可靠。%Objective To observe the effect of rapid detoxification tablets and electric aversion therapy in treating alcohol dependence. Methods 68 male patients with a CCMD-Ⅱ-R diagnosis of alcohol dependence were treated with the drug promoting the brain supersession and rapid detoxification tablets for one week, then gave themelectric aversion therapy, once a day or two days, keeping 7-10 times. Results All patients were fully recovered,one year later,92.79% of them were successful. Conclusion The effects were very good with rapid detoxifcation tablets and electric aversion therapy in treating alcohol dependence, this method can be popularized in practice.

  19. Val158Met COMT polymorphism and risk of aggression in alcohol dependence.

    Science.gov (United States)

    Soyka, Michael; Zill, Peter; Koller, Gabi; Samochowiec, Agnieszka; Grzywacz, Anna; Preuss, Ulrich W

    2015-01-01

    Aggression, violence and antisocial behavior are common in alcoholism, but their biological basis is poorly understood. Several studies and recent meta-analyses indicate that in schizophrenia the catecholamine-O-methyltransferase (COMT) Val158Met genotype may be associated with aggression, most often in methionine allele carriers. We tested this hypothesis in a sample of treatment-seeking alcohol-dependent in-patients (293 German patients and 499 controls, and additional 190 Polish patients as replication sample). As expected, patients with a history of violent or non-violent crime were more often male, had an earlier onset of alcoholism and more withdrawal seizures and delirium tremens, and were more likely to have a history of suicide attempts. COMT genotype was not associated with a history of violent or non-violent crime. More studies are needed on the neurobiological basis of aggression and violence in alcoholism.

  20. Analysis of psychological defense mechanism and personality character in patients with alcohol dependence%酒依赖患者心理防御机制及人格特征的分析

    Institute of Scientific and Technical Information of China (English)

    何伟健

    2013-01-01

    目的:探讨酒依赖患者心理防御机制和人格特征. 方法:64例酒依赖患者于人院治疗2周后完全戒断酒精及躯体不适消除后运用防御方式问卷(DSQ)及艾森克个性问卷(EPQ)分别评定其防御机制及人格类型,并与129名健康对照者比较. 结果:酒依赖患者心理防御机制为不成熟及中间型;EPQ精神质和神经质评分显著高于正常对照者(P<0.05或P<O.01);不成熟及中间型防御机制与EPQ精神质和神经质评分正相关. 结论:酒依赖患者可能存在不良人格,其与不成熟防御机制相互关联.%Objective:To explore the psychological defense mechanism and personality character in patients with alcohol dependence.Method:After 2 weeks treatment in hospital,the 64 patients with alcohol dependence were completely eliminated withdrawal after alcohol and body discomfort.Then,the psychological defense mechanism and personality type were assessed by defense style questionnaire (DSQ) and Eysenck personality questionnaire (EPQ).The results were compared with 129 normal controls.Results:The psychological defense mechanisms in the patients were immature type and middle type.The scores of psychoticism and neuroticism of EPQ were significantly higher than normal controls (P < 0.05 or P < 0.01).The styles of immature and middle psychological defense mechanisms were positively correlated to the scores of psychoticism and neuroticism in EPQ.Conclusion:The patients with alcohol dependence may have ill-personality; which correlated with immature defense mechanism.

  1. Coping Styles and Alcohol Dependence among Homeless People

    Science.gov (United States)

    Opalach, Cezary; Romaszko, Jerzy; Jaracz, Marcin; Kuchta, Robert; Borkowska, Alina; Buciński, Adam

    2016-01-01

    Background and Objectives The ways in which homeless individuals cope with stress may differ from those relied upon by the members of the general population and these differences may either be the result or the cause of their living conditions. The aim of the study was to determine the preferred coping style among the homeless and its relationship with alcohol dependence. Methods The study included 78 homeless individuals and involved the collection of demographic, sociological, psychological and medical data from each participant. Coping styles relied upon when dealing with stressful situations were assessed using a Polish adaptation of the Coping Inventory for Stressful Situations. Alcohol dependence was assessed using the Michigan Alcoholism Screening Test (MAST) and a quantitative analysis of alcohol consumption. Results Men accounted for 91.93% of the study population. Nearly 75% of the subjects met the alcohol dependence criterion. Significant relationships were observed between the individual's age, preferred coping style and alcohol consumption level. As an individual’s age increased, the use of emotion-oriented coping styles decreased, while an increase in alcohol consumption was associated with a more frequent use of emotion- and avoidance-oriented strategies. Conclusions The findings of this study, similarly to those of many other studies of homeless individuals but investigating other areas (e.g. epidemiology of tuberculosis and traumatic injuries), are an exaggerated representation of associations observed in the general population. The results describe a group of people living on the margins of the society, often suffering from extremely advanced alcoholism, with clear evident psychodegradation. The presence of specific ways of coping with stress related to excessive alcohol consumption in this group of individuals may interfere with active participation in support programmes provided for the homeless and may further exacerbate their problems. PMID

  2. Physiopathological and therapeutical correlations in alcohol dependence.

    Science.gov (United States)

    Szalontay, Andreea Silvana

    2014-01-01

    No doubt, alcoholism represents nowadays the toxicomany with the highest expansion rate among all population groups, being recognized by the specialists from the medical, social, economic and legal field as a true "toxic pandemy". Researchers consider ethanol, this small but highly aggressive molecule, to have supremacy if we were to consider the number of pages dedicated to it worldwide on daily bases, in the medical or any other specialty literature. Nonetheless, the large volume of data regarding ethanol toxicity does not seen to simplify things, on the contrary it points out new information about the its negative effects on human body. Ethanol represents a toxic that is rapidly and completely absorbed in the intestinal tract being distributed to most tissues and organs; ethanol is recognized as an enzymatic inductor of its own metabolization but also of the metabolization of numerous therapeutic agents.

  3. Family dysfunction differentially affects alcohol and methamphetamine dependence: a view from the Addiction Severity Index in Japan.

    Science.gov (United States)

    Sugaya, Nagisa; Haraguchi, Ayako; Ogai, Yasukazu; Senoo, Eiichi; Higuchi, Susumu; Umeno, Mitsuru; Aikawa, Yuzo; Ikeda, Kazutaka

    2011-10-01

    We investigated the differential influence of family dysfunction on alcohol and methamphetamine dependence in Japan using the Addiction Severity Index (ASI), a useful instrument that multilaterally measures the severity of substance dependence. The participants in this study were 321 male patients with alcohol dependence and 68 male patients with methamphetamine dependence. We conducted semi-structured interviews with each patient using the ASI, which is designed to assess problem severity in seven functional domains: Medical, Employment/Support, Alcohol use, Drug use, Legal, Family/Social relationships, and Psychiatric. In patients with alcohol dependence, bad relationships with parents, brothers and sisters, and friends in their lives were related to current severe psychiatric problems. Bad relationships with brothers and sisters and partners in their lives were related to current severe employment/support problems, and bad relationships with partners in their lives were related to current severe family/social problems. The current severity of psychiatric problems was related to the current severity of drug use and family/social problems in patients with alcohol dependence. Patients with methamphetamine dependence had difficulty developing good relationships with their father. Furthermore, the current severity of psychiatric problems was related to the current severity of medical, employment/support, and family/social problems in patients with methamphetamine dependence. The results of this study suggest that family dysfunction differentially affects alcohol and methamphetamine dependence. Additionally, family relationships may be particularly related to psychiatric problems in these patients, although the ASI was developed to independently evaluate each of seven problem areas.

  4. Personality traits of problem gamblers with and without alcohol dependence.

    Science.gov (United States)

    Lister, Jamey J; Milosevic, Aleks; Ledgerwood, David M

    2015-08-01

    A large proportion of individuals with gambling disorder also present with a history of alcohol dependence, but few studies have directly examined the relationship between these two conditions. This study's primary and secondary aims were to 1) examine the relationship of personality traits to co-occurring lifetime (current/past) alcohol dependence status, while 2) accounting for differences in gambling characteristics and co-occurring psychiatric disorders among problem/pathological gamblers recruited from the community. Problem/pathological gamblers (N=150) completed measures of personality traits and gambling characteristics (e.g., gambling severity, gambling involvement, delayed discounting of monetary rewards), and were clinically interviewed for co-occurring psychiatric disorders. A co-occurring lifetime diagnosis of alcohol dependence (n=61, 40.7%) was associated with lower personality scores for Control, Well-Being, Achievement, Traditionalism, and Harm Avoidance, as well as higher scores for Alienation (Tellegen & Waller, 1994) in bivariate analyses. Problem/pathological gamblers with lifetime alcohol dependence reported greater lifetime gambling severity, greater past-year gambling involvement, steeper delayed discounting, and a greater likelihood of current and lifetime substance dependence, lifetime antisocial personality disorder, and current unipolar mood disorders. Multivariate analyses indicated that lower Control, Traditionalism, and Well-Being and a co-occurring lifetime substance dependence diagnosis best accounted for a co-occurring lifetime alcohol dependence diagnosis in problem/pathological gamblers. Problem/pathological gamblers with co-occurring lifetime alcohol dependence demonstrate addictive behavior across multiple domains and report a personality style characterized by hopelessness, impaired control, and resistance to externally-motivated treatment approaches. Implications for the treatment of these complex cases are discussed

  5. Relation between plasma homocysteine and cognitive impairment of patients with alcohol dependence%酒依赖患者血浆Hcy水平与认知功能障碍的关系

    Institute of Scientific and Technical Information of China (English)

    谭秀丽; 胡建

    2015-01-01

    Objective To discuss the change of plasma homocysteine (Hcy) levels in alcohol de‐pendence patients and the relationship between Hcy levels and cognitive impairment .Methods The plas‐ma Hcy levels in alcohol dependence group and control group were examined with enzyme-linked immu‐no -sorbent assay(ELSIA) .The cognitive functions were assessed by using the modified Wisconsin Card Sorting Test (M -WCST) ,visual reproduction and the logical memory test .Results The Hcy levels in alcohol dependence group 7 .200(6 .595 ,8 .940)μmol/l were significantly higher than those in the control group 5 .905(5 .063 ,6 .630)μmol/l (P < 0 .01) .The alcohol dependence group had significantly poor performance in the correct responses and numbers of categories ,perseverative errors and non-persever‐ative errors of M -WCST compared with control group (P< 0 .05);Both of the scores of the visual re‐production and the logical memory test had significantly lower in the alcohol dependence group than those in the control group (P < 0 .01) .The Hcy levels negatively correlated with the numbers of correct re‐sponses of M -WCST in the alcohol dependence group (r = -0 .59 383 ,P < 0 .01) ,but the positively correlated with the numbers of total errors ,perseverative errors and non -perseverative errors (r =0.590 59 ,0 .728 51 ,0 .354 68 ,respectively ;P < 0 .01) .Both of the scores of the visual reproduction (r =-0 .437 24 ,P < 0 .05 ,) and the logical memory test (r= -0 .409 87 ,P< 0 .05) had significantly nega‐tive correlation with the Hcy levels in alcohod dependence group .Conclusions The Hcy levels were high‐er in alcohol dependence patients compared to the healthy controls .The alcohol dependence patients dem‐onstrate impairments in cognition .The Hcy level may be a indicator to assess the degree of the cognitive impairments of the alcohol dependence patients .%目的:探讨酒依赖患者血浆同型半胱氨酸(Hcy)水平与健康人群的区别及其与酒依赖

  6. [Comparison between alcoholic patients and primary care patients for the use of the ambulance].

    Science.gov (United States)

    Ino, Aro; Yoshimoto, Hisashi; Mizutani, Naomi; Kato, Naohisa; Hirohuji, Hideo; Takemura, Yousuke C

    2013-10-01

    Though heavy drinkers and patients with alcohol dependence make use of the ambulance more frequently as compared with the general population, there are few data on the alcohol-related use of the emergency department (ED) in Japan. A cross sectional study was conducted. 170 patients with alcohol dependence in one clinic and 306 primary care patients across two clinics provided demographic data and answered some questions about the use of emergency ambulance services over the age of 20. The questions asked included whether use of the ambulance caused injuries, as well as AUDIT-C (primary care patients only). In this study, multiple logistic regression analysis was used. The use of emergency ambulance services by patients with alcohol dependence was 4.68 times more than primary care patients, and the occurrence of ambulance-caused injuries was 6.03 times higher, as determined by multiple logistic regression. Among primary care patients, AUDIT-C positive patients (male; 5 points or more, female; 3 points or more) were 37 (12.2%), and the occurrence of ambulance-caused injuries was 3.32 times higher. Like with other countries, in Japan, heavy drinkers and patients with alcohol dependence lead to a significant increase in the use of emergency ambulance services as well as ambulance-caused injuries.

  7. Association between insulin and executive functioning in alcohol dependence: a pilot study.

    Science.gov (United States)

    Han, Changwoo; Bae, Hwallip; Won, Sung-Doo; Lim, Jaeyoung; Kim, Dai-Jin

    2015-01-01

    Alcohol dependence is a disorder ascribable to multiple factors and leads to cognitive impairment. Given that insulin dysregulation can cause cognitive impairment, patients with alcohol dependence are likely to develop insulin dysregulation such as that in diabetes. The purposes of this study are to identify an association between cognitive functioning and insulin and to investigate insulin as the biomarker of cognitive functioning in alcohol-dependent patients. Serum insulin levels were measured and cognitive functions were assessed in 45 patients with chronic alcoholism. The Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K), a battery of cognitive function tests, was used to assess cognitive functioning. Serum insulin levels were not significantly correlated with most CERAD-K scores, but there was a significant negative correlation with scores on the Trail Making Test B, which is designed to measure executive functioning. Lower serum insulin levels were associated with slower executive functioning responses on the Trail Making Test B, suggesting that executive functioning may be in proportion to serum insulin levels. Thus, in patients with alcohol dependence, insulin level is associated with cognitive functioning. In addition, the present findings suggest that insulin level is a potential biomarker for determining cognitive functioning.

  8. A Seizure Attributed to Ofloxacine in a Woman Undergoing Detoxification for Alcohol Dependence

    Directory of Open Access Journals (Sweden)

    Pierre Lahmek

    2009-01-01

    Full Text Available Objective. To report one case of seizure following administration of ofloxacin. Case Summary. A 38-year-old woman with alcohol dependence but no prior history of seizure disorder admitted in our inpatient alcohol detoxification program was prescribed ofloxacin four days after admission for a lower urinary tract infection. She was currently prescribed diazepam 30 mg per day. This treatment was continued without modification following admission. Forty eight hours after starting ofloxacin and after receiving five doses of oral ofloxacin, the patient experienced a seizure. Ofloxacin treatment was stopped and no further seizures occurred. Neurological examination of the patient, laboratory tests, computerized tomography with contrast enhancement and electroencephalography did not detect any abnormalities. Up to the last consultation, six months after admission, the patient has reported no recurrence of the seizure. Discussion. Quinolone antibiotics vary in their ability to induce seizures, with ofloxacin having one of the least potentials. In the present case, the seizure could be attributed in all probability to taking ofloxacin; since she had no previous history of seizures, she did not present an alcohol withdrawal syndrome, benzodiazepine treatment was not modified, the seizure occurred 48 h after taking ofloxacin, but seven days after stopping drinking, no alternative aetiologies for the seizure could be identified and no seizure recurrence was reported over the following seven months. Of reported cases of seizures in patients treated with fluoroquinolones, none concerned patients with alcohol dependence or patients treated with benzodiazepines. Conclusions. The present case alerts us to the possibility that seizures may occur in alcohol dependent patients treated with benzodiazepines who concomitantly prescribed a fluoroquinolone. These widely-used antibiotics should thus be prescribed with caution to patients undergoing detoxification for

  9. Alcohol withdrawal syndrome in admitted trauma patients.

    Science.gov (United States)

    Jawa, Randeep S; Stothert, Joseph C; Shostrom, Valerie K; Yetter, Diane L; Templin, Heather R; Cemaj, Samuel K; Lander, Lina; Forse, Armour R; Young, David H

    2014-11-01

    As alcohol use is highly prevalent in trauma patients, we hypothesized that a significant proportion of hospitalized trauma patients would demonstrate alcohol withdrawal (AW). The trauma registries at a joint trauma center system from 1999 to 2008 were evaluated for patients aged at least 16 years. Of 19,369 trauma admissions, 159 patients had AW. Blood alcohol concentration (BAC) testing was performed in 31.5% of the patients. BAC was significantly higher in AW patients versus other traumas (205.7 ± 130.1 vs 102.9 ± 121.7 mg/dL). BAC was 0 in 14.4% of AW patients. As compared with other trauma patients, patients with AW had a significantly greater age (50.2 vs 42.1 years), hospital length of stay (10 vs 3 days), intensive care unit length of stay (2 vs 0 days), need for mechanical ventilation (34% vs 12.7%), and pneumonia (12% vs 2.3%). AW patients were less frequently discharged to home (59.8% vs 69.9%). Mortality was not different. AW was diagnosed in few patients. Of note, it occurred in patients with an initial BAC of 0. AW is associated with adverse outcomes. Published by Elsevier Inc.

  10. Nutritional profile of asymptomatic alcoholic patients

    Directory of Open Access Journals (Sweden)

    Maria Beatriz Sobral-Oliveira

    2011-06-01

    Full Text Available CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls. METHODS: Subjects (n = 60 were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001, with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04, but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01. CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.

  11. Salivary alcohol dehydrogenase in non-smoking and smoking alcohol-dependent persons.

    Science.gov (United States)

    Waszkiewicz, Napoleon; Jelski, Wojciech; Zalewska, Anna; Szulc, Agata; Szmitkowski, Maciej; Zwierz, Krzysztof; Szajda, Sławomir Dariusz

    2014-09-01

    Increasing attention to the importance of saliva testing is not surprising because smoking and alcohol drinking act synergistically on oral tissues, and their metabolite levels, e.g., acetaldehyde, are much higher in saliva than in blood. The activity of salivary alcohol dehydrogenase (ADH) comes from oral microbiota, mucosa, and salivary glands. The purpose of this study was to investigate the involvement of ADH in the oral health pathology of smoking (AS) and non-smoking (ANS) alcohol-dependent males. The results indicated that the AS group had a more significant and longer duration (until the 30th day of alcohol abstinence) decrease in ADH activity and output than the ANS group (until the 15th day of alcohol abstinence) compared to controls (social drinkers; C). The decreased salivary flow (SF) in alcoholics was observed longer in the ANS group (until the 30th day of alcohol abstinence), whereas in the AS group SF normalized at the 15th day, probably due to the irritating effect of tobacco smoke on the oral mucosa. Because saliva was centrifuged to remove cells and debris (including microbial cells), the detected salivary ADH activity was derived from salivary glands and/or oral mucosa. A more profound and longer decrease in ADH activity/output in smoking than non-smoking alcoholics was likely due to the damaged salivary glands and/or oral mucosa, caused by the synergistic effect of alcohol drinking and smoking. The lower values of salivary ADH in smoking than non-smoking alcoholics might also be partly due to the reversed/inhibited ADH reaction by high levels of accumulated acetaldehyde.

  12. Investigation of attentional bias to word-related cues in male alcohol dependent patients%男性酒依赖患者戒酒初期对汉字线索注意偏向相关研究

    Institute of Scientific and Technical Information of China (English)

    庞良俊; 尹良爽; 朱春燕; 汪咏梅; 董文文; 戴兢; 杨琪; 孙刚强; 黄豹

    2012-01-01

    目的 探讨戒酒初期男性酒依赖患者( alcohol dependence,AD)注意偏向特点及与相关因素.方法 选取30例戒酒初期的男性AD患者以及与其人口学资料相匹配的37例健康对照组(HC)作为研究对象,采用中文情绪词stroop实验进行注意偏向的测试.结果 AD组在中性词、负性词、线索词的反应时[分别为(1382.13±323.38)ms,( 1365.76±313.03) ms,(1433.20±342.23)ms],高于HC组[分别为(797.27±216.97)ms,(794.11±209.41 )ms,(799.40±215.82)ms],差异有统计学意义(t=8.827,P<0.001;t=8.922,P<0.01;t =9.234,P<0.01);AD组对中性词、负性词的错误数[(3.70±2.56)次,(4.23±2.53)次],高于HC组[(2.11±1.87)次,(1.92±1.82)次],差异有统计学意义(t=2.939,P=0.005;t=4.355,P<0.01);在线索词错误数方面差异无统计学意义;酒相关线索词的注意偏向与首次饮酒年龄存呈负相关(P<0.05),与持续饮酒时间及抑郁自评量表得分呈正相关(P<0.05);成瘾年龄和焦虑自评量表总分进入回归方程.结论 戒酒初期男性AD患者对酒相关线索具有显著的注意偏向,这可能与犒赏中枢的异常激活有关.%Objective To explore the attentional biases in male alcohol dependent (AD) patients and the correlations between the attentional bias and alcohol-related factors.Methods A total of 30 recently detoxified male individuals with alcoholism were compared with 37 healthy controls ( HC ) on the Chinese Emotional Stroop Task using negative,neutral,and alcohol-related words.Results The comparison between AD group( ( 1382.13 ±323.38) ms,( 1365.76 ±313.03)ms,( 1433.20 ±342.23) ms,respectively) and HC group( (797.27 ±216.97)ms,( 794.11 ± 209.41 ) ms,(799.40 ± 215.82 ) ms respectively) on the reaction time of neutral,negative and alcohol-related words were significant ( t =8.822,P < 0.001 ; t =8.922,P < 0.001 ; t =9.234,P < 0.001 ).The error number of of the neutral and negative- related words of the patients ( ( 3

  13. Preventive Effects of Forced Exercise against Alcohol-induced Physical Dependency and Reduction of Pain Perception Threshold

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    Majid Motaghinejad

    2014-01-01

    Full Text Available Background: Treatment of postabstinence syndrome of alcohol is one of the major strategies of alcoholism treatment. Exercise can be modulated major brain pathways such as a reward system and pain perception centers. The aim of this study was to evaluation the effects of forced exercise in the management of alcohol dependence and pain perception alteration which induced by alcoholism. Methods: 72 adult male rats were divided into 2 major groups: (1 40 of them was divided into groups of positive control (alcohol dependent negative control and alcohol dependent groups under treatment by forced exercise, diazepam (0.4 mg/kg and forced exercise in combination with diazepam and alcohol withdrawal signs, and blood cortisols, were measured in this groups. (2 32 rats were divided into control, alcohol dependent (without treatment, and alcohol-dependent groups under treatment by forced exercise or indometacin (5 mg/kg and then pain perception was assessed by using writhing test, tail-flick and hot plate test. Results: Forced exercise, diazepam, and their combinations significantly attenuates withdrawal syndrome to 20 ± 2, 22 ± 1.3 and 16 ± 2 and blood cortisol level to 6.8 ± 1.3,7.9 ± 1.2 and 5.8 ± 1.1, respectively, in comparison with the positive control group (P < 0.05 and P < 0.001. In alcohol dependent animal under treatment by forced exercise, pain response significantly inhibited with 37%, 57% and 38% decreases in writhing test, hot plate, and tail-flick test, respectively, in comparison with alcohol dependent (without treatment group (P < 0.05. Conclusions: This study suggested that forced exercise can be useful as adjunct therapy in alcoholism patient and also can be effective in modulation of pain threshold reduction that was induced by alcohol dependency.

  14. Dissociation of "conscious desire" (craving) from and relapse in alcohol and cocaine dependence.

    Science.gov (United States)

    Miller, N S; Gold, M S

    1994-06-01

    Treatment of withdrawal and postabstinence craving has yielded mixed results in eliminating drug and alcohol use, improving outcomes, and reducing relapse in those patients addicted to alcohol and drugs. To assess the role of "conscious desire" (or craving) for drugs/alcohol during abstinence and withdrawal in continued addictive drug and alcohol use, we analyzed data from 1626 patients voluntarily admitted to a primary rehabilitation center in Minnesota. Eighty-one percent and 71% of all patients completed surveys at 6 and 12 months following discharge. Forty-two percent were diagnosed as alcohol dependent (AD) alone, 28% as alcohol and drug dependent (ADD) other than cocaine, and 25% as cocaine dependent (CD). At 6 months following discharge, the CD group had the lowest abstinence rate for drugs, at 83%, compared to the AD group, at 99%, and for alcohol, at 76%, compared to the AD group, at 75%. The AD group had the best outcomes and the least slippage from 6 to 12 months for drugs and alcohol. In all groups craving was not a major self-reported cause of relapse. For the CD subgroup, impulsive action with no known cause was the most common reason for relapse, while the AD group cited depression. These data agree with other reports in the literature suggesting that relapse is not commonly related to conscious craving. Our experience suggests that craving is rarely the first reason given for relapse. Drug seeking and use are such highly ritualized, automatic behaviors that the addict may appear not to require the intervention of conscious thoughts or distinct craving states to use.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. 地西泮联合小剂量阿立哌唑治疗酒依赖患者的疗效观察%The clinical effect observation of diazepam combined with aripiprazole in patients with alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    高晓奇; 冯芳; 刘艳江; 石秀华; 李克松; 张国辉

    2014-01-01

    目的:观察地西泮联合小剂量阿立哌唑治疗酒依赖患者的临床效果。方法将144例酒依赖患者随机分为治疗组和对照组各72例。2组均接受常规治疗,治疗组在常规治疗基础上加服阿立哌唑治疗,对比2组治疗前后戒断症状评分。结果2组治疗前戒断症状评分差异无统计学意义(P>0.05)。治疗后2组戒断症状评分均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论地西泮联合小剂量阿立哌唑治疗酒依赖患者疗效较好,且起效时间短,不良反应轻微,值得推广应用。%Objective To observe the clinical efficacy of diazepam combined with aripiprazole in patients with alcohol dependence .Methods 144 cases patients with alcohol dependence were divided into treatment group and control group ,each of 72 cases.The 2 groups were treated by conventional treatment .Treatment group,on the basis of conventional treatment ,was treated by diazepam combined with aripiprazole .After treatment,compared the withdrawal symptoms score of 2 groups.Results Before treatment,the withdrawal symptoms score of 2 groups was no statistically significant (P>0.05).After treatment,the with-drawal symptoms score of 2 groups were less than that of control group ,and the withdrawal symptoms score of treatment group was less than that of control group ,the difference was statistically significant ( P<0.05) .Conclusion Diazepam combined with arip-iprazole in patients with alcohol dependence has an good efficacy ,less adverse reactions ,and worthy of application .

  16. 电话干预对酒依赖患者出院后饮酒频率的影响%Influences of telephone intervention on post-discharge drinking f requency of alcohol dependence patients

    Institute of Scientific and Technical Information of China (English)

    瞿淑雯

    2014-01-01

    目的:探讨电话干预对酒依赖患者出院后饮酒频率的影响。方法将69名酒依赖患者分为两组,研究组33例,对照组36例。出院后每周电话联系评定患者周饮酒次数,研究组同时予以电话干预。观察12周。比较两组出院后的饮酒频率。结果出院第8周及12周,两组饮酒频率均较出院第4周显著升高(P<0.01);同期两组间比较,出院第8周研究组显著低于对照组(P<0.05),其他时段两组比较差异无显著性(P>0.05)。结论电话干预对酒依赖者的饮酒频率仅有短期的影响。%Objective To explore the influences of telephone intervention on post-discharge drinking frequency of alcohol dependence patients .Methods Sixty-nine alcohol dependence pa-tients were assigned to research (n=33) and control group (n=36) .Drinking times were evaluated with telephone weekly after discharge ,meanwhile research group received telephone intervention .They were observed for 12 weeks .Drinking frequencies of 2 groups were compared .Results In the 8th and 12th week after discharge drinking frequencies of both groups heightened more significantly compared with the 4th week (P0 .05) .Conclusion Tele-phone intervention has only short-term influence on drinking frequency of alcohol dependence patients .

  17. MORTALITY FROM SUICIDE AND ALCOHOLISM, DEPENDING ON THE LEVEL OF ALCOHOL CONSUMPTION

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    L. A. Radkevich

    2017-01-01

    Full Text Available According to WHO, the world takes place every year approximately 500 000 suicides and suicide attempts of 7 million. Since 1994, Russia ranks 2nd in the world after Lithuania, in the level of suicides, and is among the countries with the linear dependence of frequency of suicides on the level of alcohol consumption.Purpose. Install a quantitative connection between the frequency of suicide with alcohol consumption and mortality from alcoholism in the world.Material and method. For studies we used the mortality coefficient (MK from suicide and alcohol abuse (number of people/100 thousand of age standardized the population in 159 countries according to the WHO in 2004, the average daily consumption levels of alcoholic beverages: spirits, wine and beer (g/person/day according to the FAO (Food and Agriculture Organization of the United Nations. For data analysis we used correlation and regression methods.Results. We found significant positive correlation of mortality coefficient (MK from suicide for men and women with consumption of alcoholic beverages (spirits, wine and beer and mortality from alcoholism. The gender differences are revealed. Included in the regression model independent variables (levels of alcohol consumption and mortality from alcoholism explain 66% and 52% of the variability in the frequency of suicides of men and women (dependent variables. A complete rejection of the consumption of alcohol reduces the MK from suicide of men in the world at 39.5 percent, in Russia — at 76.5%; women — 37.9%, in Russia — by 54.3%. According to the regression analysis the average daily level of consumption of strong alcohol in the world is 10.4 g (3.8 kg per year for men, in Russia — 91.8 g (of 33.5 kg per year. The increase in the consumption of strong alcohol to 3 g per day (1 kg per year increases the MK from suicide in men up to 10.8% (1.6 people in the world, in Russia — 2.4% (1.6 people. The increase in the MK of alcoholism of men

  18. Codependency in families with alcohol-dependent persons

    OpenAIRE

    2010-01-01

    The article describes codependence problem in families with alcohol-dependent persons. Examination of author is based on observation of 15 families. The author argues that effective treatement of codependency appears when provided the integration of psychocorrectional, psychoterapeutic and biological (psychopharmacological) methods of influence.

  19. Codependency in families with alcohol-dependent persons

    Directory of Open Access Journals (Sweden)

    Aida Tolstikova

    2010-07-01

    Full Text Available The article describes codependence problem in families with alcohol-dependent persons. Examination of author is based on observation of 15 families. The author argues that effective treatement of codependency appears when provided the integration of psychocorrectional, psychoterapeutic and biological (psychopharmacological methods of influence.

  20. Delusional parasitosis with alcohol dependence: A case report

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    Nahid Dave, Austin Fernandes, Anup Bharati, Avinash De Sousa

    2014-04-01

    Full Text Available Delusional parasitosis is a syndrome with which most psychiatrists are familiar. However, most reports consist of case reports or small series. We present here a case report of delusional parasitosis of an extremely bizarre nature in a case of alcohol dependence that responded to pimozide, haloperidol and electroconvulsive therapy (ECT.

  1. Animal models of alcohol and drug dependence

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    Cleopatra S. Planeta

    2013-01-01

    Full Text Available Drug addiction has serious health and social consequences. In the last 50 years, a wide range of techniques have been developed to model specific aspects of drug-taking behaviors and have greatly contributed to the understanding of the neurobiological basis of drug abuse and addiction. In the last two decades, new models have been proposed in an attempt to capture the more genuine aspects of addiction-like behaviors in laboratory animals. The goal of the present review is to provide an overview of the preclinical procedures used to study drug abuse and dependence and describe recent progress that has been made in studying more specific aspects of addictive behavior in animals.

  2. Association between insulin and executive functioning in alcohol dependence: a pilot study

    Directory of Open Access Journals (Sweden)

    Han C

    2015-11-01

    Full Text Available Changwoo Han,1 Hwallip Bae,2 Sung-Doo Won,3 Jaeyoung Lim,3 Dai-Jin Kim41Department of Psychiatry, Ansan Hospital, College of Medicine, Korea University, Ansan, 2Department of Psychiatry, Myongji Hospital, College of Medicine, Seonam University, Goyang, 3Department of Clinical Psychology, Keyo Hospital, Keyo Medical Foundation, Uiwang, 4Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaAbstract: Alcohol dependence is a disorder ascribable to multiple factors and leads to cognitive impairment. Given that insulin dysregulation can cause cognitive impairment, patients with alcohol dependence are likely to develop insulin dysregulation such as that in diabetes. The purposes of this study are to identify an association between cognitive functioning and insulin and to investigate insulin as the biomarker of cognitive functioning in alcohol-dependent patients. Serum insulin levels were measured and cognitive functions were assessed in 45 patients with chronic alcoholism. The Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K, a battery of cognitive function tests, was used to assess cognitive functioning. Serum insulin levels were not significantly correlated with most CERAD-K scores, but there was a significant negative correlation with scores on the Trail Making Test B, which is designed to measure executive functioning. Lower serum insulin levels were associated with slower executive functioning responses on the Trail Making Test B, suggesting that executive functioning may be in proportion to serum insulin levels. Thus, in patients with alcohol dependence, insulin level is associated with cognitive functioning. In addition, the present findings suggest that insulin level is a potential biomarker for determining cognitive functioning.Keywords: insulin, alcohol dependence, executive function, trail making test

  3. 长期危险饮酒对酒精依赖者心血管功能的影响%Influence of long hazardous drinking on cardiovascular function among alcohol dependent patients

    Institute of Scientific and Technical Information of China (English)

    黄鹏; 王达平; 刘榴; 余晓仪; 李福球

    2016-01-01

    Objective To identify the effect of long hazardous drinking on cardiovascular function and cardiovascu⁃lar abnormalities among alcohol dependent patients. Methods A follow-up survey was conducted, 72 potential patients who were diagnosed as having alcohol dependence were recruited into case group and 75 staff who underwent routine health examination were subjected into control group. Furthermore, 52 patients were subdivided into long hazardous drinking group (GroupⅠ) according to the classification of alcohol consumption published by WHO. The rest patients in the case group were considered as not long hazardous drinkers (GroupⅡ). The blood lipid data, echocardiography and ca⁃rotid artery brachial artery ultrasonography measurement data were compared between the three groups. The high risk fac⁃tors for cardiovascular abnormalities among alcohol dependence patients were analyzed. And one year after discharge, telephone follow-up method was used to obtain the incidence of cardiovascular accident among patients. Results The dis⁃tribution of blood lipid data among GroupⅠ, Ⅱ and control group were not significantly different (P>0.05). The LVEF score in GroupⅠwas significantly lower than that in control group (P0.05)。长期危险饮酒组患者左心射血分数低于对照组(P<0.01),左房主动排空分数高于非长期危险饮酒组及对照组(P<0.05),肱动脉内皮舒张功能、颈动脉内膜中层厚度低于对照组(P<0.05)。所有患者饮酒年限与左房被动排空分数(r=-0.246,P=0.014)、左房主动排空分数(r=-0.239,P=0.016)呈负相关,平均每日饮酒量与左心射血分数呈正相关(r=0.256,P=0.010),与肱动脉内皮舒张功能呈负相关(r=-0.256,P=0.010)。多因素logistic回归分析示,酒精依赖患者发生心血管意外与年龄(OR=1.102,95%CI:1.020~1.191)、长期危险饮酒(OR=1.334,95%CI:1.060~1.678)有关联(P<0.05

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  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. Naltrexone depot formulations for opioid and alcohol dependence: a systematic review.

    Science.gov (United States)

    Lobmaier, Philipp P; Kunøe, Nikolaj; Gossop, Michael; Waal, Helge

    2011-12-01

    Naltrexone is an opioid receptor antagonist that blocks the reinforcing effects of opioids and reduces alcohol consumption and craving. It has no abuse potential, mild and transient side effects, and thus appears an ideal pharmacotherapy for opioid dependence. Its effectiveness in alcohol dependence is less evident, but compliance with naltrexone combined with psychosocial support has been repeatedly shown to improve drinking outcomes. Limited compliance with oral naltrexone treatment is a known drawback. Several naltrexone implant and injectable depot formulations are being investigated and provide naltrexone release for at least 1 month. Studies among opioid-dependent patients indicate significant reductions in heroin use, but sample sizes are usually small. In alcohol dependence, two large multicenter trials report alcohol and craving reductions for naltrexone and placebo groups, indicating a significant but moderate effect. The pharmacokinetic profile of the injectable formulation indicates reliable naltrexone release over 1 month at therapeutic levels. Implant formulations releasing naltrexone up to 7 months are reported. Findings on safety and tolerability confirm the generally mild adverse effects described for naltrexone tablets. However, further research on therapeutic levels (i.e., opioid blocking) is warranted. The majority of naltrexone implants lacks approval for regular clinical use and larger longitudinal studies are needed. The available naltrexone depot formulations have the potential to significantly improve medication compliance in opioid and alcohol dependence. In certain circumstances, they may constitute a promising new treatment option. © 2010 Blackwell Publishing Ltd.

  7. Cue reactivity and its relation to craving and relapse in alcohol dependence: a combined laboratory and field study

    NARCIS (Netherlands)

    J. Witteman; H. Post; M. Tarvainen; A. de Bruijn; E. De Sousa Fernandes Perna; J.G. Ramaekers; R.W. Wiers

    2015-01-01

    The present study investigated the nature of physiological cue reactivity and craving in response to alcohol cues among alcohol-dependent patients (N = 80) who were enrolled in detoxification treatment. Further, the predictive value with regard to future drinking of both the magnitude of the physiol

  8. Prevalence of intestinal nematodes in alcoholic patients

    Directory of Open Access Journals (Sweden)

    Zago-Gomes Maria P.

    2002-01-01

    Full Text Available We report the results of a retrospective study on the frequency of intestinal nematodes among 198 alcoholic and 440 nonalcoholic patients at the University Hospital Cassiano Antonio Moraes in Vitória, ES, Brazil. The control sample included 194 nonalcoholic patients matched according to age, sex and neighborhood and a random sample of 296 adults admitted at the same hospital. Stool examination by sedimentation method (three samples was performed in all patients. There was a significantly higher frequency of intestinal nematodes in alcoholics than in controls (35.3% and 19.2%, respectively, due to a higher frequency of Strongyloides stercoralis (21.7% and 4.1%, respectively. Disregarding this parasite, the frequency of the other nematodes was similar in both groups. The higher frequency of S. stercoralis infection in alcoholics could be explained by immune modulation and/or by some alteration in corticosteroid metabolism induced by chronic ethanol ingestion. Corticosteroid metabolites would mimic the worm ecdisteroids, that would in turn increase the fecundity of females in duodenum and survival of larvae. Consequently, the higher frequency of Strongyloides larvae in stool of alcoholics does not necessarily reflect an increased frequency of infection rate, but only an increased chance to present a positive stool examination using sedimentation methods.

  9. The role of topiramate and other anticonvulsants in the treatment of alcohol dependence: a clinical review.

    Science.gov (United States)

    De Sousa, Avinash

    2010-03-01

    Alcohol dependence is a major health problem worldwide. Various pharmacological agents have been used in the management of alcohol dependence. This review looks at the role of topiramate and other anticonvulsants in the management of alcohol dependence. Topiramate is the most widely used anticonvulsant in the treatment of alcohol dependence. The literature on topiramate is reviewed and critically analyzed, along with its proposed mechanism of action in alcohol dependence. A review of data available on other anticonvulsants like carbamazepine, oxcarbazepine, sodium valproate, gabapentin and levetiracetam are presented and their potential in the treatment of alcohol dependence is considered, together with future research directions.

  10. Biological and behavioral aspects regarding combined systemic management of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Alexinschi Ovidiu

    2015-01-01

    Full Text Available Although there are numerous ideas on the management of alcohol dependence, ranging from various schemes of pharmacologic treatment to specific psychotherapeutic approaches, the reviews and meta-analyses reveal only modest effects of these approaches. Another approach regarding the problem of alcohol is based on the behavioral biology, specifying that consumption of alcohol is actually a type of behavior, a way of life. The results presented in this report provide evidence to support the idea that the systemic, ethological approach of alcohol-related and complex problems brings additional value when complementing the standard medicinal therapy, both in terms of achieving and maintaining abstinence, as well as in improving the quality of life for the patients.

  11. Operant alcohol self-administration in dependent rats: focus on the vapor model.

    Science.gov (United States)

    Vendruscolo, Leandro F; Roberts, Amanda J

    2014-05-01

    Alcoholism (alcohol dependence) is characterized by a compulsion to seek and ingest alcohol (ethanol), loss of control over intake, and the emergence of a negative emotional state during withdrawal. Animal models are critical in promoting our knowledge of the neurobiological mechanisms underlying alcohol dependence. Here, we review the studies involving operant alcohol self-administration in rat models of alcohol dependence and withdrawal with the focus on the alcohol vapor model. In 1996, the first articles were published reporting that rats made dependent on alcohol by exposure to alcohol vapors displayed increased operant alcohol self-administration during acute withdrawal compared with nondependent rats (i.e., not exposed to alcohol vapors). Since then, it has been repeatedly demonstrated that this model reliably produces physical and motivational symptoms of alcohol dependence. The functional roles of various systems implicated in stress and reward, including opioids, dopamine, corticotropin-releasing factor (CRF), glucocorticoids, neuropeptide Y (NPY), γ-aminobutyric acid (GABA), norepinephrine, and cannabinoids, have been investigated in the context of alcohol dependence. The combination of models of alcohol withdrawal and dependence with operant self-administration constitutes an excellent tool to investigate the neurobiology of alcoholism. In fact, this work has helped lay the groundwork for several ongoing clinical trials for alcohol dependence. Advantages and limitations of this model are discussed, with an emphasis on what future directions of great importance could be.

  12. Lower Muscle Endurance in Patients with Alcoholic Liver Disease

    Science.gov (United States)

    Andersen, Henning; Aagaard, Niels K.; Jakobsen, Johannes; Dorup, Inge; Vilstrup, Hendrik

    2012-01-01

    Patients with alcoholic liver disease often complain of restricted physical capacity, which could be due to decreased muscle endurance. The aim of this study was to assess the muscular endurance in patients with alcoholic liver disease. In a cross sectional study, 24 patients with alcoholic liver disease and 22 controls were evaluated using…

  13. Lower Muscle Endurance in Patients with Alcoholic Liver Disease

    Science.gov (United States)

    Andersen, Henning; Aagaard, Niels K.; Jakobsen, Johannes; Dorup, Inge; Vilstrup, Hendrik

    2012-01-01

    Patients with alcoholic liver disease often complain of restricted physical capacity, which could be due to decreased muscle endurance. The aim of this study was to assess the muscular endurance in patients with alcoholic liver disease. In a cross sectional study, 24 patients with alcoholic liver disease and 22 controls were evaluated using…

  14. Strongyloides stercoralis Infection in Alcoholic Patients

    Science.gov (United States)

    Pacheco, Flavia T. F.; Souza, Joelma N.; Silva, Mônica L. S.; Inês, Elizabete J.; Soares, Neci M.

    2016-01-01

    The course of Strongyloides stercoralis infection is usually asymptomatic with a low discharge of rhabditoid larva in feces. However, the deleterious effects of alcohol consumption seem to enhance the susceptibility to infection, as shown by a fivefold higher strongyloidiasis frequency in alcoholics than in nonalcoholics. Moreover, the association between S. stercoralis infection and alcoholism presents a risk for hyperinfection and severe strongyloidiasis. There are several possible mechanisms for the disruption of the host-parasite equilibrium in ethanol-addicted patients with chronic strongyloidiasis. One explanation is that chronic ethanol intake stimulates the hypothalamic-pituitary-adrenal (HPA) axis to produce excessive levels of endogenous cortisol, which in turn can lead to a deficiency in type 2 T helper cells (Th2) protective response, and also to mimic the parasite hormone ecdysone, which promotes the transformation of rhabditiform larvae to filariform larvae, leading to autoinfection. Therefore, when untreated, alcoholic patients are continuously infected by this autoinfection mechanism. Thus, the early diagnosis of strongyloidiasis and treatment can prevent serious forms of hyperinfection in ethanol abusers. PMID:28105424

  15. Strongyloides stercoralis Infection in Alcoholic Patients

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    Marcia C. A. Teixeira

    2016-01-01

    Full Text Available The course of Strongyloides stercoralis infection is usually asymptomatic with a low discharge of rhabditoid larva in feces. However, the deleterious effects of alcohol consumption seem to enhance the susceptibility to infection, as shown by a fivefold higher strongyloidiasis frequency in alcoholics than in nonalcoholics. Moreover, the association between S. stercoralis infection and alcoholism presents a risk for hyperinfection and severe strongyloidiasis. There are several possible mechanisms for the disruption of the host-parasite equilibrium in ethanol-addicted patients with chronic strongyloidiasis. One explanation is that chronic ethanol intake stimulates the hypothalamic-pituitary-adrenal (HPA axis to produce excessive levels of endogenous cortisol, which in turn can lead to a deficiency in type 2 T helper cells (Th2 protective response, and also to mimic the parasite hormone ecdysone, which promotes the transformation of rhabditiform larvae to filariform larvae, leading to autoinfection. Therefore, when untreated, alcoholic patients are continuously infected by this autoinfection mechanism. Thus, the early diagnosis of strongyloidiasis and treatment can prevent serious forms of hyperinfection in ethanol abusers.

  16. Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence.

    Science.gov (United States)

    Mutschler, J; Grosshans, M; Soyka, M; Rösner, S

    2016-07-01

    As an alcohol-aversive agent, disulfiram occupies an exceptional position in the pharmacological relapse prevention of alcohol dependence. In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol. Therapeutic and adverse effects are therefore closely related: On the one hand, the aversiveness of the disulfiram ethanol reaction has the potential to support abstinence in a subgroup of alcohol-dependent patients, while on the other hand it becomes a health threat if the patient fails to maintain complete abstinence. The exceptional position of disulfiram is also related to the role that expectations play in the mediation of therapeutic effects. These are not determined by the pharmacological effects or the actual occurrence of a disulfiram-ethanol reaction, but are attributable to patient awareness that the drug was consumed and the corresponding anticipation of an aversive reaction if combined with alcohol. This is in line with the findings of a recent meta-analysis that only showed significant effects for disulfiram in open-label trials. The authors of the meta-analysis conclude that due to expectations induced in both the treatment and placebo groups, blinded studies are incapable of distinguishing a difference between groups. The mediation of therapeutic effects through expectation has a number of consequences for clinical practice and future research on disulfiram.

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

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    Jinhee Lee

    2015-01-01

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

  18. Alcohol dependence: international policy implications for prison populations

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    Hoffmann Norman G

    2006-11-01

    Full Text Available Abstract Background In light of the emphasis on drug abuse, this study explored the relative prevalence of substance use disorders among United Kingdom (UK prison inmates in the context of findings from a general inmate population in the United States (US. The lead author of the report conducted a structured diagnostic interview with 155 new admissions to one of two prisons in the UK using the CAAPE (Comprehensive Addiction And Psychological Evaluation, a structured diagnostic interview, to ensure consistent assessments. The US sample consisted of 6,881 male inmates in a state prison system evaluated with an automated version of the SUDDS-IV (Substance Use Disorder Diagnostic Schedule-IV interview. Results Alcohol dependence emerged as the most prevalent substance use disorder in both UK prisons and in the US sample. Relative frequencies of abuse and dependence for alcohol and other drugs revealed that dependence on a given substance was more prevalent than abuse ad defined by the current diagnostic criteria. Conclusion Despite the emphasis on drugs in correctional populations, alcohol dependence appears to be the most prominent substance use disorder among the incarcerated in both the US and UK and must be considered in developing treatment programs and policy priorities.

  19. Alcoholism and Alcohol Abuse

    Science.gov (United States)

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism

  20. Crystal structure of quinone-dependent alcohol dehydrogenase from Pseudogluconobacter saccharoketogenes. A versatile dehydrogenase oxidizing alcohols and carbohydrates

    NARCIS (Netherlands)

    Rozeboom, Henriette J.; Yu, Shukun; Mikkelsen, Rene; Nikolaev, Igor; Mulder, Harm J.; Dijkstra, Bauke W.

    2015-01-01

    The quinone-dependent alcohol dehydrogenase (PQQ-ADH, E.C. 1.1.5.2) from the Gram-negative bacterium Pseudogluconobacter saccharoketogenes IFO 14464 oxidizes primary alcohols (e.g. ethanol, butanol), secondary alcohols (monosaccharides), as well as aldehydes, polysaccharides, and cyclodextrins. The

  1. Relationships between the emotional and cognitive components of alexithymia and dependency in alcoholics.

    Science.gov (United States)

    Loas, G; Otmani, O; Lecercle, C; Jouvent, R

    2000-09-25

    Several authors have shown that alexithymia, emotional and perceptual dependency characterize patients suffering from substance abuse. The aim of the study is to test the hypothesis that the emotional and cognitive components of alexithymia are associated with dependency in alcoholics. Three groups were investigated: 60 inpatients meeting the DSM-IV criteria for alcohol dependence, 57 healthy subjects, 144 university students. All subjects completed the following rating scales: The 20-item Toronto Alexithymia Scale (TAS-20), the Interpersonal Dependency Inventory (IDI), the Beck Depression Inventory (BDI), and the Embedded Figures Test (EFT). Partial correlations, using the BDI score as constant, were calculated. In normal subjects, the 'Emotion' subscale of the TAS-20 correlated with the 'Lack of social self-confidence' subscale of the IDI and the 'Cognitive' subscale of the TAS-20 did not correlate with the EFT score. In alcoholics, the 'Cognitive' subscale of the TAS-20 correlated with the 'Lack of social self-confidence' subscale, with the EFT score and with the 'Affirmation of autonomy' subscale. A particular cognitive style characterized by externally oriented thinking, affirmation of autonomy as denial of emotional dependency and field dependence could characterize alcoholics.

  2. Peculiarities of biochemical blood parameters and cytokine profile in patients with non-alcoholic fatty liver disease depending on the form of hypothyroidism

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    V.P. Prysyazhnyuk

    2017-06-01

    to NAFLD patients with normal functional activity of the thyroid gland. A significant increase in liver vertical size measured by midclavicular line was observed in NAFLD patients with manifest hypothyroidism as compared to the patients with normal thyroid function or subclinical hypothyroidism.

  3. Hyperhomocysteinemia as a new risk factor for brain shrinkage in patients with alcoholism.

    Science.gov (United States)

    Bleich, S; Bandelow, B; Javaheripour, K; Müller, A; Degner, D; Wilhelm, J; Havemann-Reinecke, U; Sperling, W; Rüther, E; Kornhuber, J

    2003-01-02

    Chronic alcohol consumption can induce brain atrophy, whereby the exact mechanism of brain damage in alcoholics remains unknown. There is evidence that chronic alcoholism is associated with hyperhomocysteinemia. Homocysteine is an excitatory amino acid which markedly enhances the vulnerability of neuronal cells to excitotoxic and oxidative injury in vitro and in vivo. The present volumetric magnetic resonance imaging study included 52 chronic alcoholics and 30 non-drinking healthy controls. Patients were active drinkers and had an established diagnosis of alcohol dependence. We investigated the influence of different variables on the hippocampal volume of patients suffering from chronic alcoholism. We observed that pathological raised levels of plasma homocysteine showed the most significant correlation to hippocampal volume reduction (P<0.001, multiple regression analysis). Raised plasma levels of homocysteine are associated with hippocampal (brain) atrophy in alcoholism.

  4. Assessment of Benzodiazepine dependence in alcohol and drug dependent outpatients: A research report

    NARCIS (Netherlands)

    Kan, C.C.; Breteler, M.H.M.; Ven, A.H.G.S. van der; Timmermans, M.A.Y.; Zitman, F.G.

    2001-01-01

    In this study on 99 outpatients who were being treated for alcohol and/or drug dependence and also using benzodiazepines (BZDs), prevalence rates of DSM-III-R and ICD-10 substance dependence diagnoses were ascertained and scalability, reliability and validity of the scales of the Benzodiazepine Depe

  5. Study on response inhibition and working memory in alcohol dependent patients%酒依赖患者的反应抑制和工作记忆研究

    Institute of Scientific and Technical Information of China (English)

    洪珊珊; 韩伯军; 季凯; 杜春艳; 王庆广; 刘定华

    2014-01-01

    Objective To detect the impairment of response inhibition and working memory in patients with alcohol dependence.Methods A total of forty-eight alcohol dependent patients and fifty age,gender,IQ,education matched controls were recruited.Neuropsychological tests were applied to measure the differences of response inhibition and working memory between the two groups.Results In the response inhibition task,the patient group had more commission errors ((7.02± 3.48) vs (3.45± 1.52)) and longer reaction time ((605.45 ± 142.56)ms vs (435.72±51.18)ms) compared to the control group (t=6.534,P=0.000; t=7.781,P=0.000).In the spacial working memory task,the patient group also had more commission errors ((4.58± 3.45) vs (0.43± 0.88)) and longer reaction time((10566.16±2455.61) ms vs (9185.44±2677.52) ms) than control (t=8.085,P =0.000; t=2.657,P=0.009).Conclusion There are significant deficiencies in response inhibition and working memory in patients with alcohol dependence.%目的 了解酒依赖患者是否存在反应抑制和工作记忆损害.方法 选取48例酒依赖患者为病例组,另外选取50例在年龄、性别、平均智商、平均受教育年限与病例组相匹配的正常人为对照组.运用神经心理学测试的方法比较两组之间反应抑制、工作记忆任务的差异.结果 病例组在执行抑制任务时误按数显著高于对照组[(7.02±3.48)次vs (3.45±1.52)次],反应时显著长于对照组[(605.45±142.56)ms vs (435.72±51.18)ms],差异有统计学意义(t=6.534,P=0.000;t=7.781,P=0.000).酒依赖患者在完成空间工作记忆任务时误按数显著提高[(4.58±3.45)次vs (0.43±0.88)次],反应时[(10 566.16±2 455.61) ms vs(9 185.44±2 677.52) ms]明显增加(t=8.085,P=0.000;t=2.657,P=0.009).结论 酒依赖患者存在抑制功能及工作记忆缺陷.

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

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    Abhishek Ghosh

    2016-01-01

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

  7. Alterations of BDNF and GDNF serum levels in alcohol-addicted patients during alcohol withdrawal

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    Mehmet Bülent Sönmez

    Full Text Available Background and Objectives: Brain-derived neurotrophic factor (BDNF and glial cell line-derived neurotrophic factor (GDNF are neurotrophic neuropeptides that play important roles in the synaptic plasticity, neuronal growth, survival and function. A possible neuroprotective role of neurotrophic factors against alcohol-induced cell damage has been suggested, and dysregulations in neurotrophic factors may be involved in the vulnerability to addiction. The aim of this study was to investigate the alterations of BDNF and GDNF serum levels in alcohol-addicted patients during alcohol withdrawal compared to healthy controls. Methods: BDNF and GDNF serum levels of 34 male inpatients diagnosed with alcohol addiction according to DSM-IV-TR were investigated during alcohol withdrawal (day 1, 7 and 14 in comparison to 32 healthy controls using an enzyme-linked immunosorbent assay (ELISA. Severity of alcohol withdrawal was measured by Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar, and intensity of alcohol craving was measured by Penn Alcohol Craving Scale (PACS during alcohol withdrawal (day 1, 7 and 14. Results: BDNF serum levels increased significantly during alcohol withdrawal (p = 0.020. They were negatively correlated to the severity of alcohol withdrawal, and the correlation was close to being statistically significant (p = 0.058. BDNF and GDNF serum levels did not differ significantly between the patient and control groups. GDNF serum levels did not change significantly during alcohol withdrawal. Conclusions: Our results may provide support for the previously hypothesized role of BDNF in the neuroadaptation during alcohol withdrawal.

  8. Alexithymia and personality dimensions in relation to depression and anxiety in male alcohol-dependent inpatients.

    Science.gov (United States)

    Evren, Cuneyt; Evren, Bilge; Dalbudak, Ercan

    2009-01-01

    Objective. The aim of this study was to determine the relationship of alexithymia and temperament and character model of personality with depression and anxiety symptoms in detoxified male alcohol-dependent inpatients. Method. The subjects consisted of 176 male alcohol-dependent inpatients according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Patients were investigated with the Beck Depression Inventory, Beck Anxiety Inventory, State and Trait Anxiety Inventory, Michigan Alcoholism Screening Test (MAST), Toronto Alexithymia Scale (TAS-20) and Temperament and Character Inventory (TCI). Results. MAST score and scores of all three factors of the TAS-20 significantly predicted depression scale and anxiety scales. Difficulty in identifying feelings and difficulty in describing feelings factors were particularly effective, relative to the externally orientated thinking factor of the TAS-20 for prediction depression and anxiety. The TCI dimensions emerged as distinct and conceptually meaningful predictors for the depression scale and anxiety scales. Conclusion. Depression and anxiety symptoms among detoxified male alcohol dependents are associated with alexithymia, a broad range of personality dimensions and higher severity of alcohol-related problems, which make these related factors highly relevant for clinical practice.

  9. THE IMPACT ON PSYCHOPATHOLOGY AND NEURODEVELOPMENT OF CHILDREN’S OF ALCOHOL DEPENDENT FATHER

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    Koustubh R.

    2015-05-01

    Full Text Available BACKGROUND: Children of parents with alcohol dependence syndrome are particularly at high risk of emotional and behavioral problems such as learning disability, hyperactivity, psychomotor delays, somatic symptoms and emotional problems. Neuropsychological functions in these children have been the focus of attention over the last decade. AIM: Aim of this study was to compare the nature and extent of behavioral and cognitive problems in children of men with and without alcohol dependence. MATERIALS AND METHODS: Children of patients with Alcohol Dependence Syndrome, with no known psychiatric illness; aged between 5 and 10 years (B oth male & female; with mother having GHQ scores less than 4, formed the study group and control group formed by the children of normal. 108 such Children (54 in Study group and 54 in Control group were evaluated for psychopathology, neuro development and cognitive functioning. Tools used were: DSM IV criteria for diagnosis of Alcohol Dependence Syndrome, Severity of Alcohol Dependence Questionnaire, General Health Questionnaire (GHQ - 28, and Socio - demographic data sheet, Child Behavior Checklist (CBCL, Wechsler Intelligence Scale for Children – IV (WISC - IV, Trail Making Test (TMT and Neurodevelopment Scale. RESULTS: Behavioral, emotional difficulties and Neuro developmental deficits are commonly seen in children of alcohol - dependent parents as they scored statistically significant high scores on Neurodevelopmental Scale, Externalizing subscale and a marginal high score on Internalizing Subscale of CBCL. On the WISC - IV , there was a statistically significant difference in various subtests and indices including verbal comprehension, perceptual reasoning, working memory, processing speed and total intellectual quotient ; indicating a global dysfunction. On the TMT, children of alcohol - dependent parents took as much time to do the task as the control group but tended to make more errors and this difference is

  10. Family Dysfunction Differentially Affects Alcohol and Methamphetamine Dependence: A View from the Addiction Severity Index in Japan

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    Kazutaka Ikeda

    2011-10-01

    Full Text Available We investigated the differential influence of family dysfunction on alcohol and methamphetamine dependence in Japan using the Addiction Severity Index (ASI, a useful instrument that multilaterally measures the severity of substance dependence. The participants in this study were 321 male patients with alcohol dependence and 68 male patients with methamphetamine dependence. We conducted semi-structured interviews with each patient using the ASI, which is designed to assess problem severity in seven functional domains: Medical, Employment/Support, Alcohol use, Drug use, Legal, Family/Social relationships, and Psychiatric. In patients with alcohol dependence, bad relationships with parents, brothers and sisters, and friends in their lives were related to current severe psychiatric problems. Bad relationships with brothers and sisters and partners in their lives were related to current severe employment/support problems, and bad relationships with partners in their lives were related to current severe family/social problems. The current severity of psychiatric problems was related to the current severity of drug use and family/social problems in patients with alcohol dependence. Patients with methamphetamine dependence had difficulty developing good relationships with their father. Furthermore, the current severity of psychiatric problems was related to the current severity of medical, employment/support, and family/social problems in patients with methamphetamine dependence. The results of this study suggest that family dysfunction differentially affects alcohol and methamphetamine dependence. Additionally, family relationships may be particularly related to psychiatric problems in these patients, although the ASI was developed to independently evaluate each of seven problem areas.

  11. Correlation of social support and quality of life in alcohol-dependent patients and its related nursing%社会支持与酒依赖患者生活质量的相关性及护理对策

    Institute of Scientific and Technical Information of China (English)

    赵丽琼; 张跃坤

    2012-01-01

    目的 探讨社会支持状况与酒依赖患者生活质量的相关性.方法 采用社会支持评定量表(SSRS),生活质量综合评定问卷(GQOLI-74),对60名住院治疗的酒依赖患者进行测评,并与正常对照组进行比较,分析酒依赖患者的社会支持与其生活质量的关系.结果 酒依赖患者组SSRS总分及3个维度分,均显著低于正常人群组(P<0.05);社会支持与生活质量为正相关(r=0.764,P<0.01).结论 酒依赖患者获得的社会支持比正常人群低,酒依赖患者的生活质量与社会支持密切相关;护理中应重视社会支持的效果,改善酒依赖患者的生活质量.%OBJECTIVE To explore the relevance of social support and quality of life of alcohol-dependent patients. METHODS The Social Support Rating Scale (SSRS), general quality of life questionnaire (GQOLI~74) were conducted to evaluate 60 hospitalized patients with alcohol dependence, and compared the patients with the normal control group, analyzed the relationships of social support and quality of life in patients with alcohol dependence. RESULTS SSRS total score and three sub-dimensions in the patients with alcohol dependence group were significantly lower than normal group (P < 0.05); social support and quality of life had the positive correlation (r = 0.764, P< 0.01). CONCLUSION The alcohol-dependent patients receive less social support than the normal population, quality of life and social support of alcohol-dependent patients are closely related ; it should pay attention to the effect of social support in nursing to improve the quality of life in patients with alcohol dependence.

  12. Conditioned learning in alcohol dependence: implications for cue exposure treatment.

    Science.gov (United States)

    Drummond, D C; Cooper, T; Glautier, S P

    1990-06-01

    A review of the literature pertinent to cue exposure treatment in alcohol dependence is presented. Psychological models of relapse, based on conditioning and social learning theories, are critically evaluated. In particular, attention is drawn to the potential implications for cue exposure research and treatment of an interaction between Pavlovian and operant conditioning, problems with the application of the concepts of arousal and craving and the importance of a systems model to understand physiological responses. It is concluded that no study has so far demonstrated a link between conditioned responses to alcohol-related cues and relapse, an assumption on which cue exposure treatment is based. Further, the evidence for the effectiveness of cue exposure as a treatment is lacking. Promising research directions are identified.

  13. Empathy, and its relationship with cognitive and emotional functions in alcohol dependency.

    Science.gov (United States)

    Erol, Almila; Akyalcin Kirdok, Asusinem; Zorlu, Nabi; Polat, Serap; Mete, Levent

    2017-04-01

    Empathy can be defined as the ability to understand the other's thoughts and feelings. It contains both cognitive and emotional components. The aim of this study was to investigate the empathy ability of patients with alcohol dependency in association with cognitive and emotional functions, after acute detoxification and during long-term abstinence. Thirty-three alcohol dependent inpatients that completed a detoxification process and stayed abstinent throughout the study, and 33 healthy comparison subjects that matched the patients for age, gender, and education level were included in the study. All the participants were administered the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT), Trail Making Test (TMT), Digit Span Test (DST), Auditory Consonant Trigram Test (ACT), and Empathy Quotient Scale (EQS). All the tests were repeated after 3 months of abstinence. At the first evaluation conducted after detoxification, patients performed significantly worse than healthy comparisons in almost all tests. At the second evaluation, which was conducted after 3 months of abstinence, the patients improved significantly in all measures, and no significant differences were detected between the patient and comparison groups. There were significant correlations between the test scores and EQS score. Alcohol dependency has deleterious effects on empathy ability, and cognitive and emotional functions. Those impairments can improve with abstinence. Empathy ability has strong relationships with cognitive and emotional functions.

  14. [Comorbidity of opioid addiction and alcoholism in patients of young age: clinical variants of the double diagnosis].

    Science.gov (United States)

    Bokhan, N A; Blagov, L N; Kurgak, D I

    2012-01-01

    A study included 115 male patients with opioid addiction, aged from 17 to 27 years. Comorbidity of opioid addiction and alcoholism in patients of young age was represented by two main variants distinguishing between primary dependence on opioid or alcohol. In the first variant, additional variants of vicarious alcoholization and replacement of addiction form were singled out. In the second case, alcoholism preceded opioid addiction that developed as a form of polyaddiction and the formation of preliminary (primary) alcoholism was considered as a protracted stage of searching narcotism with the transition from alcoholism to opioid addiction. Stages and differential criteria of the variants of double disorders are described.

  15. Sex differences in alcohol consumption and alterations in nucleus accumbens endocannabinoid mRNA in alcohol-dependent rats.

    Science.gov (United States)

    Henricks, Angela M; Berger, Anthony L; Lugo, Janelle M; Baxter-Potter, Lydia N; Bieniasz, Kennedy V; Craft, Rebecca M; McLaughlin, Ryan J

    2016-10-29

    Chronic intermittent alcohol (CIA) exposure produces altered motivational states characterized by anxiety and escalated alcohol consumption during withdrawal. The endocannabinoid (ECB) system contributes to these symptoms, and sex differences in alcohol dependence, as well as bidirectional interactions between ECBs and gonadal hormones have been documented. Thus, we evaluated sex differences in alcohol consumption, anxiety-like behavior, and ECB mRNA expression in the nucleus accumbens (NAc) of alcohol-dependent rats during acute withdrawal. Male rats exposed to six weeks of CIA showed escalated alcohol consumption during acute withdrawal and reductions in NAc N-acyl phosphatidylethanolamine phospholipase D (NAPEPLD), DAG lipase alpha (DAGLα), and monoacylglycerol lipase (MAGL) mRNA. Intact alcohol-dependent female rats also escalated their consumption, but notably, this effect was also present in non-dependent females. No differences in NAc ECB mRNA were observed between CIA- and air-exposed females during acute withdrawal. However, when these data were analyzed according to estrous stage, significant differences in NAPEPLD and MAGL mRNA expression emerged in the NAc of air-exposed control rats, which were absent in alcohol-dependent females. We subsequently measured alcohol consumption and NAc ECB mRNA in ovariectomized (OVX) females with or without estradiol (E2) replacement during withdrawal. Neither E2 nor CIA altered alcohol consumption in OVX females. However, E2 reduced both DAGLα and MAGL mRNA, suggesting that E2 may influence the biosynthesis and degradation of 2-arachidonoylglycerol (2-AG) in the NAc. Collectively, these studies indicate sexual dimorphism in alcohol consumption in non-dependent rats and suggest that E2-mediated alterations in NAc ECB mRNA expression during withdrawal may be a mechanism by which sex differences in alcohol dependence emerge. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  16. Neuropsychological Impairment in Detoxified Alcohol-Dependent Subjects with Preserved Psychosocial Functioning

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    Catherine Martelli

    2017-09-01

    Full Text Available BackgroundChronic alcoholism and its related cognitive impairments are associated with increased social, relational, and professional deficits which have a variable overall impact on social integration. These impairments are known to have varying severities and have rarely been studied among healthy alcohol-dependent subjects with preserved psychosocial functioning. Thus, the objective of this study is to describe neuropsychological performance in this particular population.MethodTwenty-nine socially adjusted alcohol-dependent men, hospitalized for a first or second withdrawal and abstinent for 3 weeks minimum, were compared to 29 healthy non-alcoholic controls. All subjects underwent clinical and psychiatric examination, neuropsychological tests of memory (M, working memory (WM, and executive functions (EF. Comparisons were performed using Student’s t-tests or Mann–Whitney U tests.ResultsNo group differences were found on the Self-Reported Social Adjustment Scale (SAS-SR or in the Mini-Mental State Examination. Compared to controls, patients had greater episodic, spatial, and WM deficits as well as slightly altered executive functions. In contrast, their executive functions (spontaneous flexibility, criteria generation, rule maintenance, and inhibitory control were relatively preserved.ConclusionOur sample of socially and professionally integrated alcoholic patients shows fewer cognitive deficits than described in previous studies. Our results suggest that early on, alcohol-dependent subjects develop compensatory adaptation processes to preserve social function and adaptation. Minor cognitive impairments should be screened early in the disease to integrate cognitive interventions into the health-care plan to thus eventually prevent further socio-professional marginalization.

  17. High-dose baclofen for the treatment of alcohol dependence (BACLAD study): a randomized, placebo-controlled trial.

    Science.gov (United States)

    Müller, Christian A; Geisel, Olga; Pelz, Patricia; Higl, Verena; Krüger, Josephine; Stickel, Anna; Beck, Anne; Wernecke, Klaus-Dieter; Hellweg, Rainer; Heinz, Andreas

    2015-08-01

    Previous randomized, placebo-controlled trials (RCTs) assessing the efficacy of the selective γ-aminobutyric acid (GABA)-B receptor agonist baclofen in the treatment of alcohol dependence have reported divergent results, possibly related to the low to medium dosages of baclofen used in these studies (30-80mg/d). Based on preclinical observations of a dose-dependent effect and positive case reports in alcohol-dependent patients, the present RCT aimed to assess the efficacy and safety of individually titrated high-dose baclofen for the treatment of alcohol dependence. Out of 93 alcohol-dependent patients initially screened, 56 were randomly assigned to a double-blind treatment with individually titrated baclofen or placebo using dosages of 30-270mg/d. The multiple primary outcome measures were (1) total abstinence and (2) cumulative abstinence duration during a 12-week high-dose phase. More patients of the baclofen group maintained total abstinence during the high-dose phase than those receiving placebo (15/22, 68.2% vs. 5/21, 23.8%, p=0.014). Cumulative abstinence duration was significantly higher in patients given baclofen compared to patients of the placebo group (mean 67.8 (SD 30) vs. 51.8 (SD 29.6) days, p=0.047). No drug-related serious adverse events were observed during the trial. Individually titrated high-dose baclofen effectively supported alcohol-dependent patients in maintaining alcohol abstinence and showed a high tolerability, even in the event of relapse. These results provide further evidence for the potential of baclofen, thereby possibly extending the current pharmacological treatment options in alcohol dependence.

  18. Joint analysis of the NACP-REP1 marker within the alpha synuclein gene concludes association with alcohol dependence.

    Science.gov (United States)

    Bönsch, D; Lederer, T; Reulbach, U; Hothorn, T; Kornhuber, J; Bleich, S

    2005-04-01

    Various studies have linked alcohol dependence phenotypes to chromosome 4. One candidate gene is NACP (non-amyloid component of plaques), coding for alpha synuclein. Recently, it has been shown that alpha synuclein mRNA is increased in alcohol-dependent patients within withdrawal state. This increase is significantly associated with craving, especially obsessive craving. On the basis of these observations, the present study analysed two polymorphic repeats within the NACP gene. We found highly significant longer alleles of NACP-REP1 in alcohol-dependent patients compared with healthy controls (Kruskal-Wallis test, chi(2)=99.5; df=3, Pcraving, a key factor in the genesis and maintenance not only of alcoholism but also of addiction in general.

  19. Patient preferences and perspectives regarding reducing alcohol consumption: role of nalmefene

    Directory of Open Access Journals (Sweden)

    Luquiens A

    2014-09-01

    Full Text Available Amandine Luquiens, Henri-Jean Aubin INSERM U669, Université Paris Sud, Hôpital Paul Brousse, Assistance Publique – Hôpitaux de Paris (AP-HP, Villejuif, France Abstract: Alcohol use disorder is a major public health issue. The absolute mortality burden of alcohol-attributable death has increased over the last 20 years. However, access to care remains very poor and many people with alcohol use disorder are untreated. The main limiting factor for access to care in alcohol use disorder appears to be the reluctance to engage in abstinence. Risk reduction is a developing approach in the treatment of alcohol use disorders, drawing its inspiration, with quite a delay, from the decades-long dominant approach in other substance use disorders. A paradigm shift has recently occurred that places more of an emphasis on reducing alcohol as a therapeutic strategy for patients with alcohol use disorder, to better meet the patients’ preferences and needs. The development and recent approval of nalmefene, in alcohol-dependent adults with a high drinking risk level, contributes to enlarging the therapeutic arsenal for alcohol dependence, strengthening the legitimacy of alcohol reduction strategies. Keywords: harm reduction, alcohol use disorder, therapeutic goal, patients’ satisfaction

  20. TO STUDY AND EVALUATE DIASTOLIC DYSFUNCTION IN PATIENTS OF ALCOHOLIC AND NON-ALCOHOLIC CIRRHOSIS

    Directory of Open Access Journals (Sweden)

    Gaurav Sudhir

    2016-04-01

    Full Text Available BACKGROUND Cardiovascular dysfunction is the major component of morbidity in patients of liver cirrhosis and a cardinal prognostic indicator in patients undergoing liver transplantation. The constellation of hyperdynamic circulation, peripheral vasodilation and volume overload alters the systolic and diastolic dysfunction leading to cirrhotic cardiomyopathy (CCM. In this study, we evaluated and compared the diastolic dysfunction among alcoholic and non-alcoholic cirrhotic patients. AIMS 1 To Study the Prevalence of Diastolic Dysfunction in Alcoholic & Non-Alcoholic Cirrhotics and Controls. 2 To Compare the Diastolic functional status between alcoholic and non-alcoholic cirrhosis patients. MATERIALS AND METHODS A cross-sectional case control study was conducted in 100 male cirrhotic patients consisting of alcoholic and non-alcoholic cirrhotic subjects with age matched 50 controls in Pt. JNM Medical College & Dr. BRAM Hospital, Raipur. Left ventricular diastolic dysfunction was assessed using echocardiographic parameters. STATISTICAL ANALYSIS The range, median, standard deviation and statistical significance were calculated. Most of the data is analysed by Student Ttest, Mann Whitney U test, while the data with frequency distribution is analysed by Fisher’s exact. With p value 1. CONCLUSION Our study showed that patients with alcoholic and non-alcoholic cirrhosis have higher occurrence of DD (49% and 46% respectively than controls owing to alterations in the myocardial contractile and relaxation function. It also shows that although DD is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There were no significant differences in diastolic parameters between alcoholic and non-alcoholic cirrhosis concluding that alcohol likely plays a non-significant role in cardiovascular dysfunction in cirrhotics.

  1. Transcranial electrostimulation in patients with alcoholic encephalopathy

    Directory of Open Access Journals (Sweden)

    Barylnik Yu.B.

    2010-09-01

    Full Text Available The method of transcranial electrostimulation (TES was used for treating patients with alcoholic encephalopathy against the background of the basic treatment, which includes nootropics, normotimics, soporifics, over-all strengthening therapy and other devices. The course of treatment consisted of 10 daily procedures lasting for 30 minutes. The TES influence was evaluated according to the clinical state, the neurologic status, including EEG (electroencephalogram, the psychometric scales were also used for evaluating the manifestation of depression, anxiety and working memory in comparison with appropriate indices in the control group of patients, who were being treated by the traditional method. TES led to normalization of health state, neurologic status and vegetative innervation, the reduction in pathologic inclination, which corresponded to general improvement of the state of patients, EEG indices and psychometric scales

  2. Ethnicity and gender comparisons of health consequences in adults with alcohol dependence.

    Science.gov (United States)

    Chartier, Karen G; Hesselbrock, Michie N; Hesselbrock, Victor M

    2013-02-01

    The moderating effects of ethnicity and gender on factors associated with physical health consequences in adults manifesting alcohol dependence were examined using data from the 2001-2002 US National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Black and white respondents with a lifetime diagnosis of DSM-IV alcohol dependence were selected for the study (n = 3,852). A multiple-group structural equation model tested ethnicity, gender, and intervening variables as predictors of physical health status in alcohol-dependent men and women. Study findings offer implications for clinical practice with alcohol-dependent individuals by identifying likely target groups and problems for intervention.

  3. Sample bias from different recruitment strategies in a randomised controlled trial for alcohol dependence.

    Science.gov (United States)

    Morley, Kirsten C; Teesson, Maree; Sannibale, Claudia; Haber, Paul S

    2009-05-01

    Participants may be recruited from diverse sources for randomised controlled trials (RCT) of treatments for alcohol dependence. A mixed recruitment strategy might facilitate recruitment and increase generalisability at the expense of introducing systematic selection bias. The current study aims to compare the effects of recruitment method on socio-demographics, baseline illness characteristics, treatment retention and treatment outcome measures. A secondary analysis from a previous 12 week RCT of naltrexone, acamprosate and placebo for alcohol dependence was conducted. Participants (n = 169) were obtained via four channels of recruitment including in-patient and outpatient referral, live media and print media solicitation. Baseline parameters, retention in treatment and treatment outcomes were compared in these groups. Relative to in-patient subjects, those recruited via live and print media had significantly lower scores on taking steps, less in-patient rehabilitation admissions and less previous abstinence before entering the trial. Subjects recruited via print media had significantly lower scores of alcohol dependence relative to all other modes recruitment. There were no differences between recruitment strategies on treatment retention or compliance. At outcome, no significant effect of recruitment method was detected. These results suggest that different recruitment methods may be sourcing subjects with different baseline characteristics of illness. Nonetheless, these differences did not significantly impact on treatment retention or outcome, suggesting that in this population it was appropriate to recruit subjects from mixed sources.

  4. Nurse counseling of patients with an overconsumption of alcohol

    DEFF Research Database (Denmark)

    Willaing, Ingrid; Ladelund, Steen

    2005-01-01

    PURPOSE: To identify the associations between self-reported alcohol-related clinical practice among hospital nurses and their (a) self-rated qualifications for counseling on alcohol, and (b) attitudes toward care of patients with an overconsumption of alcohol. DESIGN AND METHODS: A survey based...... on self-administered questionnaires was undertaken at a Danish University Hospital in the Copenhagen area. Descriptive statistics, chi-square test, and multiple logistic regression analyses were used. Variables were self-reported alcohol-related counseling, self-rated qualifications for counseling...... patients with an overconsumption of alcohol, attitudes toward the priority of counseling on alcohol and other lifestyle issues, and attitudes toward caring for patients with an overconsumption of alcohol. FINDINGS: Self-rated qualifications for counseling and attitudes toward care significantly influenced...

  5. Relationship between alcohol craving levels and sleep disorders in the initial stage of withdrawal of alcohol dependence patients%酒依赖患者戒断初期酒精渴求程度与睡眠障碍的关系

    Institute of Scientific and Technical Information of China (English)

    杜好瑞; 李拴荣; 穆俊林; 徐建强; 王传升; 崔二龙; 李冲

    2014-01-01

    Objective To explore the characteristic of sleep disorders in the initial stage of withdrawal and their relationships with alcohol craving levels in alcohol dependence (AD) patients,and provide support for diagnosis and prevention of re-drinking.Methods Thirty-two AD inpatients were assigned to AD group and 20 male healthy volunteers to control group.Alcohol craving was assessed with the Pennsylvania Alcohol Craving Scale (PACS) within the 2nd week after alcohol withdrawal for AD patients,and then the whole-night polysomnogram (PSG) tracings were conducted on the day of the night.Results The five item scores of the PACS were from 3.48 to 4.26 in AD patients.The sleep latency was(42.48±22.42) min,total sleep time was(289.61± 103.22)min,sleep efficiency was(71.45± 19.86) %,S1 sleep was (23.47± 11.07) %,arousal frequencies was (8.01 ± 2.77),S3+4 sleep was(6.26±5.35)% in AD group.Compared with control group((19.65±8.57) min,(407.33±21.29) min,(81.52 ± 6.46) %,(8.79± 1.83) %,(2.17 ± 1.04),(15.87 ± 5.24) % respectively),the differences had statistical significances(t=2.206-9.082,P< 0.05-0.001).Alcohol craving levels were positively related to sleep latency,arousal frequencies and S1 sleep (r=0.424-0.898,P<0.05-0.01) and negatively to total sleep time,sleep efficiency and S3+4 sleep (r=-0.416--0.662,P<0.05-0.01) in AD group.Conclusion AD patients have sleep continuity and structure disturbances in the initial stage of alcohol withdrawal,sleep continuity and structure disturbances are related to alcohol craving.Improvements of sleep disorders should be paid during clinical alcohol dependence treatment.%目的 探讨酒依赖患者酒精戒断初期睡眠障碍的特点,及其与饮酒渴求程度的关系,为临床诊治和防止复饮提供帮助.方法 以32例住院治疗的酒依赖患者为酒依赖组,20例男性健康志愿者为对照组,在酒精戒断后第2周内,酒依赖组采用宾夕

  6. Pregabalin in the treatment of alcohol and benzodiazepines dependence.

    Science.gov (United States)

    Oulis, Panagiotis; Konstantakopoulos, George

    2010-01-01

    We review all available studies on the use of the newer anticonvulsant drug pregabalin (PGB) in the treatment of both alcohol dependence (AD) and benzodiazepine dependence (BD). In AD, the available evidence includes one open-label and one double-blind randomized studies, whereas in BD, only a few case reports and one open-label study are as yet available. In both conditions, PGB was found efficacious with significant improvement in withdrawal symptoms at the dosage ranges of 150-450 mg/day (AD) and 225-900 mg/day (BD). Moreover, its side effects were mild and transient. Despite the limited quality of the studies design, their findings suggest that PGB might constitute a novel efficacious and safe option in the treatment of both AD and BD.

  7. Alcohol consumption in patients with acute or chronic pancreatitis.

    Science.gov (United States)

    Sand, J; Lankisch, P G; Nordback, I

    2007-01-01

    Understanding of the relation between the alcoholic consumption and the development of pancreatitis should help in defining the alcoholic etiology of pancreatitis. Although the association between alcohol consumption and pancreatitis has been recognized for over 100 years, it remains still unclear why some alcoholics develop pancreatitis and some do not. Surprisingly little data are available about alcohol amounts, drinking patterns, type of alcohol consumed and other habits such as dietary habits or smoking in respect to pancreatitis preceding the attack of acute pancreatitis or the time of the diagnosis of chronic pancreatitis. This review summarizes the current knowledge. Epidemiological studies clearly show connection between the alcohol consumption in population and the development of acute and chronic pancreatitis. In the individual level the risk to develop either acute or chronic pancreatitis increases along with the alcohol consumption. Moreover, the risk for recurrent acute pancreatitis after the first acute pancreatitis episode seems also to be highly dependent on the level of alcohol consumption. Abstaining from alcohol may prohibit recurrent acute pancreatitis and reduce pain in chronic pancreatitis. Therefore, all the attempts to decrease alcohol consumption after acute pancreatitis and even after the diagnosis of chronic pancreatitis should be encouraged. Smoking seems to be a remarkable co-factor together with alcohol in the development of chronic pancreatitis, whereas no hard data are available for this association in acute pancreatitis. Setting the limits for accepting the alcohol as the etiology cannot currently be based on published data, but rather on the 'political' agreement.

  8. 酒依赖患者的非理性信念特点及与酒依赖严重程度的关系%CHARACTERISTICS OF IRRATIONAL BELIEFS IN THE PATIENTS WITH ALCOHOL DEPENDENCE AND THEIR RELATIONSHIPS WITH SEVERITY DEGREE

    Institute of Scientific and Technical Information of China (English)

    杜晶阁; 孙洪强

    2012-01-01

    Objective: To investigate the characteristics of irrational beliefs in the patients with alcohol dependence, and their relationships with the severity degree. Methods: Thirty -five patients with alcohol dependence and 36 healthy controls were enrolled from July, 2009 to May, 2010. The data were recorded as follows: sex, age, duration of education, drinking amount per day, date of starting drinking. IBS was assessed in both groups, and the scores of total scale and the three subscales, low frustration tolerance( LFT) , global evaluation GE) , absolute demands( AD) were recorded. MAST was evaluated in the patients with alcohol dependence. Results: ( 1) IBS' total scales of alcoholic group were statistically higher than those of control grouP0.05).结论:酒依赖患者存在非理性信念,主要是低挫折耐受和概括化评论.酒依赖患者的非理性信念与酒依赖严重程度有关,但是与开始饮酒时间和酒依赖时间及每日饮酒量无关.

  9. Anticipatory 50 kHz ultrasonic vocalizations are associated with escalated alcohol intake in dependent rats.

    Science.gov (United States)

    Buck, Cara L; Malavar, Jordan C; George, Olivier; Koob, George F; Vendruscolo, Leandro F

    2014-09-01

    Rats emit 50kHz ultrasonic vocalizations (USVs) in situations of increased motivation, such as during the anticipation of palatable food or drugs of abuse. Whether the same holds true for the anticipation of alcohol intake remains unknown. Alcohol drinking in a nondependent state is thought to be mediated by its rewarding effects (positive reinforcement), whereas drinking in the dependent state is motivated by alcohol's stress-relieving effects (negative reinforcement). Here, we measured context-elicited 50kHz USVs in alcohol-dependent (alcohol vapor-exposed) and nondependent rats immediately before operant alcohol self-administration sessions. Dependent rats showed escalated levels of alcohol intake compared with nondependent rats. Overall, dependent and nondependent rats showed similar levels of anticipatory 50kHz USVs. However, the number of anticipatory USVs was positively correlated with alcohol intake in dependent rats but not nondependent rats. Additionally, dependent rats with higher alcohol intake displayed increased anticipatory 50kHz USVs compared with rats that had lower alcohol intake, whereas no difference was observed between rats with high and low alcohol intake in the nondependent group. Increased 50kHz USVs were specific for the anticipation of alcohol self-administration and did not generalize to a novel environment. These findings suggest that anticipatory 50kHz USVs may be an indicator of context-elicited negative reinforcement learning.

  10. Deficits in Emotion-Regulation Skills Predict Alcohol Use during and after Cognitive-Behavioral Therapy for Alcohol Dependence

    Science.gov (United States)

    Berking, Matthias; Margraf, Matthias; Ebert, David; Wupperman, Peggilee; Hofmann, Stefan G.; Junghanns, Klaus

    2011-01-01

    Objective: As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, our aim in the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD). Method: A prospective study investigated whether emotion-regulation skills were associated with AD and whether these…

  11. [Creation of a scale for evaluating attitudes of partners toward alcohol dependency].

    Science.gov (United States)

    Sugawara, Tazuko; Morita, Noriaki; Nakatani, Youji

    2013-12-01

    The aim of this study was to develop a scale to evaluate characteristics of how alcohol-dependent people perceive the attitudes of their partners toward alcohol dependency. Based on previous research, we created the "Attitudes of partners toward alcohol dependency" scale, from the perspective of the alcohol dependent individual. Using the new scale, 71 alcohol-dependent people (52 men, 19 women) were surveyed after obtaining their consent, and the reliability and validity of the scale were tested. The results identified 3 factors, "indifference", "acceptance" and "hypersensitivity", and factorial validity was verified. Relatively high reliability was obtained on each sub-scale (alpha = .60-.82). Furthermore, correlations were obtained with the alcohol-dependency "Denial and Awareness Scale (for alcohol-dependent people)" and with the 13-item "Usefulness of heterosexual love relations for recovery from alcohol dependency" questionnaire, which includes content on "beneficial" or "obstructive" to recovery, and with the satisfaction and the importance of relations. This demonstrates that the "Attitudes of partners toward alcohol dependency" scale has reliability and criterion-related validity. The scale facilitates evaluation of types of attitudes of partners toward alcohol dependency, and may thus be useful as one tool for investigating the influence of partners in heterosexual love relationships for recovery, and for providing advice.

  12. 内观认知疗法治疗酒依赖患者临床疗效研究%Clinical efficacy of Naikan cognitive therapy in the treatment of alcohol dependent patients

    Institute of Scientific and Technical Information of China (English)

    常琦; 毛富强; 陈静医; 张勇辉; 韩邵明

    2013-01-01

    目的 探讨内观认知疗法对酒依赖患者的临床疗效.方法 将64例酒依赖患者应用随机数字表法分为研究组(32例)和对照组(32例).两组患者仍服用原有药物治疗,其中研究组给予连续7d集中内观认知疗法(NaiKan cognitive therapy,NCT).在治疗前和治疗后应用强制性饮酒问卷(OCDS)、症状自评量表(SCL-90)、护士观察量表(NOSIE)进行评定.结果 ①治疗后研究组OCDS评分[(49.51±1.63)分],低于对照组[(53.92±1.82)分],差异有统计学意义(P<0.01).②治疗后研究组SCL-90总分、人际关系、抑郁、焦虑因子分低于对照组,均差异有统计学意义(t=-2.413,P=0.019;t=-2.033,P=0.047;t=-2.065,P=0.044;t=-2.038,P=0.046).③治疗后研究组NOSIE量表病情总估计、总积极因素评分[分别为(187.10±18.80)分,(78.51±12.22)分],高于对照组[分别为(175.51±11.71)分,(68.22±11.87)分],总消极因素评分(15.55±9.46)分低于对照组(20.51±9.33)分,均差异有统计学意义(P<0.05).结论 内观认知疗法能有效降低酒依赖患者的饮酒渴求,减少饮酒相关问题.%Objective To explore the clinical efficacy of Naikan cognitive therapy(NCT) for alcohol dependent patients.Methods 64 cases of alcohol-dependent patients were randomly assigned to the study group (32 cases) and the control group (32 cases).The study group was treated with NCT for successive 7 days on the basis of taking original drugs; and the control group was only given the original drug therapy.The obsessive compulsive drinking scale (OCDS),self-report symptom inventory(SCL-90),nurses observation scale for inpatient evaluation(NOSIE) were administered to all subjects at pre-and post-treatment.Results ①After the treatments,the scores of OCDS in study group (49.51 ± 1.63) were lower than that in control group(53.92 ± 1.82),and the statistical difference had the significance (P < 0.01).②After the treatments,the total scores and some factor scores of SCL-90 in

  13. Dose-dependent effects of intravenous alcohol administration on cerebral blood flow in young adults.

    Science.gov (United States)

    Strang, Nicole M; Claus, Eric D; Ramchandani, Vijay A; Graff-Guerrero, Ariel; Boileau, Isabelle; Hendershot, Christian S

    2015-02-01

    Functional magnetic resonance imaging (fMRI) studies involving alcohol challenge are important for identifying neural correlates of alcohol's psychopharmacological effects. However, evaluating acute alcohol effects on blood oxygen level-dependent (BOLD) signal change is complicated by alcohol-related increases in cerebral blood flow (CBF). The present study aimed to further characterize acute alcohol effects on CBF using intravenous alcohol administration to maximize control over brain alcohol exposure. Twenty heavy-drinking young adults (M = 19.95 years old, SD = 0.76) completed alcohol and placebo imaging sessions in a within-subject, counter-balanced, placebo-controlled design. Arterial spin labeling (ASL) provided estimates of perfusion change at two target blood alcohol concentrations (40 and 80 mg%) relative to baseline and relative to a saline control infusion. Voxel-wise analyses showed widespread and dose-dependent effects of alcohol on CBF increase. Region-of-interest analyses confirmed these findings, also indicating regional variation in the magnitude of perfusion change. Additional findings indicated that lower self-reported sensitivity to alcohol corresponded with reduced perfusion change during alcohol administration. This study provides further evidence for widespread effects of acute alcohol on cerebral perfusion, also demonstrating regional, dose-dependent, and inter-individual variation. Further research is needed to evaluate implications of these effects for the design and interpretation of pharmacological fMRI studies involving alcohol challenge.

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

    Directory of Open Access Journals (Sweden)

    Martin D. Ohlmeier

    2011-09-01

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

  15. Effectiveness of psychoanalysis and alcoholics anonymous on reducing re - drinking rate among patients with alcohol dependence%精神分析治疗与嗜酒者互诫协会对降低酒依赖患者复饮率的效果

    Institute of Scientific and Technical Information of China (English)

    张旭兰; 鲍建军; 张丽梅; 杨爽艺; 刘红艳

    2016-01-01

    anonymous (AA) on reducing re - drinking rate among patients with alcohol dependence .Methods Totals of 108 pa-tients with alcohol dependence were randomly divided into psychoanalytic treatment group (n = 54) and AA treatment group (n = 54) .Treatment time was 16 weeks .On the basis of given routine therapy to patients in both groups ,patients with psychoanalytic treatment were given psychoanalytic therapy twice a week , and holding alcoholics anonymous activity for patients with AA treatment group on every Wednesday afternoon ,assessing each group of patients by Hamilton Depression Scale(HAMD) before treatment ,after 4 ,8 ,12 ,16 weeks of treatment ,evaluating each group of patients by Symptom Self -assessment Scale(SCL - 90) before treatment and after 16 weeks of treatment ,keeping 1 or 2 times a month of telephone follow - up or outpatient care within 6 months after the patients discharged ,in order to understand the patients're - drinking situation .Results The scores of HAMD and SCL - 90 showed no significant difference before treatment (P > 0 .05) .HAMD scores were significantly decreased in two groups after treatment ,and the score in psychoanalytic treatment group were lower than AA treatment group after 8 ,12 ,16 weeks of treatment ,the difference were statistically significant (P < 0.01) .After treatment ,SCL - 90 score except the psychiatric disorder factor ,the score in two groups were improved obviously before treatment ,the difference were statistically significant (P < 0 .05) ,and the score of so-matization ,anxiety ,depression ,hostility ,interpersonal sensitivity and poor sleep and diet in psychoana-lytic treatment group were better than those in AA treatment group ,the difference were also statistically significant (P < 0 .05) .Compared re - drinking rate 6 months after hospital discharge ,the psychoanalytic treatment group was 30 .4% (14/54) was lower than the AA treatment group 39 .1% (18/54) ,but there was no statistically significant difference (χ2

  16. Smoking and alcohol use in gastric bypass patients.

    Science.gov (United States)

    Lent, Michelle R; Hayes, Sharon M; Wood, G Craig; Napolitano, Melissa A; Argyropoulos, George; Gerhard, Glenn S; Foster, Gary D; Still, Christopher D

    2013-12-01

    Bariatric surgery may increase the risk of substance use. The purpose of this study was to prospectively assess smoking and alcohol use before and after bariatric surgery, identify characteristics associated with alcohol use and smoking, and examine substance use and weight loss. Participants (N = 155, mean = 50.1 ± 11.3 y and 45.7 ± 7.0 kg/m(2)) were Roux-en-Y gastric bypass (RYGB) patients that completed surveys on substance use preoperatively and postoperatively. Alcohol use decreased significantly from the preoperative (72.3%) to the postoperative (63.2%) period. As preoperative alcohol quantity rose, the odds of consuming any alcohol postoperatively increased six-fold. Higher BMI increased the odds of high alcohol consumption. Older age decreased the odds of alcohol use and smoking. Smoking status did not differ pre- (19.4%) to post- (14.8%) surgery. Alcohol use and smoking were not associated with weight loss. After weight-loss surgery, alcohol use declined but smoking rates did not significantly change. Younger patients were more likely to use alcohol and smoke postoperatively. Patients with a higher BMI or a history of substance use may be more likely to use alcohol postoperatively. © 2013.

  17. Women's alcohol dependence and abuse: the relation to social network and leisure time.

    Science.gov (United States)

    Thundal, K L; Granbom, S; Allebeck, P

    1999-03-01

    The aim of this study was to analyse the occurrence of alcohol dependence and abuse in relation to variables reflecting social network and leisure time, social class, education, occupation and family conditions. The study was based on the second wave of interviews performed within the longitudinal study of Women and Alcohol in Göteborg. In this present study we analysed 416 face-to-face interviews performed in 1995 96. Women with only one or no friends for support had higher rates of alcohol dependence and abuse than did women with more friends. Women with high rates of alcohol dependence or abuse did not take part in cultural events as much as women with low rates of alcohol dependence and abuse. Women with homemaking skills and gardening as leisure time interests had lower prevalences of alcohol dependence and abuse. In general, women with diagnoses of alcohol dependence and abuse in this population-based sample were not alone and without a social network. However, their pattern of activity differed slightly from those without such diagnoses. The association between women with alcohol dependence and abuse and leisure time activities is probably circular: a poor social network and low participation in social activities increase the risk of alcohol dependence and abuse, and alcohol dependence and abuse lead to low participation in social activities.

  18. Tratamento farmacológico da dependência do álcool The pharmacologic treatment of the alcohol dependence

    Directory of Open Access Journals (Sweden)

    Luís André Castro

    2004-05-01

    Full Text Available As intervenções farmacológicas podem ter um papel crucial na redução do craving, consumo de álcool e manutenção da abstinência. Este artigo revisa a farmacoterapia para a dependência de álcool com ênfase na naltrexona, dissulfiram e acamprosato. O antagonista opióide naltrexona diminui taxas de recaída, reduz dias de consumo e prolonga períodos de abstinência. Acamprosato restaura a atividade normal dos sistemas glutamato e GABA. Dissulfiram tem demonstrado ser mais efetivo para pacientes que acreditam em sua eficácia e permaneçam aderentes ao tratamento. Ondansetron tem-se mostrado promissor na dependência de álcool de início precoce, mas necessita estudos mais extensivos. Topiramato (até 300 mg/dia foi mais eficaz do que placebo no tratamento da dependência de álcool.The pharmacological intervention can play a crucial role in the reduction of craving and drinking and the maintenance of abstinence. This article reviews pharmacotherapy for alcohol dependence with an emphasis on the naltrexone, dissulfiram and acamprosate. The opioid antagonist naltrexone lowers relapse rate, reduces drinking days and prolongs periods of abstinence. Acamprosate restores the normal activity of glutamate and GABA systems. Disulfiram has been shown to be most effective for patients who believe in its efficacy and remain compliant with the treatment. Ondansetron, has shown promise in the early-onset alcohol dependence but needs more extensive study. Topiramate (up to 300 mg per day was more efficacious than placebo in the treatment of alcohol dependence.

  19. Road rage among drug dependent patients.

    Science.gov (United States)

    Benavidez, Daniela C; Flores, Antonio Marcos; Fierro, Inmaculada; Alvarez, F Javier

    2013-01-01

    The consumption of alcohol, cocaine and cannabis is associated with aggressive behaviour, being a victim of injuries from various causes, and suffering traffic accidents. On the other hand, there is a significant association between road rage and traffic accidents, yet this has not been studied in persons suffering a substance dependence disorder. This study analyses the prevalence of road rage in substance dependent patients undergoing treatment. 100 patients randomly selected at an outpatient treatment centre were included in the study. 63% of the patients had experienced road rage in the year prior to the interview, and 18% were serious perpetrators. There was a higher frequency among drivers and those who were starting treatment for cocaine and cocaine+heroin. The study shows that road rage is very frequent among patients with disorders due to substance dependence who are undergoing treatment, in particular the most severe form ("serious perpetrators"). Special attention should be addressed to the issue of driving and road rage during the treatment of these patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Alcohol-Dependent Subjects Show Different Personality Traits Compared With Subjects With Multiple Substance Dependence: Preliminary Data.

    Science.gov (United States)

    Koller, Gabi; Preuss, Ullrich; Lü, Osman; Soyka, Michael; Pogarell, Oliver

    2015-01-01

    We compared personality traits of 27 persons with multiple substance dependence with personality data of 52 alcohol-dependent persons regarding their personality traits and disorders (obtained by using SCID-II, TCI and NEO FFI). Both patient groups were free of any other mental disorder. In SKD-II, we found significant differences in the male group in dependent and scizotypic personality disorder. There were no significant differences in the female group, but sample was very small. We also found significant differences between alcohol-dependent and multiple substance-dependent persons in extraversion and novelty seeking. We detected significant differences in personality disorders evaluated by SCID-II. Temperament and character items—as evaluated by NEO FFI and TCI—showed also significant differences in personality traits. Given the limited number of subjects, the data should be regarded as preliminary until replicated in a larger sample. Nevertheless, the findings may be of clinical relevance with respect to prognosis or individualized treatment. These findings should be treated with caution until replicated.

  1. Drinking patterns and biochemical signs of alcoholic liver disease in Danish and Greenlandic patients with alcohol addiction

    DEFF Research Database (Denmark)

    Lavik, Berit; Holmegaard, Claes; Becker, Ulrik

    2006-01-01

    . This study was designed to document the prevalence of alcoholic liver diseases in Greenlanders with a high alcohol intake, and to describe and compare the populations of patients with alcohol addiction in Greenland and Denmark. STUDY DESIGN: Clinical cross-sectional study of patients attending alcohol...

  2. Prevalence of psoriasis in patients with alcoholic liver disease.

    LENUS (Irish Health Repository)

    Tobin, A M

    2012-02-01

    BACKGROUND: Excessive alcohol use has been implicated as a risk factor in the development of psoriasis, particularly in men. Despite this, little is known of the incidence or prevalence of psoriasis in patients who misuse alcohol. OBJECTIVE: To assess the prevalence of psoriasis in patients with alcoholic liver disease. METHODS: In total, 100 patients with proven alcoholic liver disease were surveyed for a history of psoriasis and a full skin examination was performed if relevant. RESULTS: Of the 100 patients, 15 reported a history of psoriasis and another 8 had evidence of current activity, suggesting a prevalence (past or present) of 15% in this group of patients. CONCLUSION: It would appear that the prevalence of psoriasis in patients who misuse alcohol is much higher than the 1-3% variously quoted in the general population.

  3. Sex-Dependent Decrease of Sphingomyelinase Activity During Alcohol Withdrawal Treatment

    Directory of Open Access Journals (Sweden)

    Christiane Mühle

    2014-06-01

    Full Text Available Background: In vitro and in vivo studies have demonstrated the role of the acid sphingomyelinase (ASM in pathophysiological processes and alterations in response to ethanol exposure. Cellular and plasmatic ASM activities are increased in male alcohol dependent patients and decrease during physical withdrawal. Methods: Here, we analyzed the time course of ASM in male and also female acutely intoxicated patients during alcohol withdrawal and compared the activity levels to those under long-term maintenance treatment. Craving and further psychometric parameters were assessed by questionnaires. Results: The gradual decrease of serum ASM was confirmed in males (pConclusion: These data support the potential of ASM as a biomarker for the course of withdrawal therapy in males and provide the first associations of this enzyme with psychological variables such as craving and depression.

  4. Alcohol-Adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence.

    Science.gov (United States)

    Walitzer, Kimberly S; Deffenbacher, Jerry L; Shyhalla, Kathleen

    2015-12-01

    A randomized controlled trial for an innovative alcohol-adapted anger management treatment (AM) for outpatient alcohol dependent individuals scoring moderate or above on anger is described. AM treatment outcomes were compared to those of an empirically-supported intervention, Alcoholics Anonymous Facilitation treatment (AAF). Clients in AM, relative to clients in AAF, were hypothesized to have greater improvement in anger and anger-related cognitions and lesser AA involvement during the 6-month follow-up. Anger-related variables were hypothesized to be stronger predictors of improved alcohol outcomes in the AM treatment condition and AA involvement was hypothesized to be a stronger predictor of alcohol outcomes in the AAF treatment group. Seventy-six alcohol dependent men and women were randomly assigned to treatment condition and followed for 6 months after treatment end. Both AM and AAF treatments were followed by significant reductions in heavy drinking days, alcohol consequences, anger, and maladaptive anger-related thoughts and increases in abstinence and self-confidence regarding not drinking to anger-related triggers. Treatment with AAF was associated with greater AA involvement relative to treatment with AM. Changes in anger and AA involvement were predictive of posttreatment alcohol outcomes for both treatments. Change in trait anger was a stronger predictor of posttreatment alcohol consequences for AM than for AAF clients; during-treatment AA meeting attendance was a stronger predictor of posttreatment heavy drinking and alcohol consequences for AAF than for AM clients. Anger-related constructs and drinking triggers should be foci in treatment of alcohol dependence for anger-involved clients. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Polygenic risk for alcohol dependence associates with alcohol consumption, cognitive function and social deprivation in a population-based cohort.

    Science.gov (United States)

    Clarke, Toni-Kim; Smith, Andrew H; Gelernter, Joel; Kranzler, Henry R; Farrer, Lindsay A; Hall, Lynsey S; Fernandez-Pujals, Ana M; MacIntyre, Donald J; Smith, Blair H; Hocking, Lynne J; Padmanabhan, Sandosh; Hayward, Caroline; Thomson, Pippa A; Porteous, David J; Deary, Ian J; McIntosh, Andrew M

    2016-03-01

    Alcohol dependence is frequently co-morbid with cognitive impairment. The relationship between these traits is complex as cognitive dysfunction may arise as a consequence of heavy drinking or exist prior to the onset of dependence. In the present study, we tested the genetic overlap between cognitive abilities and alcohol dependence using polygenic risk scores (PGRS). We created two independent PGRS derived from two recent genome-wide association studies (GWAS) of alcohol dependence (SAGE GWAS: n = 2750; Yale-Penn GWAS: n = 2377) in a population-based cohort, Generation Scotland: Scottish Family Health Study (GS:SFHS) (n = 9863). Data on alcohol consumption and four tests of cognitive function [Mill Hill Vocabulary (MHV), digit symbol coding, phonemic verbal fluency (VF) and logical memory] were available. PGRS for alcohol dependence were negatively associated with two measures of cognitive function: MHV (SAGE: P = 0.009, β = -0.027; Yale-Penn: P = 0.001, β = -0.034) and VF (SAGE: P = 0.0008, β = -0.036; Yale-Penn: P = 0.00005, β = -0.044). VF remained robustly associated after adjustment for education and social deprivation; however, the association with MHV was substantially attenuated. Shared genetic variants may account for some of the phenotypic association between cognitive ability and alcohol dependence. A significant negative association between PGRS and social deprivation was found (SAGE: P = 5.2 × 10(-7) , β = -0.054; Yale-Penn: P = 0.000012, β = -0.047). Individuals living in socially deprived regions were found to carry more alcohol dependence risk alleles which may contribute to the increased prevalence of problem drinking in regions of deprivation. Future work to identify genes which affect both cognitive impairment and alcohol dependence will help elucidate biological processes common to both disorders.

  6. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  7. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  8. Development and Implementation of an Ambulatory Integrated Care Pathway for Major Depressive Disorder and Alcohol Dependence.

    Science.gov (United States)

    Awan, Saima; Samokhvalov, Andriy V; Aleem, Nadia; Hendershot, Christian S; Irving, Julie Anne; Kalvik, Anne; Lefebvre, Lisa; Le Foll, Bernard; Quilty, Lena; Voore, Peter

    2015-12-01

    Integrated care pathways (ICPs) provide an approach for delivering evidence-based treatment in a hospital setting. This column describes the development and pilot implementation in a clinical setting of an ICP for patients with concurrent major depressive disorder and alcohol dependence at the Centre for Addiction and Mental Health (CAMH), an academic tertiary care hospital, in Toronto, Canada. The ICP methodology includes evidence reviews, knowledge translation, process reengineering, and change management. Pilot results indicate high patient satisfaction, evidence of symptom improvement, and excellent retention.

  9. [Work and alcohol: considerations on a caseload of patients undergoing treatment].

    Science.gov (United States)

    Biscaldi, G; Vittadini, G; Giorgi, I; Fonte, R; Maglio, R; Nervi, O

    1999-01-01

    An enquiry into alcohol dependent subjects admitted to the clinical wards of the first section of Occupational Medicine belonging to Medicina Preventiva Occupazionale e di Comunità of University of Pavia for an alcohol disaddiction treatment has been performed through a phone interview. 289 patients have been contacted and time elapsed from admission to interview was one to three years. The questions focused alcohol abstinence, occupational position before and after admission, any improvement in the work sphere (relationship with the collegues), any feeling of empowerment of the work abilities and any increase in the responsibilities load. From our results we can conclude that alcohol disaddiction carried on during admission has positively contributed to the reinstatement of alcoholics patients.

  10. Screening for alcohol use disorders in HIV patients

    Directory of Open Access Journals (Sweden)

    C Ward

    2012-11-01

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

  11. 酒精所致震颤谵妄患者血液相关指标的对照研究%The measurement of blood related indexes in the patients with delirium tremens due to alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    庞良俊; 尹良爽; 朱春燕; 董文文; 戴兢; 王晓玲

    2012-01-01

    Objective: To investigate the blood related indexes in the patients with delirium tremens dueto alcohol dependence and explore the high risk factors for delirium tremens. Method; 142 male inpatients with alcohol dependence were divided into two groups ( delirium tremens and non delirium tremens) in terms of delirium tremens occurrence. The blood related indexes were measured and compared between the two groups. Results; Compared non delirium tremens group, delirium tremens group showed higher levels on AST (aspartate aminotransferase) [ (183.53 ± 174. 55 ) U/L vs. (95. 83 ± 118. 38 ) U/L] , GGT ( glutamate transaminase) [(647.26 ±618. 27) U/L vs. (250.48 ±313. 91) U/L] ,CK(creatine kinase) [ (738. 85 ± 1023. 72)U/L vs. (330.59 ±433.42)U/L] and Ca [(2.34 ±0.91) mmol/1 vs. (2.22 ±0. 14)mmol/l] ,and lower levels in HGB (hemoglobin) [ (126.00 ± 17.77)g/l vs. (135.38 ± 17.85)g/l] ,RBC(red blood cell) [ (3.55 ±0.64) x 1012/L vs. (3.93 ±0.60) ×10'2/L],PLT (platelet count) [ (86.41 ±31.56) x 109/L vs. ( 173.78 ±79.44) x 109/L],K[(3.45±0.75)mmol/L vs. (3.88 ±0.55)mmol/L] and Cl [(100.94 ±5.02)mmol/L vs (104.46 ± 6.64)mmol/L]. The above index differences between the two groups were statistically significant (P<0.05 or P < 0.01). Logistic regression analysis indicated that thrombocytopenia and low serum potassium were risk factors fro delirium tremens. Conclusion;The blood related indexes in patients with alcohol dependence to some degree can predict delirium tremens onset.%目的:对酒依赖患者进行血液相关指标的观察与分析,探讨慢性酒精中毒患者发生震颤谵妄(delirium tremens,DT)的高危因素. 方法:对近4年142例首次住院的男性酒依赖住院患者按照是否出现DT分组进行血液相关指标比较. 结果:出现震颤谵妄(DT)的17例酒依赖患者与非震颤谵妄组相比,在谷草转氨酶[(183.53±174.55) U/L;(95.83±118.38) U/L]、谷氨酸转氨酶[(647.26±618.27)U/L; (250.48±313.91) U

  12. Do alcoholics anonymous groups really work? Factors of adherence in a Brazilian sample of hospitalized alcohol dependents.

    Science.gov (United States)

    Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Palermo, Luiz Henrique; Athayde, Luciana Dias; de Souza Gonçalves, Marcelo; da Silveira, Dartiu Xavier

    2008-01-01

    This study was designed to determine factors affecting adherence to Alcoholics Anonymous (AA) groups. This cohort involved 300 alcoholics committed to three hospitals in Porto Alegre, Brazil. They were interviewed again in their homes after six months. The SCID-I and a questionnaire focusing on patient relationship with AA groups were used. The responses obtained through the questionnaire were independently evaluated by two researchers. AA adherence was below 20%. The main factors reported by patients as reasons for non-adherence to AA were relapse, lack of identification with the method, lack of need, and lack of credibility. The factors reported by patients as reasons for adherence were identification with the method and a way to avoid relapse. Although AA is considered an effective intervention for alcoholism, its adherence rate was excessively low. The identification of these nonadherence factors could help health professionals in referring certain alcoholic patients to therapeutic interventions other than AA.

  13. Alcohol consumption among patients with diabetes

    DEFF Research Database (Denmark)

    Jakobsen, Mathilde L.; Larsen, Julie R.; Glumer, Charlote

    2016-01-01

    Aims: To estimate alcohol consumption among Danish adults with diabetes and to investigate whether certain comorbidities are related to a high alcohol intake. Methods: A total of 162,283 participants responded to the Danish National Health Survey 2013 (questionnaire study, response rate 54.0%). V...... are less prone to exhibit addictive behaviour and many abstain from alcohol. Fewer women with diabetes than without diabetes have an excessive drinking pattern. High alcohol consumption in men with diabetes correlates to a lower occurrence of cardiovascular events....

  14. Neonatal vitamin K might reduce vulnerability to alcohol dependence in Danish men

    DEFF Research Database (Denmark)

    Manzardo, Ann M; Penick, Elizabeth C; Knop, Joachim;

    2005-01-01

    . The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnosis of alcohol dependence and a measure of lifetime problem drinking served as the 30-year outcome variables. RESULTS: Vitamin K treatment, inherited risk and low birth weight each independently predicted alcohol dependence...... of alcohol dependence later in life. METHOD: Subjects were approximately full-term male infants, selected from a large Danish birth cohort. Two thirds of the original 330 subjects in this study were high-risk sons of alcoholic fathers; 241 of the total completed the 30-year follow-up. Of subjects reported...... and problem drinking at age 30. Vitamin K treatment was associated with significantly lower rates of alcohol dependence and fewer symptoms of problem drinking. CONCLUSIONS: Vitamin K treatment at birth might protect against the development of alcoholism in adults by reducing early postnatal hemorrhage...

  15. NPY Leu7Pro and alcohol dependence in Finnish and Swedish populations.

    Science.gov (United States)

    Zhu, Guanshan; Pollak, Lotta; Mottagui-Tabar, Salim; Wahlestedt, Claes; Taubman, Julie; Virkkunen, Matti; Goldman, David; Heilig, Markus

    2003-01-01

    Neuropeptide Y (NPY) is a modulator of alcohol intake in animal models of alcoholism, and is potentially involved in alcohol dependence. A coding Leu7Pro polymorphism in the signal peptide of preproNPY has been described, and the Pro7 allele has been reported to correlate with increased alcohol consumption in non-dependent Finnish males. Recently, this polymorphism was also reported to be associated with an actual diagnosis of alcohol dependence. We compared Pro7 allele frequencies in one Finnish (n = 135) and one Swedish (n = 472) population of alcohol dependent individuals, and ethnically matched controls (Finns: n = 213; Swedes: n = 177) in whom alcohol dependence was established, or any diagnosis of substance disorder was excluded, respectively, through the use of structured face-to-face interviews. Pro7 frequencies in alcoholics were 5.2 and 4.1% in Finns and Swedes, respectively, similar to the 5.0-5.5% recently reported in European Americans in a Yale study. However, corresponding frequencies in the control populations were similar, at 6.1 and 5.9% in Finns and Swedes, respectively, yielding no association, in contrast with the Yale study, where an association was reported based on a 2.0% Pro7 frequency in European American controls. A meta-analysis of available data yields Pro7 frequencies of 4.7% both in Caucasian alcoholics and Caucasian controls. Pro7 does not seem to be associated with a diagnosis of alcoholism in Caucasian populations.

  16. Alcohol dependence and anxiety increase error-related brain activity

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Bruijn, E.R.A. de; Lankveld, C.A.A. van; Hulstijn, W.; Buitelaar, J.K.; Jong, C.A.J. de; Verkes, R.J.

    2010-01-01

    Aims Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in other

  17. Alcohol dependence and anxiety increase error-related brain activity.

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Bruijn, E.R. de; Lankveld, C.A. van; Hulstijn, W.; Buitelaar, J.K.; Jong, C.A.J. de; Verkes, R.J.

    2010-01-01

    AIMS: Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in othe

  18. TaqI-A polymorphism linked to the DRD2 gene and P300 in alcoholic patients

    Directory of Open Access Journals (Sweden)

    M.A. Jiménez-Arriero

    2006-03-01

    Full Text Available BACKGROUND AND OBJECTIVES: Different studies carried out mainly in young non-consuming children of alcoholics show an association of P300 abnormalities with alcoholism and with the TaqI-A1 allele. Since the relationship between P300 and the TaqI-A1 allele has not been specifically studied in alcoholic patients, our objective was to investigate whether the association exits in this population. METHODS: Our sample consisted of 176 recently detoxified male alcohol-dependent patients. These patients had been alcohol dependent from a mean age of 22.6 years and consumed on average 164.63 (± 142.99 cm³ of alcohol daily. P300 was studied using an auditory paradigm. TaqI-A polymorphism genotyping was performed. The association between P300 and TaqI-A, and correlation with age and alcohol consumption, was studied. RESULTS: The TaqI-A1 allele was found in 38.6% of our patients (n = 68. The latency and amplitude of P300 were 361.64 milliseconds and 17.53 microvolts, respectively. P300 wave latency in alcoholic patients was longer than the reference value obtained from a sample of healthy men of the Event-Related Potentials Unit (p < 0.001. Alcoholic patients who carried the TaqI-A1 allele showed more prolonged P300 latency than non-carriers, and these in turn more than the control subjects. P300 characteristics varied according to age, but an association with amount of alcohol or number of years consuming was not found. CONCLUSIONS: There is a relationship between the TaqI-A polymorphism and P300 wave characteristics in alcoholic patients. Further investigations need to be carried out in non-consuming alcoholic patients and in healthy control subjects to confirm this association and to clarify the possible influence of the neurotoxic effects of alcohol on P300 physiology.

  19. Acute effects of nicotine on alcohol cue-reactivity in nondependent and dependent smokers.

    Science.gov (United States)

    McGrath, Daniel S; Peloquin, Marcel P; Ferdinand, Justin C; Barrett, Sean P

    2015-02-01

    Evidence from alcohol self-administration studies suggests that nicotine replacement therapy may influence subjective and behavioral responses to alcohol. However, its effect on alcohol cue-reactivity is unknown. The present study examined the impact of acutely administered nicotine on subjective responses to alcohol-focused pictorial stimuli. In a mixed within/between-subjects design, nondependent smokers (n = 51) and dependent smokers (n = 45) who socially drink were assigned to either a nicotine (4 mg) or placebo lozenge condition following overnight tobacco abstinence. Following lozenge absorption, participants viewed neutral images followed by alcohol-focused pictures. Craving measures for alcohol and tobacco were completed at baseline, following lozenge absorption, following neutral cues, and following alcohol cues. The presentation of alcohol cues increased alcohol-related craving relative to neutral cues, especially among men, but the administration of nicotine did not influence the magnitude of these effects. Nicotine lozenges were found to decrease intentions to smoke and withdrawal-related craving in dependent but not in nondependent smokers. Finally, the presentation of alcohol cues was found to increase intentions to smoke relative to neutral cues across participants regardless of lozenge condition. Findings suggest that although the presentation of alcohol cues can increase alcohol- and tobacco-related cravings in smokers, such effects do not appear to be affected by acute nicotine administration. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  20. Promoter specific methylation of the dopamine transporter gene is altered in alcohol dependence and associated with craving.

    Science.gov (United States)

    Hillemacher, Thomas; Frieling, Helge; Hartl, Thomas; Wilhelm, Julia; Kornhuber, Johannes; Bleich, Stefan

    2009-01-01

    Dopaminergic neurotransmission plays a crucial role in the genesis and maintenance of alcohol dependence. Epigenetic regulation via promoter specific DNA methylation of the dopamine transporter gene (DAT) may influence altered dopaminergic neurotransmission in alcoholism. Aim of the present study was to investigate DNA promoter methylation of DAT in early alcohol withdrawal and in relation to alcohol craving. We analyzed blood samples of 76 patients admitted for detoxification treatment and compared them to 35 healthy controls. Methylation specific quantitative real-time PCR was used to measure the promoter specific DNA methylation of the dopamine transporter. We assessed the extent of alcohol craving using the obsessive compulsive drinking scale (OCDS). Compared to healthy controls we found a significant hypermethylation of the DAT-promoter (Mann-Whitney U-test: p=0.001). Ln-transformed methylation of the DAT-promoter was negatively associated with the OCDS (linear regression: Beta=-0.275, p=0.016), particularly with the obsessive subscale (Beta=-0.300, p=0.008). Findings of the present study show that the epigenetic regulation of the DAT-promoter is altered in patients undergoing alcohol withdrawal. Furthermore, hypermethylation of the DAT-promoter may play an important role in dopaminergic neurotransmission and is associated with decreased alcohol craving.

  1. Isoforms of transferrin in psoriasis patients abusing alcohol

    NARCIS (Netherlands)

    P. Hoefkens (Peter); E.M. Higgins; R.J. Ward (Roberta); H.G. van Eijk (Henk)

    1997-01-01

    textabstractThe different isoforms of transferrin have been quantified by isoelectric focusing in the sera of psoriasis patients with and without a history of abusing alcohol. In both male and female psoriasis subjects abusing alcohol, there were significant increases in the 2-sial

  2. A Randomized Trial of Extended Telephone-Based Continuing Care for Alcohol Dependence: Within-Treatment Substance Use Outcomes

    Science.gov (United States)

    McKay, James R.; Van Horn, Deborah H. A.; Oslin, David W.; Lynch, Kevin G.; Ivey, Megan; Ward, Kathleen; Drapkin, Michelle L.; Becher, Julie R.; Coviello, Donna M.

    2010-01-01

    Objective: The study tested whether adding up to 18 months of telephone continuing care, either as monitoring and feedback (TM) or longer contacts that included counseling (TMC), to intensive outpatient programs (IOPs) improved outcomes for alcohol-dependent patients. Method: Participants (N = 252) who completed 3 weeks of IOP were randomized to…

  3. Attentional bias and approach/avoidance tendencies do not predict relapse or time to relapse in alcohol dependency.

    NARCIS (Netherlands)

    Snelleman, M.; Schoenmakers, T.M.; Mheen, D. van de

    2015-01-01

    Background: Implicit processes such as attentional bias (AB) and automatic approach/avoidance tendencies (AA) play a role in substance use disorders. Whether these processes can predict a relapse in alcohol-dependent patients is still unclear and must be examined in more detail than has been done pr

  4. Gender Differences in Early Maladaptive Schemas in a Treatment-Seeking Sample of Alcohol-Dependent Adults

    Science.gov (United States)

    Shorey, Ryan C.; Anderson, Scott E.; Stuart, Gregory L.

    2012-01-01

    The current study examined early maladaptive schemas among alcohol-dependent men and women and sought to determine whether men and women differed in their early maladaptive schemas. Using preexisting patient records of adults diagnosed with alcohol dependence from a residential treatment center in the Southeastern United States, from 2005 to 2010 (N = 854), results showed that women scored significantly higher than men on 14 of the 18 early maladaptive schemas assessed. Both women and men endorsed having a number of early maladaptive schemas, with four schemas being particularly prevalent across gender. Study limitations are noted and implications of these findings for treatment and future research are discussed. PMID:22060801

  5. Malnutrition and hospital prognosis in the alcoholic patient.

    Science.gov (United States)

    Bienia, R; Ratcliff, S; Barbour, G L; Kummer, M

    1982-01-01

    The nutritional status of 65 alcoholic patients admitted to the Medical Service of a Veterans Administration Hospital was evaluated and compared to that 87 nonalcoholic patients admitted during the same period of time. There was no statistical difference in the prevalence of malnutrition in the alcoholic population (36.9%) when compared to the nonalcoholic population (43.7%). The death rate and incidence of infection were similar in both populations as was the prevalence of anemia, depressed total lymphocyte count, and skin test anergy. Malnutrition, however, correlated with an increased death rate and incidence of infection, regardless of whether the patient was an alcoholic or not.

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

    Science.gov (United States)

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

    1998-01-01

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

  7. Nuclear magnetic resonance spectroscopy based metabolomics to identify novel biomarkers of alcohol-dependence

    Directory of Open Access Journals (Sweden)

    Hamza Mostafa

    2017-04-01

    Full Text Available Alcohol misuse is a ravaging public health and social problem. Its harm can affect the drinkers and the whole society. Alcohol-dependence is a phase of alcohol misuse in which the drinker consumes excessive amounts of alcohol and has a continuous urge to consume alcohol. Current methods of alcohol dependence diagnoses are questionnaires and some biomarkers. However, both methods lack specificity and sensitivity. Metabolomics is a scientific field which deals with the identification and the quantification of the metabolites present in the metabolome using spectroscopic techniques such as nuclear magnetic resonance (NMR. Metabolomics helps to indicate the perturbation in the levels of metabolites in cells and tissues due to diseases or ingestion of any substances. NMR is one of the most widely used spectroscopic techniques in metabolomics because of its reproducibility and speed. Some recent metabolomics studies were conducted on alcohol consumption and alcohol misuse in animals and humans. However, few focused on identifying alcohol dependence novel biomarkers. A sensitive and specific technique such as NMR based metabolomics applied to find novel biomarkers in plasma and urine can be useful to diagnose alcohol-dependence.

  8. Alcohol and Masculinity: A Review and Reformulaton of the Sex Role, Dependency, and Power Theories of Alcoholism.

    Science.gov (United States)

    Lemle, Russell

    This review examines three theories of alcohol abuse by American males: (1) the sex role theory which states that men drink heavily because American culture accepts and encourages that activity in males; (2) the dependency theory, which interprets drinking as a means by which men secretly gratify their dependency needs while manifesting an…

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

    DEFF Research Database (Denmark)

    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...... childhood measures were correlated, a multiple regression showed that each independently predicted a measure of lifetime alcoholism severity. Conclusions: ADHD comorbid with CD was the strongest predictor of later alcohol dependence. (J. Stud. Alcohol Drugs 70: 169-177, 2009)....

  10. Metacognition, emotion, and alcohol dependence in college students: a moderated mediation model.

    Science.gov (United States)

    Moneta, Giovanni B

    2011-07-01

    Based on Wells and Matthews' (1994) theory of psychological dysfunction and prior empirical studies, it was hypothesized that negative emotion would mediate the relationship between maladaptive metacognition and alcohol dependence, and maladaptive metacognition would moderate the relationship between negative emotion and alcohol dependence. A sample of 300 British college students completed the Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, and Meta-Cognitions Questionnaire 30. Metacognitive traits, emotions, and alcohol dependence were positively intercorrelated. Moderated mediation modeling indicated that metacognition fosters emotion and moderates the relationship between emotion and alcohol dependence in such a way that emotion and dependence are positively associated for high metacognition and are negatively associated for low metacognition. The implications of the findings are discussed.

  11. 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

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

    Directory of Open Access Journals (Sweden)

    Susana eJiménez-Murcia

    2016-03-01

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

  13. 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

    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. 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. 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. 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.

  14. Positive Selection on Loci Associated with Drug and Alcohol Dependence.

    Directory of Open Access Journals (Sweden)

    Brooke Sadler

    Full Text Available Much of the evolution of human behavior remains a mystery, including how certain disadvantageous behaviors are so prevalent. Nicotine addiction is one such phenotype. Several loci have been implicated in nicotine related phenotypes including the nicotinic receptor gene clusters (CHRNs on chromosomes 8 and 15. Here we use 1000 Genomes sequence data from 3 populations (Africans, Asians and Europeans to examine whether natural selection has occurred at these loci. We used Tajima's D and the integrated haplotype score (iHS to test for evidence of natural selection. Our results provide evidence for strong selection in the nicotinic receptor gene cluster on chromosome 8, previously found to be significantly associated with both nicotine and cocaine dependence, as well as evidence selection acting on the region containing the CHRNA5 nicotinic receptor gene on chromosome 15, that is genome wide significant for risk for nicotine dependence. To examine the possibility that this selection is related to memory and learning, we utilized genetic data from the Collaborative Studies on the Genetics of Alcoholism (COGA to test variants within these regions with three tests of memory and learning, the Wechsler Adult Intelligence Scale (WAIS Block Design, WAIS Digit Symbol and WAIS Information tests. Of the 17 SNPs genotyped in COGA in this region, we find one significantly associated with WAIS digit symbol test results. This test captures aspects of reaction time and memory, suggesting that a phenotype relating to memory and learning may have been the driving force behind selection at these loci. This study could begin to explain why these seemingly deleterious SNPs are present at their current frequencies.

  15. Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity.

    Science.gov (United States)

    Leclercq, Sophie; Matamoros, Sébastien; Cani, Patrice D; Neyrinck, Audrey M; Jamar, François; Stärkel, Peter; Windey, Karen; Tremaroli, Valentina; Bäckhed, Fredrik; Verbeke, Kristin; de Timary, Philippe; Delzenne, Nathalie M

    2014-10-21

    Alcohol dependence has traditionally been considered a brain disorder. Alteration in the composition of the gut microbiota has recently been shown to be present in psychiatric disorders, which suggests the possibility of gut-to-brain interactions in the development of alcohol dependence. The aim of the present study was to explore whether changes in gut permeability are linked to gut-microbiota composition and activity in alcohol-dependent subjects. We also investigated whether gut dysfunction is associated with the psychological symptoms of alcohol dependence. Finally, we tested the reversibility of the biological and behavioral parameters after a short-term detoxification program. We found that some, but not all, alcohol-dependent subjects developed gut leakiness, which was associated with higher scores of depression, anxiety, and alcohol craving after 3 wk of abstinence, which may be important psychological factors of relapse. Moreover, subjects with increased gut permeability also had altered composition and activity of the gut microbiota. These results suggest the existence of a gut-brain axis in alcohol dependence, which implicates the gut microbiota as an actor in the gut barrier and in behavioral disorders. Thus, the gut microbiota seems to be a previously unidentified target in the management of alcohol dependence.

  16. Alcohol Dependence Associated with Increased Utilitarian Moral Judgment: A Case Control Study

    Science.gov (United States)

    Khemiri, Lotfi; Guterstam, Joar; Franck, Johan; Jayaram-Lindström, Nitya

    2012-01-01

    Recent studies indicate that emotional processes, mediated by the ventromedial prefrontal cortex (VMPC), are of great importance for moral judgment. Neurological patients with VMPC dysfunction have been shown to generate increased utilitarian moral judgments, i.e. are more likely to endorse emotionally aversive actions in order to maximize aggregate welfare, when faced with emotionally salient personal moral dilemmas. Patients with alcohol dependence (AD) also exhibit impairments in functions mediated by the prefrontal cortex, but whether they exhibit increased utilitarian moral reasoning has not previously been investigated. The aim of this study was to investigate moral judgment in AD patients (n = 20) compared to healthy controls (n = 20) matched by sex, age and education years. Each subject responded to a battery of 50 hypothetical dilemmas categorized as non-moral, moral impersonal and moral personal. They also responded to a questionnaire evaluating explicit knowledge of social and moral norms. Results confirmed our hypothesis that AD patients generated increased utilitarian moral judgment compared to controls when faced with moral personal dilemmas. Crucially, there was no difference in their responses to non-moral or impersonal moral dilemmas, nor knowledge of explicit social and moral norms. One possible explanation is that damage to the VMPC, caused by long term repeated exposure to alcohol results in emotional dysfunction, predisposing to utilitarian moral judgment. This work elucidates a novel aspect of the neuropsychological profile of AD patients, namely a tendency to generate utilitarian moral judgment when faced with emotionally salient moral personal dilemmas. PMID:22761922

  17. Analysis of alcohol dependence in indigenous peoples in Northern Siberia.

    Directory of Open Access Journals (Sweden)

    Michail Savchenko

    2015-06-01

    More severe course of alcoholism among indigenous population of North of Siberia leads to the destruction of traditional lifestyles and reduction of the indigenous population in the northern territories of the Russian Federation.

  18. Clinical profile of patients with nascent alcohol related seizures

    Directory of Open Access Journals (Sweden)

    P Sandeep

    2013-01-01

    Full Text Available Aim: The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS and to identify the prevalence of idiopathic generalized epilepsy (IGE in the same. Materials and Methods: 100 consecutive male patients presenting to a tertiary care center in South India with new onset ARS were analyzed with alcohol use disorders identification test (AUDIT score. All underwent 19 channel digital scalp electroencephalography (EEG and at least computed tomography (CT scan. Results: A total of 27 patients (27% who had cortical atrophy on CT had a mean duration of alcohol intake of 23.62 years compared with 14.55 years in patients with no cortical atrophy (P < 0.001. Twenty-two patients (22% had clustering in the current episode of whom 18 had cortical atrophy. Nearly, 88% patients had generalized tonic clonic seizures while 12% who had partial seizures underwent magnetic resonance imaging (MRI, which identified frontal focal cortical dysplasia in one. Mean lifetime duration of alcohol intake in patients presenting with seizures within 6 hours (6H-gp of intake of alcohol was significantly lower (P = 0.029. One patient in the 6H-gp with no withdrawal symptoms had EEG evidence for IGE and had a lower AUDIT score compared with the rest. Conclusion: CT evidence of cortical atrophy is related to the duration of alcohol intake and portends an increased risk for clustering. Partial seizures can be a presenting feature of ARS and those patients may benefit from MRI to identify underlying symptomatic localization related epilepsy (8.3% of partial seizures. IGE is more likely in patients presenting with ARS within first 6 hours especially if they do not have alcohol withdrawal symptoms and scalp EEG is helpful to identify this small subgroup (~1% who may require long-term anti-epileptic medication.

  19. Impact of a medical student alcohol intervention workshop using recovering alcoholics as simulated patients

    Directory of Open Access Journals (Sweden)

    Johnson JA

    2014-05-01

    Full Text Available J Aaron Johnson,1 J Paul Seale,1 Sylvia Shellenberger,1 Mary M Velasquez,2 Candice Alick,1 Katherine Turk3 1Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA, 2School of Social Work, University of Texas-Austin, Austin, TX, 3Department of Surgery, University of Alabama-Birmingham, Birmingham, AL, USA Background: Alcohol screening and brief intervention (SBI reduces drinking among at-risk drinkers. Lack of training and negative attitudes represents a barrier to SBI performance. This study evaluates the impact of a medical student workshop using recovering alcoholics in simulated patient interviews to teach SBI skills. Methods: Third-year students (n=94 were surveyed before and after a 3-hour alcohol SBI workshop regarding their perceived importance and confidence in performing eleven SBI behaviors. Students were also asked to list factors increasing and decreasing motivation to conduct SBI. Students completing off-campus rotations (n=71 served as controls, completing surveys during the same time period but without attending the workshop. Results: Analysis of variance found a significant interaction effect between the students participating in the workshop and control students on both importance scores [F(2,174=3.34] and confidence scores [F(2,174=9.13], indicating higher scores for the workshop students at the follow-up time periods. Commonly listed motivators for performing SBI included clinical experience with alcohol misuse and the impact of alcohol on health and relationships. High relapse rates and patient reactions to questions about alcohol use decreased the motivation to perform SBI. Conclusion: SBI workshops that include recovering alcoholics as simulated patients can produce long-term improvements in students' perceived importance and confidence in performing SBI. Keywords: alcohol, screening, medical students, brief intervention

  20. Loss in Connectivity (LoCo) among regions of the brain reward system in alcohol dependence

    OpenAIRE

    Kuceyeski, Amy; Meyerhoff, Dieter J.; Timothy C. Durazzo; Raj, Ashish

    2012-01-01

    A recently developed measure of structural brain connectivity disruption, the Loss in Connectivity (LoCo), is adapted for studies in alcohol dependence. LoCo uses independent tractography information from young healthy controls to project the location of white matter microstructure abnormalities in alcohol dependent vs. non-dependent individuals onto connected gray matter regions. The LoCo scores are computed from white matter abnormality masks derived at two levels: 1) group-wise differences...

  1. Abnormal intrinsic functional hubs in alcohol dependence: evidence from a voxelwise degree centrality analysis.

    Science.gov (United States)

    Luo, Xiaoping; Guo, Linghong; Dai, Xi-Jian; Wang, Qinglai; Zhu, Wenzhong; Miao, Xinjun; Gong, Honghan

    2017-01-01

    To explore the abnormal intrinsic functional hubs in alcohol dependence using voxelwise degree centrality analysis approach, and their relationships with clinical features. Twenty-four male alcohol dependence subjects free of medicine (mean age, 50.21±9.62 years) and 24 age- and education-matched male healthy controls (mean age, 50.29±8.92 years) were recruited. The alcohol use disorders identification test and the severity of alcohol dependence questionnaire (SADQ) were administered to assess the severity of alcohol craving. Voxelwise degree centrality approach was used to assess the abnormal intrinsic functional hubs features in alcohol dependence. Simple linear regression analysis was performed to investigate the relationships between the clinical features and abnormal intrinsic functional hubs. Compared with healthy controls, alcohol dependence subjects exhibited significantly different degree centrality values in widespread left lateralization brain areas, including higher degree centrality values in the left precentral gyrus (BA 6), right hippocampus (BA 35, 36), and left orbitofrontal cortex (BA 11) and lower degree centrality values in the left cerebellum posterior lobe, bilateral secondary visual network (BA 18), and left precuneus (BA 7, 19). SADQ revealed a negative linear correlation with the degree centrality value in the left precentral gyrus (R(2)=0.296, P=0.006). The specific abnormal intrinsic functional hubs appear to be disrupted by alcohol intoxication, which implicates at least three principal neural systems: including cerebellar, executive control, and visual cortex, which may further affect the normal motor behavior such as an explicit type of impaired driving behavior. These findings expand our understanding of the functional characteristics of alcohol dependence and may provide a new insight into the understanding of the dysfunction and pathophysiology of alcohol dependence.

  2. Neuropeptide Y (NPY) in the extended amygdala is recruited during the transition to alcohol dependence.

    Science.gov (United States)

    Gilpin, Nicholas W

    2012-12-01

    Neuropeptide Y (NPY) is abundant in the extended amygdala, a conceptual macrostructure in the basal forebrain important for regulation of negative affective states. NPY has been attributed a central role in anxiety-like behavior, fear, nociception, and reward in rodents. Deletion of the NPY gene in mice produces a high-anxiety high-alcohol-drinking phenotype. NPY infused into the brains of rats selectively bred to consume high quantities of alcohol suppresses alcohol drinking by those animals, an effect that is mediated by central amygdala (CeA). Likewise, alcohol-preferring rats exhibit basal NPY deficits in CeA. NPY infused into the brains of alcohol-dependent rats blocks excessive alcohol drinking by those animals, an effect that also has been localized to the CeA. NPY in CeA may rescue dependence-induced increases in anxiety and alcohol drinking via inhibition of downstream effector regions that receive GABAergic inputs from CeA. It is hypothesized here that NPY modulates anxiety-like behavior via Y2R regulation of NPY release, whereas NPY modulation of alcohol-drinking behavior in alcohol-dependent animals occurs via Y2R regulation of GABA release.

  3. Genetic overlap between impulsivity and alcohol dependence: a large-scale national twin study.

    Science.gov (United States)

    Khemiri, L; Kuja-Halkola, R; Larsson, H; Jayaram-Lindström, N

    2016-04-01

    Alcohol dependence is associated with increased levels of impulsivity, but the genetic and environmental underpinnings of this overlap remain unclear. The purpose of the current study was to investigate the degree to which genetic and environmental factors contribute to the overlap between alcohol dependence and impulsivity. Univariate and bivariate twin model fitting was conducted for alcohol dependence and impulsivity in a national sample of 16 819 twins born in Sweden from 1959 to 1985. The heritability estimate for alcohol dependence was 44% [95% confidence interval (CI) 31-57%] for males and 62% (95% CI 52-72%) for females. For impulsivity, the heritability was 33% (95% CI 30-36%) in males and females. The bivariate twin analysis indicated a statistically significant genetic correlation between alcohol dependence and impulsivity of 0.40 (95% CI 0.23-0.58) in males and 0.20 (95% CI 0.07-0.33) in females. The phenotypic correlation between alcohol dependence and impulsivity was 0.20 and 0.17 for males and females, respectively, and the bivariate heritability was 80% (95% CI 47-117%) for males and 53% (95% CI 19-86%) for females. The remaining variance in all models was accounted for by non-shared environmental factors. The association between alcohol dependence and impulsivity can be partially accounted for by shared genetic factors. The genetic correlation was greater in men compared with women, which may indicate different pathways to the development of alcohol dependence between sexes. The observed genetic overlap has clinical implications regarding treatment and prevention, and partially explains the substantial co-morbidity between alcohol dependence and psychiatric disorders characterized by impulsive behaviour.

  4. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak.

    Science.gov (United States)

    Wu, Ping; Liu, Xinhua; Fang, Yunyun; Fan, Bin; Fuller, Cordelia J; Guan, Zhiqiang; Yao, Zhongling; Kong, Junhui; Lu, Jin; Litvak, Iva J

    2008-01-01

    The aim of this study was to examine alcohol abuse/dependence symptoms among hospital employees exposed to a severe acute respiratory syndrome (SARS) outbreak, and the relationship between types of exposure to the SARS outbreak and subsequent alcohol abuse/dependence symptoms. A survey was conducted among 549 randomly selected hospital employees in Beijing, China, concerning the psychological impact of the 2003 SARS outbreak. Subjects were assessed on sociodemographic factors and types of exposure to the outbreak, and on symptoms of post-traumatic stress (PTS), alcohol abuse/dependence and depression. Current alcohol abuse/dependence symptom counts 3 years after the outbreak were positively associated with having been quarantined, or worked in high-risk locations such as SARS wards, during the outbreak. However, having had family members or friends contract, SARS was not related to alcohol abuse/dependence symptom count. Symptoms of PTS and of depression, and having used drinking as a coping method, were also significantly associated with increased alcohol abuse/dependence symptoms. The relationship between outbreak exposure and alcohol abuse/dependence symptom count remained significant even when sociodemographic and other factors were controlled for. When the intrusion, avoidance and hyperarousal PTS symptom clusters were entered into the model, hyperarousal was found to be significantly associated with alcohol abuse/dependence symptoms. Exposure to an outbreak of a severe infectious disease can, like other disaster exposures, lead not only to PTSD but also to other psychiatric conditions, such as alcohol abuse/dependence. The findings will help policy makers and health professionals to better prepare for potential outbreaks of diseases such as SARS or avian flu.

  5. Validation of differential GDAP1 DNA methylation in alcohol dependence and its potential function as a biomarker for disease severity and therapy outcome.

    Science.gov (United States)

    Brückmann, Christof; Di Santo, Adriana; Karle, Kathrin Nora; Batra, Anil; Nieratschker, Vanessa

    2016-06-02

    Alcohol dependence is a severe disorder contributing substantially to the global burden of disease. Despite the detrimental consequences of chronic alcohol abuse and dependence, effective prevention strategies as well as treatment options are largely missing to date. Accumulating evidence suggests that gene-environment interactions, including epigenetic mechanisms, play a role in the etiology of alcohol dependence. A recent epigenome-wide study reported widespread alterations of DNA methylation patterns in alcohol dependent patients compared to control individuals. In the present study, we validate and replicate one of the top findings from this previous investigation in an independent cohort: the hypomethylation of GDAP1 in patients. To our knowledge, this is the first independent replication of an epigenome-wide finding in alcohol dependence. Furthermore, the AUDIT as well as the GSI score were negatively associated with GDAP1 methylation and we found a trend toward a negative association between GDAP1 methylation and the years of alcohol dependency, pointing toward a potential role of GDAP1 hypomethylation as biomarker for disease severity. In addition, we show that the hypomethylation of GDAP1 in patients reverses during a short-term alcohol treatment program, suggesting that GDAP1 DNA methylation could also serve as a potential biomarker for treatment outcome. Our data add to the growing body of knowledge on epigenetic effects in alcohol dependence and support GDAP1 as a novel candidate gene implicated in this disorder. As the role of GDAP1 in alcohol dependence is unknown, this novel candidate gene should be followed up in future studies.

  6. Do premorbid predictors of alcohol dependence also predict the failure to recover from alcoholism?

    DEFF Research Database (Denmark)

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

    2010-01-01

    a Danish birth cohort (N = 9,182). Two thirds of the subjects were high-risk biological sons of treated alcoholics. A large number of measures (361) were obtained at different periods before any subject had developed an alcohol-use disorder. At age 40, a psychiatrist provided mutually exclusive lifetime......: cognitive efficiency and early behavioral dyscontrol in childhood. Both factors predicted the failure to remit (low cognitive efficiency and high behavioral dyscontrol) even when lifetime alcoholism severity was controlled. CONCLUSIONS: This 4-decade study found a striking disconnect between measures...

  7. Dependency conflict, marital threat, and alcohol consumption in a middle-aged sample.

    Science.gov (United States)

    Schwarz, J C; Wheeler, D S

    1992-09-01

    The hypothesis that dependency conflict is associated with higher levels of alcohol consumption when dependency needs are threatened or thwarted was tested with a sample of 672 middle-aged, married adults with college-age children. The subjects' current level of alcohol consumption was predicted based on the present level of threat to the marital relationship (assessed by reports from several family members) and on indices of dependency need and inhibition of dependent behavior estimated from sibship size, sibship density, and sibling position. A multiple regression analysis yielded a significant two-way interaction (p less than .05) between marital threat and subject sex, and a significant three-way interaction of dependency need, inhibition of dependent behavior, and marital threat. High marital threat was associated with higher levels of alcohol consumption in men and slightly lower levels of alcohol consumption in women. Additionally, when dependency need was high, alcohol consumption was generally low, except when both inhibition of dependent behavior and marital threat were high. However, when dependency need was low, the highest alcohol consumption score occurred when marital threat was low and inhibition was high.

  8. Psychological factors of propensity for alcoholism (social anxiety, hostility, Machiavellianism in depressive patients.

    Directory of Open Access Journals (Sweden)

    Popinako A.V.

    2014-07-01

    Full Text Available Based on the analysis of psychosocial models of alcoholism and depression the general and specific factors of occurrence and course of illness are identified in the present study. The authors put forward hypotheses regarding the mechanisms of activation of psychological addiction to alcohol as an ineffective coping strategy. The necessity of empirical research needed to refine the techniques and targets of patient care within the psychiatric and psychological care is justified. The results of the pilot study show that depressed patients who are subject to alcohol dependence feature marked distress in interpersonal relations, coupled with hostility and aim at gaining profit and pleasure by manipulating other people. These patients are hostile to others, while in interpersonal relationships personal safety is important to them, so they may be more likely to resort to manipulation. In their attitudes with respect to health the communication of these patients is characterized by hedonistic tendencies and histrionic traits in interpersonal contacts.

  9. Cerebral Hemodynamics With rTMS in Alcohol Dependence: A Randomized, Sham-Controlled Study.

    Science.gov (United States)

    Mishra, Biswa Ranjan; Maiti, Rituparna; Nizamie, S Haque

    2016-04-08

    The authors studied cerebral hemodynamics in alcohol dependence and evaluated their changes with application of high-frequency rTMS. A prospective, single-blind, randomized, parallel-group, sham-controlled clinical study was conducted with patients with alcohol dependence (DSM-IV-TR). The study population comprised 25 subjects each in active rTMS, sham rTMS, and healthy control groups. At baseline, cerebral hemodynamic indices were measured with transcranial Doppler sonography. Subjects in the active rTMS group received 10 sessions of rTMS daily; the sham group was administered sham rTMS with the same parameters. Cerebral hemodynamic parameters were repeated 5 minutes after the last rTMS session. At baseline, mean velocity (MV) of both middle cerebral artery (MCA; R-MCA: p=0.003; L-MCA: p=0.002) and anterior cerebral artery (ACA; R-ACA: p=0.003; L-ACA: p=.001) was significantly reduced. Pulsatility index (PI) of MCA (prTMS group, except L-MCA PI, significant differences were observed in values of MV, PI, and RI of both MCA and ACA following rTMS intervention; such changes were not evident in the sham rTMS group. The changes in mean difference in MV of L-MCA (p=0.006) and L-ACA (p=0.015) were statistically significant in the active rTMS group, in comparison with the sham group. Significant differences were also observed between the two groups postintervention, in RI of L-MCA (p=0.001) and ACA (R-ACA: p=0.010; L-ACA: p=0.015). Alcohol dependence may result in altered cerebral hemodynamic parameters, which can be improved with high-frequency rTMS application.

  10. Rehabilitation analysis of relapse drinking rate caused by psychological therapy and family intervention treating patients with alcohol dependence%对酒依赖患者采用心理治疗与家庭干预后复饮率的分析

    Institute of Scientific and Technical Information of China (English)

    马世发; 李亚军

    2015-01-01

    Objective:To explore the influence of psychological treatment and family intervention for patients with alcohol dependence on relapse drinking rate.Methods:61 cases of patients with alcohol dependence were divided into two groups randomly.The control group was given simple drug therapy,the observation group was given psychological treatment and family intervention based on drug therapy.Follow-up for 6 months after discharged from hospital,the relapse drinking rate of the two groups were compared.Results:The relapse drinking rate of the observation group 25.0% was significantly lower than that of the control group 64.0% ,the difference was statistically significant(P<0.05).Conclusion:Psychological treatment and family intervention based on drug therapy for patients with alcohol dependence could decrease the relapse drinking rate of patients.%目的:探讨心理治疗与家庭干预对酒依赖患者复饮率的影响。方法:收治酒依赖患者61例,随机分为两组。对照组给予单纯药物治疗,观察组在此基础上给予心理治疗及家庭干预。出院6个月后随访,比较两组复饮率。结果:观察组复饮率25.0%,明显低于对照组的64.0%,差异具有统计学意义(P<0.05)。结论:对酒依赖患者在药物治疗的基础上行心理治疗及家庭干预,可以适当降低患者的复饮率。

  11. Informal Control by Family and Risk Markers for Alcohol Abuse/Dependence in Seoul.

    Science.gov (United States)

    Emery, Clifton R; Wu, Shali; Yang, Hyerin; Lee, Hotaek; Kim, Junpyo; Chan, Ko Ling

    2016-05-08

    Although previous research documents a reliable relationship between physical intimate partner violence (IPV) victimization and alcoholism, relatively little research has examined new theoretical constructs in IPV research that may increase risk for or help buffer women from alcohol abuse/dependence. The purpose of the present study was to examine informal social control of IPV by family members as a protective factor against and coercive control as a risk factor for alcohol abuse/dependence in a small population sample of married women in Seoul, South Korea. We hypothesized that (a) informal social control by family members would be negatively associated with victim alcohol abuse/dependence and (b) husband's coercive control would be positively associated with victim alcohol abuse/dependence. We measured alcohol abuse/dependence (CAGE scale), IPV and coercive control by husbands, and informal social control of IPV (ISC_IPV) by extended family members in a three-stage random cluster sample of 462 married women in Seoul, South Korea. Both random effects regression and zero-inflated Poisson regression models found that ISC_IPV by extended family members was associated with a significantly lower CAGE scores, and coercive control was associated with significantly higher CAGE scores. Interventions to boost ISC_IPV by extended family members may mitigate some of the risk of alcohol abuse/dependence by victims.

  12. In vivo imaging of translocator protein, a marker of activated microglia, in alcohol dependence.

    Science.gov (United States)

    Hillmer, A T; Sandiego, C M; Hannestad, J; Angarita, G A; Kumar, A; McGovern, E M; Huang, Y; O'Connor, K C; Carson, R E; O'Malley, S S; Cosgrove, K P

    2017-02-28

    Neuroinflammation may be a critical component of the neurobiology of alcohol use disorders, yet the exact nature of this relationship is not well understood. This work compared the brain and peripheral immune profile of alcohol-dependent subjects and controls. Brain levels of 18-kDa translocator protein (TSPO), a marker of microglial activation and neuroinflammation, were measured with [(11)C]PBR28 positron emission tomography imaging in 15 healthy controls and 15 alcohol-dependent subjects. Alcohol-dependent subjects were imaged 1-4 days (n=14) or 24 days (n=1) after their last drink. Linear mixed modeling of partial-volume-corrected [(11)C]PBR28 data revealed a main effect of alcohol dependence (P=0.034), corresponding to 10% lower TSPO levels in alcohol-dependent subjects. Within this group, exploratory analyses found a negative association of TSPO levels in the hippocampus and striatum with alcohol dependence severity (PMolecular Psychiatry advance online publication, 28 February 2017; doi:10.1038/mp.2017.10.

  13. Assessment of abstract reasoning abilities in alcohol-dependent subjects: an fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Bagga, Deepika; Singh, Namita; Singh, Sadhana; Modi, Shilpi; Kumar, Pawan [Institute of Nuclear Medicine and Allied Sciences (INMAS), NMR Research Centre, Delhi (India); Bhattacharya, D. [Base Hospital, Department of Psychiatry, Delhi Cantt (India); Garg, Mohan L. [Panjab University, Department of Biophysics, Chandigarh (India); Khushu, Subash [Institute of Nuclear Medicine and Allied Sciences (INMAS), NMR Research Centre, Delhi (India); INMAS, DRDO, NMR Research Centre, Delhi (India)

    2014-01-15

    Chronic alcohol abuse has been traditionally associated with impaired cognitive abilities. The deficits are most evident in higher order cognitive functions, such as abstract reasoning, problem solving and visuospatial processing. The present study sought to increase current understanding of the neuropsychological basis of poor abstract reasoning abilities in alcohol-dependent subjects using functional magnetic resonance imaging (fMRI). An abstract reasoning task-based fMRI study was carried out on alcohol-dependent subjects (n = 18) and healthy controls (n = 18) to examine neural activation pattern. The study was carried out using a 3-T whole-body magnetic resonance scanner. Preprocessing and post processing was performed using SPM 8 software. Behavioral data indicated that alcohol-dependent subjects took more time than controls for performing the task but there was no significant difference in their response accuracy. Analysis of the fMRI data indicated that for solving abstract reasoning-based problems, alcohol-dependent subjects showed enhanced right frontoparietal neural activation involving inferior frontal gyrus, post central gyrus, superior parietal lobule, and occipito-temporal gyrus. The extensive activation observed in alcohol dependents as compared to controls suggests that alcohol dependents recruit additional brain areas to meet the behavioral demands for equivalent task performance. The results are consistent with previous fMRI studies suggesting decreased neural efficiency of relevant brain networks or compensatory mechanisms for the execution of task for showing an equivalent performance. (orig.)

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

    Science.gov (United States)

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

    2016-01-01

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

  15. A double-blind, placebo-controlled study of sertraline with naltrexone for alcohol dependence.

    LENUS (Irish Health Repository)

    Farren, Conor K

    2009-01-01

    Significant preclinical evidence exists for a synergistic interaction between the opioid and the serotonin systems in determining alcohol consumption. Naltrexone, an opiate receptor antagonist, is approved for the treatment of alcohol dependence. This double-blind placebo-controlled study examined whether the efficacy of naltrexone would be augmented by concurrent treatment with sertraline, a selective serotonin receptor uptake inhibitor (SSRI).

  16. Assessment of lexical semantic judgment abilities in alcohol-dependent subjects: An fMRI study

    Indian Academy of Sciences (India)

    D Bagga; N Singh; S Modi; P Kumar; D Bhattacharya; M L Garg; S Khushu

    2013-12-01

    Neuropsychological studies have shown that alcohol dependence is associated with neurocognitive deficits in tasks requiring memory, perceptual motor skills, abstraction and problem solving, whereas language skills are relatively spared in alcoholics despite structural abnormalities in the language-related brain regions. To investigate the preserved mechanisms of language processing in alcohol-dependents, functional brain imaging was undertaken in healthy controls (=18) and alcohol-dependents (=16) while completing a lexical semantic judgment task in a 3 T MR scanner. Behavioural data indicated that alcohol-dependents took more time than controls for performing the task but there was no significant difference in their response accuracy. fMRI data analysis revealed that while performing the task, the alcoholics showed enhanced activations in left supramarginal gyrus, precuneus bilaterally, left angular gyrus, and left middle temporal gyrus as compared to control subjects. The extensive activations observed in alcoholics as compared to controls suggest that alcoholics recruit additional brain areas to meet the behavioural demands for equivalent task performance. The results are consistent with previous fMRI studies suggesting compensatory mechanisms for the execution of task for showing an equivalent performance or decreased neural efficiency of relevant brain networks. However, on direct comparison of the two groups, the results did not survive correction for multiple comparisons; therefore, the present findings need further exploration.

  17. The Use of Gestalt Interventions in the Treatment of the Resistant Alcohol-Dependent Client.

    Science.gov (United States)

    Ramey, Luellen

    1998-01-01

    Reviews ethical and practical dilemmas associated with clients who have hidden alcohol dependencies, and proposes an approach rooted in Gestalt counseling theory which confronts these issues and is compatible with a current emerging alcohol-treatment model. Suggests specific activities for addressing client resistance to revealing a hidden alcohol…

  18. Industrialization Stresses, Alcohol Abuse & Substance Dependence: Differential Gender Effects in a Kenyan Rural Farming Community

    Science.gov (United States)

    Walt, Lisa C.; Kinoti, Elias; Jason, Leonard A.

    2013-01-01

    Developing countries' industrialization and urbanization attempts have been linked to psychological distress and alcohol abuse. We used Hobfoll's COR theory to examine the relationship between gender, perceived resource loss (an indicator of industrialization stress), and alcohol abuse and dependence in a sample of Kenyan rural village men and…

  19. Gene-environment interactions and alcohol use and dependence: current status and future challenges

    NARCIS (Netherlands)

    Zwaluw, C.S. van der; Engels, R.C.M.E.

    2009-01-01

    To discuss the current status of gene-environment interaction research with regard to alcohol use and dependence. Further, we highlight the difficulties concerning gene-environment studies. Overview of the current evidence for gene-environment interactions in alcohol outcomes, and of the associated

  20. Metabolic syndrome in alcohol-dependent men: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jitender Aneja

    2013-01-01

    Full Text Available Background: In the context to mental illness metabolic syndrome (MS has gained significant attention in the last decade. The present research aimed to study the prevalence of MS and its correlates among the alcohol-dependent men at a deaddiction center in Northern India. Materials and Methods: A cross-sectional analysis was done for consecutive male subjects who met the diagnosis of alcohol-dependence syndrome currently using alcohol according to the International Clinical Diagnostic criteria- tenth revision mental and behavioral disorder- Clinical description and diagnostic guidelines criteria (ICD-10. The subjects were evaluated for alcohol consumption and the components of MS as per the International Diabetic Federation (IDF and National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III. Results: A total of 200 male subjects were studied: 100 subjects meeting ICD-10 criteria for alcohol dependence currently using alcohol; 50 each of genetically related controls and nongenetically related healthy controls. As per the IDF (with ethnicity specific modifications for waist circumference and NCEP ATP- III definitions, respectively, MS was found to be less prevalent in alcohol-dependent subjects (27% and 18% in comparison the healthy controls (30% and 20%. Conclusion: Findings of the study suggest that irrespective of the amount the current alcohol intake is associated with a lower prevalence of MS and a favorable effect on serum high density lipoproteins and waist circumference. However, the cross-sectional nature of our study does not allow any definitive causal inference.

  1. Persistent cannabis dependence and alcohol dependence represent risks for midlife economic and social problems: A longitudinal cohort study.

    Science.gov (United States)

    Cerdá, Magdalena; Moffitt, Terrie E; Meier, Madeline H; Harrington, HonaLee; Houts, Renate; Ramrakha, Sandhya; Hogan, Sean; Poulton, Richie; Caspi, Avshalom

    2016-11-01

    With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18-38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (n=1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence.

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  3. Counteracting incentive sensitization in severe alcohol dependence using deep brain stimulation of the nucleus accumbens: clinical and basic science aspects

    Directory of Open Access Journals (Sweden)

    Hans-Jochen Heinze

    2009-09-01

    Full Text Available The ventral striatum / nucleus accumbens has been implicated in the craving for drugs and alcohol which is a major reason for relapse of addicted people. Craving might be induced by drug-related cues. This suggests that disruption of craving-related neural activity in the nucleus accumbens may significantly reduce craving in alcohol-dependent patients. Here we report on preliminary clinical and neurophysiological evidence in three male patients who were treated with high frequency deep brain stimulation of the nucleus accumbens bilaterally. All three had been alcohol dependent for many years, unable to abstain from drinking, and had experienced repeated relapses prior to the stimulation. After the operation, craving was greatly reduced and all three patients were able to abstain from drinking for extended periods of time. Immediately after the operation but prior to connection of the stimulation electrodes to the stimulator, local field potentials were obtained from the externalized cables in two patients while they performed cognitive tasks addressing action monitoring and incentive salience of drug related cues. LFPs in the action monitoring task provided further evidence for a role of the nucleus accumbens in goal-directed behaviors. Importantly, alcohol related cue stimuli in the incentive salience task modulated LFPs even though these cues were presented outside of the attentional focus. This implies that cue-related craving involves the nucleus accumbens and is highly automatic.

  4. Coprophagia and Entomophagia in a Patient with Alcohol Related Dementia

    Directory of Open Access Journals (Sweden)

    João B. Fonseca

    2017-01-01

    Full Text Available Coprophagia and entomophagia are two phenomena not commonly reported in the medical literature and their occurrence is usually associated with mental disorders. We present the case of a 59-year-old man with a history of alcohol abuse who was evaluated due to cognitive deterioration and disturbed eating habits including feces and living insects. Organic causes were ruled out and an important cognitive impairment became evident on neuropsychological formal test. The behavior remitted after antipsychotic pharmacologic therapy and alcohol detoxification, leaving the diagnostic impression of alcohol related dementia. This report shows a rare association of these two conditions in a patient with dementia.

  5. Differential effects of ghrelin antagonists on alcohol drinking and reinforcement in mouse and rat models of alcohol dependence.

    Science.gov (United States)

    Gomez, Juan L; Cunningham, Christopher L; Finn, Deborah A; Young, Emily A; Helpenstell, Lily K; Schuette, Lindsey M; Fidler, Tara L; Kosten, Therese A; Ryabinin, Andrey E

    2015-10-01

    An effort has been mounted to understand the mechanisms of alcohol dependence in a way that may allow for greater efficacy in treatment. It has long been suggested that drugs of abuse seize fundamental reward pathways and disrupt homeostasis to produce compulsive drug seeking behaviors. Ghrelin, an endogenous hormone that affects hunger state and release of growth hormone, has been shown to increase alcohol intake following administration, while antagonists decrease intake. Using rodent models of dependence, the current study examined the effects of two ghrelin receptor antagonists, [DLys3]-GHRP-6 (DLys) and JMV2959, on dependence-induced alcohol self-administration. In two experiments adult male C57BL/6J mice and Wistar rats were made dependent via intermittent ethanol vapor exposure. In another experiment, adult male C57BL/6J mice were made dependent using the intragastric alcohol consumption (IGAC) procedure. Ghrelin receptor antagonists were given prior to voluntary ethanol drinking. Ghrelin antagonists reduced ethanol intake, preference, and operant self-administration of ethanol and sucrose across these models, but did not decrease food consumption in mice. In experiments 1 and 2, voluntary drinking was reduced by ghrelin receptor antagonists, however this reduction did not persist across days. Despite the transient effects of ghrelin antagonists, the drugs had renewed effectiveness following a break in administration as seen in experiment 1. The results show the ghrelin system as a potential target for studies of alcohol abuse. Further research is needed to determine the central mechanisms of these drugs and their influence on addiction in order to design effective pharmacotherapies.

  6. Sulpiride Psychopharmacotherapy in Patients with Alcohol Addiction and Depression Comorbidity

    OpenAIRE

    2003-01-01

    Depression is quite common in the early stage of treatment for alcohol addiction. The patient's awareness of his difficult situation may be one of the reasons for depression. Furthermore, depression can develop as the result of depressive disorders that are primarily or secondarily associated with alcohol addiction. Antidepressive therapy is usually initiated after a two-week detoxification procedure. Only exceptionally it may start earlier in case of severe depressive disorder. The administr...

  7. Dorsolateral prefrontal cortex contributes to the impaired behavioral adaptation in alcohol dependence

    Directory of Open Access Journals (Sweden)

    Sinem Balta Beylergil

    2017-01-01

    Full Text Available Substance-dependent individuals often lack the ability to adjust decisions flexibly in response to the changes in reward contingencies. Prediction errors (PEs are thought to mediate flexible decision-making by updating the reward values associated with available actions. In this study, we explored whether the neurobiological correlates of PEs are altered in alcohol dependence. Behavioral, and functional magnetic resonance imaging (fMRI data were simultaneously acquired from 34 abstinent alcohol-dependent patients (ADP and 26 healthy controls (HC during a probabilistic reward-guided decision-making task with dynamically changing reinforcement contingencies. A hierarchical Bayesian inference method was used to fit and compare learning models with different assumptions about the amount of task-related information subjects may have inferred during the experiment. Here, we observed that the best-fitting model was a modified Rescorla-Wagner type model, the “double-update” model, which assumes that subjects infer the knowledge that reward contingencies are anti-correlated, and integrate both actual and hypothetical outcomes into their decisions. Moreover, comparison of the best-fitting model's parameters showed that ADP were less sensitive to punishments compared to HC. Hence, decisions of ADP after punishments were loosely coupled with the expected reward values assigned to them. A correlation analysis between the model-generated PEs and the fMRI data revealed a reduced association between these PEs and the BOLD activity in the dorsolateral prefrontal cortex (DLPFC of ADP. A hemispheric asymmetry was observed in the DLPFC when positive and negative PE signals were analyzed separately. The right DLPFC activity in ADP showed a reduced correlation with positive PEs. On the other hand, ADP, particularly the patients with high dependence severity, recruited the left DLPFC to a lesser extent than HC for processing negative PE signals. These results

  8. A randomized comparative trial in the management of Alcohol Dependence: Individualized Homoeopathy versus standard Allopathic Treatment

    Directory of Open Access Journals (Sweden)

    Raj K Manchanda

    2016-01-01

    Full Text Available Objectives: This study was undertaken to compare the effects of IH with standard allopathic (SA treatment. Methods: A randomized controlled, open-label, comparative trial, was conducted, in which alcohol dependents were screened verbally using the CAGE scale. The participants 80 patients fulfilling the inclusion criteria were randomized either IH (n=40 or SA (n=40 and treated cum followed up for 12 months. The primary outcome was more than 50% reduction in the Severity of Alcohol Dependence Questionnaire [SADQ] rating scale at 12 th month. Data analysis was done for both intention-to-treat (ITT and per-protocol (PP populations. Results: ITT analysis reflected 80% (n = 32 of the patients in IH and 37.5% (n = 15 of the patients in the SA responding to CI before 2.4 treatment with absolute difference was 42.5% (42.5 [95% confidence interval [CI]: 23.0, 61.6] and estimated effect: 6.6 (95% C.I: 2.4, 18.2, P = 0.0002. A significant difference favoring IH was also observed in three out of four domains of WHO QOL-BREF. Statistically significant difference was found in the number of drinking days (median difference: −24.00; CI: −39.0-−8.0; P = 0.001 and number of drinks per drinking day (median difference: −6.3 [95% CI: −11.3-−1.9]; P = 0.004, favoring IH. The results showed a similar trend in PP analysis. Medicines found useful were Sulphur, Lycopodium clavatum, Arsenicum album, Nux vomica, Phosphorus, and Lachesis. Conclusion: The results conclude that IH is not inferior to SA in the management of AD patients. More rigorous studies with large sample size are however desirable.

  9. Prefrontal response and frontostriatal functional connectivity to monetary reward in abstinent alcohol-dependent young adults

    National Research Council Canada - National Science Library

    Forbes, Erika E; Rodriguez, Eric E; Musselman, Samuel; Narendran, Rajesh

    2014-01-01

    ... function that are central to addiction. In addition, few studies have examined function in these regions during young adulthood, when exposure is less chronic than in typical samples of alcohol-dependent adults...

  10. Crystal structure of quinone-dependent alcohol dehydrogenase from Pseudogluconobacter saccharoketogenes. A versatile dehydrogenase oxidizing alcohols and carbohydrates.

    Science.gov (United States)

    Rozeboom, Henriëtte J; Yu, Shukun; Mikkelsen, Rene; Nikolaev, Igor; Mulder, Harm J; Dijkstra, Bauke W

    2015-12-01

    The quinone-dependent alcohol dehydrogenase (PQQ-ADH, E.C. 1.1.5.2) from the Gram-negative bacterium Pseudogluconobacter saccharoketogenes IFO 14464 oxidizes primary alcohols (e.g. ethanol, butanol), secondary alcohols (monosaccharides), as well as aldehydes, polysaccharides, and cyclodextrins. The recombinant protein, expressed in Pichia pastoris, was crystallized, and three-dimensional (3D) structures of the native form, with PQQ and a Ca(2+) ion, and of the enzyme in complex with a Zn(2+) ion and a bound substrate mimic were determined at 1.72 Å and 1.84 Å resolution, respectively. PQQ-ADH displays an eight-bladed β-propeller fold, characteristic of Type I quinone-dependent methanol dehydrogenases. However, three of the four ligands of the Ca(2+) ion differ from those of related dehydrogenases and they come from different parts of the polypeptide chain. These differences result in a more open, easily accessible active site, which explains why PQQ-ADH can oxidize a broad range of substrates. The bound substrate mimic suggests Asp333 as the catalytic base. Remarkably, no vicinal disulfide bridge is present near the PQQ, which in other PQQ-dependent alcohol dehydrogenases has been proposed to be necessary for electron transfer. Instead an associated cytochrome c can approach the PQQ for direct electron transfer. © 2015 The Protein Society.

  11. Alcohol

    Science.gov (United States)

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

  12. Alcohol

    Science.gov (United States)

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

  13. Children of men with alcohol dependence: Psychopathology, neurodevelopment and family environment

    OpenAIRE

    Raman, Vijaya; Prasad, Suveera; Appaya, M. Prakash

    2010-01-01

    Background: Children of people with alcohol dependence (COAs) are at high risk for behavioral and cognitive problems. Aim: Aim of this study was to compare the nature and extent of these problems in children of men with and without alcohol dependence. Materials and Methods: 32 children (17 in study group and 15 controls) were evaluated for psychopathology, neurodevelopment, cognitive functioning and family environment. Tools used were: Socio-demographic data sheet, Malin’s Intelligence Scale ...

  14. Loss in connectivity among regions of the brain reward system in alcohol dependence

    OpenAIRE

    Kuceyeski, A.; Meyerhoff, DJ; Durazzo, TC; Raj, A.

    2013-01-01

    A recently developed measure of structural brain connectivity disruption, the loss in connectivity (LoCo), is adapted for studies in alcohol dependence. LoCo uses independent tractography information from young healthy controls to project the location of white matter (WM) microstructure abnormalities in alcohol-dependent versus nondependent individuals onto connected gray matter (GM) regions. LoCo scores are computed from WM abnormality masks derived at two levels: (1) groupwise differences o...

  15. Excitability of jcBNST neurons is reduced in alcohol-dependent animals during protracted alcohol withdrawal.

    Directory of Open Access Journals (Sweden)

    Attila Szücs

    Full Text Available Alcohol dependence and withdrawal has been shown to cause neuroadaptive changes at multiple levels of the nervous system. At the neuron level, adaptations of synaptic connections have been extensively studied in a number of brain areas and accumulating evidence also shows the importance of alcohol dependence-related changes in the intrinsic cellular properties of neurons. At the same time, it is still largely unknown how such neural adaptations impact the firing and integrative properties of neurons. To address these problems, here, we analyze physiological properties of neurons in the bed nucleus of stria terminalis (jcBNST in animals with a history of alcohol dependence. As a comprehensive approach, first we measure passive and active membrane properties of neurons using conventional current clamp protocols and then analyze their firing responses under the action of simulated synaptic bombardment via dynamic clamp. We find that most physiological properties as measured by DC current injection are barely affected during protracted withdrawal. However, neuronal excitability as measured from firing responses under simulated synaptic inputs with the dynamic clamp is markedly reduced in all 3 types of jcBNST neurons. These results support the importance of studying the effects of alcohol and drugs of abuse on the firing properties of neurons with dynamic clamp protocols designed to bring the neurons into a high conductance state. Since the jcBNST integrates excitatory inputs from the basolateral amygdala (BLA and cortical inputs from the infralimbic and the insular cortices and in turn is believed to contribute to the inhibitory input to the central nucleus of the amygdala (CeA the reduced excitability of the jcBNST during protracted withdrawal in alcohol-dependent animals will likely affect ability of the jcBNST to shape the activity and output of the CeA.

  16. Interaction of paracetamol in chronic alcoholic patients. Importance for odontologists.

    Science.gov (United States)

    Gómez-Moreno, Gerardo; Guardia, Javier; Cutando, Antonio

    2008-04-01

    For social, cultural and historical motives alcohol (ethanol or isopenthanol) is considered to be just a beverage rather than a liquor. However, from a pharmatherapeutic point of view alcohol is a depressor of the central nervous system. The effects of alcohol consumption can range from raised loquacity to drunkenness, loss of consciousness and death as a result of insufficient respiration. Probably the most frequent pharmacological interaction is the combination of alcohol with other depressors of the central nervous system which increases the depression even further. Some medicaments which more frequently produce an interaction are antihistamines, analgesics, antidepressants and medicaments for coughs, common cold and influenza. Paracetamol or acetaminophen is an analgesic medicament similar to acetylsalicylic acid lacking anticoagulatory properties and gastric irritation. However, its major drawback is hepatic toxicity as a result of a toxic metabolite produced in the liver by cytochrome P-450, principally cytochrome CYP2E1, which is detoxified under normal conditions by hepatic glutathione. Ethanol is also detoxified by CYP2E1, which is an inducer of ethanol such that chronic ingestion increases the level of this enzyme. When the ingestion of alcohol is stopped, CYP2E1 is greatly increased and only metabolises the paracetamol giving rise to high quantities of hepatotoxic metabolites so that the hepatic glutathione is unable to detoxify resulting in irreversible hepatic damage. Therefore for odontologists it is important that in chronic alcoholic patients the consumption of alcohol should not be suspended on prescribing paracetamol.

  17. Does Sexual Self-Concept Ambiguity Moderate Relations Among Perceived Peer Norms for Alcohol Use, Alcohol-Dependence Symptomatology, and HIV Risk-Taking Behavior?

    Science.gov (United States)

    Talley, Amelia E; Brown, Jennifer L; Stevens, Angela K; Littlefield, Andrew K

    2014-01-01

    Objective: The current study examines the relation between peer descriptive norms for alcohol involvement and alcohol-dependence symptomatology and whether this relation differs as a function of sexual self-concept ambiguity (SSA). This study also examines the associations among peer descriptive norms for alcohol involvement, alcohol-dependence symptomatology, and lifetime HIV risk-taking behavior and how these relations are influenced by SSA. Method: Women between ages 18 and 30 years (N = 351; M = 20.96, SD = 2.92) completed an online survey assessing sexual self-concept, peer descriptive norms, alcohol-dependence symptomatology, and HIV risk-taking behaviors. Structural equation modeling was used to test hypotheses of interest. Results: There was a significant latent variable interaction between SSA and descriptive norms for peer alcohol use. There was a stronger positive relationship between peer descriptive norms for alcohol and alcohol-dependence symptomatology when SSA was higher compared with when SSA was lower. Both latent variables exhibited positive simple associations with alcohol-dependence symptoms. Peer descriptive norms for alcohol involvement directly and indirectly influenced HIV risk-taking behaviors, and the indirect influence was conditional based on SSA. Conclusions: The current findings illustrate complex, nuanced associations between perceived norms, identity-related self-concepts, and risky health behaviors from various domains. Future intervention efforts may be warranted to address both problem alcohol use and HIV-risk engagement among individuals with greater sexual self-concept ambiguity. PMID:25343661

  18. Posttreatment Functioning of Alcoholic Patients: Its Relation to Program Participation

    Science.gov (United States)

    Bromet, Evelyn; And Others

    1977-01-01

    Assessed posttreatment functioning of 429 alcoholic patients selected from five different types of treatment facilities. Substantial improvement in three areas of functioning (drinking, occupational, and psychological) occurred among patients in each program, although there were significant differences among programs in level of functioning at…

  19. Thiamine in septic shock patients with alcohol use disorders

    DEFF Research Database (Denmark)

    Holmberg, Mathias Johan; Moskowitz, Ari; Patel, Parth Vijay

    2017-01-01

    PURPOSE: Alcohol-use disorders (AUDs) have been associated with increased sepsis-related mortality. As patients with AUDs are often thiamine deficient, we investigated practice patterns relating to thiamine administration in patients with AUDs presenting with septic shock and explored the associa...

  20. KCNJ6 is Associated with Adult Alcohol Dependence and Involved in Gene × Early Life Stress Interactions in Adolescent Alcohol Drinking

    OpenAIRE

    Clarke, Toni-Kim; Laucht, Manfred; Ridinger, Monika; Wodarz, Norbert; Rietschel, Marcella; Maier, Wolfgang; Lathrop, Mark; Lourdusamy, Anbarasu; Zimmermann, Ulrich S.; Desrivieres, Sylvane,; Schumann, Gunter

    2011-01-01

    Alcohol abuse and dependence have proven to be complex genetic traits that are influenced by environmental factors. Primate and human studies have shown that early life stress increases the propensity for alcohol abuse in later life. The reinforcing properties of alcohol are mediated by dopaminergic signaling; however, there is little evidence to indicate how stress alters alcohol reinforcement. KCNJ6 (the gene encoding G-protein-coupled inwardly rectifying potassium channel 2 (GIRK2)) is a b...

  1. [Is "the resistance to negative reinforcement" a feature of alcohol dependence syndrome?].

    Science.gov (United States)

    Kato, Shin

    2006-10-01

    In 1979, "Alcoholism Diagnosis Committee, the Ministry of Health and Welfare" established the diagnostic criteria for alcohol dependence syndrome, which included "the resistance to negative reinforcement". The author raises a question about this criterion which indicates the condition that "an individual continues to drink despite alcohol-related physical diseases, rejection by his/her family or economic poverty and drinking-related criminal problem." The author defines this condition not as "resistance to negative reinforcement" but as "resistance to punishment." Furthermore, the author can not find the data supporting that "the resistance to negative reinforcement" in the correct sense exists in the individuals with alcohol dependence syndrome. In a theoretical sense, an opposite idea seems to exist. There is an observed fact that can be regarded as a phenomenon that explains the involvement of "negative reinforcement" in enhancement of psychological dependence as in the case of the secondary development of psychological dependence. Consequently, the author would have to say that defining "the resistance to negative reinforcement" as one of common features of alcohol dependence syndrome or one of diagnostic criteria for alcohol dependence syndrome is inappropriate.

  2. Study on Alcoholic Withdrawal Score, with Questionnaire Based Session Conducted on Acute and Chronic Alcoholic Liver Disease Patients

    Directory of Open Access Journals (Sweden)

    Bandi Navyatha

    2016-07-01

    Full Text Available Alcohol liver disease is damage to the Liver and its function due to alcohol abuse. It occurs after years of heavy drinking and by through which cirrhosis can occur and which leads to the final phase of Alcoholic liver disease. It not only occurs in heavy drinkers but also there is a chance of getting liver disease go up the longer of been drinking and more alcohol consumption. A study was observational, prospective and descriptive; and was carried out one hundred and nine patients [n=109] who were with suffering from an Alcoholic liver disease, to determine the alcohol withdrawal score and there symptoms involved after they were kept on alcohol withdrawal therapy. An observational, prospective and randomized study was conducted in the hospital from March 2014-March 2016. Questionnaire based session with 10 scaled questions were framed according to CIWA (assessment and management of alcohol withdrawal and the score was noted with their symptoms occurrence after the alcohol cessation plan. CIWA score with moderate severity were found to be highest. 7 patients out of 33 patients in severe category of CIWA score were admitted in the hospital with alcohol withdrawal syndrome and psychological disturbances. Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA helps clinicians assess and treat potential alcohol withdrawal.

  3. Evolution of Metabolic Abnormalities in Alcoholic Patients during Withdrawal

    Directory of Open Access Journals (Sweden)

    X. Vandemergel

    2015-01-01

    Full Text Available Chronic alcohol intoxication is accompanied by metabolic abnormalities. Evolution during the early withdrawal period has been poorly investigated. The aim of this study was to determine the evolution of metabolic parameters during alcohol withdrawal. Patients and Methods. Thirty-three patients admitted in our department for alcohol withdrawal were prospectively included. Results. Baseline hypophosphatemia was found in 24% of cases. FEPO4 was reduced from 14.2 ± 9% at baseline to 7.3 ± 4.2% at day 3 (Pnl, respectively. No correlation was found between the sodium and CPK levels (P=0.75 nor between the CPK level and the amount of alcohol ingested (rs = 0.084, P=0.097. Baseline urate level was elevated and returned to normal after three days. Baseline magnesium concentration was normal and stable over time. Conclusion. Chronic alcohol intoxication was accompanied by phosphaturia, rapidly reversible after alcohol withdrawal and inversely correlated with albuminemia, slight hyponatremia, low levels of 25 hydroxy vitamin D, elevated CPK level in about 30% of women, and hyperuricemia with rapid normalization.

  4. Lack of association between alcohol-dependence and D3 dopamine receptor gene in three independent samples

    Energy Technology Data Exchange (ETDEWEB)

    Gorwood, P.; Feingold, J. [Universite Paris VII (France); Ades, J. [Paris Hospital Louis Mourier (France)] [and others

    1995-12-18

    Numerous studies on the involvement of dopamine receptors in the genetics of alcoholism focused on associations between a polymorphism of the D2 dopamine receptor (DRD2) gene and alcohol dependence. However, the results of these studies are conflicting. Another receptor, the D3 dopamine receptor (DRD3), may be of additional interest since it is specifically located in the limbic area, and in particular in the nucleus accumbens which plays a significant role in the reward process of addiction behavior. We thus tested the association in three independent samples of alcoholic patients, with different origins and various inclusion criteria. No difference in the DRD3 gene polymorphism emerged between controls and alcoholic patients, regardless of their origin, inclusion criteria, or presence or absence of the DRD2 TaqI A1-allele. Despite the fact that more information could have been considered and that association studies provide limited information, there is good evidence that this DRD3 polymorphism does not play a major role in the genetic component of alcoholism. 17 refs., 2 tabs.

  5. Efficacy of a combination of flumazenil and gabapentin in the treatment of alcohol dependence: relationship to alcohol withdrawal symptoms.

    Science.gov (United States)

    Anton, Raymond F; Myrick, Hugh; Baros, Alicia M; Latham, Patricia K; Randall, Patrick K; Wright, Tara M; Stewart, Scott H; Waid, Randy; Malcolm, Robert

    2009-08-01

    Improved treatment of alcohol dependence is a high priority, including defining subtypes that might respond differently. We evaluated a medication combination of intravenous flumazenil (FMZ) and oral gabapentin (GBP) in alcoholics who did and did not exhibit pretreatment alcohol withdrawal (AW) symptoms. Sixty alcohol-dependent individuals (44 with low AW and 16 with high AW) were randomized to receive FMZ (2 mg of incremental bolus for 20 minutes for 2 consecutive days) and GBP (up to 1200 mg nightly for 39 days) or their inactive placebos. Alcohol withdrawal was measured for the first 2 days, and drinking, sleep parameters, and adverse events were monitored during weekly evaluations, along with behavioral counseling sessions. Percent days abstinent (PDA) during treatment and time to first heavy drinking (TFHD) day were primary outcome variables. There was an interaction between the pretreatment AW status and the medication group on PDA (P = 0.0006) and TFHD (P = 0.06). Those in the high AW group had more PDA and more TFHD if treated with active medications, whereas those in the low AW group had more PDA and more TFHD if treated with placebo. This interaction remained for those totally abstinent (P = 0.03) and was confirmed by percent carbohydrate-deficient transferrin values. In addition, the pattern of response remained up to 8 weeks after treatment. In addition, in those with high AW, greater improvement in AW symptoms was observed in the active medication group compared with the placebo group. These results suggest a differential response to FMZ/GBP treatment, depending on pretreatment AW status that should be taken into account during future treatment trials.

  6. Pathological gambling and alcohol dependence: neural disturbances in reward and loss avoidance processing.

    Science.gov (United States)

    Romanczuk-Seiferth, Nina; Koehler, Saskia; Dreesen, Caspar; Wüstenberg, Torsten; Heinz, Andreas

    2015-05-01

    Pathological gambling (PG) shares clinical characteristics such as craving and loss of control with substance use disorders and is thus considered a behavioral addiction. While functional alterations in the mesolimbic reward system have been correlated with craving and relapse in substance use disorders, only a few studies have examined this brain circuit in PG, and no direct comparison has been conducted so far. Thus, we investigated the neuronal correlates of reward processing in PG in contrast to alcohol-dependent (AD) patients and healthy subjects. Eighteen PG patients, 15 AD patients and 17 controls were investigated with a monetary incentive delay task, in which visual cues predict the consequence (monetary gain, avoidance of loss, none) of a fast response to a subsequent target stimulus. Functional magnetic resonance imaging data were analyzed to account for possible confounding factors such as local gray matter volume. Activity in the right ventral striatum during loss anticipation was increased in PG patients compared with controls and AD patients. Moreover, PG patients showed decreased activation in the right ventral striatum and right medial prefrontal cortex during successful loss avoidance compared with controls, which was inversely associated with severity of gambling behavior. Thus, despite neurobiological similarities to substance use disorders in reward processing, as reported by previous studies, we found relevant differences with respect to the anticipation of loss as well as its avoidance (negative reinforcement), which further contributes to the understanding of PG.

  7. Differential spontaneous recovery across cognitive abilities during detoxification period in alcohol-dependence.

    Science.gov (United States)

    Petit, Géraldine; Luminet, Olivier; Cordovil de Sousa Uva, Mariana; Zorbas, Alexis; Maurage, Pierre; de Timary, Philippe

    2017-01-01

    There is a lack of consensus regarding the extent to which cognitive dysfunctions may recover upon cessation of alcohol intake by alcohol-dependents (AD), and the divergent findings are most likely due to methodological differences between the various studies. The present study was aimed at conducting a very strict longitudinal study of cognitive recovery in terms of assessment points, the duration of abstinence, control of age and duration of the addiction, and by use of individual analyses in addition to mean group comparisons. Our study further focused on the 2-3 week phase of alcohol detoxification that is already known to positively affect many biological, emotional, motivational, as well as neural variables, followed by longer-term therapies for which good cognitive functioning is needed. 41 AD inpatients undergoing a detoxification program, and 41 matched controls, were evaluated twice in terms of five cognitive functions (i.e., short-term memory, working memory, inhibition, cognitive flexibility, and verbal fluency) within a three-week interval [on the first day (T1) and the 18th day (T2) of abstinence for AD patients]. Emotional (positive and negative affectivity and depression) and motivational (craving) variables were also measured at both evaluation times. Although verbal fluency, short-term memory, and cognitive flexibility did not appear to be affected, the patients exhibited impaired inhibition and working memory at T1. While no recovery of inhibition was found to occur, the average working memory performance of the patients was comparable to that of the controls at T2. Improvements in emotional and motivational dimensions were also observed, although they did not correlate with the ones in working memory. Individual analysis showed that not all participants were impaired or recover the same functions. While inhibition deficits appear to persist after 18 days of detoxification, deficits in working memory, which is a central component of cognition

  8. Differential spontaneous recovery across cognitive abilities during detoxification period in alcohol-dependence

    Science.gov (United States)

    Petit, Géraldine; Luminet, Olivier; Cordovil de Sousa Uva, Mariana; Zorbas, Alexis; Maurage, Pierre; de Timary, Philippe

    2017-01-01

    Objective There is a lack of consensus regarding the extent to which cognitive dysfunctions may recover upon cessation of alcohol intake by alcohol-dependents (AD), and the divergent findings are most likely due to methodological differences between the various studies. The present study was aimed at conducting a very strict longitudinal study of cognitive recovery in terms of assessment points, the duration of abstinence, control of age and duration of the addiction, and by use of individual analyses in addition to mean group comparisons. Our study further focused on the 2–3 week phase of alcohol detoxification that is already known to positively affect many biological, emotional, motivational, as well as neural variables, followed by longer-term therapies for which good cognitive functioning is needed. Methods 41 AD inpatients undergoing a detoxification program, and 41 matched controls, were evaluated twice in terms of five cognitive functions (i.e., short-term memory, working memory, inhibition, cognitive flexibility, and verbal fluency) within a three-week interval [on the first day (T1) and the 18th day (T2) of abstinence for AD patients]. Emotional (positive and negative affectivity and depression) and motivational (craving) variables were also measured at both evaluation times. Results Although verbal fluency, short-term memory, and cognitive flexibility did not appear to be affected, the patients exhibited impaired inhibition and working memory at T1. While no recovery of inhibition was found to occur, the average working memory performance of the patients was comparable to that of the controls at T2. Improvements in emotional and motivational dimensions were also observed, although they did not correlate with the ones in working memory. Individual analysis showed that not all participants were impaired or recover the same functions. Conclusions While inhibition deficits appear to persist after 18 days of detoxification, deficits in working memory, which

  9. [Beta-endorphin and endogenous alcohol level of the blood in alcoholic patients].

    Science.gov (United States)

    Burov, Iu V; Treskov, V G; Iukhananov, R Iu; Kovalenko, A K

    1984-11-01

    Radioimmunoassay was used to measure the blood content of beta-endorphines in patients with chronic alcoholism. The concentration of endogenous ethanol in these patients was determined by gas chromatography. The blood concentration of beta-endorphines was found to be high in patients who showed atypical affective disorders off the period of abstinence. It is assumed that peripheral beta-endorphine is not linked with the development of the narcomanic syndrome proper but mirrors the pathogenetic mechanisms of psychopathological disorders. The levels of endogenous ethanol vary in alcoholics and healthy subjects within the same ranges. However, the percentage distribution indicates that in patients, they are shifted toward lower concentrations, which is likely to be conditioned by the induction of enzymatic systems that metabolize ethanol.

  10. Sweet preference, sugar addiction and the familial history of alcohol dependence: shared neural pathways and genes.

    Science.gov (United States)

    Fortuna, Jeffrey L

    2010-06-01

    Contemporary research has shown that a high number of alcohol-dependent and other drug-dependent individuals have a sweet preference, specifically for foods with a high sucrose concentration. Moreover, both human and animal studies have demonstrated that in some brains the consumption of sugar-rich foods or drinks primes the release of euphoric endorphins and dopamine within the nucleus accumbens, in a manner similar to some drugs of abuse. The neurobiological pathways of drug and "sugar addiction" involve similar neural receptors, neurotransmitters, and hedonic regions in the brain. Craving, tolerance, withdrawal and sensitization have been documented in both human and animal studies. In addition, there appears to be cross sensitization between sugar addiction and narcotic dependence in some individuals. It has also been observed that the biological children of alcoholic parents, particularly alcoholic fathers, are at greater risk to have a strong sweet preference, and this may manifest in some with an eating disorder. In the last two decades research has noted that specific genes may underlie the sweet preference in alcohol- and drug-dependent individuals, as well as in biological children of paternal alcoholics. There also appears to be some common genetic markers between alcohol dependence, bulimia, and obesity, such as the A1 allele gene and the dopamine 2 receptor gene.

  11. Abnormal intrinsic functional hubs in alcohol dependence: evidence from a voxelwise degree centrality analysis

    Directory of Open Access Journals (Sweden)

    Luo X

    2017-07-01

    Full Text Available Xiaoping Luo,1,2 Linghong Guo,1 Xi-Jian Dai,3 Qinglai Wang,2 Wenzhong Zhu,2 Xinjun Miao,2 Honghan Gong1 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Radiology, Wenzhou Chinese Medicine Hospital, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People’s Republic of China Objective: To explore the abnormal intrinsic functional hubs in alcohol dependence using voxelwise degree centrality analysis approach, and their relationships with clinical features.Materials and methods: Twenty-four male alcohol dependence subjects free of medicine (mean age, 50.21±9.62 years and 24 age- and education-matched male healthy controls (mean age, 50.29±8.92 years were recruited. The alcohol use disorders identification test and the severity of alcohol dependence questionnaire (SADQ were administered to assess the severity of alcohol craving. Voxelwise degree centrality approach was used to assess the abnormal intrinsic functional hubs features in alcohol dependence. Simple linear regression analysis was performed to investigate the relationships between the clinical features and abnormal intrinsic functional hubs.Results: Compared with healthy controls, alcohol dependence subjects exhibited significantly different degree centrality values in widespread left lateralization brain areas, including higher degree centrality values in the left precentral gyrus (BA 6, right hippocampus (BA 35, 36, and left orbitofrontal cortex (BA 11 and lower degree centrality values in the left cerebellum posterior lobe, bilateral secondary visual network (BA 18, and left precuneus (BA 7, 19. SADQ revealed a negative linear correlation with the degree centrality value in the left precentral gyrus (R2=0.296, P=0.006.Conclusion: The specific abnormal intrinsic functional hubs appear

  12. Cognitive control moderates the association between emotional instability and alcohol dependence symptoms.

    Science.gov (United States)

    Stevenson, Brittany L; Dvorak, Robert D; Kuvaas, Nicholas J; Williams, Thomas J; Spaeth, Destini T

    2015-06-01

    Previous research has linked emotional instability with problematic alcohol use. This may be a function of increased "hot" information processing (which is relatively automatic in nature and highly influenced by emotional states) for individuals with more emotional instability. According to dual-process models, cognitive control may attenuate the impact of emotional instability by preventing an overreliance on hot information processing. It was hypothesized that emotional instability would be positively associated with alcohol-related consequences, but that cognitive control would moderate this association. Participants were undergraduate students (n = 80) who endorsed drinking at moderate levels. Participants completed laboratory assessments of emotional instability, alcohol use and its consequences, and cognitive control. An observed variable path model examined the association between emotional instability and alcohol problems. Consistent with hypotheses, emotional instability was positively associated with alcohol consequences, and this relationship was moderated by cognitive control, at least for dependence symptoms. At low levels of cognitive control, there was a positive association between emotional instability and dependence symptoms (β = 0.514, p Emotional instability may promote alcohol dependence via an overreliance on hot information processing. Consistent with dual-process theory, this relationship is diminished among individuals with more cognitive control. Interventions focusing on increasing cognitive control may be effective in reducing alcohol pathology associated with emotional instability. (PsycINFO Database Record

  13. Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Philippe Laramée

    2015-10-01

    Interpretation: AD was found to significantly increase an individual's risk of all-cause mortality. While abstinence in alcohol-dependent subjects led to greater mortality reduction than non-abstinence, this study suggests that alcohol-dependent subjects can significantly reduce their mortality risk by reducing alcohol consumption.

  14. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Science.gov (United States)

    2010-07-01

    ... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Alcohol and...

  15. Human leucocyte antigens in patients with alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Aldershvile, J; Dietrichson, O;

    1980-01-01

    No significant differences in the frequencies of HLA-B8, -B40, and other HLA-A, -B, and -C phenotypes were found among patients with histologically verified alcoholic cirrhosis compared with normal controls when the p values were multiplied by the number of comparisons. This was found both...... in the present study of 45 patients and in the combined data of this and three other similar studies. However, these findings do not rule out that alcoholic cirrhosis might be associated with HLA factors (for example. HLA-D/DR antigens) controlling immune responses....

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

    Science.gov (United States)

    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.

  17. Relationship between serum uric acid level with psychosis and cognitive function in patients with alcohol dependence%酒精依赖患者血尿酸水平及其与精神障碍、认知功能的关系

    Institute of Scientific and Technical Information of China (English)

    张建东; 郭连峰; 李宁; 刘北陆; 尹学敬

    2015-01-01

    Objective To investigate the serum uric acid level in the patients with alcohol dependence ,and to analyze its correlation with the alcoholic sychosis and cognitive function .Methods 97 inpatients with alcohol depend‐ence were selected as the study subjects .The contemporaneous 100 healthy individuals undergoing the physical exam‐ination were taken as the controls .The fasting venous blood 3mL in the two groups was collected and detected the blood uric acid level by using the Hitachi 7600‐D biochemical analyzer .The relationship between the uric acid level with the mental disorders and alcoholic dependence was analyzed by using the t‐test .The linear regression was adopt‐ed to analyze the relationship between alcohol dependence and the cognitive function .Results The uric acid level in alcohol dependent patients was significantly higher than that in the healthy control group(P0 .05) .Conclusion Alcoholic dependence compensatorily increases the serum uric acid level ,activates the protective mechanism ,the com‐pensatory mechanism also reduces brain tissue nucleotides level and damages the nerve cells and signal transduction .%目的:探讨酒精依赖患者的血尿酸水平,分析其与酒精性精神障碍、认知功能的相关性。方法选择酒精依赖住院患者97例作为研究对象,选择同期100例健康者作为对照。两组受检者抽取空腹静脉血3 m L ,应用日立7600‐D全自动生化分析仪测定血尿酸水平,分析血尿酸水平与酒精依赖及其精神障碍的关系,用线性回归分析酒精依赖与认知功能的关系。结果酒精依赖患者血尿酸水平明显高于健康对照组(P<0.05),伴有精神障碍组血尿酸水平明显高于无精神障碍组(P<0.05),血尿酸水平与认知功能相关测试无明显相关性(P>0.05)。结论酒精依赖代偿性提高血尿酸水平,启动保护性机制,代偿机制又导致脑组织核苷酸的降低,损害神经细胞和信号传导。

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

    Science.gov (United States)

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

    2006-05-01

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

  19. Associations of prodynorphin sequence variation with alcohol dependence and related traits are phenotype-specific and sex-dependent.

    Science.gov (United States)

    Winham, Stacey J; Preuss, Ulrich W; Geske, Jennifer R; Zill, Peter; Heit, John A; Bakalkin, Georgy; Biernacka, Joanna M; Karpyak, Victor M

    2015-10-27

    We previously demonstrated that prodynorphin (PDYN) haplotypes and single nucleotide polymorphism (SNP) rs2281285 are associated with alcohol dependence and the propensity to drink in negative emotional states, and recent studies suggest that PDYN gene effects on substance dependence risk may be sex-related. We examined sex-dependent associations of PDYN variation with alcohol dependence and related phenotypes, including negative craving, time until relapse after treatment and the length of sobriety episodes before seeking treatment, in discovery and validation cohorts of European ancestry. We found a significant haplotype-by-sex interaction (p  =  0.03), suggesting association with alcohol dependence in males (p = 1E-4) but not females. The rs2281285 G allele increased risk for alcohol dependence in males in the discovery cohort (OR = 1.49, p = 0.002), with a similar trend in the validation cohort (OR = 1.35, p = 0.086). However, rs2281285 showed a trend towards association with increased negative craving in females in both the discovery (beta = 10.16, p = 0.045) and validation samples (OR = 7.11, p = 0.066). In the discovery cohort, rs2281285 was associated with time until relapse after treatment in females (HR = 1.72, p = 0.037); in the validation cohort, it was associated with increased length of sobriety episodes before treatment in males (beta = 13.49, p = 0.001). Our findings suggest that sex-dependent effects of PDYN variants in alcohol dependence are phenotype-specific.

  20. Subjective Response to Alcohol and Associated Craving in Heavy Drinkers vs. Alcohol Dependents: An Examination of Koob's Allostatic Model in Humans*

    OpenAIRE

    Bujarski, S; Ray, LA

    2014-01-01

    Background: Koob's allostatic model of addiction emphasizes the transition from positive reinforcement to negative reinforcement as dependence develops. This study seeks to extend this well-established neurobiological model to humans by examining subjective response to alcohol (SR) as a biobehavioral marker of alcohol reinforcement. Specifically, this study examines (a) differential SR in heavy drinkers (HDs) vs. alcohol dependent individuals (ADs) and (b) whether HDs and ADs differ in terms ...

  1. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature.

    Science.gov (United States)

    Tofighi, Babak; Nicholson, Joseph M; McNeely, Jennifer; Muench, Frederick; Lee, Joshua D

    2017-07-01

    Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions. The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows. We conducted a systematic review to assess the acceptability, feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence. Studies were required to evaluate the use of text messaging as an intervention for persons who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion for a diagnosis of illicit drug and/or alcohol dependence. Authors searched for articles published to date in MEDLINE (pubmed.gov), the Cochrane Library, EMBASE, CINAHL, Google Scholar and PsychINFO. Eleven articles met the search criteria for this review and support the acceptability and feasibility of text messaging interventions for addressing illicit drug and alcohol dependence. Most studies demonstrated improved clinical outcomes, medication adherence and engagement with peer support groups. Text messaging interventions also intervened on multiple therapeutic targets such as appointment attendance, motivation, self-efficacy, relapse prevention and social support. Suggestions for future research are described, including intervention design features, clinician contact, privacy measures and integration of behaviour change theories. Text messaging interventions offer a feasible platform to address a range of substances (i.e. alcohol, methamphetamine, heroin and alcohol), and there is increasing evidence supporting further larger-scale studies. [Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017;36:477-491]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  2. Detection of alcohol consumption in patients with alcoholic liver cirrhosis during the evaluation process for liver transplantation.

    Science.gov (United States)

    Hempel, Johann-Martin; Greif-Higer, Gertrud; Kaufmann, Thomas; Beutel, Manfred E

    2012-11-01

    Alcoholic liver cirrhosis (ALC) is a commonly accepted indication for liver transplantation (LT). Any alcohol consumption is considered a contraindication for LT. However, the assessment of abstinence in everyday practice mostly relies on patient self-reporting, which must be considered highly unreliable. After consumption, ethanol is eliminated by alcohol dehydrogenase, with methanol accumulating in the blood. Methanol, which is known to be a sensitive and specific indicator for recent alcohol consumption, has not been used for verifying alcohol consumption in LT assessments yet. Therefore, the purpose of this study was to test the feasibility of using methanol testing to identify recent alcohol consumption in LT candidates during routine and short-notice appointments. We compared methanol and ethanol measurements with self-reported alcohol consumption for 41 patients with ALC during the evaluation process before they were accepted onto the waiting list. In 32 of the 92 blood samples drawn from these 41 patients during the study, a relapse was detected by the methanol test. Both the ethanol test results and the self-reported data were positive in only 3 cases. Thus, the methanol test identified 29 additional cases of alcohol consumption. Furthermore, the methanol test discovered recent alcohol consumption in 5 of 10 transplant patients when both self-reported data and ethanol test results were negative. As a part of blood alcohol analysis, the methanol test is more sensitive than self-reporting and ethanol testing for the detection of recent alcohol consumption. Also, short-notice appointments for blood alcohol analysis reveal more cases of alcohol relapse than routine, long-term appointments. The measurement of methanol as a sensitive screening test for recent alcohol consumption should be implemented both in law and in daily, routine practice. Liver Transpl 18:1310-1315, 2012. © 2012 AASLD.

  3. Hazardous and Harmful Alcohol Use and Associated Factors in Tuberculosis Public Primary Care Patients in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-09-01

    Full Text Available The aim of this study was to assess the prevalence of hazardous and harmful alcohol use and associated factors among patients with tuberculosis in South Africa. In a cross-sectional survey new tuberculosis (TB and TB retreatment patients were consecutively screened using the Alcohol Use Disorder Identification Test (AUDIT within one month of anti-tuberculosis treatment. The sample included 4,900 (54.5% men and women 45.5% tuberculosis patients from 42 primary care clinics in three districts. Results indicate that, overall 23.2% of the patients were hazardous or harmful alcohol drinkers, 31.8% of men and 13.0% of women were found to be hazardous drinkers, and 9.3% of men and 3.4% of women meet criteria for probable alcohol dependence (harmful drinking as defined by the AUDIT. Men had significantly higher AUDIT scores than women. In multivariable analyses it was found that among men poor perceived health status, tobacco use, psychological distress, being a TB retreatment patient and not being on antiretroviral therapy (ART, and among women lower education, tobacco use and being a TB retreatment patient were associated with hazardous or harmful alcohol use. The study found a high prevalence of hazardous or harmful alcohol use among tuberculosis primary care patients. This calls for screening and brief intervention and a comprehensive alcohol treatment programme as a key component of TB management in South Africa.

  4. The role of the glutamatergic system in the patogenesis and treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Karina Łukasik

    2010-10-01

    Full Text Available The lack of satisfactory results of alcohol dependence treatment has necessitated the search for new directions of studies. One of them is connected with glutamatergic transmission. The influence of alcohol on this transmission is very complex and relates to changes including at the molecular level. However, the diversity of glutamatergic receptors creates a new possibility of modulation of its activity. It leads to decrease of alcohol reward abilities, prolongs abstinence time and reduces the incidence of acute alcohol intoxication in alcohol addicts. The use of acamprosate – a glutamatergic transmission modulator drug – and naltrexone (an opioid receptor antagonist improves therapy effectiveness of acamprosate alone. Satisfactory results were achieved in the studies of topiramate – an antagonist of AMPA and KA receptors. Its effectiveness was proved in clinical studies. Topiramate reduced alcohol craving and prolonged abstinence time, which decreased the probability of relapse. There are promising preclinical results of groups I and II metabotropic receptor antagonists. However, further studies are necessary to elucidate precisely their role in alcohol dependence.

  5. Gender differences in relationships among PTSD severity, drinking motives, and alcohol use in a comorbid alcohol dependence and PTSD sample.

    Science.gov (United States)

    Lehavot, Keren; Stappenbeck, Cynthia A; Luterek, Jane A; Kaysen, Debra; Simpson, Tracy L

    2014-03-01

    Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) are highly prevalent and comorbid conditions associated with a significant level of impairment. Little systematic study has focused on gender differences specific to individuals with both AD and PTSD. The current study examined gender-specific associations between PTSD symptom severity, drinking to cope (i.e., reduce negative affect), drinking for enhancement (i.e., increase positive affect), and average alcohol use in a clinical sample of men (n = 46) and women (n = 46) with comorbid AD and PTSD. Results indicated that PTSD symptoms were highly associated with drinking-to-cope motives for both men and women, but with greater drinking for enhancement motives for men only. Enhancement motives were positively associated with average alcohol quantity for both men and women, but coping motives were significantly associated with average alcohol quantity for women only. These findings suggest that for individuals with comorbid AD and PTSD, interventions that focus on reducing PTSD symptoms are likely to lower coping motives for both genders, and targeting coping motives is likely to result in decreased drinking for women but not for men, whereas targeting enhancement motives is likely to lead to reduced drinking for both genders.

  6. Behavior of Oxidative Stress Markers in Alcoholic Liver Cirrhosis Patients

    Directory of Open Access Journals (Sweden)

    Marina Galicia-Moreno

    2016-01-01

    Full Text Available Alcohol is the most socially accepted addictive substance worldwide, and its metabolism is related with oxidative stress generation. The aim of this work was to evaluate the role of oxidative stress in alcoholic liver cirrhosis (ALC. This study included 187 patients divided into two groups: ALC, classified according to Child-Pugh score, and a control group. We determined the levels of reduced and oxidized glutathione (GSH and GSSG and the GSH/GSSG ratio by an enzymatic method in blood. Also, protein carbonyl and malondialdehyde (MDA content were estimated in serum. MDA levels increased in proportion to the severity of damage, whereas the GSH and GSSG levels decreased and increased, respectively, at different stages of cirrhosis. There were no differences in the GSH/GSSG ratio and carbonylated protein content between groups. We also evaluated whether the active consumption of or abstinence from alcoholic beverages affected the behavior of these oxidative markers and only found differences in the MDA, GSH, and GSSG determination and the GSH/GSSG ratio. Our results suggest that alcoholic cirrhotic subjects have an increase in oxidative stress in the early stages of disease severity and that abstinence from alcohol consumption favors the major antioxidant endogen: GSH in patients with advanced disease severity.

  7. Blonanserin, an antipsychotic and dopamine D₂/D₃receptor antagonist, and ameliorated alcohol dependence.

    Science.gov (United States)

    Takaki, Manabu; Ujike, Hiroshi

    2013-01-01

    Blonanserin (BNS) is used for treatment of both positive and negative symptoms of schizophrenia in Japan and Korea. Because BNS has weak α1 receptor blocking activities and is almost devoid of histamine H1 and muscarinic M1 antagonist activity, BNS is better tolerated than other atypical antipsychotics. A high degree of D₃ receptor blockage is reported to be predictive of drug abuse and alcoholism, and BNS has strong D₃ receptor antagonism. Thus, BNS may be useful in the treatment of alcoholism. We present a case in which BNS ameliorated alcohol dependence.

  8. Nalmefene and alcohol dependence: a new approach or the same old unacceptable marketing?

    Directory of Open Access Journals (Sweden)

    Braillon A

    2015-06-01

    Full Text Available Alain Braillon,1,* Bernard Granger,2,*1Alcohol Treatment Unit, University Hospital, Amiens, France; 2Psychiatry, Tarnier Hospital (AP-HP, Paris, France*Both authors contributed equally to this work“A great deal of intelligence can be invested in ignorance when the need for illusion is deep”. Saul BellowPaille and Martini’s review on nalmefene for alcohol dependence deserves some comment.1 Read the original article  

  9. Histomorphologic liver abnormalities in a group of alcoholic patients

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    Libán Álvarez Cáceres

    2010-11-01

    Full Text Available Background: the ingestion of alcohol has been directly involved in the development of liver diseases. Nowadays, the liver damage by ethanol is a serious health problem all over the world. To achieve satisfactory results In order to face it, it is necessary to provide multidisciplinary attention. Objective: to determine the histomorphologic liver impairments in alcoholic patients. Methods: an observational, descriptive, co-relational and prospective study conducted in 23 patients with an alcoholism diagnosis at the Provincial University Hospital "Arnaldo Milián Castro" in Villa Clara. Inclusion and exclusion criteria were taken into account. The variables studied were: laparoscopic evolution, period of time consuming alcohol (in years, histologic evolution and alanine aminotransferase. Results: both trough laparoscopic and liver biopsy, the most frequent diagnosis was steatosis, followed by chronic hepatitis. In one patient cirrhosis was diagnosed through laparoscopy: a biopsy was not performed in this case. Conclusion: there were a high proportion of patients with impaired liver aminotransferases and severe histological diagnoses, especially those of chronic hepatitis and liver cirrhosis.

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

    Science.gov (United States)

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

    2016-09-29

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

  11. Alcohol consumption, blood alcohol concentration level and guideline compliance in hospital referred patients with minimal, mild and moderate head injuries

    DEFF Research Database (Denmark)

    Harr, Marianne Efskind; Heskestad, Ben; Ingebrigtsen, Tor;

    2011-01-01

    In 2000 the Scandinavian Neurotrauma Committee published guidelines for safe and cost-effective management of minimal, mild and moderate head injured patients.The aims of this study were to investigate to what extent the head injury population is under the influence of alcohol, and to evaluate...... whether the physicians' compliance to the guidelines is affected when patients are influenced by alcohol....

  12. Prevalence of problem alcohol use among patients attending primary care for methadone treatment

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2009-06-11

    Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make

  13. Prevalence of problem alcohol use among patients attending primary care for methadone treatment.

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2012-02-01

    BACKGROUND: Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. METHODS: We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. RESULTS: We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. CONCLUSION: Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this

  14. Smoking, Alcohol, Drug Use, Abuse and Dependence in Narcolepsy and Idiopathic Hypersomnia: A Case-Control Study.

    Science.gov (United States)

    Barateau, Lucie; Jaussent, Isabelle; Lopez, Régis; Boutrel, Benjamin; Leu-Semenescu, Smaranda; Arnulf, Isabelle; Dauvilliers, Yves

    2016-03-01

    Basic experiments support the impact of hypocretin on hyperarousal and motivated state required for increasing drug craving. Our aim was to assess the frequencies of smoking, alcohol and drug use, abuse and dependence in narcolepsy type 1 (NT1, hypocretin-deficient), narcolepsy type 2 (NT2), idiopathic hypersomnia (IH) (non-hypocretin-deficient conditions), in comparison to controls. We hypothesized that NT1 patients would be less vulnerable to drug abuse and addiction compared to other hypersomniac patients and controls from general population. We performed a cross-sectional study in French reference centres for rare hypersomnia diseases and included 450 adult patients (median age 35 years; 41.3% men) with NT1 (n = 243), NT2 (n = 116), IH (n = 91), and 710 adult controls. All participants were evaluated for alcohol consumption, smoking habits, and substance (alcohol and illicit drug) abuse and dependence diagnosis during the past year using the Mini International Neuropsychiatric Interview. An increased proportion of both tobacco and heavy tobacco smokers was found in NT1 compared to controls and other hypersomniacs, despite adjustments for potential confounders. We reported an increased regular and frequent alcohol drinking habit in NT1 versus controls but not compared to other hypersomniacs in adjusted models. In contrast, heavy drinkers were significantly reduced in NT1 versus controls but not compared to other hypersomniacs. The proportion of patients with excessive drug use (codeine, cocaine, and cannabis), substance dependence, or abuse was low in all subgroups, without significant differences between either hypersomnia disorder categories or compared with controls. We first described a low frequency of illicit drug use, dependence, or abuse in patients with central hypersomnia, whether Hcrt-deficient or not, and whether drug-free or medicated, in the same range as in controls. Conversely, heavy drinkers were rare in NT1 compared to controls but not to other

  15. Could cognitive event-related potentials be used to orient neuropsychological rehabilitation? A perspective paper through the example of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Elisa Schroder

    2015-04-01

    Full Text Available The prevention of relapse is a main challenge to face with in alcohol dependence. Two major cognitive factors can partially account for alcoholics’ inability to remain abstinent: attentional biases directed towards alcohol-related stimuli that increase the urge to drink, and impaired response inhibition towards these cues that makes it more difficult for alcoholics to resist temptation. A recent study of ours investigated response inhibition in alcohol dependent patients, by means of an event-related potentials (ERP modified Go/No-Go paradigm, right after a three weeks detoxification cure. Main results of the study are: (1 among 27 recently detoxified patients, 13 relapsed after a three month follow-up period; (2 at a behavioural level, patients displayed more commission errors than healthy matched controls; however, behavioural data did not allow to discriminate between future relapsers and non-relapsers; and (3 the only parameter discriminating relapsers and non-relapsers was the No-Go P300 component: future relapsers displayed increased amplitudes, suggesting that patients who involve more neural resources to perform inhibition will be those of higher risk to relapse. These preliminary data suggest a great clinical potential of the ERP technique in preventing relapse in alcohol dependent patients, as using cognitive ERP may orient an individual patient to an adapted cognitive rehabilitation program.

  16. Alcohol binge drinking during adolescence or dependence during adulthood reduces prefrontal myelin in male rats.

    Science.gov (United States)

    Vargas, Wanette M; Bengston, Lynn; Gilpin, Nicholas W; Whitcomb, Brian W; Richardson, Heather N

    2014-10-29

    Teen binge drinking is associated with low frontal white matter integrity and increased risk of alcoholism in adulthood. This neuropathology may result from alcohol exposure or reflect a pre-existing condition in people prone to addiction. Here we used rodent models with documented clinical relevance to adolescent binge drinking and alcoholism in humans to test whether alcohol damages myelinated axons of the prefrontal cortex. In Experiment 1, outbred male Wistar rats self-administered sweetened alcohol or sweetened water intermittently for 2 weeks during early adolescence. In adulthood, drinking behavior was tested under nondependent conditions or after dependence induced by 1 month of alcohol vapor intoxication/withdrawal cycles, and prefrontal myelin was examined 1 month into abstinence. Adolescent binge drinking or adult dependence induction reduced the size of the anterior branches of the corpus callosum, i.e., forceps minor (CCFM), and this neuropathology correlated with higher relapse-like drinking in adulthood. Degraded myelin basic protein in the gray matter medial to the CCFM of binge rats indicated myelin was damaged on axons in the mPFC. In follow-up studies we found that binge drinking reduced myelin density in the mPFC in adolescent rats (Experiment 2) and heavier drinking predicted worse performance on the T-maze working memory task in adulthood (Experiment 3). These findings establish a causal role of voluntary alcohol on myelin and give insight into specific prefrontal axons that are both sensitive to alcohol and could contribute to the behavioral and cognitive impairments associated with early onset drinking and alcoholism.

  17. A Double Blind, Placebo-Controlled Trial that Combines Disulfiram and Naltrexone for Treating Co-Occurring Cocaine and Alcohol Dependence

    Science.gov (United States)

    Pettinati, Helen; Kampman, Kyle M.; Lynch, Kevin G.; Xie, Hu; Dackis, Charles; Rabinowitz, Amanda R.; O’Brien, Charles P.

    2008-01-01

    BACKGROUND This is a double blind, placebo-controlled trial that evaluated the efficacy of disulfiram, naltrexone and their combination in patients with co-occurring cocaine and alcohol dependence. METHODS 208 patients were randomized to disulfiram (250mg/day), naltrexone (100mg/day), the combination, or placebo for 11 weeks. Outcomes were in-trial abstinence from cocaine and/or alcohol. RESULTS Few safety concerns were reported, although medication adherence was low in a number of patients for both medications, alone or in combination. In the primary analyses (GEE modeling), abstinence from cocaine as measured by cocaine-negative urines and days of self-reported abstinence from cocaine or alcohol did not differ between placebo and any of the medication groups. However, patients taking disulfiram (alone or in combination) were most likely to achieve combined abstinence from cocaine and alcohol. Secondary analyses revealed that patients taking the disulfiram-naltrexone combination were most likely to achieve 3 consecutive weeks of abstinence from cocaine and alcohol. CONCLUSION There was an association between disulfiram treatment and abstinence from cocaine and alcohol. More patients taking the disulfiram-naltrexone combination achieved 3 consecutive weeks of abstinence in treatment than placebo-treated patients. PMID:18079068

  18. Simulation and Learning to Care for Patients: Acute Alcohol Withdrawal

    Directory of Open Access Journals (Sweden)

    Leighsa Sharoff

    2013-03-01

    Full Text Available This paper examines the development of a complex patient simulation scenario providing senior nursing students experiences in enhanced clinical judgment, clinical reasoning, problem-solving and communication skills. Unforeseen co-morbid conditions, such as alcohol withdrawal syndrome, can become pronounced upon hospitalization. Teaching-learning strategies to provide opportunities to experience all facets of possible work-related experiences promote excellent patient care. [J Contemp Med 2013; 3(1.000: 28-35

  19. Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis

    Science.gov (United States)

    Skinner, Marilyn D.; Lahmek, Pierre; Pham, Héloïse; Aubin, Henri-Jean

    2014-01-01

    Background Despite its success with compliant or supervised patients, disulfiram has been a controversial medication in the treatment of alcoholism. Often, study designs did not recognize a pivotal factor in disulfiram research, the importance of an open-label design. Our objectives are: (1) to analyze the efficacy and safety of disulfiram in RCTs in supporting abstinence and (2) to compare blind versus open-label studies, hypothesizing that blinded studies would show no difference between disulfiram and control groups because the threat would be evenly spread across all groups. Methods and Findings We searched PubMed, EMBASE and the Cochrane Central Register for RCTs on disulfiram use with alcoholics in comparison to any alcoholic control group. The primary outcome was defined by the authors of each trial. Additional analyses included: blind vs. open-label, with or without supervision, cocaine study or not, and type of control. Overall, the 22 included studies showed a higher success rate of disulfiram compared to controls Hedges'g = .58 (95%CI = .35–.82). When comparing blind and open-label RCTs, only open-label trials showed a significant superiority over controls g = .70 (95%CI = .46–.93). RCTs with blind designs showed no efficacy of disulfiram compared to controls. Disulfiram was also more effective than the control condition when compared to naltrexone g = .77, 95%CI = .52–1.02, to acamprosate g = .76, 95%CI = .04–1.48, and to the no disulfiram groups g = .43, 95%CI = .17–.69. Limits include: (1) a population of 89% male subjects and (2) a high but unavoidable heterogeneity of the studies with a substantial I-square in most subgroups of studies. Conclusions Blinded studies were incapable of distinguishing a difference between treatment groups and thus are incompatible with disulfiram research. Based on results with open-label studies, disulfiram is a safe and efficacious treatment compared to other abstinence

  20. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Marilyn D Skinner

    Full Text Available BACKGROUND: Despite its success with compliant or supervised patients, disulfiram has been a controversial medication in the treatment of alcoholism. Often, study designs did not recognize a pivotal factor in disulfiram research, the importance of an open-label design. Our objectives are: (1 to analyze the efficacy and safety of disulfiram in RCTs in supporting abstinence and (2 to compare blind versus open-label studies, hypothesizing that blinded studies would show no difference between disulfiram and control groups because the threat would be evenly spread across all groups. METHODS AND FINDINGS: We searched PubMed, EMBASE and the Cochrane Central Register for RCTs on disulfiram use with alcoholics in comparison to any alcoholic control group. The primary outcome was defined by the authors of each trial. Additional analyses included: blind vs. open-label, with or without supervision, cocaine study or not, and type of control. Overall, the 22 included studies showed a higher success rate of disulfiram compared to controls Hedges'g = .58 (95%CI = .35-.82. When comparing blind and open-label RCTs, only open-label trials showed a significant superiority over controls g = .70 (95%CI = .46-.93. RCTs with blind designs showed no efficacy of disulfiram compared to controls. Disulfiram was also more effective than the control condition when compared to naltrexone g = .77, 95%CI = .52-1.02, to acamprosate g = .76, 95%CI = .04-1.48, and to the no disulfiram groups g = .43, 95%CI = .17-.69. LIMITS INCLUDE: (1 a population of 89% male subjects and (2 a high but unavoidable heterogeneity of the studies with a substantial I-square in most subgroups of studies. CONCLUSIONS: Blinded studies were incapable of distinguishing a difference between treatment groups and thus are incompatible with disulfiram research. Based on results with open-label studies, disulfiram is a safe and efficacious treatment compared to other abstinence supportive

  1. How CAGE, RAPS4QF and AUDIT can help practitioners for patients admitted with acute alcohol intoxication in emergency departments?

    Directory of Open Access Journals (Sweden)

    Georges eBrousse

    2014-06-01

    Full Text Available Aims: To help clinicians to identify the severity of Alcohol Use Disorders (AUD from optimal thresholds found for recommended scales. Especially, taking account of the high prevalence of alcohol dependence among patients admitted to the Emergency Department (ED for acute alcohol intoxication (AAI, we propose to define thresholds of severity of dependence based on the AUDIT score.Methods: All patients admitted to the ED with AAI (blood alcohol level >0.8g/L, in a two-month period, were assessed using the CAGE, RAPS-QF and AUDIT, with the alcohol dependence/abuse section of the Mini International Neuropsychiatric Interview (MINI used as the gold standard. To explore the relation between the AUDIT and the MINI the sum of the positive items on the MINI (dependence as a quantitative variable and as an ordinal parameter were analyzed. From the threshold score (TS found for each scale we proposed intervals of severity of Alcohol Use Disorders (AUDs. Results: The mean age of the sample (122 males, 42 females was 46 years. Approximately 12 % of the patients were identified with alcohol abuse and 78 % with dependence (DSM-IV. Cut points were determined for the AUDIT in order to distinguish mild and moderate dependence from severe dependence. A strategy of intervention based on levels of severity of AUD was proposed. Conclusion: Different thresholds proposed for the CAGE, RAPS4-QF and AUDIT could be used to guide the choice of intervention for a patient: brief intervention, brief negotiation interviewing or longer more intensive motivational intervention.

  2. Association of ADH and ALDH Genes With Alcohol Dependence in the Irish Affected Sib Pair Study of Alcohol Dependence (IASPSAD) Sample

    Science.gov (United States)

    Kuo, Po-Hsiu; Kalsi, Gursharan; Prescott, Carol A.; Hodgkinson, Colin A.; Goldman, David; van den Oord, Edwin J.; Alexander, Jeffry; Jiang, Cizhong; Sullivan, Patrick F.; Patterson, Diana G.; Walsh, Dermot; Kendler, Kenneth S.; Riley, Brien P.

    2008-01-01

    Background: The genes coding for ethanol metabolism enzymes [alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH)] have been widely studied for their influence on the risk to develop alcohol dependence (AD). However, the relation between polymorphisms of these metabolism genes and AD in Caucasian subjects has not been clearly established. The present study examined evidence for the association of alcohol metabolism genes with AD in the Irish Affected Sib Pair Study of alcohol dependence. Methods: We conducted a case–control association study with 575 independent subjects who met Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, AD diagnosis and 530 controls. A total of 77 single nucleotide polymorphisms (SNPs) in the seven ADH (ADH1-7) and two ALDH genes (ALDH1A1 and ALDH2) were genotyped using the Illumina GoldenGate protocols. Several statistical procedures were implemented to control for false discoveries. Results: All markers with minor allele frequency greater than 0.01 were in Hardy–Weinberg equilibrium. Numerous SNPs in ADH genes showed association with AD, including one marker in the coding region of ADH1C (rs1693482 in exon6, Ile271Gln). Haplotypic association was observed in the ADH5 and ADH1C genes, and in a long haplotype block formed by the ADH1A and ADH1B loci. We detected two significant interactions between pairs of markers in intron 6 of ADH6 and intron 12 of ALDH2 (p = 5 × 10−5), and 5′ of both ADH4 and ADH1A (p = 2 × 10−4). Conclusion: We found evidence for the association of several ADH genes with AD in a sample of Western European origin. The significant interaction effects between markers in ADH and ALDH genes suggest possible epistatic roles between alcohol metabolic enzymes in the risk for AD. PMID:18331377

  3. An Exploration of Quality of Life and Its Predictors in Patients with Addictive Disorders: Gambling, Alcohol and Drugs

    Science.gov (United States)

    Manning, Victoria; Gomez, Brenda; Guo, Song; Low, Yee Deng; Koh, Puay Kee; Wong, Kim Eng

    2012-01-01

    The study set out to examine Quality of Life (QoL), specifically subjective well being in three different addiction populations (260 alcohol-dependent, 282 drug-dependent, and 132 pathological gambling outpatients) at their first visit to treatment, using the Personal Well being Index (PWI). The mean PWI score for all patients was significantly…

  4. KCNJ6 is associated with adult alcohol dependence and involved in gene × early life stress interactions in adolescent alcohol drinking.

    Science.gov (United States)

    Clarke, Toni-Kim; Laucht, Manfred; Ridinger, Monika; Wodarz, Norbert; Rietschel, Marcella; Maier, Wolfgang; Lathrop, Mark; Lourdusamy, Anbarasu; Zimmermann, Ulrich S; Desrivieres, Sylvane; Schumann, Gunter

    2011-05-01

    Alcohol abuse and dependence have proven to be complex genetic traits that are influenced by environmental factors. Primate and human studies have shown that early life stress increases the propensity for alcohol abuse in later life. The reinforcing properties of alcohol are mediated by dopaminergic signaling; however, there is little evidence to indicate how stress alters alcohol reinforcement. KCNJ6 (the gene encoding G-protein-coupled inwardly rectifying potassium channel 2 (GIRK2)) is a brain expressed potassium channel with inhibitory effects on dopaminergic tone. The properties of GIRK2 have been shown to be enhanced by the stress peptide corticotrophin-releasing hormone. Therefore, we sought to examine the role of KCNJ6 polymorphisms in adult alcohol dependence and stress-related alcohol abuse in adolescents. We selected 11 SNPs in the promoter region of KCNJ6, which were genotyped in 1152 adult alcohol dependents and 1203 controls. One SNP, rs2836016, was found to be associated with alcohol dependence (p=0.01, false discovery rate). We then assessed rs2836016 in an adolescent sample of 261 subjects, which were characterized for early life stress and adolescent hazardous drinking, defined using the Alcohol Use Disorders Identification Test (AUDIT), to examine gene-environment interactions. In the adolescent sample, the risk genotype of rs2836016 was significantly associated with increased AUDIT scores, but only in those individuals exposed to high levels of psychosocial stress in early life (p=0.01). Our findings show that KCNJ6 is associated with alcohol dependence and may moderate the effect of early psychosocial stress on risky alcohol drinking in adolescents. We have identified a candidate gene for future studies investigating a possible functional link between the response to stress and alcohol reinforcement.

  5. Alcohol Dependence and Altered Engagement of Neural Networks in Risky Decisions

    Directory of Open Access Journals (Sweden)

    Xi eZhu

    2016-03-01

    Full Text Available Alcohol dependence is associated with heightened risk tolerance and altered decision- making. This raises the question as to whether alcohol dependent patients (ADP are incapable of proper risk assessment. We investigated how healthy controls (HC and ADP engage neural networks to cope with the increased cognitive demands of risky decisions. We collected fMRI data while 34 HC and 16 ADP played a game that included safe and risky trials. In safe trials, participants accrued money at no risk of a penalty. In risky trials, reward and risk simultaneously increased as participants were instructed to decide when to stop a reward accrual period. If the participant failed to stop before an undisclosed time, the trial would bust and participants would not earn the money from that trial. Independent Component Analysis was used to identify networks engaged during the anticipation and the decision execution of risky compared with safe trials. Like HC, ADP demonstrated distinct network engagement for safe and risky trials at anticipation. However, at decision execution, ADP exhibited severely reduced discrimination in network engagement between safe and risky trials. Although ADP behaviorally responded to risk they failed to appropriately modify network engagement as the decision continued, leading ADP to assume similar network engagement regardless of risk prospects. This may reflect disorganized network switching and a facile response strategy uniformly adopted by ADP across risk conditions. We propose that aberrant salience network (SN engagement in ADP might contribute to ineffective network switching and that the role of the SN in risky decisions warrants further investigation.

  6. ALCOHOL AND HEART RHYTHM DISORDERS

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    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.

  7. Early emotional trauma in alcohol-dependent men: prevalence, associations and predictive value

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    Mariana Fortunata Donadon

    2016-06-01

    Full Text Available Abstract Background Several studies have indicated that early emotional traumas (EET are highly prevalent in alcohol-dependent individuals, and that these traumas work as risk factors for the development of this disorder. Objective The aim of the current study is to evaluate the EET associations and predictive value regarding active alcohol dependence among male individuals from a developing country. Methods The sample consisted of two groups. The first was composed by adult male individuals diagnosed as alcohol dependents (AG, N = 110, and the second with no alcohol abuse and/or dependence diagnosis (CG, N = 110. Both groups were evaluated using Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders; Early Emotional Trauma Inventory; and a sociodemographic questionnaire. Results All trauma subtypes (general, physical, emotional and sexual were more prevalent among AG than CG. However, only traumas categorized as general and emotional worked as risk factor for alcoholism development and they increased the chances to develop this disorder by 1.45 and 1.23 times, respectively. Discussion EETs are important factors that should be taken into account in interventions that aim to prevent, minimize and/or treat this clinical condition and its impact and/or severity, especially in countries such as Brazil.

  8. Loss of control over alcohol seeking in rats depends on individual vulnerability and duration of alcohol consumption experience

    NARCIS (Netherlands)

    Spoelder, Marcia; Pol, Sylvana; Janssen, Boris S G; Baars, Annemarie M; Vanderschuren, Louk J M J; Lesscher, Heidi M B

    Alcohol use disorder (AUD) is characterized by excessive alcohol use and persistent alcohol seeking despite knowledge of its negative consequences. Importantly, AUD typically develops after chronic excessive alcohol use in a subgroup of individuals who drink alcohol, suggesting that AUD results from

  9. Loss of control over alcohol seeking in rats depends on individual vulnerability and duration of alcohol consumption experience

    NARCIS (Netherlands)

    Spoelder, M.; Pol, S. van der; Janssen, B.S.G.; Baars, A.M.; Vanderschuren, L.J.M.J.; Lesscher, H.M.

    2017-01-01

    Alcohol use disorder (AUD) is characterized by excessive alcohol use and persistent alcohol seeking despite knowledge of its negative consequences. Importantly, AUD typically develops after chronic excessive alcohol use in a subgroup of individuals who drink alcohol, suggesting that AUD results from

  10. Are the effects of gamma-hydroxybutyrate (GHB) treatment partly physiological in alcohol dependence?

    Science.gov (United States)

    Ameisen, Olivier

    2008-01-01

    It has been hypothesized that the therapeutic effects of Gamma-hydroxybutyrate (GHB) in alcohol dependence could be related to ethanol-mimicking action of the drug and that GHB could reduce alcohol craving, intake and withdrawal by acting as a "substitute" of the alcohol in the central nervous system. Nevertheless, alcohol being the strongest trigger of craving and intake, it is difficult to ascribe reduction of craving and intake to ethanol-mimicking activity of GHB. I have recently proposed that alcohol/substance dependence could result from a GHB-deficiency-related dysphoric syndrome in which alcohol/substances would be sought to "substitute" for insufficient GHB effect. GHB is the sole identified naturally occurring gamma-aminobutyric acid B (GABA (B)) receptor agonist. Here, I propose that exogenous GHB might in fact "substitute" for deficient endogeneous GHB and represent true substitutive treatment for GHB-deficiency. And that baclofen and GHB could both compensate for deficient effect of the physiological GABA (B) receptor agonist(s).

  11. 42 CFR 2.2 - Statutory authority for confidentiality of alcohol abuse patient records.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.2 Statutory authority for confidentiality of alcohol abuse patient records. The restrictions of these regulations upon the disclosure and use of alcohol abuse patient records were initially...

  12. Public and professional attitudes to transplanting alcoholic patients.

    Science.gov (United States)

    Neuberger, James

    2007-11-01

    The discrepancy between the number of people who might benefit from liver transplantation continues to exceed the availability of donor livers available, so rationing of grafts must occur. Alcoholic liver disease (ALD) is an excellent indication for liver transplantation, with outcomes at least as good as for other indications.ALD remains a controversial indication for liver transplantation. There is no robust evidence that public disquiet over distribution of donor livers to those with ALD (even if they return to alcohol) greatly affects organ donation, although this does not mean there is no consequence of such disquiet. Numerous surveys of the general public, patients, and health care professionals indicate the these patients are thought to have lower priority for access to available liver grafts. Public education is required to demonstrate that patients with ALD are carefully selected for liver transplantation and available grafts are used with attention to equity, justice, and utility.

  13. Sex- and hormone-dependent alterations in alcohol withdrawal-induced anxiety and corticolimbic endocannabinoid signaling.

    Science.gov (United States)

    Henricks, Angela M; Berger, Anthony L; Lugo, Janelle M; Baxter-Potter, Lydia N; Bieniasz, Kennedy V; Petrie, Gavin; Sticht, Martin A; Hill, Matthew N; McLaughlin, Ryan J

    2017-09-15

    Alcohol dependence is associated with anxiety during withdrawal. The endocannabinoid (ECB) system participates in the neuroendocrine and behavioral response to stress and changes in corticolimbic ECB signaling may contribute to alcohol withdrawal-induced anxiety. Moreover, symptoms of alcohol withdrawal differ between sexes and sexual dimorphism in withdrawal-induced ECB recruitment may be a contributing factor. Herein, we exposed intact male and female rats and ovariectomized (OVX) female rats with or without estradiol (E2) replacement to 6 weeks of chronic intermittent alcohol vapor and measured anxiety-like behavior, ECB content, and ECB-related mRNA in the basolateral amygdala (BLA) and ventromedial prefrontal cortex (vmPFC). Acute alcohol withdrawal increased anxiety-like behavior, produced widespread disturbances in ECB-related mRNA, and reduced anandamide (AEA) content in the BLA and 2-arachidonoylglycerol (2-AG) content in the vmPFC of male, but not female rats. Similar to males, alcohol-exposed OVX females showed reductions in Napepld mRNA in the BLA, decreased AEA content in the BLA and vmPFC, and reductions in all ECB-related genes measured in the vmPFC. Importantly, E2 replacement prevented withdrawal-induced alterations in ECB content (but not mRNA) in OVX females, and although alcohol-exposed OVX females failed to exhibit more anxiety compared to their respective control, chronic alcohol exposure abolished the anxiolytic properties of E2 in OVX rats. These data indicate that ovarian sex hormones (but not E2 alone) protect against withdrawal-induced alterations in corticolimbic ECB signaling but do not impart resilience to withdrawal-induced anxiety. Thus, the mechanisms implicated in the manifestation of alcohol withdrawal-induced anxiety are most likely sex-specific. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology". Published by Elsevier Ltd.

  14. Long-term changes of salivary exoglycosidases and their applicability as chronic alcohol-drinking and dependence markers.

    Science.gov (United States)

    Waszkiewicz, Napoleon; Kratz, Ewa Maria; Chojnowska, Sylwia; Zalewska, Anna; Zwierz, Krzysztof; Szulc, Agata; Szajda, Sławomir Dariusz; Nestsiarovich, Anastasiya; Kapitau, Andrei; Kępka, Alina; Ostrowska, Lucyna; Ferens-Sieczkowska, Mirosława

    2017-06-29

    Investigation of long-term dynamic changes of salivary activity/output of exoglycosidases, deglycosylation processes and their applicability as alcohol markers. Exoglycosidase (α-fucosidase (FUC), β-galactosidase (GAL), β-glucuronidase (GLU), β-hexosaminidase (HEX, HEX A and HEX B isoenzymes) and α-mannosidase (MAN)) activities were measured in the saliva of healthy social drinking controls (C), alcohol-dependent non-smokers (ANS) and alcohol-dependent smokers (AS) at the 1st, 15th, 30th and 50th day of abstinence after chronic alcohol drinking. The activity of exoglycosidases was 2-3-fold (MAN), 2-6 fold (FUC), 8-25-fold (HEX A) and 19-40-fold (GLU) higher in the ANS and AS groups than in controls, and had good/excellent sensitivity, specificity and accuracy. The higher outputs of exoglycosidases were in the AS and ANS groups than in controls at the 1st day (GLU, HEX A) and at the 50th day (GLU, FUC, MAN) of abstinence. We found numerous correlations between alcohol-drinking days with GLU and HEX A, alcohol amounts with HEX A and duration of alcohol dependence with FUC and MAN activity/output. Salivary exoglycosidases/deglycosylation processes were still very high up to 50 days after the end of alcohol consumption. We found markers of chronic alcohol consumption (HEX A), alcohol dependence (FUC and MAN) and chronic alcohol consumption and dependence (GLU).

  15. The activity of lysosomal exoglycosidases in serum of alcohol-dependent men supplemented with borage oil enriched with vitamin E.

    Science.gov (United States)

    Zaniewska, Agnieszka; Borzym-Kluczyk, Malgorzata; Szajda, Slawomir D; Romatowski, Jacek; Gil, Andrzej; Knas, Malgorzata; Dobryniewski, Jacek; Zwierz, Krzysztof

    2009-08-01

    The aim of this study was to determine the activity of the lysosomal exoglycosidases: alpha-mannosidase (MAN), alpha-fucosidase (FUC), and beta-glucuronidase (GLUCUR) in serum of alcohol-dependent men supplemented and not supplemented with borage oil enriched with vitamin E. Serum was collected from eight social drinkers and 16 alcohol-dependent men after a drinking period. The activity of exoglycosidases and the concentration of protein in serum were determined. The increase in specific activity of MAN and GLUCUR was significant in serum of alcohol-dependent men both not supplemented and supplemented with borage oil enriched with vitamin E, in comparison with the specific activity in serum of social drinkers. In serum of alcohol-dependent men treated with borage oil enriched with vitamin E, specific activity of MAN and GLUCUR fluctuated in comparison with alcohol-dependent men not supplemented. Specific activity of FUC in serum of alcohol-dependent men both not supplemented and supplemented with borage oil enriched with vitamin E showed a tendency to increase, in comparison with social drinkers. Specific activity of FUC had a tendency to decrease in serum of alcohol-dependent men supplemented with borage oil enriched with vitamin E, in comparison with alcohol-dependent men not supplemented. Thus, supplementation of alcohol-dependent men after a long-lasting drinking period with borage oil and vitamin E did not change the rate of catabolism of the oligosaccharide chains of glycoconjugates, as evaluated by serum activity of exoglycosidases.

  16. Temporal dynamics and determinants of whole brain tissue volume changes during recovery from alcohol dependence.

    Science.gov (United States)

    Gazdzinski, Stefan; Durazzo, Timothy C; Meyerhoff, Dieter J

    2005-06-01

    Brain shrinkage and its partial reversibility with abstinence is a common neuroimaging finding in alcohol dependent individuals. We used an automated three-dimensional whole brain magnetic resonance imaging method (boundary shift integral) in 23 alcohol dependent individuals to measure the temporal dynamics of cerebral tissue and spinal fluid volume changes over a 12-month interval and to examine the major determinants of brain tissue change rates during abstinence and non-abstinence. We found more rapid brain tissue gain during the first month of sobriety than in the following months. The most rapid volume recovery was observed in abstinent individuals with the greatest baseline brain shrinkage and drinking severity. The rapid reversal of brain volume gains in non-abstinent individuals and tissue volume changes are modulated by duration of abstinence and non-abstinence periods, as well as recency of non-abstinence. Age, family history density of alcoholism, relapse severity, and duration or age of onset of heavy drinking were not major determinants of brain shrinkage and brain volume recovery rates. Treatment providers may use this tangible information to reinforce the biomedical benefits of sobriety. Previous quantitative measurements of brain volumes in alcohol dependent individuals performed after several weeks of abstinence likely underestimated the full extent of chronic alcohol-associated brain shrinkage.

  17. SWI/SNF chromatin remodeling regulates alcohol response behaviors in Caenorhabditis elegans and is associated with alcohol dependence in humans.

    Science.gov (United States)

    Mathies, Laura D; Blackwell, GinaMari G; Austin, Makeda K; Edwards, Alexis C; Riley, Brien P; Davies, Andrew G; Bettinger, Jill C

    2015-03-10

    Alcohol abuse is a widespread and serious problem. Understanding the factors that influence the likelihood of abuse is important for the development of effective therapies. There are both genetic and environmental influences on the development of abuse, but it has been difficult to identify specific liability factors, in part because of both the complex genetic architecture of liability and the influences of environmental stimuli on the expression of that genetic liability. Epigenetic modification of gene expression can underlie both genetic and environmentally sensitive variation in expression, and epigenetic regulation has been implicated in the progression to addiction. Here, we identify a role for the switching defective/sucrose nonfermenting (SWI/SNF) chromatin-remodeling complex in regulating the behavioral response to alcohol in the nematode Caenorhabditis elegans. We found that SWI/SNF components are required in adults for the normal behavioral response to ethanol and that different SWI/SNF complexes regulate different aspects of the acute response to ethanol. We showed that the SWI/SNF subunits SWSN-9 and SWSN-7 are required in neurons and muscle for the development of acute functional tolerance to ethanol. Examination of the members of the SWI/SNF complex for association with a diagnosis of alcohol dependence in a human population identified allelic variation in a member of the SWI/SNF complex, suggesting that variation in the regulation of SWI/SNF targets may influence the propensity to develop abuse disorders. Together, these data strongly implicate the chromatin remodeling associated with SWI/SNF complex members in the behavioral responses to alcohol across phyla.

  18. Supplier-dependent differences in intermittent voluntary alcohol intake and response to naltrexone in Wistar rats.

    Science.gov (United States)

    Momeni, Shima; Segerström, Lova; Roman, Erika

    2015-01-01

    Alcohol use disorder (AUD) is a worldwide public health problem and a polygenetic disorder displaying substantial individual variation. This work aimed to study individual differences in behavior and its association to voluntary alcohol intake and subsequent response to naltrexone in a seamless heterogenic group of animals. Thus, by this approach the aim was to more accurately recapitulate the existing heterogeneity within the human population. Male Wistar rats from three different suppliers (Harlan Laboratories B.V., RccHan™:WI; Taconic Farms A/S, HanTac:WH; and Charles River GmbH, Crl:WI) were used to create a heterogenic group for studies of individual differences in behavior, associations to intermittent voluntary alcohol intake and subsequent response to naltrexone. The rats were tested in the open field prior to the Y-maze and then given voluntary intermittent access to alcohol or water in the home cage for 6 weeks, where after, naltrexone in three different doses or saline was administered in a Latin square design over 4 weeks and alcohol intake and preference was measured. However, supplier-dependent differences and concomitant skew subgroup formations, primarily in open field behavior and intermittent alcohol intake, resulted in a shifted focus to instead study voluntary alcohol intake and preference, and the ensuing response to naltrexone in Wistar rats from three different suppliers. The results showed that outbred Wistar rats are diverse with regard to voluntary alcohol intake and preference in a supplier-dependent manner; higher in RccHan™:WI relative to HanTac:WH and Crl:WI. The results also revealed supplier-dependent differences in the effect of naltrexone that were dose- and time-dependent; evident differences in high-drinking RccHan™:WI rats relative to HanTac:WH and Crl:WI rats. Overall these findings render RccHan™:WI rats more suitable for studies of individual differences in voluntary alcohol intake and response to naltrexone and

  19. A Literature Review of Cost-Benefit Analyses for the Treatment of Alcohol Dependence

    Directory of Open Access Journals (Sweden)

    Satya Mohapatra

    2011-08-01

    Full Text Available The purpose of this study was to conduct a literature review of cost-benefit studies on pharmacotherapy and psychotherapy treatments of alcohol dependence (AD. A literature search was performed in multiple electronic bibliographic databases. The search identified seven psychotherapy studies from the USA and two pharmacotherapy studies from Europe. In the psychotherapy studies, major benefits are typically seen within the first six months of treatment. The benefit-cost ratio ranged from 1.89 to 39.0. Treatment with acamprosate was found to accrue a net benefit of 21,301 BEF (528 € per patient over a 24-month period in Belgium and lifetime benefit for each patient in Spain was estimated to be Pta. 3,914,680 (23,528 €. To date, only a few studies exist that have examined the cost-benefit of psychotherapy or pharmacotherapy treatment of AD. Most of the available treatment options for AD appear to produce marked economic benefits.

  20. Alcohol misuse in patients with psoriasis: identification and relationship to disease severity and psychological distress.

    LENUS (Irish Health Repository)

    McAleer, M A

    2012-02-01

    BACKGROUND: Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers provide an objective measure of alcohol consumption. Carbohydrate-deficient transferrin (CDT) is the single most sensitive and specific alcohol biomarker. OBJECTIVES: To assess alcohol consumption in a cohort of patients with moderate to severe psoriasis using standard alcohol screening questionnaires and biomarkers. We investigated whether there was an association between alcohol intake, anxiety, depression and disease severity. METHODS: Consecutive patients with chronic plaque psoriasis were recruited and completed a range of anonymized assessments. Psoriasis severity, anxiety and depression, and the impact of psoriasis on quality of life were assessed. Alcohol screening questionnaires were administered. Blood specimens were taken and gamma-glutamyltransferase (gammaGT) and CDT were measured. RESULTS: A total of 135 patients completed the study. Using validated questionnaires, between 22% and 32% had difficulties with alcohol. Seven per cent had CDT > 1.6% indicating a heavy alcohol intake. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was superior to other validated questionnaires in detecting alcohol misuse. There were no significant associations between measures of excessive alcohol consumption and disease severity. Excessive alcohol intake as measured by the CAGE questionnaire was associated with increased depression (P = 0.001) but other measures of alcohol excess did not correlate with psychological distress. Men had significantly more difficulties with alcohol than women (P < 0.001). CONCLUSION: Alcohol misuse is common in patients with moderate to severe psoriasis. Screening with the AUDIT questionnaire and CDT may allow the identification of patients who are misusing alcohol and allow appropriate intervention.

  1. 柴胡加龙骨牡蛎汤化裁方对酒精依赖症患者生存质量的影响%Influence of modified Chaihu Plus Longgu Muli Tang on quality of life in patients with alcohol dependence

    Institute of Scientific and Technical Information of China (English)

    王志斌; 李军祥; 韩海啸; 余轶群

    2014-01-01

    目的:采用随机对照研究观察柴胡加龙骨牡蛎汤化裁方对酒精依赖症患者生存质量的影响。方法将56名酒精依赖症患者随机分为2组,分别服用配方颗粒制剂的柴胡加龙骨牡蛎汤化裁方(治疗组)或安慰剂(对照组)4周。并以健康状况问卷(Short Form 36 Health Survey Questionnaire,SF-36)为研究工具,量化评估柴胡加龙骨牡蛎汤化裁方对酒精依赖症患者生活质量的影响。结果经治疗前后SF-36计分数据比较,治疗组在服药4周后,在生理机能、生理职能、躯体疼痛、一般健康状况、精力、精神健康6个维度上的得分均高于对照组。结论柴胡加龙骨牡蛎汤化裁方可以改善酒精依赖症患者的生活质量。%Objective To investigate the influence of modified Chaihu Plus Longgu Muli Tang on quality of life in the patients with alcohol dependence by using a randomized controlled study. Methods The patients with alcohol dependence (n=56) were randomly divided into two groups, and treatment group was treated with granules formulation of Chaihu plus Longgu Muli Tang and control group was treated with placebo for 4 weeks. With a research tool of health status questionnaire (Short Form 36 Health Survey Questionnaire:SF-36), the influence of Chaihu plus Longgu Muli Tang on quality of life in patients with alcohol dependence was reviewed quantatively. Results After 4 weeks, through the comparison in SF-36 scoring data before and after treatment, scores of 6 dimensions of physical functioning (PF), role of physiology (RP), bodily pain (BP), general health (GH), vitality (VT) and mental health (MH) were all significantly higher in treatment group than those in control group, while comparison in dimensions of social functioning (SF) and role emotional (RE) showed there was no statistically significant difference. Conclusion Modified Chaihu Plus Longgu Muli Tang can improve the quality of life in patients with alcohol

  2. EEG alpha phenotypes: linkage analyses and relation to alcohol dependence in an American Indian community study

    Directory of Open Access Journals (Sweden)

    Phillips Evelyn

    2010-03-01

    Full Text Available Abstract Background Evidence for a high degree of heritability of EEG alpha phenotypes has been demonstrated in twin and family studies in a number of populations. However, information on linkage of this phenotype to specific chromosome locations is still limited. This study's aims were to map loci linked to EEG alpha phenotypes and to determine if there was overlap with loci previously mapped for alcohol dependence in an American Indian community at high risk for substance dependence. Methods Each participant gave a blood sample and completed a structured diagnostic interview using the Semi Structured Assessment for the Genetics of Alcoholism. Bipolar EEGs were collected and spectral power determined in the alpha (7.5-12.0 Hz frequency band for two composite scalp locations previously identified by principal components analyses (bilateral fronto-central and bilateral centro-parietal-occipital. Genotypes were determined for a panel of 791 micro-satellite polymorphisms in 410 members of multiplex families using SOLAR. Results Sixty percent of this study population had a lifetime diagnosis of alcohol dependence. Analyses of multipoint variance component LOD scores, for the EEG alpha power phenotype, revealed two loci that had a LOD score of 3.0 or above for the fronto-central scalp region on chromosomes 1 and 6. Additionally, 4 locations were identified with LOD scores above 2.0 on chromosomes 4, 11, 14, 16 for the fronto-central location and one on chromosome 2 for the centro-parietal-occipital location. Conclusion These results corroborate the importance of regions on chromosome 4 and 6 highlighted in prior segregation studies in this and other populations for alcohol dependence-related phenotypes, as well as other areas that overlap with other substance dependence phenotypes identified in previous linkage studies in other populations. These studies additionally support the construct that EEG alpha recorded from fronto-central scalp areas may

  3. [Prevalence of Alcohol Abuse and Dependence in Adults With Social Phobia in Medellin].

    Science.gov (United States)

    Peña-Salas, Gabriel Felipe; Bareño, José; Berbesi Fernández, Dedsy Yajaira; Gaviria, Silvia L

    2014-01-01

    Having a social pho