Stress-induced change in serum BDNF is related to quantitative family history of alcohol use disorder and age at first alcohol use.

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Sharma, Shobhit; Graham, Reiko; Rohde, Rodney; Ceballos, Natalie A

2017-02-01

Previous research in animal models suggests that brain-derived neurotrophic factor (BDNF) is involved in stress-modulated alcohol consumption. However, relatively few studies have investigated this issue in humans, and results of existing studies have been heterogeneous. The primary aim of the current study was to examine the within-subjects effect of acute stress (timed math plus cold pressor) on serum BDNF levels (ΔBDNF: post- minus pre-stress) in healthy social drinkers (N=68, 20 male). A secondary aim was to explore which heritable and environmental factors in our limited sample might exert the greatest influences on ΔBDNF. Importantly, presence versus absence of the BDNF Val 66 Met polymorphism (rs6265), which has often been discounted in studies of human serum BDNF, was included as a between-subjects control variable in all statistical analyses. Our results indicated that acute stress decreased serum BDNF. Further, multiple regression analyses revealed that quantitative family history of alcohol use disorder (qFH) and age at first alcohol use together accounted for 15% of the variance in ΔBDNF. Thus, the influences of qFH and age at first alcohol use may explain some of the heterogeneity that exists in previous studies of human serum BDNF. These results parallel findings in animal models and suggest that stress-related changes in serum BDNF are influenced by both heritable (qFH) and environmental (early alcohol consumption) factors. Copyright © 2016 Elsevier Inc. All rights reserved.

Neuropeptide Y in Alcohol Addiction and Affective Disorders

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Annika Thorsell

2017-07-01

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

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

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

2001-07-01

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

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

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

2016-01-01

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

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

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Gilpin, N W; Weiner, J L

2017-01-01

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

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

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

2001-01-01

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

Interactive effects of stress and individual differences on alcohol use and posttraumatic stress disorder among personnel deployed to Guantanamo Bay.

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De La Rosa, Gabriel M; Delaney, Eileen M; Webb-Murphy, Jennifer A; Johnston, Scott L

2015-11-01

This study examines the role of factors such as perceived stress, neuroticism, beliefs in psychotherapy stigma, resilience, and demographics in understanding posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) among deployed military personnel. Results show that personnel who screened positive for PTSD were more likely to screen positive for AUD (versus those who did not screen positive for PTSD). Perceived stress, neuroticism, and psychotherapy stigma all have direct multivariate relationships with PTSD symptoms. Moderated regression analyses show that the positive relationship between perceived stress and PTSD symptoms is significantly stronger among those scoring high on neuroticism and psychotherapy stigma. The positive relationship between perceived stress and AUD symptoms is only significant among those scoring high on psychotherapy stigma. Given the moderating role of psychotherapy stigma in the relationship between perceived stress and PTSD symptoms and the relationship between perceived stress and AUD symptoms efforts to reduce the stigma associated with mental health care in the military should be expanded. Also, the current research adds to the literature highlighting the role of neuroticism as a key variable in understanding PTSD. Copyright © 2015. Published by Elsevier Ltd.

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

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

2006-02-01

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

A family history of Type 1 alcoholism differentiates alcohol consumption in high cortisol responders to stress.

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Brkic, Sejla; Söderpalm, Bo; Söderpalm Gordh, Anna

2015-03-01

The differentiation between high and low cortisol responders to stress is of interest in determining the risk factors which may, along with genetic vulnerability, influence alcohol intake. Thirty-two healthy volunteers, family history positive to alcoholism (FHP, n = 16) and family history negative (FHN, n = 16) attended two laboratory sessions during which alcohol or placebo was offered. There were no differences in consumption of alcohol or placebo between FHP and FHN subjects. STUDY 2: Fifty-eight healthy social drinkers, FHP (n = 27) and FHN (n = 31) attended two laboratory sessions. They were administered either alcohol or placebo in both sessions they attended. All subjects underwent either a stress task (the Trier Social Stress Test, TSST) or a stress-free period, at two separate occasions, before being offered beverage. After the salivary cortisol analysis, subjects in each group were divided into high (HCR) or low (LCR) cortisol responders. After stress, subjects who were FHP-HCR consumed more alcohol than FHN-HCR. There were no differences in the placebo intake between FHP and FHN subjects regardless of their cortisol response. This result indicates that stress promotes alcohol consumption only in subjects with a family history of Type 1 alcoholism who show an increase in cortisol response to stress. This behaviour is similar to that previously observed in alcohol dependent individuals after stress and thus could represent an endophenotype posing a risk for future development of alcohol use disorders. Copyright © 2015. Published by Elsevier Inc.

Parental alcohol use disorders and child delinquency: the mediating effects of executive functioning and chronic family stress.

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Grekin, Emily R; Brennan, Patricia A; Hammen, Constance

2005-01-01

This study examines the relationship between parental alcohol use disorders (AUDs) and child violent and nonviolent delinquency. It also explores the mediating effects of executive functioning and chronic family stress on the parental AUD/child delinquency relationship. Participants were 816 families with children (414 boys and 402 girls) born between 1981 and 1984 at Mater Misericordiae Mother's Hospital in Brisbane, Australia. Parents and children completed semistructured interviews, questionnaires and neuropsychological tests that assessed parental alcohol use, family psychiatric history, chronic family stress, child delinquency and child executive functioning. Paternal (but not maternal) AUDs predicted child violent and nonviolent delinquency. Executive functioning mediated the relationship between paternal AUDs and violent delinquency, whereas family stress mediated the relationship between paternal AUDs and both violent and nonviolent delinquency. Results support a biosocial conceptualization of the paternal AUD/delinquency relationship. They suggest that paternal AUDs may be associated with child executive functioning and family stress, which may in turn lead to child delinquency.

Anxiety, Anxiety Sensitivity, and Perceived Stress as Predictors of Recent Drinking, Alcohol Craving, and Social Stress Response in Heavy Drinkers

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McCaul, Mary E.; Hutton, Heidi E.; Stephens, Mary Ann C.; Xu, Xiaoqiang; Wand, Gary S.

2017-01-01

Background Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder (AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol?related problems have been equivocal. This study examined relationships between scores on self?report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, al...

Anxiety, Anxiety Sensitivity, and Perceived Stress as Predictors of Recent Drinking, Alcohol Craving, and Social Stress Response in Heavy Drinkers.

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McCaul, Mary E; Hutton, Heidi E; Stephens, Mary Ann C; Xu, Xiaoqiang; Wand, Gary S

2017-04-01

Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder (AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol-related problems have been equivocal. This study examined relationships between scores on self-report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, alcohol craving during early withdrawal, as well as laboratory measures of alcohol craving and stress reactivity among heavy drinkers with AUD. Media-recruited, heavy drinkers with AUD (N = 87) were assessed for recent alcohol consumption. Anxiety and stress levels were characterized using paper-and-pencil measures, including the Beck Anxiety Inventory (BAI), the Anxiety Sensitivity Index-3 (ASI-3), and the Perceived Stress Scale (PSS). Eligible subjects (N = 30) underwent alcohol abstinence on the Clinical Research Unit; twice daily measures of alcohol craving were collected. On day 4, subjects participated in the Trier Social Stress Test; measures of cortisol and alcohol craving were collected. In multivariate analyses, higher BAI scores were associated with lower drinking frequency and reduced drinks/drinking day; in contrast, higher ASI-3 scores were associated with higher drinking frequency. BAI anxiety symptom and ASI-3 scores also were positively related to Alcohol Use Disorders Identification Test total scores and AUD symptom and problem subscale measures. Higher BAI and ASI-3 scores but not PSS scores were related to greater self-reported alcohol craving during early alcohol abstinence. Finally, BAI scores were positively related to laboratory stress-induced cortisol and alcohol craving. In contrast, the PSS showed no relationship with most measures of alcohol craving or stress reactivity. Overall, clinically oriented measures of anxiety compared with perceived stress were more

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

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

2017-08-29

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

Sex differences in neural responses to stress and alcohol context cues.

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Seo, Dongju; Jia, Zhiru; Lacadie, Cheryl M; Tsou, Kristen A; Bergquist, Keri; Sinha, Rajita

2011-11-01

Stress and alcohol context cues are each associated with alcohol-related behaviors, yet neural responses underlying these processes remain unclear. This study investigated the neural correlates of stress and alcohol context cue experiences and examined sex differences in these responses. Using functional magnetic resonance imaging, brain responses were examined while 43 right-handed, socially drinking, healthy individuals (23 females) engaged in brief guided imagery of personalized stress, alcohol-cue, and neutral-relaxing scenarios. Stress and alcohol-cue exposure increased activity in the cortico-limbic-striatal circuit (P left anterior insula, striatum, and visuomotor regions (parietal and occipital lobe, and cerebellum). Activity in the left dorsal striatum increased during stress, while bilateral ventral striatum activity was evident during alcohol-cue exposure. Men displayed greater stress-related activations in the mPFC, rostral ACC, posterior insula, amygdala, and hippocampus than women, whereas women showed greater alcohol-cue-related activity in the superior and middle frontal gyrus (SFG/MFG) than men. Stress-induced anxiety was positively associated with activity in emotion-modulation regions, including the medial OFC, ventromedial PFC, left superior-mPFC, and rostral ACC in men, but in women with activation in the SFG/MFG, regions involved in cognitive processing. Alcohol craving was significantly associated with the striatum (encompassing dorsal, and ventral) in men, supporting its involvement in alcohol "urge" in healthy men. These results indicate sex differences in neural processing of stress and alcohol-cue experiences and have implications for sex-specific vulnerabilities to stress- and alcohol-related psychiatric disorders. Copyright © 2010 Wiley-Liss, Inc.

Role of anuloma viloma pranayama in reducing stress in chronic alcoholics

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Kumar, L.R.

2011-01-01

Despite improved clinical care, heightened public awareness and wide spread use of health innovations, alcoholism remains a leading cause of death in many parts of the world. Chronic alcoholics suffer from stress and multitude of symptoms. The progressive addiction to alcohol will gradually nullify all other interests in the patient's life so that a deterioration of the physical, psychological, social, cultural and religious values takes place. The role of yoga in healing asthma, arthritis and other disorders has been known. Methods: Breathing technique (Anuloma Viloma Pranayama) was taught to chronic alcoholics. Using galvanic skin resistance, stress levels were measured before and after anuloma viloma yoga in controls and chronic alcoholics. Results: Reduced stress levels were noted using the galvanic skin resistance in both controls and chronic alcoholics after yogic breathing. Conclusion: There is a promising effect of simple yoga techniques in organising effective rehabilitation and treatment programmes to reduce stress in chronic alcoholics. This study would help to chart out a better management programme for enhancing relapse and alleviate the symptoms. (author)

Posttraumatic Stress Disorder Patients and Results of Violent Behavior

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Taner Oznur

2014-08-01

Full Text Available AIM: High levels of anger and aggression in post-traumatic stress disorder lead to unfavorable social, legal, physical and economic results to family members and the other social layers as much as patients. In this study, it is aimed to investigate the relation between both alcohol-cigarette consumption ratios and anger levels, characteristics of aggressive behaviors and the judicial outcome in cases diagnosed post-traumatic stress disorder due to armed conflict. METHODS: 38 cases diagnosed as post-traumatic stress disorder were included to the study. Pre- and post-traumatic alcohol/cigarette consumption amounts and aggressive behaviors are determined. Impact of Events Scale (Revised (IES-R was used for evaluating post-traumatic stress disorder symptom patterns and severity, Buss Perry Aggression Questionnaire was used for measuring anger and aggression levels, and Taylor and #8217;s Violence Rating Scale was used for evaluating the judicial outcome of aggression. RESULTS: 23 of cases (60.6% were married with children, 13 of cases (34.25 were single and 2 of cases (5.2% were divorced.18 of cases (47.4% were graduate. IES-R total score was 66,9 +/- 12,7, Buss Perry total score was 111,3 +/- 20,5, and Taylor and #8217;s Violence Rate was 2,5 +/- 1,0. When the pre- and post-traumatic aggressive behaviors were compared; physical violence to the partner was increased more than ten times, Physical and verbal violence to social individuals were increased more than four and seven times, respectively. And also it is observed that inflicting damage to property was increased 17 times, reckless driving was increased 11 times, and self-mutilation was increased 5 times. Alcohol consumption was determined as 0 (0 - 126 g/day for pre-trauma cases and 16.5 (0 - 294 g/day for post-trauma cases. Cigarette smoking was determined as 5 (0 and #8211; 40 cigarette/day for pre-trauma cases and 30 (0 -60 cigarette/day for post-trauma cases. CONCLUSION: Post

Relaxin-3 receptor (RXFP3 signalling mediates stress-related alcohol preference in mice.

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Andrew W Walker

Full Text Available Stressful life events are causally linked with alcohol use disorders (AUDs, providing support for a hypothesis that alcohol consumption is aimed at stress reduction. We have previously shown that expression of relaxin-3 mRNA in rat brain correlates with alcohol intake and that central antagonism of relaxin-3 receptors (RXFP3 prevents stress-induced reinstatement of alcohol-seeking. Therefore the objectives of these studies were to investigate the impact of Rxfp3 gene deletion in C57BL/6J mice on baseline and stress-related alcohol consumption. Male wild-type (WT and Rxfp3 knockout (KO (C57/B6JRXFP3TM1/DGen littermate mice were tested for baseline saccharin and alcohol consumption and preference over water in a continuous access two-bottle free-choice paradigm. Another cohort of mice was subjected to repeated restraint followed by swim stress to examine stress-related alcohol preference. Hepatic alcohol and aldehyde dehydrogenase activity was assessed in mice following chronic alcohol intake and in naive controls. WT and Rxfp3 KO mice had similar baseline saccharin and alcohol preference, and hepatic alcohol processing. However, Rxfp3 KO mice displayed a stress-induced reduction in alcohol preference that was not observed in WT littermates. Notably, this phenotype, once established, persisted for at least six weeks after cessation of stress exposure. These findings suggest that in mice, relaxin-3/RXFP3 signalling is involved in maintaining high alcohol preference during and after stress, but does not appear to strongly regulate the primary reinforcing effects of alcohol.

Stress history increases alcohol intake in relapse: relation to phosphodiesterase 10A.

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Logrip, Marian L; Zorrilla, Eric P

2012-09-01

Stressful experiences can result in elevated alcohol drinking, as exemplified in many individuals with post-traumatic stress disorder. However, how stress history, rather than acute stressors, influences alcohol intake remains uncertain. To model the protracted effects of past stress, male Wistar rats were subjected to light-cued footshock (stress history) or light cues alone (control) prior to acquisition of alcohol self-administration (1-hour sessions, fixed ratio 1-3, 100 µl of 10% v/v alcohol as reinforcer). Stress history did not alter mean alcohol intake during acquisition of self-administration, but it increased preference for the alcohol-paired lever over the inactive lever. Following an extinction period, rats with a history of stress exposure and low baseline alcohol intake showed a twofold elevation in alcohol self-administration, as compared with low-drinking rats with no stress history. Similar effects were not seen in rats self-administering 0.1% sucrose. Analysis of mRNA levels of phosphodiesterase 10A (PDE10A), a dual-specificity cyclic adenosine monophosphate and cyclic guanosine monophosphate hydrolyzing enzyme, showed that stress history increased Pde10a mRNA levels in the basolateral amygdala and, in low-drinking rats, the prelimbic prefrontal cortex (plPFC). Pde10a mRNA levels in the plPFC correlated directly with greater alcohol self-administration during the relapse-like phase, and greater BLA Pde10a mRNA levels correlated with increased ethanol preference after acquisition. The data demonstrate that stress history sensitizes otherwise low alcohol drinkers to consume more alcohol in a relapse-like situation and identify stress-induced neuroadaptations in amygdala and prefrontal cortical Pde10a expression as changes that may drive heightened alcohol intake and preference in susceptible individuals. © 2012 The Authors. Addiction Biology © 2012 Society for the Study of Addiction.

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

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

2017-07-01

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

Comorbidity of Alcohol Use Disorder and Chronic Pain: Genetic Influences on Brain Reward and Stress Systems.

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Yeung, Ellen W; Craggs, Jason G; Gizer, Ian R

2017-11-01

Alcohol use disorder (AUD) is highly comorbid with chronic pain (CP). Evidence has suggested that neuroadaptive processes characterized by reward deficit and stress surfeit are involved in the development of AUD and pain chronification. Neurological data suggest that shared genetic architecture associated with the reward and stress systems may contribute to the comorbidity of AUD and CP. This monograph first delineates the prevailing theories of the development of AUD and pain chronification focusing on the reward and stress systems. It then provides a brief summary of relevant neurological findings followed by an evaluation of evidence documented by molecular genetic studies. Candidate gene association studies have provided some initial support for the genetic overlap between AUD and CP; however, these results must be interpreted with caution until studies with sufficient statistical power are conducted and replications obtained. Genomewide association studies have suggested a number of genes (e.g., TBX19, HTR7, and ADRA1A) that are either directly or indirectly related to the reward and stress systems in the AUD and CP literature. Evidence reviewed in this monograph suggests that shared genetic liability underlying the comorbidity between AUD and CP, if present, is likely to be complex. As the advancement in molecular genetic methods continues, future studies may show broader central nervous system involvement in AUD-CP comorbidity. Copyright © 2017 by the Research Society on Alcoholism.

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

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Sessa, Ben

2017-11-07

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

Increased anxiety, voluntary alcohol consumption and ethanol-induced place preference in mice following chronic psychosocial stress.

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Bahi, Amine

2013-07-01

Stress exposure is known to be a risk factor for alcohol use and anxiety disorders. Comorbid chronic stress and alcohol dependence may lead to a complicated and potentially severe treatment profile. To gain an understanding of the interaction between chronic psychosocial stress and drug exposure, we studied the effects of concomitant chronic stress exposure on alcohol reward using two-bottle choice and ethanol-conditioned place preference (CPP). The study consisted of exposure of the chronic subordinate colony (CSC) mice "intruders" to an aggressive "resident" mouse for 19 consecutive days. Control mice were single housed (SHC). Ethanol consumption using two-bottle choice paradigm and ethanol CPP acquisition was assessed at the end of this time period. As expected, CSC exposure increased anxiety-like behavior and reduced weight gain as compared to SHC controls. Importantly, in the two-bottle choice procedure, CSC mice showed higher alcohol intake than SHC. When testing their response to ethanol-induced CPP, CSC mice achieved higher preference for the ethanol-paired chamber. In fact, CSC exposure increased ethanol-CPP acquisition. Taken together, these data demonstrate the long-term consequences of chronic psychosocial stress on alcohol intake in male mice, suggesting chronic stress as a risk factor for developing alcohol consumption and/or anxiety disorders.

Polygenic risk for alcohol consumption and its association with alcohol-related phenotypes: Do stress and life satisfaction moderate these relationships?

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Mies, Gabry W; Verweij, Karin J H; Treur, Jorien L; Ligthart, Lannie; Fedko, Iryna O; Hottenga, Jouke Jan; Willemsen, Gonneke; Bartels, Meike; Boomsma, Dorret I; Vink, Jacqueline M

2018-02-01

Genetic and environmental factors contribute about equally to alcohol-related phenotypes in adulthood. In the present study, we examined whether more stress at home or low satisfaction with life might be associated with heavier drinking or more alcohol-related problems in individuals with a high genetic susceptibility to alcohol use. Information on polygenic scores and drinking behavior was available in 6705 adults (65% female; 18-83 years) registered with the Netherlands Twin Register. Polygenic risk scores (PRSs) were constructed for all subjects based on the summary statistics of a large genome-wide association meta-analysis on alcohol consumption (grams per day). Outcome measures were quantity of alcohol consumption and alcohol-related problems assessed with the Alcohol Use Disorders Identification Test (AUDIT). Stress at home and life satisfaction were moderating variables whose significance was tested by Generalized Estimating Equation analyses taking familial relatedness, age and sex into account. PRSs for alcohol were significantly associated with quantity of alcohol consumption and alcohol-related problems in the past year (R 2 =0.11% and 0.10% respectively). Participants who reported to have experienced more stress in the past year and lower life satisfaction, scored higher on alcohol-related problems (R 2 =0.27% and 0.29 respectively), but not on alcohol consumption. Stress and life satisfaction did not moderate the association between PRSs and the alcohol outcome measures. There were significant main effects of polygenic scores and of stress and life satisfaction on drinking behavior, but there was no support for PRS-by-stress or PRS-by-life satisfaction interactions on alcohol consumption and alcohol-related problems. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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

NARCIS (Netherlands)

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

2012-01-01

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

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

NARCIS (Netherlands)

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

2012-01-01

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

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

Directory of Open Access Journals (Sweden)

Caitlin A Durkee

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

Risky alcohol use in young persons with emerging bipolar disorder is associated with increased oxidative stress.

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Chitty, Kate M; Lagopoulos, Jim; Hickie, Ian B; Hermens, Daniel F

2013-09-25

Alcohol misuse is highly prevalent in bipolar disorder (BD) and has been associated with increased formation of reactive oxygen species in the CNS. Proton magnetic resonance spectroscopy ((1)H-MRS) is an in vivo tissue-based imaging modality that allows the investigation of changes in the brains primary antioxidant, glutathione (GSH), as a result of alcohol use in this population. Thirty-three patients with BD and 17 controls aged 18-30 years were recruited. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and underwent (1)H-MRS. Levels of GSH in the anterior cingulate cortex (ACC) were determined. ANOVA was conducted to determine differences between high and low risk drinking bipolar participants and controls. ANOVA with all groups revealed a significant difference in GSH between bipolar high and low risk drinkers, with those in the high-risk group displaying reduced GSH levels. A significant negative correlation was found between total AUDIT score and GSH in bipolar (R=-0.478, p=0.005) which remained significant when controlling for age and medication status. Our participant sample consisted of a heterogeneous group of patients, most of whom were medicated at time of testing. Young people with emerging BD who drink at risky levels display reduced levels of ACC-GSH. Increased oxidative stress and its resulting neurotoxic effects may be especially detrimental in an emerging bipolar sample where the illness trajectory is unclear and the brain is still undergoing significant development. © 2013 Elsevier B.V. All rights reserved.

Post-traumatic Stress Disorder by Gender and Veteran Status.

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Lehavot, Keren; Katon, Jodie G; Chen, Jessica A; Fortney, John C; Simpson, Tracy L

2018-01-01

Population-based data on the prevalence, correlates, and treatment utilization of post-traumatic stress disorder by gender and veteran status are limited. With changes in post-traumatic stress disorder diagnostic criteria in 2013, current information from a uniform data source is needed. This was a secondary analysis of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, which consisted of in-person interviews that were conducted with a representative sample of U.S. adults. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version was used to assess past-year and lifetime post-traumatic stress disorder among veterans (n=3,119) and civilians (n=32,982). Data were analyzed from January to March 2017. Adjusting for age and race/ethnicity, women veterans reported the highest rates of lifetime and past-year post-traumatic stress disorder (13.4%, 95% CI=8.8%, 17.9%, and 11.7%, 95% CI=7.1%, 16.4%) compared with women civilians (8.0%, 95% CI=7.4%, 8.6%, and 6.0%, 95% CI=5.5%, 6.6%); men veterans (7.7%, 95% CI=6.5%, 8.8%, and 6.7%, 95% CI=5.7%, 7.8%); and men civilians (3.4%, 95% CI=3.0%, 3.9%, and 2.6%, 95% CI=2.2%, 2.9%). Traumatic event exposure, correlates of lifetime post-traumatic stress disorder, and treatment seeking varied across subgroups. Men and women veterans were more likely than civilians to use a variety of treatment sources, with men civilians being least likely to seek treatment and men veterans exhibiting the longest delay in seeking treatment. Post-traumatic stress disorder is a common mental health disorder that varies by gender and veteran status. Women veterans' high rates of post-traumatic stress disorder highlight a critical target for prevention and intervention, whereas understanding treatment barriers for men veterans and civilians is necessary. Published by Elsevier Inc.

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

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

2010-06-01

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

Alcohol-related and mental health care for patients with unhealthy alcohol use and posttraumatic stress disorder in a National Veterans Affairs cohort.

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Chen, Jessica A; Owens, Mandy D; Browne, Kendall C; Williams, Emily C

2018-02-01

Unhealthy alcohol use and posttraumatic stress disorder (PTSD) frequently co-occur. Patients with both conditions have poorer functioning and worse treatment adherence compared to those with either condition alone. Therefore, it is possible that PTSD, when co-occurring with unhealthy alcohol use, may influence receipt of evidence-based alcohol-related care and mental health care. We evaluated receipt of interventions for unhealthy alcohol use and receipt of mental health follow-up care among patients screening positive for unhealthy alcohol use with and without PTSD in a national sample from the Veterans Health Administration (VA). National clinical and administrative data from VA's electronic medical record were used to identify all patients who screened positive for unhealthy alcohol use (AUDIT-C score≥5) between 10/1/09-5/30/13. Unadjusted and adjusted Poisson regression models were fit to estimate the relative rate and prevalence of receipt of: brief interventions (advice to reduce or abstain from drinking≤14days after positive screening), specialty addictions treatment for alcohol use disorder (AUD; documented visit≤365days after positive screening), pharmacotherapy for AUD (filled prescription≤365days after positive screening), and mental health care ≤14days after positive screening for patients with and without PTSD (documented with ICD-9 CM codes). In secondary analyses, we tested effect modification by both severity of unhealthy alcohol use and age. Among 830,825 patients who screened positive for unhealthy alcohol use, 140,388 (16.9%) had documented PTSD. Of the full sample, 71.6% received brief interventions, 10.3% received specialty AUD treatment, 3.1% received pharmacotherapy for AUD, and 24.0% received mental health care. PTSD was associated with increased likelihood of receiving all types of care. Adjusted relative rates were 1.04 (95% CI 1.03-1.05) for brief interventions, 1.06 (1.05-1.08) for specialty AUD treatment, 1.35 (1.31-1.39) for

Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

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Leggio, Lorenzo; Lee, Mary R.

2016-01-01

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

Alcohol and Nonmedical Prescription Drug Use to Cope With Posttraumatic Stress Disorder Symptoms: An Analysis of Hurricane Sandy Survivors.

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Lowe, Sarah R; Sampson, Laura; Young, Megan N; Galea, Sandro

2017-08-24

Postdisaster increases in substance use have been attributed to use of substances to cope with emotional reactions. However, no study to our knowledge has explored disaster survivors' substance use to cope with posttraumatic stress disorder (PTSD) symptoms. We investigated the prevalence and correlates of alcohol use and nonmedical prescription drug use (NMPDU) to cope with PTSD symptoms in two population-based samples of adult residents of New York City neighborhoods affected by Hurricane Sandy. Participants completed structured interviews at either 13-16 or 25-28 months postdisaster (combined N = 914). Participants with PTSD symptoms, assessed via the Posttraumatic Stress Checklist for DSM-5, indicated whether they coped with their symptoms through alcohol use or NMPDU, via items adapted from the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models explored correlates of substance use coping, including demographic characteristics, lifetime and hurricane-related exposures, and psychiatric symptoms in the combined sample. Over a third of participants in the combined sample (n = 311, 34.0%) reported PTSD symptoms, and of these, 12.8% used alcohol to cope and 9.2% endorsed NMPDU to cope. Older age and being a parent living with a child under 18 years old at the time of the hurricane were associated with a lower likelihood, and more severe depression symptoms with a higher likelihood, of alcohol use coping. Conclusions/Importance: Although preliminary, the results provide evidence for the use of substances to cope with postdisaster PTSD symptoms, and that age, parent status, and depression symptoms are associated with alcohol use coping.

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

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

1995-01-01

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

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

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

1994-09-01

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

Posttraumatic stress disorder, depression, and alcohol and tobacco use in public health workers after the 2004 Florida hurricanes.

Science.gov (United States)

Fullerton, Carol S; McKibben, Jodi B A; Reissman, Dori B; Scharf, Ted; Kowalski-Trakofler, Kathleen M; Shultz, James M; Ursano, Robert J

2013-02-01

We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.

Mortality from alcohol consumption and alcohol use disorder

DEFF Research Database (Denmark)

Lundin, Andreas; Mortensen, Laust Hvas

2015-01-01

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

Biomarker-Based Approaches for Assessing Alcohol Use Disorders

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Onni Niemelä

2016-01-01

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

Fetal Alcohol Spectrum Disorders

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

The management of trauma and posttraumatic stress disorder in HIV ...

African Journals Online (AJOL)

Women are disproportionately affected by the HIV epidemic and also carry a higher burden of early childhood trauma, other life traumas (e.g. rape and partner violence) and post-traumatic stress disorder (PTSD).1,2 Yet PTSD and other common psychiatric disorders (e.g. depression, alcohol abuse) are commonly ...

Posttraumatic stress disorder (ptsd and co-morbidity

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Ifeta Ličanin

2002-02-01

Full Text Available Posttraumatic Stress Disorder (PTSD very often occurs accompanied with other psychiatric disorders such as: Alcohol and Drug abuse, Personality Disorder, General Anxiety Disorder, Obsessive Compulsive Disorder, Schizophrenia etc. Sometimes it might be a problem for clinicians to differ PTSD symptoms from symptoms of coexisting psychic disorders. The aim of this study was to present the most common PTSD coexisting psycho-disorders. This research was conducted during the period from April 1998 to October 1999. Participants were divided in two groups each containing 30 examinees. The first group consisted of 30 participants with symptoms of PTSD only while the second group included participants who suffered from both PTSD and other psychic disorders (co-morbidity. Both groups were quite similar regarding participants gender and age. The scientific tools used in the research were: Standard Psychiatric Interview, Harvard Trauma Questionnaire (HTQ, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Drug and Alcohol Abuse Checklist. Our research results are indicating that PTSDsymptoms are most common in middle-aged persons, regardless of their gender and age. We have found following coexisting psychic disorders: personality disorder 46.6% (from which 13.3% is permanent personality disorder after the traumatic experience; depression 29.9% (depression without psychotic symptoms 23.3% and depression with coexisting psychotic symptoms 6.6%; drug abuse 13.3; alcohol abuse 6.7% and dissociative (conversion disorder 3.3%. The results of our work are suggesting that co-morbid psychic symptoms have significant regressive influence on PTSD course and prognosis.

Pharmacotherapy for anxiety and comorbid alcohol use disorders.

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

2015-01-20

anxiety disorders with comorbid alcohol use disorders. Trials assessing drugs administered for the treatment of drinking behaviour, such as naltrexone, disulfiram and acomprosate were not eligible for inclusion in this systematic review. A systematic review is a standardised evaluation of all research studies that address a particular clinical issue.Two review authors independently assessed RCTs for inclusion in the review, collated trial data and assessed trial quality. We contacted investigators to obtain missing data. We calculated categorical and continuous treatment effect estimates and their 95% confidence intervals (CI) for treatment using a random-effects model with effect-size variability expressed using Chi(2) and I(2) heterogeneity statistics. We included five placebo-controlled pharmacotherapy RCTs (with 290 participants) in the review. Most of the trials provided little information on how randomization was performed or on whether both participants and study personnel were blinded to the intervention. Two of the three trials reporting superiority of medication compared with placebo on anxiety symptom outcomes were industry funded. We regarded one trial as being at high risk of bias due to selective reporting.Study participants had Diagnostic and Statistical Manual (DSM) III- and DSM IV-diagnosed alcohol use disorders and post-traumatic stress disorder (two studies), social anxiety disorder (SAD; two studies) or generalized anxiety disorder (GAD; one study). Four trials assessed the efficacy of the selective serotonin re-uptake inhibitors (SSRIs: sertraline, paroxetine); one RCT investigated the efficacy of buspirone, a 5-hydroxytryptamine (5-HT) partial agonist. Treatment duration lasted between eight and 24 weeks. Overall, 70% of participants included in the review were male.There was very low quality evidence for an effect of paroxetine on global clinical response to treatment, as assessed by the Clinical Global Impressions - Improvement scale (CGI

Sub-clinical Alcohol Consumption and Gambling Disorder.

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

2017-06-01

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

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

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

2012-10-01

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

Alcohol use disorders among Nigerian University students ...

African Journals Online (AJOL)

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

Bipolar Disorder and Alcoholism: Are They Related?

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

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

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Manoj Kumar

2017-01-01

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

Maternal post-traumatic stress disorder, depression and alcohol dependence and child behaviour outcomes in mother-child dyads infected with HIV: a longitudinal study.

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Nöthling, Jani; Martin, Cherie L; Laughton, Barbara; Cotton, Mark F; Seedat, Soraya

2013-12-10

HIV and psychiatric disorders are prevalent and often concurrent. Childbearing women are at an increased risk for both HIV and psychiatric disorders, specifically depression and post-traumatic stress disorder (PTSD). Poor mental health in the peripartum period has adverse effects on infant development and behaviour. Few studies have investigated the relationship between maternal PTSD and child behaviour outcomes in an HIV vertically infected sample. The aim of this study was to investigate whether maternal postpartum trauma exposure and PTSD were risk factors for child behaviour problems. In addition, maternal depression, alcohol abuse and functional disability were explored as cofactors. The study was conducted in Cape Town, South Africa. 70 mother-child dyads infected with HIV were selected from a group of participants recruited from community health centres. The study followed a longitudinal design. Five measures were used to assess maternal trauma exposure, PTSD, depression, alcohol abuse and functional disability at 12 months postpartum: Life Events Checklist (LEC), Harvard Trauma Scale (HTS), Alcohol Use Disorders Identification Test (AUDIT), Center for Epidemiological Studies Depression (CESD) Scale and the Sheehan Disability Scale (SDS). Child behaviour was assessed at 42 months with the Child Behaviour Checklist (CBCL). The rate of maternal disorder was high with 50% scoring above the cut-off for depression, 22.9% for PTSD and 7% for alcohol abuse. Half of the children scored within the clinical range for problematic behaviour. Children of mothers with depression were significantly more likely to display total behaviour problems than children of mothers without depression. Maternal PTSD had the greatest explanatory power for child behaviour problems, although it did not significantly predict child outcomes. This study highlights the importance of identifying and managing maternal PTSD and depression in mothers of children infected with HIV. The

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

Directory of Open Access Journals (Sweden)

Isabel Marian Hartmann Quadros

2016-10-01

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

Childhood adversities as specific contributors to the co-occurrence of posttraumatic stress and alcohol use disorders.

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Müller, Mario; Vandeleur, Caroline; Rodgers, Stephanie; Rössler, Wulf; Castelao, Enrique; Preisig, Martin; Ajdacic-Gross, Vladeta

2015-08-30

There is much evidence that alcohol use disorders (AUD) often co-occur with posttraumatic stress disorders (PTSD), and that the comorbid condition is associated with a more severe clinical profile than that of PTSD without AUD. However, little is known about the role of childhood adversities as specific risk factors for the development of AUD in individuals presenting with PTSD. The aim of the study was to explore whether specific stressors from the spectrum of trauma and childhood adversities contribute to the development of AUD among subjects with PTSD. From a large community sample, of N=140 individuals with PTSD, N=24 (17.14%) received an additional diagnosis of AUD with an onset after the onset of PTSD. Those with comorbid PTSD/AUD and those with PTSD only were compared regarding type and features of their trauma, childhood adversities and psychiatric comorbidity. Compared to PTSD alone, PTSD/AUD was associated with higher levels of stress in terms of childhood adversities; in particular, sexual abuse below the age of 16, but also with having been brought up in a foster home. PTSD/AUD was also associated with an earlier age of adverse events. Treatment of AUD should include standardized assessments of trauma, especially of trauma experienced during childhood. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment

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Gimeno, Carmen; Dorado, Marisa Luisa; Roncero, Carlos; Szerman, Nestor; Vega, Pablo; Balanzá-Martínez, Vicent; Alvarez, F. Javier

2017-01-01

Patients with alcohol-use disorders (AUDs) have a high prevalence of anxiety disorders (AnxDs). “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives. PMID:29018367

Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment

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Carmen Gimeno

2017-09-01

Full Text Available Patients with alcohol-use disorders (AUDs have a high prevalence of anxiety disorders (AnxDs. “Co-occurring disorders” refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs, especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD–AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives.

Alcohol use disorders in pregnancy.

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

2015-01-01

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

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

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

2014-01-01

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

The effect of a yoga intervention on alcohol and drug abuse risk in veteran and civilian women with posttraumatic stress disorder.

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Reddy, Shivani; Dick, Alexandra M; Gerber, Megan R; Mitchell, Karen

2014-10-01

Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse. Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies. The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests. The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy. Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.

Intersection of stress and gender in association with transitions in past year DSM-5 substance use disorder diagnoses in the United States.

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Verplaetse, Terril L; Moore, Kelly E; Pittman, Brian P; Roberts, Walter; Oberleitner, Lindsay M; Smith, Philip H; Cosgrove, Kelly P; McKee, Sherry A

2018-01-01

Stress contributes to the development and maintenance of substance use disorders (SUD), with some research suggesting that the impact of stress on SUD is greater in women. However, this has yet to be evaluated in a national dataset, across major substances of abuse. Using data from the newly available U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 3; n =36,309) we evaluated relationships among past year stressful life events (0 or 1 vs. 2+ events, range 0-16) and gender, and their association with transitions (new vs. absent cases; ongoing vs. remitted cases) in Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) alcohol use disorder (AUD), tobacco use disorder (TUD), cannabis use disorder (CUD), and nonmedical prescription opioid use disorder (OUD) diagnoses. Having 2 or more stressful life events in the past year increased the odds of having a new AUD, TUD, CUD, and OUD (OR=3.14, 2.15, 5.52, and 3.06, respectively) or ongoing AUD, TUD, and CUD (OR=2.39, 2.62, and 2.95, respectively) compared to 0 or 1 stressful life event. A stress by gender interaction for new vs. absent AUD demonstrated that having 2 or more stressful life events was associated with increased odds of new AUD in men (OR=2.51) and even greater odds of new AUD in women (OR=3.94). Results highlight that stress is a robust factor in both men and women with new or ongoing substance use disorders, and that effective treatments for substance use should consider the role of stress in addiction etiology and maintenance. There was little evidence for gender differences in the role of stress on transitions in substance use disorders, except for the onset of alcohol use disorders. Given that rates of alcohol use disorders are increasing in women; the impact of stress needs to be considered.

Lifetime history of traumatic events in a young adult Mexican American sample: relation to substance dependence, affective disorder, acculturation stress, and PTSD

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Ehlers, Cindy L.; Kim, Corinne; Gilder, David A.; Stouffer, Gina M.; Caetano, Raul; Yehuda, Rachel

2016-01-01

Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18–30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure. PMID:27569652

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

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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.

Alcohol Abuse and Other Psychiatric Disorders

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

GLIA AND NEURODEVELOPMENT: FOCUS ON FETAL ALCOHOL SPECTRUM DISORDERS

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Marina eGuizzetti

2014-11-01

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

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

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

2017-06-01

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

Lifetime history of traumatic events in a young adult Mexican American sample: Relation to substance dependence, affective disorder, acculturation stress, and PTSD.

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Ehlers, Cindy L; Kim, Corinne; Gilder, David A; Stouffer, Gina M; Caetano, Raul; Yehuda, Rachel

2016-12-01

Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18-30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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

2018-04-01

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

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

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Divane de Vargas

2014-08-01

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

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

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

2009-01-01

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

Alcohol Use Disorder (AUD) Treatment

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

Posttraumatic Stress Disorder

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... Safe Videos for Educators Search English Español Posttraumatic Stress Disorder (PTSD) KidsHealth / For Parents / Posttraumatic Stress Disorder ( ... My Child? Looking Ahead Print What Is Posttraumatic Stress Disorder (PTSD)? Someone who is the victim of ( ...

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

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

2018-01-01

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

Alcohol Demand, Future Orientation, and Craving Mediate the Relation Between Depressive and Stress Symptoms and Alcohol Problems.

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Soltis, Kathryn E; McDevitt-Murphy, Meghan E; Murphy, James G

2017-06-01

Elevated depression and stress have been linked to greater levels of alcohol problems among young adults even after taking into account drinking level. This study attempts to elucidate variables that might mediate the relation between symptoms of depression and stress and alcohol problems, including alcohol demand, future time orientation, and craving. Participants were 393 undergraduates (60.8% female, 78.9% White/Caucasian) who reported at least 2 binge-drinking episodes (4/5+ drinks for women/men, respectively) in the previous month. Participants completed self-report measures of stress and depression, alcohol demand, future time orientation, craving, and alcohol problems. In separate mediation models that accounted for gender, race, and weekly alcohol consumption, future orientation and craving significantly mediated the relation between depressive symptoms and alcohol problems. Alcohol demand, future orientation, and craving significantly mediated the relation between stress symptoms and alcohol problems. Heavy-drinking young adults who experience stress or depression are likely to experience alcohol problems, and this is due in part to elevations in craving and alcohol demand, and less sensitivity to future outcomes. Interventions targeting alcohol misuse in young adults with elevated levels of depression and stress should attempt to increase future orientation and decrease craving and alcohol reward value. Copyright © 2017 by the Research Society on Alcoholism.

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

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

2013-07-30

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

Exposure to the Lebanon War of 2006 and effects on alcohol use disorders: The moderating role of childhood maltreatment☆

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Keyes, Katherine M.; Shmulewitz, Dvora; Greenstein, Eliana; McLaughlin, Kate; Wall, Melanie; Aharonovich, Efrat; Weizman, Abraham; Frisch, Amos; Spivak, Baruch; Grant, Bridget F.; Hasin, Deborah

2013-01-01

Background Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history. Methods Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1306 respondents. War measures included self-reported days in an exposed region. Results Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95%C.I. 1.01–27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95%C.I. 0.25–1.01); test for interaction: X2 = 5.28, df = 1, P = 0.02. Conclusions Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened the risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life. PMID:24262650

Exposure to the Lebanon War of 2006 and effects on alcohol use disorders: the moderating role of childhood maltreatment.

Science.gov (United States)

Keyes, Katherine M; Shmulewitz, Dvora; Greenstein, Eliana; McLaughlin, Kate; Wall, Melanie; Aharonovich, Efrat; Weizman, Abraham; Frisch, Amos; Spivak, Baruch; Grant, Bridget F; Hasin, Deborah

2014-01-01

Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history. Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1306 respondents. War measures included self-reported days in an exposed region. Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95%C.I. 1.01-27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95%C.I. 0.25-1.01); test for interaction: X(2)=5.28, df=1, P=0.02. Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened the risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Personality disorder and treatment outcome in alcohol use disorder.

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Newton-Howes, Giles; Foulds, James

2018-01-01

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

Alcohol Alert: Link Between Stress and Alcohol

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... patients to better address how stress affects their motivation to drink. Early screening also is vital. For ... C.; Hong, K.A.; et al Enhanced negative emotion and alcohol craving, and altered physiological responses following ...

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

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Waja T

2016-11-01

=2.04, [1.10, 3.78], taking carbamazepine (AOR =2.38, [1.13, 5.01], and drinking alcohol to find relief from stress (AOR =4.28, [1.89, 9.67] were significantly associated with alcohol use disorder among people with epilepsy. Conclusion and recommendation: The findings of this study revealed that the prevalence of alcohol use disorder among people with epilepsy was high. Routine screening of epileptic patients with the Alcohol Use Disorders Identification Test is recommended. Keywords: alcohol use disorder, epilepsy, Amanuel Mental Specialized Hospital, sub-Saharan Africa, stress relief 

Effects of stress on alcohol drinking: a review of animal studies

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Lopez, Marcelo F.; Doremus-Fitzwater, Tamara L.

2011-01-01

Rationale While stress is often proposed to play a significant role in influencing alcohol consumption, the relationship between stress and alcohol is complex and poorly understood. Over several decades, stress effects on alcohol drinking have been studied using a variety of animal models and experimental procedures, yet this large body of literature has generally produced equivocal results. Objectives This paper reviews results from animal studies in which alcohol consumption is evaluated under conditions of acute/sub-chronic stress exposure or models of chronic stress exposure. Evidence also is presented indicating that chronic intermittent alcohol exposure serves as a stressor that consequently influences drinking. Results The effects of various acute/sub-chronic stress procedures on alcohol consumption have generally been mixed, but most study outcomes suggest either no effect or decreased alcohol consumption. In contrast, most studies indicate that chronic stress, especially when administered early in development, results in elevated drinking later in adulthood. Chronic alcohol exposure constitutes a potent stressor itself, and models of chronic intermittent alcohol exposure reliably produce escalation of voluntary alcohol consumption. Conclusions A complex and dynamic interplay among a wide array of genetic, biological, and environmental factors govern stress responses, regulation of alcohol drinking, and the circumstances in which stress modulates alcohol consumption. Suggestions for future directions and new approaches are presented that may aid in developing more sensitive and valid animal models that not only better mimic the clinical situation, but also provide greater understanding of mechanisms that underlie the complexity of stress effects on alcohol drinking. PMID:21850445

The Association of Panic Disorder, Posttraumatic Stress Disorder, and Major Depression With Smoking in American Indians.

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Sawchuk, Craig N; Roy-Byrne, Peter; Noonan, Carolyn; Bogart, Andy; Goldberg, Jack; Manson, Spero M; Buchwald, Dedra

2016-03-01

Rates of cigarette smoking are disproportionately high among American Indian populations, although regional differences exist in smoking prevalence. Previous research has noted that anxiety and depression are associated with higher rates of cigarette use. We asked whether lifetime panic disorder, posttraumatic stress disorder, and major depression were related to lifetime cigarette smoking in two geographically distinct American Indian tribes. Data were collected in 1997-1999 from 1506 Northern Plains and 1268 Southwest tribal members; data were analyzed in 2009. Regression analyses examined the association between lifetime anxiety and depressive disorders and odds of lifetime smoking status after controlling for sociodemographic variables and alcohol use disorders. Institutional and tribal approvals were obtained for all study procedures, and all participants provided informed consent. Odds of smoking were two times higher in Southwest participants with panic disorder and major depression, and 1.7 times higher in those with posttraumatic stress disorder, after controlling for sociodemographic variables. After accounting for alcohol use disorders, only major depression remained significantly associated with smoking. In the Northern Plains, psychiatric disorders were not associated with smoking. Increasing psychiatric comorbidity was significantly linked to increased smoking odds in both tribes, especially in the Southwest. This study is the first to examine the association between psychiatric conditions and lifetime smoking in two large, geographically diverse community samples of American Indians. While the direction of the relationship between nicotine use and psychiatric disorders cannot be determined, understanding unique social, environmental, and cultural differences that contribute to the tobacco-psychiatric disorder relationship may help guide tribe-specific commercial tobacco control strategies. © The Author 2015. Published by Oxford University Press on

Contribution of early environmental stress to alcoholism vulnerability

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Campbell, Joannalee C.; Szumlinski, Karen K.; Kippin, Tod E.

2009-01-01

The most problematic aspects of alcohol abuse disorder are excessive alcohol consumption and the inability to refrain from alcohol consumption during attempted abstinence. The root causes that predispose certain individuals to these problems are poorly understood but are believed to be produced by a combination of genetic and environmental factors. Early environmental trauma alters neurodevelopmental trajectories that can predispose an individual to a number of neuropsychiatric disorders, inc...

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

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Bozkurt M

2016-07-01

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

Fetal Alcohol Spectrum Disorder: Potential Role of Endocannabinoids Signaling

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Balapal S. Basavarajappa

2015-10-01

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

Comorbidity in illness-induced posttraumatic stress disorder versus posttraumatic stress disorder due to external events in a nationally representative study.

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Sommer, Jordana L; Mota, Natalie; Edmondson, Donald; El-Gabalawy, Renée

2018-05-10

The current study compared physical and mental health characteristics and quality of life of illness-induced posttraumatic stress disorder (PTSD) versus those with PTSD due to external traumatic events in a population-based sample. PTSD was assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5) using DSM-5 criteria in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Participants with past-year PTSD (n = 1779) were categorized into two groups: illness-induced (6.5%) and other trauma-induced PTSD (92.9%) based on index trauma. Group differences in physical health, mental health, and quality of life were estimated using multiple logistic and linear regressions with adjustment for demographics and medical morbidity. Compared to PTSD due to external events, illness-induced PTSD had higher rates of life-threatening illness in the past year. Illness-induced PTSD compared to PTSD due to external events was associated with reduced odds of depressive/bipolar disorders and antisocial personality disorder, but increased odds of cannabis use disorder. The groups did not differ on quality of life after accounting for medical morbidity. Illness-induced PTSD is common among American adults and has a similar impact on quality of life as PTSD due to external events, but may have distinct mental health correlates. Copyright © 2018 Elsevier Inc. All rights reserved.

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

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

2016-06-01

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

The association between post-traumatic stress disorder and lifetime DSM-5 psychiatric disorders among veterans: Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).

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Smith, Sharon M; Goldstein, Rise B; Grant, Bridget F

2016-11-01

This study examined the prevalence, correlates and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. veterans using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 3119 veteran respondents). The overall prevalence of lifetime PTSD was 6.9%. Lifetime PTSD prevalence was higher among veterans who were female (13.2%), aged 18-29 years (15.3%), Native American (24.1%) or Black (11.0%), previously or never married (9.6% and 11.2, respectively), had incomes less than $70,000 (7.2%-10.1%) and had >2 traumatic events (5.2%-14.7%). After adjusting for sociodemographic characteristics, comorbidity between lifetime PTSD and other psychiatric disorders was highest for any personality disorder (adjusted odds ratio [AOR] = 11.1, 95% confidence interval [CI], 5.7, 21.5), any mood disorder (AOR = 9.7, 95% CI, 4.6, 20.4) and any anxiety disorder (AOR = 9.6, 95% CI, 5.1, 17.7), followed by nicotine, drug, and alcohol use disorders (AOR = 3.4, 95% CI, 1.8, 6.5; AOR = 3.1, 95% CI, 2.0, 5.9; 2.1, 95% CI, 1.5, 3.1, respectively). Associations remained with any mood, anxiety, and personality disorders after controlling for other psychiatric disorders (AOR = 3.7, 95% CI, 1.2, 10.9; AOR = 3.5, 95% CI, 1.6, 7.4; AOR = 4.5, 95% CI, 2.3, 8.7, respectively). Veterans who sought treatment for PTSD had more comorbid conditions, although treatment was only associated with comorbid drug use disorder (AOR = 2.4, 95% CI, 1.0, 5.7). In U.S. veterans, PTSD is highly comorbid with other psychiatric disorders. Although many veterans remain untreated, comorbidity may influence treatment seeking. Published by Elsevier Ltd.

Response inhibition and cognitive appraisal in clients with acute stress disorder and posttraumatic stress disorder.

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Abolghasemi, Abass; Bakhshian, Fereshteh; Narimani, Mohammad

2013-08-01

The purpose of the present study was to compare response inhibition and cognitive appraisal in clients with acute stress disorder, clients with posttraumatic stress disorder, and normal individuals. This was a comparative study. The sample consisted of 40 clients with acute stress disorder, 40 patients with posttraumatic stress disorder, and 40 normal individuals from Mazandaran province selected through convenience sampling method. Data were collected using Composite International Diagnostic Interview, Stroop Color-Word Test, Posttraumatic Cognitions Inventory, and the Impact of Event Scale. Results showed that individuals with acute stress disorder are less able to inhibit inappropriate responses and have more impaired cognitive appraisals compared to those with posttraumatic stress disorder. Moreover, results showed that response inhibition and cognitive appraisal explain 75% of the variance in posttraumatic stress disorder symptoms and 38% of the variance in posttraumatic stress disorder symptoms. The findings suggest that response inhibition and cognitive appraisal are two variables that influence the severity of posttraumatic stress disorder and acute stress disorder symptoms. Also, these results have important implications for pathology, prevention, and treatment of posttraumatic stress disorder and acute stress disorder.

Negative Affect Intensity and Hostility in Individuals with Alcohol Use Disorder with or without Post-Traumatic Stress Disorder.

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Gandelman, Erin; Petrakis, Ismene; Kachadourian, Lorig; Ralevski, Elizabeth

2018-02-20

Negative affect intensity and hostility have both been implicated in alcohol use disorders (AUD) and post-traumatic stress disorder (PTSD) when they occur separately, but have neither been compared nor explored among those with dual diagnosis AUD and PTSD. This study is a secondary analysis designed to compare levels of negative affect intensity and hostility among those with AUD to those with dual diagnosis AUD and PTSD. Participants (n = 113) were recruited from the placebo-controlled groups of two distinct 12-week clinical trials (NCT00342563 and NCT00744055). The Short Affect Intensity Scale and Buss-Durkee Hostility Inventory were administered at weeks 0, 4, 8 and 12 to all study participants to assess negative affect intensity and hostility levels, respectively. Dual diagnosis AUD and PTSD individuals showed significantly higher levels of negative affect intensity and hostility than individuals with single diagnosis AUD. These levels remained relatively stable over the course of the study in spite of all study participants showing clinically significant improvements in AUD severity and PTSD symptomology (for those with dual diagnosis). Our results indicate that individuals with dual diagnosis AUD and PTSD have higher levels of negative affect and higher levels of hostility compared to individuals with single diagnosis AUD. In addition, these heightened levels of negative affect intensity and hostility appear to function somewhat independently of diagnosis severity and symptomology improvement. To our knowledge, this is the first study to compare negative affect intensity and hostility levels between single diagnosis AUD and dual diagnosis AUD and PTSD individuals.

Post-traumatic Stress Disorder

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H Javidi

2011-12-01

Full Text Available Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD. Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack, being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events. PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed “acute PTSD,” otherwise, it is called “chronic PTSD.” 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%–40%; the rate in rescue workers was 10%–20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%–32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%, firefighters (21%, and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults. Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for

Assessment of Alcohol Use Disorders among Court-Mandated DWI Offenders

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

2007-01-01

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

Response Inhibition and Cognitive Appraisal in Clients with Acute Stress Disorder and Posttraumatic Stress Disorder

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Abass Abolghasemi

2013-09-01

Full Text Available Objective: The purpose of the present study was to compare response inhibition and cognitive appraisal in clients with acute stress disorder, clients with posttraumatic stress disorder, and normal individuals .Method:This was a comparative study. The sample consisted of 40 clients with acute stress disorder, 40 patients with posttraumatic stress disorder, and 40 normal individuals from Mazandaran province selected through convenience sampling method. Data were collected using Composite International Diagnostic Interview, Stroop Color-Word Test, Posttraumatic Cognitions Inventory, and the Impact of Event Scale. Results:Results showed that individuals with acute stress disorder are less able to inhibit inappropriate responses and have more impaired cognitive appraisals compared to those with posttraumatic stress disorder. Moreover, results showed that response inhibition and cognitive appraisal explain 75% of the variance in posttraumatic stress disorder symptoms and 38% of the variance in posttraumatic stress disorder symptoms .Conclusion:The findings suggest that response inhibition and cognitive appraisal are two variables that influence the severity of posttraumatic stress disorder and acute stress disorder symptoms. Also, these results have important implications for pathology, prevention, and treatment of posttraumatic stress disorder and acute stress disorder

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

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Pradhan Bickram

2012-10-01

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

Alcohol consumption and use of health care services in people with severe mental illness and stressful childhood experiences.

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Schneeberger, Andres R; Huber, Christian G; Seixas, Azizi; Muenzenmaier, Kristina H; Lang, Undine E; Castille, Dorothy; Larkin, Stefan; Link, Bruce G

2017-01-01

People who suffer from severe mental illness often present with histories of abuse during childhood. Alcohol use disorders is a common co-morbidity of survivors of childhood abuse and neglect. This study analyzes the effects of stressful childhood experiences, a proxy for trauma, on the frequency of alcohol consumption and the utilization of health care services in a population of people with severe mental illness. There were 111 men (mean age: 35 years) and 72 women (mean age: 40.0 years) with severe mental illness that were recruited from psychiatric outpatient clinics in New York City. The analysis focused on lifetime prevalence of stressful childhood experiences, alcohol consumption, and utilization of health care services over time. The longitudinal data were analyzed over 12 months with a level-2 model (multilevel modeling). Out of the participants, 41.5% reported a history of more than four types of abusive experiences. There were 33.3% that had a DSM-IV diagnosis of alcohol abuse and 27.3% qualified for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of alcohol dependence throughout their lives. Stressful childhood experiences predicted an increased frequency of alcohol consumption over time. People with histories of childhood abuse had more often been to outpatient clinics and 12-step programs, but at the same time showed lower frequency rates of psychiatrist visits and visits to outpatient clinics. Childhood abuse is prevalent in people with severe mental illness and is related to an increased alcohol consumption. Despite an increased need of health care services, affected persons might encounter more barriers to access them.

Host homeostatic responses to alcohol-induced cellular stress in animal models of alcoholic liver disease.

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Wang, He Joe; Murray, Gary J; Jung, Mary Katherine

2015-01-01

Humans develop various clinical phenotypes of severe alcoholic liver disease, including alcoholic hepatitis and cirrhosis, generally after decades of heavy drinking. In such individuals, following each episode of drinking, their livers experience heightened intracellular and extracellular stresses that are closely associated with alcohol consumption and alcohol metabolism. This article focuses on the latest advances made in animal models on evolutionarily conserved homeostatic mechanisms for coping with and resolving these stress conditions. The mechanisms discussed include the stress-activated protein kinase JNK, energy regulator AMPK, autophagy and the inflammatory response. Over time, the host may respond variably to stress with protective mechanisms that are critical in determining an individual's vulnerability to developing severe alcoholic liver disease. A systematic review of these mechanisms and their temporal changes in animal models provides the basis for general conclusions, and raises questions for future studies. The relevance of these data to human conditions is also discussed.

Longitudinal cohort study of depression, post-traumatic stress, and alcohol use in South African women who attend alcohol serving venues.

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Abler, Laurie A; Sikkema, Kathleen J; Watt, Melissa H; Eaton, Lisa A; Choi, Karmel W; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree

2014-08-06

In South Africa, alcohol use poses a public health burden. Hazardous alcohol use often co-occurs with psychological distress (e.g., depression and post-traumatic stress). However, the majority of the research establishing the relationship between alcohol use and psychological distress has been cross-sectional, so the nature of co-occurring changes in psychological distress and alcohol use over time is not well characterized. The objective of this study is to examine the longitudinal relationship between psychological distress and alcohol use among South African women who attend alcohol serving venues. Four waves of data were collected over the course of a year from 560 women in a Cape Town township who attended drinking venues. At each assessment wave, participants reported depressive symptoms, post-traumatic stress symptoms, and alcohol use. Multilevel growth models were used to: 1) assess the patterns of alcohol use; 2) examine how depressive symptoms uniquely, post-traumatic stress symptoms uniquely, and depressive and post-traumatic stress symptoms together were associated with alcohol use; and 3) characterize the within person and between person associations of depressive symptoms and post-traumatic stress symptoms with alcohol use. Women reported high levels of alcohol use throughout the study period, which declined slightly over time. Post-traumatic stress symptoms were highly correlated with depressive symptoms. Modeled separately, both within person and between person depressive and post-traumatic stress symptoms were uniquely associated with alcohol use. When modeled together, significant between person effects indicated that women who typically have more post-traumatic stress symptoms, when controlling for depressive symptoms, are at risk for increased alcohol use; however, women with more depressive symptoms, controlling for post-traumatic stress symptoms, do not have differential risk for alcohol use. Significant within person effects indicated an

A Study of the Relationship Between Alcoholism and Character Disorder.

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Wolfley, Virgil L.

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

Animal Models of Post-Traumatic Stress Disorder and Recent Neurobiological Insights

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Whitaker, Annie M.; Gilpin, Nicholas W.; Edwards, Scott

2014-01-01

Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to develop PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress- and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often observed combination of PTSD and co-morbid conditions such as alcohol use disorder (AUD). Future studies will continue to refine preclinical PTSD models in hopes of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders. PMID:25083568

Subthreshold Post-Traumatic Stress Disorder

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Eylem Ozten

2015-12-01

Full Text Available Post-traumatic stress disorder is a very broad category among mental disorders. Since its inclusion in DSM-III, the diagnostic criteria of post-traumatic stress disorder has undergone a number of changes. The diagnosis and treatment of people who have some symptoms of post-traumatic stress disorder without meeting full criteria still remains controversial. Although subthreshold post-traumatic stress disorder has been debated since it was first defined, the presence of subthreshold post-traumatic stress disorder symptoms has found to raise the risk for suicidal ideation significantly. This article overviews the definitions of trauma related disorders in history of psychiatry and highlights the need to define subthreshold post-traumatic stress disorder symptoms that were reported to be associated with impairment, comorbidity, and suicidal ideation. Clinical differences between subthreshold and full post-traumatic stress disorder will also be discussed.

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

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

2008-01-01

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

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

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Ahalya Thinaharan

2016-12-01

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

Effectiveness of Cognitive Behavioral Group Therapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review

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Seda Tokgunaydin

2016-03-01

Full Text Available This study aims to review empirical studies that were used to evaluate the effectiveness of cognitive-behavioral group therapy programs for the treatment for posttraumatic stress disorder. Articles in English and Turkish that were published between the years of 2000 and 2015 (February have been searched in national and international databases. The articles that were gathered by the search have been read and the ones that were not therapy effectiveness studies, cognitive behavioral group therapies and that included posttraumatic stress disorder comorbid with alcohol/substance abuse, personality disorders and psychotic disorders were eliminated. The remaining 13 studies that fulfiilrf research criteria were introduced in the context of method and therapy characteristics. It can be seen that the cognitive behavioral group therapies are effective in decreasing the symptoms of posttraumatic stress disorder and/or comorbid disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(Supplement 1: 95-107

Diagnosis and management of post-traumatic stress disorder.

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Grinage, Bradley D

2003-12-15

Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.

Childhood maltreatment, stressful life events, and alcohol craving in adult drinkers

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Kim, June H.; Martins, Silvia S.; Shmulewitz, Dvora; Santaella, Julian; Wall, Melanie M.; Keyes, Katherine M.; Eaton, Nicholas R.; Krueger, Robert; Grant, Bridget F.; Hasin, Deborah S.

2014-01-01

Background Little is known about the relationship of stressful life events and alcohol craving in the general population, and whether a history of childhood maltreatment sensitizes individuals to crave alcohol after adult stressors. Methods Participants were 22,147 past-year drinkers from Wave 2 (2004-2006) of the National Epidemiologic Survey on Alcohol and Related Conditions. A structured, face-to-face interview assessed past-year stressful life events, alcohol craving, and history of childhood maltreatment. Logistic regression was used to generate adjusted odds ratios (aOR) to evaluate the relationship between stressful life events and craving, adjusting for demographic characteristics and parental history of alcoholism. Interaction between stressful life events and childhood maltreatment was also assessed. Results Compared to participants with no stressful life events, those with ≥3 events had increased odds of moderate alcohol craving (aOR=3.15 [95% CI=2.30-4.33]) and severe craving (aOR=8.47 [95% CI=4.78-15.01]). Stressful life events and childhood maltreatment interacted in predicting severe craving (p=0.017); those with ≥3 events were at higher risk for craving if they had been exposed to childhood maltreatment. Conclusion A direct relationship between stressful life events and risk for alcohol craving was observed. Further, history of childhood maltreatment increased the salience of stressful life events in adulthood. Future studies should examine the role of psychiatric comorbidity in more complex models of stress sensitization and alcohol craving. PMID:24961735

Alcohol Use Disorders: Implications for the Clinical Toxicologist

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Michael McDonough

2015-03-01

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

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

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Brower, Kirk J

2015-06-01

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

The effect of post-traumatic stress disorder on the risk of developing prescription opioid use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III.

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Hassan, Ahmed N; Foll, Bernard Le; Imtiaz, Sameer; Rehm, Jürgen

2017-10-01

To evaluate the effect of baseline post-traumatic stress disorder (PTSD) and each symptoms cluster on the risk of developing opioid use disorder (OUD) in those exposed to opioid painkillers and to assess the effect of comorbid PTSD and OUD on functioning, OUD severity, and treatment seeking compared with individuals with OUD only. We obtained data from 4025 individuals exposed to opioid painkillers from the National Epidemiologic Survey on Alcohol and Related Conditions III. We matched individuals with baseline PTSD with individuals without PTSD on demographics, developmental background, family history, personalities, and exposure to stressful life events with propensity score methodology. We controlled for clinical diagnoses and other risk factors that may have occurred after PTSD onset. Quality of life was assessed with the SF-12; the number of diagnostic criteria met indicated OUD severity. Baseline PTSD predicted OUD after controlling for matching variables and other risk factors, including baseline mood/anxiety disorders and other substance use disorders (odds ratio[OR]: 1.58; 95% confidence interval[CI]: 1.14-2.17; p=0.02). Among individuals with PTSD, arousal/reactivity cluster predicted OUD. Individuals with comorbid PTSD and OUD had lower mean scores on the SF-12 scale and greater severity of OUD than individuals with OUD. There were no differences in help-seeking. Baseline PTSD increases the risk of developing OUD after exposure to opioid painkillers. Clinicians should screen for PTSD diagnosis and arousal/reactivity symptoms prior to prescribing painkillers. Integrated treatments are strongly recommended for patients with this dual diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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Scott, Russ

2018-02-01

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

Profile of Class I Histone Deacetylases (HDAC) by Human Dendritic Cells after Alcohol Consumption and In Vitro Alcohol Treatment and Their Implication in Oxidative Stress: Role of HDAC Inhibitors Trichostatin A and Mocetinostat.

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Agudelo, Marisela; Figueroa, Gloria; Parira, Tiyash; Yndart, Adriana; Muñoz, Karla; Atluri, Venkata; Samikkannu, Thangavel; Nair, Madhavan P

2016-01-01

Epigenetic mechanisms have been shown to play a role in alcohol use disorders (AUDs) and may prove to be valuable therapeutic targets. However, the involvement of histone deacetylases (HDACs) on alcohol-induced oxidative stress of human primary monocyte-derived dendritic cells (MDDCs) has not been elucidated. In the current study, we took a novel approach combining ex vivo, in vitro and in silico analyses to elucidate the mechanisms of alcohol-induced oxidative stress and role of HDACs in the periphery. ex vivo and in vitro analyses of alcohol-modulation of class I HDACs and activity by MDDCs from self-reported alcohol users and non-alcohol users was performed. Additionally, MDDCs treated with alcohol were assessed using qRT-PCR, western blot, and fluorometric assay. The functional effects of alcohol-induce oxidative stress were measured in vitro using PCR array and in silico using gene expression network analysis. Our findings show, for the first time, that MDDCs from self-reported alcohol users have higher levels of class I HDACs compare to controls and alcohol treatment in vitro differentially modulates HDACs expression. Further, HDAC inhibitors (HDACi) blocked alcohol-induction of class I HDACs and modulated alcohol-induced oxidative stress related genes expressed by MDDCs. In silico analysis revealed new target genes and pathways on the mode of action of alcohol and HDACi. Findings elucidating the ability of alcohol to modulate class I HDACs may be useful for the treatment of alcohol-induced oxidative damage and may delineate new potential immune-modulatory mechanisms.

Posttraumatic stress disorder symptoms mediate the relationship between traumatic experiences and drinking behavior among women attending alcohol-serving venues in a South African township.

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Watt, Melissa H; Ranby, Krista W; Meade, Christina S; Sikkema, Kathleen J; MacFarlane, Jessica C; Skinner, Donald; Pieterse, Desiree; Kalichman, Seth C

2012-07-01

South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship. A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior. The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT > 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3),with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the "other" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior. Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be

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

OpenAIRE

Magnusson, Åsa

2010-01-01

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

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

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Goldstein, Benjamin I; Levitt, Anthony J

2006-06-01

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

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

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

2017-01-01

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

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

DEFF Research Database (Denmark)

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

2011-01-01

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

Delay to first treatment contact for alcohol use disorder.

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

2015-02-01

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

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

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

2017-01-01

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

Complex interactions between the subject factors of biological sex and prior histories of binge-drinking and unpredictable stress influence behavioral sensitivity to alcohol and alcohol intake.

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Quadir, Sema G; Guzelian, Eugenie; Palmer, Mason A; Martin, Douglas L; Kim, Jennifer; Szumlinski, Karen K

2017-08-10

Alcohol use disorders, affective disorders and their comorbidity are sexually dimorphic in humans. However, it is difficult to disentangle the interactions between subject factors influencing alcohol sensitivity in studies of humans. Herein, we combined murine models of unpredictable, chronic, mild stress (UCMS) and voluntary binge-drinking to examine for sex differences in the interactions between prior histories of excessive ethanol-drinking and stress upon ethanol-induced changes in motor behavior and subsequent drinking. In Experiment 1, female mice were insensitive to the UCMS-induced increase in ethanol-induced locomotion and ethanol intake under continuous alcohol-access. Experiment 2 revealed interactions between ethanol dose and sex (females>males), binge-drinking history (water>ethanol), and UCMS history (UCMS>controls), with no additive effect of a sequential prior history of both binge drinking and UCMS observed. We also observed an interaction between UCMS history and sex for righting recovery. UCMS history potentiated subsequent binge-drinking in water controls of both sexes and in male binge-drinking mice. Conversely, a prior binge-drinking history increased subsequent ethanol intake in females only, irrespective of prior UCMS history. In Experiment 3, a concurrent history of binge-drinking and UCMS did not alter ethanol intake, nor did it influence the ethanol dose-locomotor response function, but it did augment alcohol-induced sedation and reduced subsequent alcohol intake over that produced by binge-drinking alone. Thus, the subject factors of biological sex, prior stressor history and prior binge-drinking history interact in complex ways in mice to impact sensitivity to alcohol's motor-stimulating, -incoordinating and intoxicating effects, as well as to influence subsequent heavy drinking. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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

2012-01-01

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

Transtorno de estresse pós-traumático em dependente do álcool Post-traumatic stress disorder and alcoholism

Directory of Open Access Journals (Sweden)

Gilda Pulcherio

2008-01-01

promover o tratamento adequado.BACKGROUND: Psychiatric comorbidity is common among addicted patients. Post-traumatic stress disorder (PTSD is a highly symptomatic anxiety disorder of acute onset after a major distressing life-event. OBJECTIVES: In clinical practice, patients suffering from drug addiction invariably report the occurrence of psychologically stressful episodes, with frequencies of PTSD ranging from 30% to 60%. Among patients suffering from alcohol dependence, the prevalence of PTSD is estimated to range between 10% and 40%. METHODS: We report the case of a 40-year old alcoholic man presenting with comorbid bipolar disorder and long-lasting symptoms of PTSD. The subject was an outpatient at the Institute for Prevention and Research on Alcohol and Other Addictions (Instituto de Prevenção e Pesquisa em Álcool e Outras Dependências - IPPAD, being assessed for the occurrence of PTSD with the aid of several psychometric instruments. RESULTS: Data derived from clinical sessions and research interviews include the Davidson Trauma Scale (DTS, which was administered at baseline and after one year of follow-up, yielding scores of 75 and 40 respectively. Global response to treatment was achieved after the recognition and appropriate treatment of the latter condition, along with the combined approach to other comorbid disorders. DISCUSSION: The investigation of traumatic events should be encouraged in the clinical management of alcoholic patients.

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

NARCIS (Netherlands)

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

2018-01-01

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

Problematic Internet use, excessive alcohol consumption, their comorbidity and cardiovascular and cortisol reactions to acute psychological stress in a student population.

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Bibbey, Adam; Phillips, Anna C; Ginty, Annie T; Carroll, Douglas

2015-06-01

Problematic Internet use and excessive alcohol consumption have been associated with a host of maladaptive outcomes. Further, low (blunted) cardiovascular and stress hormone (e.g. cortisol) reactions to acute psychological stress are a feature of individuals with a range of adverse health and behavioural characteristics, including dependencies such as tobacco and alcohol addiction. The present study extended this research by examining whether behavioural dependencies, namely problematic Internet use, excessive alcohol consumption, and their comorbidity would also be associated with blunted stress reactivity. A large sample of university students (N = 2313) were screened using Internet and alcohol dependency questionnaires to select four groups for laboratory testing: comorbid Internet and alcohol dependence (N = 17), Internet dependence (N = 17), alcohol dependence (N = 28), and non-dependent controls (N = 26). Cardiovascular activity and salivary cortisol were measured at rest and in response to a psychological stress protocol comprising of mental arithmetic and public speaking tasks. Neither problematic Internet behaviour nor excessive alcohol consumption, either individually or in combination, were associated with blunted cardiovascular or cortisol stress reactions. Discussion It is possible that problematic Internet behaviour and excessive alcohol consumption in a student population were not related to physiological reactivity as they may not reflect ingrained addictions but rather an impulse control disorder and binging tendency. The present results serve to indicate some of the limits of the developing hypothesis that blunted stress reactivity is a peripheral marker of the central motivational dysregulation in the brain underpinning a wide range of health and behavioural problems.

Acupuncture for Alcohol Use Disorder: A Meta-Analysis

Directory of Open Access Journals (Sweden)

Na Young Shin

2017-01-01

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

Borderline personality disorder and regularly drinking alcohol before sex.

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

2017-07-01

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

The pharmacogenetics of alcohol use disorder.

Science.gov (United States)

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

2015-03-01

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

Prazosin Prevents Increased Anxiety Behavior That Occurs in Response to Stress During Alcohol Deprivations.

Science.gov (United States)

Rasmussen, Dennis D; Kincaid, Carrie L; Froehlich, Janice C

2017-01-01

Stress-induced anxiety is a risk factor for relapse to alcohol drinking. The aim of this study was to test the hypothesis that the central nervous system (CNS)-active α 1 -adrenergic receptor antagonist, prazosin, would block the stress-induced increase in anxiety that occurs during alcohol deprivations. Selectively bred male alcohol-preferring (P) rats were given three cycles of 5 days of ad libitum voluntary alcohol drinking interrupted by 2 days of alcohol deprivation, with or without 1 h of restraint stress 4 h after the start of each of the first two alcohol deprivation cycles. Prazosin (1.0 or 1.5 mg/kg, IP) or vehicle was administered before each restraint stress. Anxiety-like behavior during alcohol deprivation following the third 5-day cycle of alcohol drinking (7 days after the most recent restraint stress ± prazosin treatment) was measured by performance in an elevated plus-maze and in social approach/avoidance testing. Rats that received constant alcohol access, or alcohol access and deprivations without stress or prazosin treatments in the first two alcohol deprivations did not exhibit augmented anxiety-like behavior during the third deprivation. In contrast, rats that had been stressed during the first two alcohol deprivations exhibited increased anxiety-like behavior (compared with control rats) in both anxiety tests during the third deprivation. Prazosin given before stresses in the first two cycles of alcohol withdrawal prevented increased anxiety-like behavior during the third alcohol deprivation. Prazosin treatment before stresses experienced during alcohol deprivations may prevent the increased anxiety during subsequent deprivation/abstinence that is a risk factor for relapse to alcohol drinking. Administration of prazosin before stresses during repetitive alcohol deprivations in male alcohol-preferring (P) rats prevents increased anxiety during a subsequent deprivation without further prazosin treatment. Prazosin treatment during repeated

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

Science.gov (United States)

Mackinnon, Nathalie; Bhatia, Urvita; Nadkarni, Abhijit

2017-06-30

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

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

Physical Activity and Risk of Alcohol Use Disorders

DEFF Research Database (Denmark)

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

2015-01-01

.5- to 2-fold increased risk of developing alcohol use disorder (Hazard ratios for men 1.64; 95% CI 1.29-2.10 and women 1.45; 1.01-2.09) in individuals with a sedentary leisure-time physical activity, compared with a moderate to high level. However, when stratifying by presence of other psychiatric......AIMS: To examine the effect of physical activity on risk of developing alcohol use disorders in a large prospective cohort study with focus on leisure-time physical activity. METHODS: Data came from the four examinations of the Copenhagen City Heart Study (CCHS), performed in 1976-1978, 1981......-1983, 1991-1994 and 2001-2003. Information on physical activity (classified as Moderate/high, low or sedentary) and covariates was obtained through self-administered questionnaires, and information on alcohol use disorders was obtained from the Danish Hospital Discharge Register, the Danish Psychiatric...

Social Network as predictor for onset of alcohol use disorder

DEFF Research Database (Denmark)

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

2015-01-01

in a prospective design. Methods: Information on social network and covariates was obtained from 9589 men and women aged 21–99 years in the Copenhagen City Heart Study, followed for registration of alcohol use disorder in the Danish National Patient Registry and the WINALCO database. Results: Men who lived alone......Objective: Social network has been linked to alcohol use disorder in several studies. However, since the majority of such findings are crosssectional, causal interpretation is difficult. The aim of the present study was to test if social network characteristics predict alcohol use disorder......, were separated or divorced or widowers had a higher risk of developing alcohol use disorder: HR among men living alone vs. men not living alone was 2.28 (95% CI: 1.59–3.27), and HR among separated/divorced men vs. married men was 2.55 (95% CI: 1.33–4.89). No such associations were found among women...

Persistent escalation of alcohol consumption by mice exposed to brief episodes of social defeat stress: suppression by CRF-R1 antagonism.

Science.gov (United States)

Newman, Emily L; Albrechet-Souza, Lucas; Andrew, Peter M; Auld, John G; Burk, Kelly C; Hwa, Lara S; Zhang, Eric Y; DeBold, Joseph F; Miczek, Klaus A

2018-06-01

Episodic bouts of social stress can precede the initiation, escalation, or relapse to disordered alcohol intake. Social stress may engender neuroadaptations in the hypothalamic-pituitary-adrenal (HPA) axis and in extrahypothalamic stress circuitry to promote the escalation of alcohol intake. We aimed to (1) confirm a pattern of escalated drinking in socially defeated mice and to (2) test drugs that target distinct aspects of the HPA axis and extrahypothalamic neural substrates for their effectiveness in reducing murine, stress-escalated drinking. Male C57BL/6J (B6) mice were socially defeated by resident Swiss-derived males for ten consecutive days receiving 30 bites/day. Ten days after the final defeat, cohorts of B6 mice received continuous or intermittent access to 20% EtOH (w/v) and water. After 4 weeks of drinking, mice were injected with weekly, systemic doses of the CRF-R1 antagonist, CP376395; the glucocorticoid receptor antagonist, mifepristone; the 11-beta-hydroxylase inhibitor, metyrapone; or the 5-alpha-reductase inhibitor, finasteride. Prior to drug treatments, defeated mice reliably consumed more EtOH than non-defeated controls, and mice given alcohol intermittently consumed more EtOH than those with continuous access. CP376395 (17-30 mg/kg) reduced continuous, but not intermittent EtOH intake (g/kg) in socially defeated mice. Mifepristone (100 mg/kg), however, increased drinking by defeated mice with intermittent access to alcohol while reducing drinking during continuous access. When administered finasteride (100 mg/kg) or metyrapone (50 mg/kg), all mice reduced their EtOH intake while increasing their water consumption. Mice with a history of episodic social defeat stress were selectively sensitive to the effects of CRF-R1 antagonism, suggesting that CRF-R1 may be a potential target for treating alcohol use disorders in individuals who escalate their drinking after exposure to repeated bouts of psychosocial stress. Future studies will clarify

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

Science.gov (United States)

Rehm, J; Barbosa, C

2018-02-01

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

Moderate alcohol consumption after a mental stressor attenuates the endocrine stress response.

Science.gov (United States)

Schrieks, I C; Joosten, M M; Klöpping-Ketelaars, W A A; Witkamp, R F; Hendriks, H F J

2016-12-01

Alcohol is often consumed to reduce tension and improve mood when exposed to stressful situations. Previous studies showed that moderate alcohol consumption may reduce stress when alcohol is consumed prior to a stressor, but data on the effect of alcohol consumption after a mental stressor is limited. Therefore, our objective was to study whether moderate alcohol consumption immediately after a mental stressor attenuates the stress response. Twenty-four healthy men (age 21-40 y, BMI 18-27 kg/m 2 ) participated in a placebo-controlled trial. They randomly consumed 2 cans (660 mL, ∼26 g alcohol) of beer or alcohol-free beer immediately after a mental stressor (Stroop task and Trier Social Stress Test). Physiological and immunological stress response was measured by monitoring heart rate and repeated measures of the hypothalamic-pituitary-adrenal axis (HPA-axis), white blood cells and a set of cytokines. After a mental stressor, cortisol and adrenocorticotropic hormone (ACTH) concentrations were 100% and 176% more reduced at 60 min (P = 0.012 and P = 0.001, respectively) and 92% and 60% more reduced at 90 min (P stress recovery period after beer consumption than after alcohol-free beer consumption (P stress response as reflected by decreasing plasma ACTH and cortisol. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2017-09-01

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

Moderate alcohol consumption after a mental stressor attenuates the endocrine stress response

NARCIS (Netherlands)

Schrieks, I.C.; Joosten, M.M.; Klöpping-Ketelaars, W.A.A.; Witkamp, R.F.; Hendriks, H.F.J.

2016-01-01

Alcohol is often consumed to reduce tension and improve mood when exposed to stressful situations. Previous studies showed that moderate alcohol consumption may reduce stress when alcohol is consumed prior to a stressor, but data on the effect of alcohol consumption after a mental stressor is

Moderate alcohol consumption after a mental stressor attenuates the endocrine stress response

NARCIS (Netherlands)

Schrieks, I.C.; Joosten, M.M.; Klöpping-Ketelaars, W.A.A.; Witkamp, R.F.; Hendriks, H.F.J.

2016-01-01

Alcohol is often consumed to reduce tension and improve mood when exposed to stressful situations. Previous studies showed that moderate alcohol consumption may reduce stress when alcohol is consumed prior to a stressor, but data on the effect of alcohol consumption after a mental stressor is

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

Science.gov (United States)

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

2014-10-01

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

Children of Alcoholics/Addicts: Children at Risk.

Science.gov (United States)

Gover, F. Jill

Children of alcoholics/addicts (COAs) are at a greater risk to develop alcohol and drug dependency, eating disorders, attention deficit disorders, stress-related illness, and suicidal behavior. Children become part of a conspiracy of silence by being told not to talk about the drug problem. The family members assume different roles which…

Does Acute Stress Disorder Predict Posttraumatic Stress Disorder Following Bank Robbery?

Science.gov (United States)

Hansen, Maj; Elklit, Ask

2013-01-01

Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study…

Alcohol and Suicide: Neurobiological and Clinical Aspects

Directory of Open Access Journals (Sweden)

Leo Sher

2006-01-01

Full Text Available Alcohol, primarily in the form of ethyl alcohol (ethanol, has occupied an important place in the history of humankind for at least 8,000 years. In most Western societies, at least 90% of people consume alcohol at some time during their lives, and 30% or more of drinkers develop alcohol-related problems. Severe alcohol-related life impairment, alcohol dependence (alcoholism, is observed at some time during their lives in about 10% of men and 3—5% of women. An additional 5—10% of each sex develops persistent, but less intense, problems that are diagnosed as alcohol abuse. It this review, neurobiological aspects of suicidal behavior in alcoholism is discussed. In individuals with comorbid depression and alcoholism, greater serotonergic impairment may be associated with higher risk of completed suicide. Dopaminergic dysfunction may play an important role in the pathophysiology of suicidal behavior in alcoholism. Brain damage and neurobehavioral deficits are associated with alcohol use disorders and may contribute to suicidal behavior in persons with alcohol dependence or abuse. Aggression/impulsivity and alcoholism severity affect risk for suicide among individuals with alcoholism. Major depressive episodes and stressful life events particularly, partner-relationship disruptions, may precipitate suicidal behavior in individuals with alcohol use disorders. Alcohol misuse and psychosocial adversity can combine to increase stress on the person, and, thereby, potentially, increase the risk for suicidal behavior. The management of suicidal patients with alcohol use disorders is also discussed. It is to be hoped that the efforts of clinicians will reduce morbidity and mortality associated with alcohol misuse.

The roles of outlet density and norms in alcohol use disorder

OpenAIRE

Ahern, J; Balzer, L; Galea, S

2015-01-01

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

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

OpenAIRE

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

2007-01-01

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

Fetal alcohol spectrum disorders har fået danske kriterier

DEFF Research Database (Denmark)

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

2017-01-01

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

Ethanol metabolism, oxidative stress, and endoplasmic reticulum stress responses in the lungs of hepatic alcohol dehydrogenase deficient deer mice after chronic ethanol feeding

Energy Technology Data Exchange (ETDEWEB)

Kaphalia, Lata [Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX 775555 (United States); Boroumand, Nahal [Department of Pathology, The University of Texas Medical Branch, Galveston, TX 775555 (United States); Hyunsu, Ju [Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX 775555 (United States); Kaphalia, Bhupendra S., E-mail: bkaphali@utmb.edu [Department of Pathology, The University of Texas Medical Branch, Galveston, TX 775555 (United States); Calhoun, William J. [Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX 775555 (United States)

2014-06-01

Consumption and over-consumption of alcoholic beverages are well-recognized contributors to a variety of pulmonary disorders, even in the absence of intoxication. The mechanisms by which alcohol (ethanol) may produce disease include oxidative stress and prolonged endoplasmic reticulum (ER) stress. Many aspects of these processes remain incompletely understood due to a lack of a suitable animal model. Chronic alcohol over-consumption reduces hepatic alcohol dehydrogenase (ADH), the principal canonical metabolic pathway of ethanol oxidation. We therefore modeled this situation using hepatic ADH-deficient deer mice fed 3.5% ethanol daily for 3 months. Blood ethanol concentration was 180 mg% in ethanol fed mice, compared to < 1.0% in the controls. Acetaldehyde (oxidative metabolite of ethanol) was minimally, but significantly increased in ethanol-fed vs. pair-fed control mice. Total fatty acid ethyl esters (FAEEs, nonoxidative metabolites of ethanol) were 47.6 μg/g in the lungs of ethanol-fed mice as compared to 1.5 μg/g in pair-fed controls. Histological and immunohistological evaluation showed perivascular and peribronchiolar lymphocytic infiltration, and significant oxidative injury, in the lungs of ethanol-fed mice compared to pair-fed controls. Several fold increases for cytochrome P450 2E1, caspase 8 and caspase 3 found in the lungs of ethanol-fed mice as compared to pair-fed controls suggest role of oxidative stress in ethanol-induced lung injury. ER stress and unfolded protein response signaling were also significantly increased in the lungs of ethanol-fed mice. Surprisingly, no significant activation of inositol-requiring enzyme-1α and spliced XBP1 was observed indicating a lack of activation of corrective mechanisms to reinstate ER homeostasis. The data suggest that oxidative stress and prolonged ER stress, coupled with formation and accumulation of cytotoxic FAEEs may contribute to the pathogenesis of alcoholic lung disease. - Highlights: • Chronic

Ethanol metabolism, oxidative stress, and endoplasmic reticulum stress responses in the lungs of hepatic alcohol dehydrogenase deficient deer mice after chronic ethanol feeding

International Nuclear Information System (INIS)

Kaphalia, Lata; Boroumand, Nahal; Hyunsu, Ju; Kaphalia, Bhupendra S.; Calhoun, William J.

2014-01-01

Consumption and over-consumption of alcoholic beverages are well-recognized contributors to a variety of pulmonary disorders, even in the absence of intoxication. The mechanisms by which alcohol (ethanol) may produce disease include oxidative stress and prolonged endoplasmic reticulum (ER) stress. Many aspects of these processes remain incompletely understood due to a lack of a suitable animal model. Chronic alcohol over-consumption reduces hepatic alcohol dehydrogenase (ADH), the principal canonical metabolic pathway of ethanol oxidation. We therefore modeled this situation using hepatic ADH-deficient deer mice fed 3.5% ethanol daily for 3 months. Blood ethanol concentration was 180 mg% in ethanol fed mice, compared to < 1.0% in the controls. Acetaldehyde (oxidative metabolite of ethanol) was minimally, but significantly increased in ethanol-fed vs. pair-fed control mice. Total fatty acid ethyl esters (FAEEs, nonoxidative metabolites of ethanol) were 47.6 μg/g in the lungs of ethanol-fed mice as compared to 1.5 μg/g in pair-fed controls. Histological and immunohistological evaluation showed perivascular and peribronchiolar lymphocytic infiltration, and significant oxidative injury, in the lungs of ethanol-fed mice compared to pair-fed controls. Several fold increases for cytochrome P450 2E1, caspase 8 and caspase 3 found in the lungs of ethanol-fed mice as compared to pair-fed controls suggest role of oxidative stress in ethanol-induced lung injury. ER stress and unfolded protein response signaling were also significantly increased in the lungs of ethanol-fed mice. Surprisingly, no significant activation of inositol-requiring enzyme-1α and spliced XBP1 was observed indicating a lack of activation of corrective mechanisms to reinstate ER homeostasis. The data suggest that oxidative stress and prolonged ER stress, coupled with formation and accumulation of cytotoxic FAEEs may contribute to the pathogenesis of alcoholic lung disease. - Highlights: • Chronic

Stress, alcohol use and work engagement among university workers ...

African Journals Online (AJOL)

... workplace alcohol use and work engagement among 228 University of Nigeria, Nsukka, workers. The results of the regression analyses showed that job stress significantly predicted workplace alcohol use (â = .17, p < .01). Workplace alcohol use also significantly predicted employee work engagement (â = -.35, p < .001).

Substance abuse, memory, and post-traumatic stress disorder.

Science.gov (United States)

Tipps, Megan E; Raybuck, Jonathan D; Lattal, K Matthew

2014-07-01

A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD. Copyright © 2013 Elsevier Inc. All rights reserved.

Personality Disorders Associated with Full and Partial Posttraumatic Stress Disorder in the U.S. Population: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

Science.gov (United States)

Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2010-01-01

Background While it is well known that personality disorders are associated with trauma exposure and PTSD, limited nationally representative data are available on DSM-IV personality disorders that co-occur with posttraumatic stress disorder (PTSD) and partial PTSD. Methods Face-to-face interviews were conducted with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses controlling for sociodemographics and additional psychiatric comorbidity evaluated associations of PTSD and partial PTSD with personality disorders. Results Prevalence rates of lifetime PTSD and partial PTSD were 6.4% and 6.6%, respectively. After adjustment for sociodemographic characteristics and additional psychiatric comorbidity, respondents with full PTSD were more likely than trauma controls to meet criteria for schizotypal, narcissistic, and borderline personality disorders (ORs=2.1–2.5); and respondents with partial PTSD were more likely than trauma controls to meet diagnostic criteria for borderline (OR=2.0), schizotypal (OR=1.8), and narcissistic (OR=1.6) PDs. Women with PTSD were more likely than controls to have obsessive-compulsive PD. Women with partial PTSD were more likely than controls to have antisocial PD; and men with partial PTSD were less likely than women with partial PTSD to have avoidant PD. Conclusions PTSD and partial PTSD are associated with borderline, schizotypal, and narcissistic personality disorders. Modestly higher rates of obsessive-compulsive PD were observed among women with full PTSD, and of antisocial PD among women with partial PTSD. PMID:20950823

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

Science.gov (United States)

Bujarski, Spencer; Ray, Lara A

2016-11-01

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

Association of PER2 genotype and stressful life events with alcohol drinking in young adults.

Directory of Open Access Journals (Sweden)

Dorothea Blomeyer

Full Text Available BACKGROUND: Clock genes govern circadian rhythms and shape the effect of alcohol use on the physiological system. Exposure to severe negative life events is related to both heavy drinking and disturbed circadian rhythmicity. The aim of this study was 1 to extend previous findings suggesting an association of a haplotype tagging single nucleotide polymorphism of PER2 gene with drinking patterns, and 2 to examine a possible role for an interaction of this gene with life stress in hazardous drinking. METHODS: Data were collected as part of an epidemiological cohort study on the outcome of early risk factors followed since birth. At age 19 years, 268 young adults (126 males, 142 females were genotyped for PER2 rs56013859 and were administered a 45-day alcohol timeline follow-back interview and the Alcohol Use Disorders Identification Test (AUDIT. Life stress was assessed as the number of severe negative life events during the past four years reported in a questionnaire and validated by interview. RESULTS: Individuals with the minor G allele of rs56013859 were found to be less engaged in alcohol use, drinking at only 72% of the days compared to homozygotes for the major A allele. Moreover, among regular drinkers, a gene x environment interaction emerged (p = .020. While no effects of genotype appeared under conditions of low stress, carriers of the G allele exhibited less hazardous drinking than those homozygous for the A allele when exposed to high stress. CONCLUSIONS: These findings may suggest a role of the circadian rhythm gene PER2 in both the drinking patterns of young adults and in moderating the impact of severe life stress on hazardous drinking in experienced alcohol users. However, in light of the likely burden of multiple tests, the nature of the measures used and the nominal evidence of interaction, replication is needed before drawing firm conclusions.

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

Teesson, Maree; Hodder, Tracey; Buhrich, Neil

2003-01-01

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

Post-Traumatic Stress Disorder (PDQ)

Science.gov (United States)

... stress (PTS) is a lot like post-traumatic stress disorder (PTSD) but not as severe. Patients have a ... PTS) are a lot like symptoms of other stress-related disorders. PTS has many of the same symptoms as ...

Fetal alcohol spectrum disorders har fået danske kriterier

DEFF Research Database (Denmark)

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

2017-01-01

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

Fetal alcohol spectrum disorders har fået danske kriterier

DEFF Research Database (Denmark)

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

2017-01-01

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

The effect of comorbid alcoholism on recurrence in affective disorder

DEFF Research Database (Denmark)

Kessing, L V

1999-01-01

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

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

OpenAIRE

Stark, Claire

2017-01-01

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

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2015-12-21

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

Stress exposure and the risk for the onset of alcohol use disorders and nicotine dependence in deployed military personnel: the role of prior internalizing disorders.

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Trautmann, Sebastian; Schönfeld, Sabine; Behrendt, Silke; Heinrich, Anke; Höfler, Michael; Siegel, Stefan; Zimmermann, Peter; Wittchen, Hans-Ulrich

2015-04-01

This prospective study aimed to investigate whether prior internalizing disorders (PIDs) moderate the relationship between stress exposure (SE) and the onset of alcohol use disorders (AUDs) and nicotine dependence (ND) in deployed military personnel. 358 male soldiers were examined directly before and 12months after return from deployment using standardized interviews. Combat experiences, concerns about family disruptions, and difficult living and working environment were assessed as different aspects of SE. PID diagnoses (mood disorders (PMDs), anxiety disorders (PADs)) and substance use disorders were defined according to the DSM-IV-TR. PMDs were related to a stronger association between concerns about family disruptions and the risk of AUD onset (OR=7.7, 95% CI 1.8-32.8, p=0.006). The number of PID diagnoses (OR per diagnosis: 1.7, 95% CI 1.0-2.8, p=0.036) and PADs (OR: 2.6, 95% CI 1.1-6.3, p=0.038) were further related to a stronger association between difficult living and working environment and the risk of AUD onset. With regard to ND, PMDs were related to a weaker association between difficult living and working environment and the risk of ND onset (OR=0.4, 95% CI 0.2-0.8, p=0.013). PIDs might be related to an increased risk for the onset of AUDs but not ND following SE. This effect is probably restricted to specific constellations of PADs, PMDs, comorbid PIDs and specific aspects of SE. These critical constellations of PIDs and SE might be a promising target for future research and could contribute to the development of preventive measures to reduce the risk of AUDs following SE. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Complex posttraumatic stress disorder].

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Green, Tamar; Kotler, Moshe

2007-11-01

The characteristic symptoms resulting from exposure to an extreme trauma include three clusters of symptoms: persistent experience of the traumatic event, persistent avoidance of stimuli associated with the trauma and persistent symptoms of increased arousal. Beyond the accepted clusters of symptoms for posttraumatic stress disorder exists a formation of symptoms related to exposure to extreme or prolonged stress e.g. childhood abuse, physical violence, rape, and confinement within a concentration camp. With accumulated evidence of the existence of these symptoms began a trail to classify a more complex syndrome, which included, but was not confined to the symptoms of posttraumatic stress disorder. This review addresses several subjects for study in complex posttraumatic stress disorder, which is a complicated and controversial topic. Firstly, the concept of complex posttraumatic stress disorder is presented. Secondly, the professional literature relevant to this disturbance is reviewed and finally, the authors present the polemic being conducted between the researchers of posttraumatic disturbances regarding validity, reliability and the need for separate diagnosis for these symptoms.

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

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

2017-08-01

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

Traditional Gender Roles and the Stress-Alcohol Relationship Among Latina/o College Students.

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Perrotte, Jessica K; Baumann, Michael R; Knight, Cory F

2018-02-09

Latina/o college students have been shown to engage in more high risk drinking behavior than students from other ethnic minority groups, and are more likely to experience certain negative alcohol related consequences as a result of drinking. Previous research links stress to drinking among college students and indicates drinking occurs within a gendered context. Although this suggests an effect of gender role socialization, studies exploring these relationships among Latina/os are lacking. To explore potential relationships of stress, gender role prescriptions of the heritage culture, and drinking among Latina/o college students. Specifically, to explore potential interactions between stress and multiple dimensions of machismo and marianismo as related to alcohol use. Latina/o undergraduates (N = 248) completed a questionnaire. Self-reported stress, quantity of alcohol consumption, and frequency of binge drinking were recorded for all participants. Gender role prescriptions were assessed via endorsement of two dimensions of machismo (men) or two dimensions of marianismo (women). Stress was positively related to general quantity for women. Each dimension of machismo was distinctly related to binge drinking for men. Significant interactions emerged between both machismo and marianismo and stress as related to both alcohol use outcomes. For women, the moderating pattern between marianismo and stress varied according to type of alcohol use. Conclusions/Importance: Gender role beliefs influence the relationship between stress and alcohol use among Latina/o college students. Future research should account for the intersection of gender and culture when considering the stress-alcohol relationship.

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

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

2017-07-01

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

Value-based decision making and alcohol use disorder

OpenAIRE

Nebe, Stephan

2018-01-01

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

PER1 rs3027172 genotype interacts with early life stress to predict problematic alcohol use, but not reward-related ventral striatum activity

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David eBaranger

2016-03-01

Full Text Available Increasing evidence suggests that the circadian and stress regulatory systems contribute to alcohol use disorder (AUD risk, which may partially arise through effects on reward-related neural function. The C allele of the PER1 rs3027172 single nucleotide polymorphism reduces PER1 expression in cells incubated with cortisol and has been associated with increased risk for adult AUD and problematic drinking among adolescents exposed to high levels of familial psychosocial adversity. Using data from undergraduate students who completed the ongoing Duke Neurogenetics Study (n=665, we tested whether exposure to early life stress (ELS; Childhood Trauma Questionnaire moderates the association between rs3027172 genotype and later problematic alcohol use (Alcohol Use Disorders Identification Test as well as ventral striatum (VS reactivity to reward (card-guessing task while functional magnetic resonance imaging data were acquired. Initial analyses found that PER1 rs3027172 genotype interacted with ELS to predict both problematic drinking and VS reactivity; minor C allele carriers, who were also exposed to elevated ELS reported greater problematic drinking and exhibited greater ventral striatum reactivity to reward-related stimuli. When gene x covariate and environment x covariate interactions were controlled for, the interaction predicting problematic alcohol use remained significant (p<0.05, corrected while the interaction predicting VS reactivity was no longer significant. These results extend our understanding of relationships between PER1 genotype, early life stress, and problematic alcohol use, and serve as a cautionary tale on the importance of controlling for potential confounders in studies of moderation including gene x environment interactions.

Prevalence and Axis I Comorbidity of Full and Partial Posttraumatic Stress Disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

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Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2010-01-01

The present study used data from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653) to examine lifetime Axis I psychiatric comorbidity of posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. adults. Lifetime prevalences±standard errors of PTSD and partial PTSD were 6.4%±0.18 and 6.6%±0.18, respectively. Rates of PTSD and partial PTSD were higher among women (8.6%±0.26 and 8.6%±0.26) than men (4.1%±0.19 and 4.5%±0.21). Respondents with both PTSD and partial PTSD most commonly reported unexpected death of someone close, serious illness or injury to someone close, and sexual assault as their worst stressful experiences. PTSD and partial PTSD were associated with elevated lifetime rates of mood, anxiety, and substance use disorders, and suicide attempts. Respondents with partial PTSD generally had intermediate odds of comorbid Axis I disorders and psychosocial impairment relative to trauma controls and full PTSD. PMID:21168991

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

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Samai Laprawat

2017-05-01

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

Stress-induced and cue-induced craving for alcohol in heavy drinkers: Preliminary evidence of genetic moderation by the OPRM1 and CRH-BP genes.

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Ray, Lara A

2011-01-01

Neurobiological theories of addiction have highlighted disruption in stress pathways as a central feature of addictive disorders, and pharmacological treatments targeting stress mechanisms hold great promise. This study examines genetic determinants of stress-induced and cue-induced craving in heavy drinkers by testing single-nucleotide polymorphisms (SNPs) of the corticotrophin-releasing hormone binding protein (CRH-BP) gene and the mu-opioid receptor (OPRM1) gene. This study combines guided imagery stress exposure and in vivo alcohol cue exposure in a sample of 64 (23 women) non-treatment-seeking heavy drinkers. Analyses, uncorrected for multiple comparisons, revealed that a tag SNP of the CRH-BP gene (rs10055255) moderated stress-induced craving in this sample. The same SNP predicted greater affective responses to the stress manipulation, including greater levels of subjective tension and negative mood. The Asp40 allele of the OPRM1 was associated with greater cue-induced alcohol craving following the neutral imagery condition. These initial results extend recent preclinical and clinical findings implicating the CRH-BP in stress-related alcoholism and confirm the role of the Asp40 allele of the OPRM1 gene in reward-driven alcohol phenotypes. Human laboratory models of stress and cue-induced craving may be useful in pharmacotherapy development targeting dysregulation of stress systems. Larger studies are needed to validate these preliminary findings, which should also be extended to clinical samples. Copyright © 2010 by the Research Society on Alcoholism.

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

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

2014-01-01

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

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

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

2011-01-01

hospital with a psychiatric disorder. The prospective cohort study, the Copenhagen City Heart Study (n=18,146), was used, containing three updated sets of alcohol intake and lifestyle covariates and up to 26 years follow-up. Alcohol intake was measured by self-report while psychiatric disorders were......The potential effects of alcohol intake upon the risk of psychiatric disorders have not often been investigated. The purpose of this study was to investigate, in a population sample, the association between self-reported amount of alcohol intake and the later risk of being registered in a Danish.......31-3.04) compared to women drinking below the sensible drinking limits. For men, the risk functions were slightly U-shaped; thus, a weekly low or moderate alcohol intake seemed to have a protective effect towards developing psychiatric disorders. The findings suggest sex differences in the association between...

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

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

2018-06-01

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

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

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

2015-01-01

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

Does acute stress disorder predict posttraumatic stress disorder following bank robbery?

DEFF Research Database (Denmark)

Hansen, M.; Elklit, A.

2013-01-01

Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies...... following nonsexual assault. The present study investigated the predictive power of different aspects of the ASD diagnosis and symptom severity on PTSD prevalence and symptom severity in 132 bank employees. The PTSD diagnosis, based on the three core symptom clusters, was best identified using cutoff scores...... on the Acute Stress Disorder scale. ASD severity accounted for 40% and the inclusion of other risk factors accounted for 50% of the PTSD severity variance. In conclusion, results indicated that ASD appears to predict PTSD differently following nonsexual assault than other trauma types. ASD severity...

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

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

2014-01-01

Background It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI), current suicidality (1 month prior to assessment), mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59%) and (meth)amphetamine (24%). Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537) had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81). While those who used illicit drugs alone (no mental/alcohol use disorder) (n=348) had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65), the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively) had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively). Conclusion A key limitation of this study was the combined suicidal behaviors as a suicidality risk. Mental or alcohol use disorders found in this population actually increased the suicide risk. These findings support the coexisting relationship that mental and alcohol use disorders play a vital role in increasing the suicide

Distress tolerance and physiological reactivity to stress predict women's problematic alcohol use.

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Holzhauer, Cathryn Glanton; Wemm, Stephanie; Wulfert, Edelgard

2017-06-01

Research has shown that measures of reactivity to distress-including distress tolerance and physiological reactivity to stress-are dysregulated in women who misuse alcohol. These variables may interact and create a risk profile for young adult women, reflecting patterns of stress reactivity that confer a risk for alcohol misuse. The current study tested this hypothesis by examining the independent and interactive associations of subjective distress tolerance, behavioral distress tolerance, and physiological stress reactivity with women's alcohol misuse. The study was conducted with a sample of 91 college women recruited on a large northeastern university campus. Results showed that subjective levels of distress tolerance and physiological reactivity to stress (skin conductance reactivity, SCR), but not behavioral distress tolerance, were independently associated with alcohol misuse. In addition, subjective distress tolerance moderated the relationship between SCR and negative alcohol-related consequences. Specifically, women with low physiological reactivity (SCR) to a stressful task and greater urge to quickly rid themselves of distress (low subjective distress tolerance) endorsed a significantly greater number of adverse consequences from their alcohol use. These results extend prior findings by showing that, even among a nonclinical sample of women, lower stress reactivity in combination with low subjective distress tolerance is associated with increased risk for various drinking-related negative consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

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Ghosh, Abhishek; Malhotra, Savita; Basu, Debasish

2014-10-01

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

Work stress and alcohol consumption among adolescents: moderation by family and peer influences.

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Liu, Xianfang C; Keyes, Katherine M; Li, Guohua

2014-12-18

Excessive alcohol use in adolescence can be detrimental to health and academic performance. Few studies consider the moderating effects of parental and peer influence within the context of adolescent work outside of the school environment. This study aims to examine work stress among adolescents and the association with alcohol use and drunkenness, in the context of parental and peer influences. Grade 12 students who participated in Monitoring the Future surveys between 2005 and 2009 (n = 12,341) were included in this study. Independent variables included work stress (job satisfaction, perceived safety, and perceived safety of possessions), self-reported perceptions towards academics and influence from parents and peers. Frequency of alcohol use and drunkenness were measured for lifetime, last 30 days and 12 months. The moderating effects of academic aspiration, parental, and peer influence were assessed on the relationship between work stress and alcohol use. Any work stress was positively associated with alcohol use over the past 12 months (odds ratio = 1.12, 95% confidence interval (CI) 1.02-1.23). Stratified analysis found that peer influence significantly moderated the relationship between work stress and alcohol use over the lifetime and past 12 months. Among adolescents with work stress, odds ratios of alcohol use over the lifetime was 0.83 (95% CI 0.71-0.97) for those with low negative peer influence and 1.09 (95% CI 0.97-1.22) for those with high negative peer influence. Problematic drinking patterns were more apparent among high school students who experienced stress at work. Positive peer influence, however, may buffer the adverse effect of work stress on alcohol use.

Fetal alcohol programming of hypothalamic proopiomelanocortin system by epigenetic mechanisms and later life vulnerability to stress.

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Bekdash, Rola; Zhang, Changqing; Sarkar, Dipak

2014-09-01

Hypothalamic proopiomelanocortin (POMC) neurons, one of the major regulators of the hypothalamic-pituitary-adrenal (HPA) axis, immune functions, and energy homeostasis, are vulnerable to the adverse effects of fetal alcohol exposure (FAE). These effects are manifested in POMC neurons by a decrease in Pomc gene expression, a decrement in the levels of its derived peptide β-endorphin and a dysregulation of the stress response in the adult offspring. The HPA axis is a major neuroendocrine system with pivotal physiological functions and mode of regulation. This system has been shown to be perturbed by prenatal alcohol exposure. It has been demonstrated that the perturbation of the HPA axis by FAE is long-lasting and is linked to molecular, neurophysiological, and behavioral changes in exposed individuals. Recently, we showed that the dysregulation of the POMC system function by FAE is induced by epigenetic mechanisms such as hypermethylation of Pomc gene promoter and an alteration in histone marks in POMC neurons. This developmental programming of the POMC system by FAE altered the transcriptome in POMC neurons and induced a hyperresponse to stress in adulthood. These long-lasting epigenetic changes influenced subsequent generations via the male germline. We also demonstrated that the epigenetic programming of the POMC system by FAE was reversed in adulthood with the application of the inhibitors of DNA methylation or histone modifications. Thus, prenatal environmental influences, such as alcohol exposure, could epigenetically modulate POMC neuronal circuits and function to shape adult behavioral patterns. Identifying specific epigenetic factors in hypothalamic POMC neurons that are modulated by fetal alcohol and target Pomc gene could be potentially useful for the development of new therapeutic approaches to treat stress-related diseases in patients with fetal alcohol spectrum disorders. Copyright © 2014 by the Research Society on Alcoholism.

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

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Varadinova, Miroslava; Boyadjieva, Nadka

2015-12-01

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

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

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

2018-03-29

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

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

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Nathasha R Moallem

2013-07-01

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

Is the effect of alcohol on risk of stroke confined to highly stressed persons?

DEFF Research Database (Denmark)

Nielsen, N R; Truelsen, T; Barefoot, J C

2005-01-01

BACKGROUND: Psychological stress and alcohol are both suggested as risk factors for stroke. Further, there appears to be a close relation between stress and alcohol consumption. Several experimental studies have found alcohol consumption to reduce the immediate effects of stress in a laboratory...... setting. We aimed to examine whether the association between alcohol and stroke depends on level of self-reported stress in a large prospective cohort. METHODS: The 5,373 men and 6,723 women participating in the second examination of the Copenhagen City Heart Study in 1981-1983 were asked at baseline...... about their self-reported level of stress and their weekly alcohol consumption. The participants were followed-up until 31st of December 1997 during which 880 first ever stroke events occurred. Data were analysed by means of Cox regression modelling. RESULTS: At a high stress level, weekly total...

Comorbidade entre transtorno de estresse pós-traumático e abuso e dependência de álcool e drogas: uma revisão da literatura Comorbidity of post traumatic stress disorder (PTSD with alcohol and drug abuse and dependency: a literature review

Directory of Open Access Journals (Sweden)

Heloisa de Souza Dantas

2008-01-01

Full Text Available CONTEXTO: Pesquisas revelam uma alta comorbidade entre o transtorno de estresse pós-traumático (TEPT e o abuso e dependência de álcool e drogas (ADAD. OBJETIVOS: Descrever a natureza da associação entre TEPT e ADAD, as diferenças entre os gêneros feminino e masculino, bem como os principais tratamentos utilizados. MÉTODOS: Pesquisa bibliográfica entre os anos de 1995 e 2007 no PubMed, utilizando os termos "trauma" AND "alcohol", "trauma" AND "substance abuse", "trauma" AND "dependence", "trauma" AND "drugs", "posttraumatic stress" AND "alcohol", posttraumatic stress" AND "substance abuse", "posttraumatic stress" AND "dependence", "posttraumatic stress" AND "drugs". RESULTADOS: As seguintes hipóteses foram identificadas: 1 o abuso de substâncias aumenta os riscos para a ocorrência de TEPT em virtude de estilos de vida que expõem mais o sujeito à ocorrência de traumas e pelo fato de as drogas potencializarem as seqüelas do trauma; 2 o TEPT levaria ao aumento do uso de álcool e drogas acompanhado de possível abuso com o objetivo de aliviar sintomas decorrentes do transtorno. Conclusões: A identificação precoce da comorbidade entre o TEPT e o ADAD é fundamental para o bom prognóstico do paciente, bem como o atendimento adequado às vítimas de situações traumáticas para que sejam minimizadas as chances da ocorrência do TEPT.BACKGROUND: The literature reveals high comorbidity rates between post traumatic stress disorder (PTSD and substance abuse and dependence (SAD. OBJECTIVES: This paper seeks to describe the relationship between the two disorders; the gender differences; and the primary treatments used to reduce PTSD as well as SAD symptoms. METHODS: A review of the literature between 1995 and 2007. A PubMed search was used to find articles with the key words: "trauma" AND "alcohol", "trauma" AND "substance abuse", "trauma" AND "dependence", "trauma" AND "drugs", "post traumatic stress" AND "alcohol", post traumatic

depressive and post- traumatic stress disorder symptoms

African Journals Online (AJOL)

alcohol disorder can both serve to initiate the other. ... (unlike that previously identified), and a J-shaped association between binge drinking frequency and depressive symptoms and ..... O'Donnell K, Wardle J, Dantzer C, Steptoe A. Alcohol.

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

NARCIS (Netherlands)

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

2003-01-01

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

Association of Oxidative Stress with Psychiatric Disorders.

Science.gov (United States)

Hassan, Waseem; Noreen, Hamsa; Castro-Gomes, Vitor; Mohammadzai, Imdadullah; da Rocha, Joao Batista Teixeira; Landeira-Fernandez, J

2016-01-01

When concentrations of both reactive oxygen species and reactive nitrogen species exceed the antioxidative capability of an organism, the cells undergo oxidative impairment. Impairments in membrane integrity and lipid and protein oxidation, protein mutilation, DNA damage, and neuronal dysfunction are some of the fundamental consequences of oxidative stress. The purpose of this work was to review the associations between oxidative stress and psychological disorders. The search terms were the following: "oxidative stress and affective disorders," "free radicals and neurodegenerative disorders," "oxidative stress and psychological disorders," "oxidative stress, free radicals, and psychiatric disorders," and "association of oxidative stress." These search terms were used in conjunction with each of the diagnostic categories of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and World Health Organization's International Statistical Classification of Diseases and Related Health Problems. Genetic, pharmacological, biochemical, and preclinical therapeutic studies, case reports, and clinical trials were selected to explore the molecular aspects of psychological disorders that are associated with oxidative stress. We identified a broad spectrum of 83 degenerative syndromes and psychiatric disorders that were associated with oxidative stress. The multi-dimensional information identified herein supports the role of oxidative stress in various psychiatric disorders. We discuss the results from the perspective of developing novel therapeutic interventions.

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

Science.gov (United States)

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

2013-10-01

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

Intergenerational transmission of post-traumatic stress disorder in Australian Vietnam veterans' families.

Science.gov (United States)

O'Toole, B I; Burton, M J; Rothwell, A; Outram, S; Dadds, M; Catts, S V

2017-05-01

To assess the association between parental post-traumatic stress disorder (PTSD) and offspring PTSD and its specificity for other disorders in a non-clinical epidemiological cohort of Australian Vietnam veterans, their partners and their sons and daughters. Veterans were interviewed twice, in 1992-1994 and 2005-2006; partners were interviewed in 2006-2007, and their offspring in 2012-2014. A total of 125 sons and 168 daughters were interviewed from 197 families, 137 of which also included partners who were the mothers of the children. Statistical analysis used multi-level modelling to compute odds ratios and 95% confidence intervals while controlling for clustering effects within families. Parent PTSD diagnoses were examined for associations with offspring trauma exposure, PTSD and other psychiatric diagnoses. Veteran PTSD increased the risk of PTSD and no other disorder in both sons and daughters; partner PTSD did not. Veteran depression was also a risk factor for sons' PTSD, and alcohol disorder was linked to alcohol dependence in sons and PTSD in daughters, but not when controlling for veteran PTSD. We conclude that PTSD in a Vietnam veteran father increases the risk specifically for PTSD in his sons and daughters. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Early Maternal Deprivation Enhances Voluntary Alcohol Intake Induced by Exposure to Stressful Events Later in Life

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Sara Peñasco

2015-01-01

Full Text Available In the present study, we aimed to assess the impact of early life stress, in the form of early maternal deprivation (MD, 24 h on postnatal day, pnd, 9, on voluntary alcohol intake in adolescent male and female Wistar rats. During adolescence, from pnd 28 to pnd 50, voluntary ethanol intake (20%, v/v was investigated using the two-bottle free choice paradigm. To better understand the relationship between stress and alcohol consumption, voluntary alcohol intake was also evaluated following additional stressful events later in life, that is, a week of alcohol cessation and a week of alcohol cessation combined with exposure to restraint stress. Female animals consumed more alcohol than males only after a second episode of alcohol cessation combined with restraint stress. MD did not affect baseline voluntary alcohol intake but increased voluntary alcohol intake after stress exposure, indicating that MD may render animals more vulnerable to the effects of stress on alcohol intake. During adolescence, when animals had free access to alcohol, MD animals showed lower body weight gain but a higher growth rate than control animals. Moreover, the higher growth rate was accompanied by a decrease in food intake, suggesting an altered metabolic regulation in MD animals that may interact with alcohol intake.

Resveratrol Ameliorates Experimental Alcoholic Liver Disease by Modulating Oxidative Stress

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He Peiyuan

2017-01-01

Full Text Available The aim of this study was to investigate the hepatoprotective effects of resveratrol in alcoholic liver disease (ALD. Alcohol was administered to healthy female rats starting from 6% (v/v and gradually increased to 20% (v/v by the fifth week. After 16 weeks of intervention, liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT] were analyzed using a chemistry analyzer, while hepatic antioxidant enzymes, oxidative stress markers, and caspase 3 activity were assessed using ELISA kits. Furthermore, hepatic CYP2E1 protein levels and mRNA levels of antioxidant and inflammation-related genes were determined using western blotting and RT-PCR, respectively. The results showed that resveratrol significantly attenuated alcohol-induced elevation of liver enzymes and improved hepatic antioxidant enzymes. Resveratrol also attenuated alcohol-induced CYP2E1 increase, oxidative stress, and apoptosis (caspase 3 activity. Moreover, genes associated with oxidative stress and inflammation were regulated by resveratrol supplementation. Taken together, the results suggested that resveratrol alleviated ALD through regulation of oxidative stress, apoptosis, and inflammation, which was mediated at the transcriptional level. The data suggests that resveratrol is a promising natural therapeutic agent against chronic ALD.

The interaction of chronic restraint stress and voluntary alcohol intake: effects on spatial memory in male rats.

Science.gov (United States)

Gomez, Juan L; Lewis, Michael J; Luine, Victoria N

2012-08-01

Alcohol consumption and exposure to stressful life events activate similar neural pathways and thus result in several comparable physiological and behavioral effects. Alcoholics in treatment claim that life stressors are the leading cause of continued drinking or relapse. However, few studies have investigated the interactive effects of stress and alcohol on cognitive behavior. The effects of restraint stress, alcohol, and stress in combination with alcohol were examined on a spatial memory test, the object placement (OP) task. In addition, intake levels were measured to determine if stress altered general consumption of alcohol. Male Sprague-Dawley rats were assigned to one of four conditions: no alcohol/no stress control (CON), stress alone (STR), alcohol alone (ALC), and STR+alcohol (STR+ALC). Following each restraint stress bout, the STR+ALC and the ALC groups were given access to 8% alcohol for 1h using the two-bottle choice limited access paradigm. As predicted, the STR+ALC group significantly increased alcohol consumption, while the ALC group had consistent drinking over the 10-day treatment. On the OP task, STR and ALC groups performed at chance levels, whereas the CON and STR+ALC groups significantly discriminated between objects in the new and old locations. These data show that stress increases alcohol intake and the intake of alcohol is associated with reduction of the stress-induced impairment of spatial memory. The data have important implications for the development of alcohol abuse and its treatment. Copyright © 2012 Elsevier Inc. All rights reserved.

Beverage preference and risk of alcohol-use disorders

DEFF Research Database (Denmark)

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

2008-01-01

OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data...... on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women...... women or men. CONCLUSIONS: Individuals who include wine when they drink alcohol have lower risks of AUD, independent of the total amount of alcohol consumed. The most likely explanation of these results is that lifestyle factors and personal characteristics are associated with beverage preference....

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

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Kittirattanapaiboon P

2014-03-01

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

Posttraumatic stress disorder among black Vietnam veterans.

Science.gov (United States)

Allen, I M

1986-01-01

Because of racism in the military and racial and social upheaval in the United States during the Vietnam War years, as well as limited opportunities for blacks in the postwar period, black veterans of the Vietnam War often harbor conflicting feelings about their wartime experiences and have difficulty rationalizing brutality against the Vietnamese. As a result, black veterans suffer from posttraumatic stress disorder (PTSD) at a higher rate than white veterans. Diagnosis and treatment of PTSD in black veterans is complicated by the tendency to misdiagnose black patients, by the varied manifestations of PTSD, and by patients' frequent alcohol and drug abuse and medical, legal, personality, and vocational problems. The author presents his and others' recommendations about ways to treat black veterans with PTSD.

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

Science.gov (United States)

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

2016-01-01

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

Stress-related neuropeptides and alcoholism: CRH, NPY and beyond

Science.gov (United States)

Ciccocioppo, Roberto; Gehlert, Donald R.; Ryabinin, Andrey; Kaur, Simranjit; Cippitelli, Andrea; Thorsell, Annika; Lê, Anh D.; Hipskind, Philip A.; Hamdouchi, Chafiq; Lu, Jianliang; Hembre, Erik J.; Cramer, Jeffrey; Song, Min; McKinzie, David; Morin, Michelle; Economidou, Daina; Stopponi, Serena; Cannella, Nazzareno; Braconi, Simone; Kallupi, Marsida; de Guglielmo, Giordano; Massi, Maurizio; George, David T.; Gilman, Jody; Hersh, Jacqueline; Tauscher, Johannes T.; Hunt, Stephen P.; Hommer, Daniel; Heilig, Markus

2009-01-01

This article summarizes the proceedings of a symposium held at the conference on “Alcoholism and Stress: A Framework for Future Treatment Strategies” in Volterra, Italy, May 6–9, 2008. Chaired by Markus Heilig and Roberto Ciccocioppo, this symposium offered a forum for the presentation of recent data linking neuropetidergic neurotransmission to the regulation of different alcohol related behaviours in animals and in humans. Dr. Donald Gehlert described the development of a new corticotrophin releasing factor (CRH) receptor 1 antagonist and showed its efficacy in reducing alcohol consumption and stress-induced relapse in different animal models of alcohol abuse. Dr. Andrey Ryabinin reviewed recent findings in his laboratory indicating a role of the urocortin 1 (Ucn) receptor system in the regulation of alcohol intake. Dr. Annika Thorsell showed data supporting the significance of the neuropetide Y (NPY) receptor system in the modulation of behaviours associated with a history of ethanol intoxication. Dr. Roberto Ciccocioppo focused his presentation on the nociceptin/orphanin FQ (N/OFQ) receptors as treatment targets for alcoholism. Finally, Dr. Markus Heilig showed recent preclinical and clinical evidence suggesting that neurokinin 1 (NK1) antagonism may represent a promising new treatment for alcoholism. Collectively, these investigators highlighted the significance of neuropeptidergic neurotransmission in the regulation of neurobiological mechanisms of alcohol addiction. Data also revealed the importance of these systems as treatment targets for the development of new medication for alcoholism. PMID:19913192

Life stress and mental disorders in the South African Stress and ...

African Journals Online (AJOL)

Life stress and mental disorders in the South African Stress and Health study. ... Although stressful life events (SLEs) are associated with psychopathology, the ... life stress and sociodemographic predictors of 12-month and lifetime disorder.

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

NARCIS (Netherlands)

Tuithof, M.

2015-01-01

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

Relationship between stress coping and sleep disorders among the general Japanese population: a nationwide representative survey.

Science.gov (United States)

Otsuka, Yuichiro; Kaneita, Yoshitaka; Itani, Osamu; Nakagome, Sachi; Jike, Maki; Ohida, Takashi

2017-09-01

To clarify the prevalence of stress, and examine the relationship between sleep disorders and stress coping strategies among highly stressed individuals in the general Japanese population. A cross-sectional nationwide survey was undertaken in November 2007. Men and women were randomly selected from 300 districts throughout Japan. Data from 7671 (3532 men (average age 53.5 ± 17.0 years) and 4139 women (average age 53.9 ± 17.7 years)) were analyzed. Participants completed a self-reported questionnaire on stress, sleep disorders, and stress coping strategies in the previous month. Highly stressed individuals comprised 16.6% (95% confidence interval 15.8-17.5%) of the total sample, and most were aged 20-49 years. In multiple logistic regression, symptoms of insomnia (ie, difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening), excessive daytime sleepiness, nightmares, daytime malfunction, and lack of rest due to sleep deprivation were more prone to occur in highly stressed individuals. In addition, logistic regression analysis controlling for other adjustment factors revealed that stress coping strategies such as 'giving up on problem-solving', 'enduring problems patiently', 'smoking' and 'drinking alcohol' were positively associated with the above-mentioned sleep disorders. On the other hand, stress coping strategies such as 'exercising', 'enjoying hobbies', and 'sharing worries' were inversely associated with the above-mentioned sleep disorders. Distraction-based stress coping (eg, hobbies, exercise, and optimistic thinking) was found to be preferable to problem-based stress coping in a highly stressed Japanese general population. Copyright © 2017 Elsevier B.V. All rights reserved.

[Epidemiologic warnings from studies on alcohol use disorders].

Science.gov (United States)

Limosin, F

2014-04-01

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

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

Science.gov (United States)

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

2015-02-01

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

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

Science.gov (United States)

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

2016-08-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1995-10-09

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

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

Directory of Open Access Journals (Sweden)

Joel M Francis

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

Fetal alcohol-spectrum disorders: identifying at-risk mothers

Directory of Open Access Journals (Sweden)

Montag AC

2016-07-01

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

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

Science.gov (United States)

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

2017-07-14

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

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

OpenAIRE

Vaurio, Linnea

2011-01-01

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

Occupational imbalance and the role of perceived stress in predicting stress-related disorders.

Science.gov (United States)

Håkansson, Carita; Ahlborg, Gunnar

2017-03-02

Stress-related disorders are the main reason for sick leave in many European countries. The aim of the present study was to explore whether perceived occupational imbalance predicts stress-related disorders, potential gender differences, and to explore the mediating role of perceived stress. Longitudinal data on 2223 employees in a public organization in Sweden were collected by surveys, and analyzed by logistic regression. Occupational imbalance predicted stress-related disorders among both women and men. However, what aspects of occupational imbalance which predicted stress-related disorders differ by gender. Perceived stress was not a mediator in these associations. How women and men perceived their occupational balance affected the risk of stress-related disorders. The results may be used to develop effective strategies to decrease stress-related disorders.

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

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

2015-12-01

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

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

Science.gov (United States)

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

2018-04-01

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

Postmodern Stress Disorder (PMSD): A Possible New Disorder.

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Eiser, Arnold R

2015-11-01

The murder of cardiovascular surgeon, Michael Davidson, MD, suggests the existence of a new disorder, postmodern stress disorder. This disorder is characterized by repetitive exposure to digital images of violence in a variety of electronic media, including films, television, video games, music videos, and other online sources. This disorder appears to be a variant of posttraumatic stress disorder, and shares with it excessive stimulation of the amygdala and loss of the normal inhibitory inputs from the orbitofrontal cingulate cortical gyrus. In postmodern stress disorder, repetitive digital microtraumas appear to have an effect similar to that of macrotraumas of warfare or civilian assaults. Other elements of the disorder include the development of fixed ideas of bullying or public shaming, access to weapons, and loss of impulse control. This syndrome could explain a number of previously inexplicable murders/suicides. Violence against health care professionals is a profound concern for the medical profession, as are assaults on nonclinicians. The recommendation is made to change forensic procedures to include obtaining historic information concerning the use of digital media during investigations of violent crimes and murders so that the disorder may be further characterized. Gaining an understanding of this disorder will require a multidisciplinary approach to this life-threatening public health problem. Research should also focus on the development and evaluation of possible antidotes to postmodern toxicities. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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

2016-11-01

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

The role of neuroimmune signaling in alcoholism.

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Crews, Fulton T; Lawrimore, Colleen J; Walter, T Jordan; Coleman, Leon G

2017-08-01

Alcohol consumption and stress increase brain levels of known innate immune signaling molecules. Microglia, the innate immune cells of the brain, and neurons respond to alcohol, signaling through Toll-like receptors (TLRs), high-mobility group box 1 (HMGB1), miRNAs, pro-inflammatory cytokines and their associated receptors involved in signaling between microglia, other glia and neurons. Repeated cycles of alcohol and stress cause a progressive, persistent induction of HMGB1, miRNA and TLR receptors in brain that appear to underlie the progressive and persistent loss of behavioral control, increased impulsivity and anxiety, as well as craving, coupled with increasing ventral striatal responses that promote reward seeking behavior and increase risk of developing alcohol use disorders. Studies employing anti-oxidant, anti-inflammatory, anti-depressant, and innate immune antagonists further link innate immune gene expression to addiction-like behaviors. Innate immune molecules are novel targets for addiction and affective disorders therapies. This article is part of the Special Issue entitled "Alcoholism". Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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

2018-01-30

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

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

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Janelle E. Arias

2009-11-01

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

Post-traumatic Stress Disorder

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S Seedat

2013-08-01

Full Text Available Post-traumatic stress disorder (PTSD is among the most prevalentanxiety disorders, both in terms of lifetime and 12-month prevalencerates documented in epidemiological studies worldwide.

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

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

2015-11-01

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

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

DEFF Research Database (Denmark)

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

2014-01-01

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

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

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

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

Bayard Roberts

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

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

NARCIS (Netherlands)

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

2005-01-01

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

[Post-traumatic stress disorder after childbirth].

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Korábová, I; Masopustová, Z

2016-01-01

The aim of this paper is to introduce the issue of post-traumatic stress disorder after childbirth to health care professionals. The text focuses on the diagnostic definition of post-traumatic stress disorder after childbirth, symptoms, physiological background, prevalence, course, risk factors and consequences of post-traumatic stress disorder after childbirth for a woman, her child and her partner. Options for interventions and therapy are outlined as well.

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

NARCIS (Netherlands)

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

2010-01-01

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

Associations between work stress, alcohol consumption and sickness absence.

Science.gov (United States)

Vasse, R M; Nijhuis, F J; Kok, G

1998-02-01

To test an interactional model on the associations between work stressors, perceived stress, alcohol consumption and sickness absence. Cross-sectional survey. The study was part of a Worksite Health Project including an Employee Assistance Programme and a Health Promotion Programme in the Netherlands. Participants were blue-collar workers from two Municipal Garbage Collecting Departments and white-collar workers from a Pharmaceutical Company (N = 471). Measurements included socio-demographic characteristics (gender, age, education, marital status), work stressors, perceived stress, alcohol consumption and sickness absence. Type of work-site (blue- or white-collar) and smoking behaviour were used as covariates. Regression analyses resulted in three major findings. First, in the presence of stress, abstinence increased the risk of sickness absence compared with moderate drinking. We failed to find a significant relationship between excessive drinking and sickness absence. Secondly, stress mediated the associations between stressor and alcohol consumption, and between stressor and sickness absence, although stressors also directly predicted sickness absence. The association between abstinence and sickness absence could reflect medical problems of abstainers or a lack of skills for coping with stress. The failure to find a significant detrimental effect of excessive drinking may have been due to use of a low threshold for excessive drinking and/or low power. Prospective studies are needed to gain insight in causal relationships between the variables concerned.

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

DEFF Research Database (Denmark)

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

2009-01-01

AIMS: The aim of this study was to compare the cancer morbidity in a large cohort of patients with alcohol use disorders in the general Danish population. METHODS: We included 15,258 men and 3552 women free of cancer when attending the Copenhagen Outpatient Clinic for Alcoholics in the period from......, but not of breast cancer and colorectal cancer, in patients with alcohol use disorders....... incidence of colon, rectal or urinary bladder cancer. CONCLUSIONS: In conclusion, this study confirms the well-established association between high alcohol intake and cancer of the upper digestive tract and liver. In addition, the results indicate a significantly elevated occurrence of renal cancer...

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

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Georges Brousse

2014-11-01

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

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

Science.gov (United States)

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

2015-04-30

Harmful use of alcohol is one of the top five risks for burden of disease globally and in Europe; in 2012, 3.3 million net deaths (approximately 6% of all global deaths) were attributable to this risk factor. It is also linked to the development of a wide spectrum of alcohol use disorders, ranging from mild manifestations to a severe disease known as alcohol dependence. Alcohol dependence is a progressive, chronic, and relapsing brain disease resulting from the prolonged effects of alcohol on the brain. Alcohol dependence imposes a significant societal burden, with indirect societal costs reaching up to 0.64% of European countries׳ annual gross domestic product. With these facts in mind, it is important to recognize and manage alcohol dependence. Although the biological mechanisms behind the development of alcohol dependence are not fully known, factors that have been shown to influence its development include genetic predisposition, psychological problems, and social interactions. Alcohol use has also been linked to the development of hypertension, liver cirrhosis, chronic pancreatitis, multiple types of cancer, and psychiatric comorbidities such as depression and anxiety disorders. With such severe effects on both individuals and society, it is important to recognize the characteristic signs and symptoms of alcohol dependence and explore new ways to better manage patients with this brain disease. Effective treatment approaches for alcohol dependence include biological, behavioral, and social components addressing the multiple aspects of this disease. Comprehensive, educational platforms in which to explore the many facets of this disease such as the Progress in Mind: Focus on Alcohol Use Disorders Resource Centre, will provide clinicians with the tools necessary for recognizing patients with alcohol dependence and managing their disease along with related comorbidities. Online Access: http://progressinmind.elsevierresource.com. Copyright © 2015. Published by

Proton magnetic resonance spectroscopy in children with fetal alcohol spectrum disorders

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

2009-06-15

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

Proton magnetic resonance spectroscopy in children with fetal alcohol spectrum disorders

International Nuclear Information System (INIS)

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

2009-01-01

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

Work Stress and Alcohol Use: Developing and Testing a Biphasic Self-Medication Model

OpenAIRE

Frone, Michael R.

2016-01-01

This study developed and tested a moderated-mediation model of work stress and alcohol use, based on the biphasic (stimulant and sedative) effects of alcohol and the self-medication and stress-vulnerability models of alcohol use. The model proposes that exposure to work stressors can increase both negative affect and work fatigue, and that these two sources of strain can subsequently motivate the use of alcohol. However, the relations of negative affect and work fatigue to a...

Effects of alcohol on the endocrine system.

Science.gov (United States)

Rachdaoui, Nadia; Sarkar, Dipak K

2013-09-01

Chronic consumption of a large amount of alcohol disrupts the communication between nervous, endocrine, and immune system and causes hormonal disturbances that lead to profound and serious consequences at physiologic and behavioral levels. These alcohol-induced hormonal dysregulations affect the entire body and can result in various disorders such as stress abnormalities, reproductive deficits, body growth defect, thyroid problems, immune dysfunction, cancers, bone disease, and psychological and behavioral disorders. This review summarizes the findings from human and animal studies that provide consistent evidence on the various effects of alcohol abuse on the endocrine system. Copyright © 2013 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Suter, Marius; Strik, Werner; Moggi, Franz

2011-10-01

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

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

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Ralph L. Elkins

2017-09-01

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

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

Science.gov (United States)

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

2018-05-01

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

Disentangling the role of astrocytes in alcohol use disorder

Science.gov (United States)

Adermark, Louise; Bowers, M. Scott

2016-01-01

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

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

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Paulo Cesar Ribeiro Barbosa

2018-04-01

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

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

Science.gov (United States)

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

2000-01-01

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

Foetal Alcohol Spectrum Disorders and Alterations in Brain and Behaviour

OpenAIRE

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

2009-01-01

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

The relationship between stressful working conditions and high alcohol consumption and severe alcohol problems in an urban general population

DEFF Research Database (Denmark)

Romelsjö, A; Hasin, D; Hilton, M

1992-01-01

The relationship between 15 measures of stressful working conditions and high alcohol consumption (35 g 100% ethanol per day or more for men and 25 g or more for women) was studied, using cross-sectional data from a general population survey of 1344 males and 1494 females; the ages 25-64 years......-adjusted odds ratios, were positive and some were negative when high alcohol consumption was the endpoint, but there was a clear variation by sex and social class. Generally the positive associations were stronger among male non-manual employees. Among males, there was a clear association between stressful...... increased odds ratios were lower when subjects with an alcohol diagnosis at inpatient care during 1980-84 were excluded in the analyses. On the whole, our findings are not conclusive. The strong, but imprecise associations between stressful working conditions and severe alcohol problems, are however...

Imaging Neuroinflammation in Post Traumatic Stress Disorder

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2012-11-01

Post traumatic stress disorder ( PTSD ) is a complex...several central nervous system conditions including post - traumatic stress disorder ( PTSD ) and traumatic brain injury (TBI). Microglia represent over...trials. We have subsequently identified a better agent for interrogating TSPO in post - traumatic stress disorder ( PTSD ) subjects, 18-F PBR111, a

The use of alcohol use disorders identification test (AUDIT) in detecting alcohol use disorder and risk drinking in the general population: validation of AUDIT using schedules for clinical assessment in neuropsychiatry.

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Lundin, Andreas; Hallgren, Mats; Balliu, Natalja; Forsell, Yvonne

2015-01-01

The alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) are commonly used in population surveys but there are few validations studies in the general population. Validity should be estimated in samples close to the targeted population and setting. This study aims to validate AUDIT and AUDIT-C in a general population sample (PART) in Stockholm, Sweden. We used a general population subsample age 20 to 64 that answered a postal questionnaire including AUDIT who later participated in a psychiatric interview (n = 1,093). Interviews using Schedules for Clinical Assessment in Neuropsychiatry was used as criterion standard. Diagnoses were set according to the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Agreement between the diagnostic test and criterion standard was measured with area under the receiver operator characteristics curve (AUC). A total of 1,086 (450 men and 636 women) of the interview participants completed AUDIT. There were 96 individuals with DSM-IV-alcohol dependence, 36 DSM-IV-Alcohol Abuse, and 153 Risk drinkers. AUCs were for DSM-IV-alcohol use disorder 0.90 (AUDIT-C 0.85); DSM-IV-dependence 0.94 (AUDIT-C 0.89); risk drinking 0.80 (AUDIT-C 0.80); and any criterion 0.87 (AUDIT-C 0.84). In this general population sample, AUDIT and AUDIT-C performed outstanding or excellent in identifying dependency, risk drinking, alcohol use disorder, any disorder, or risk drinking. Copyright © 2015 by the Research Society on Alcoholism.

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

African Journals Online (AJOL)

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

Psychiatry Trainees' Training and Experience in Fetal Alcohol Spectrum Disorders

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Eyal, Roy; O'Connor, Mary J.

2011-01-01

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

Sleep Disorders in Patients with Post-Traumatic Stress Disorder.

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El-Solh, Ali A; Riaz, Usman; Roberts, Jasmine

2018-04-20

A growing body of evidence supports a bidirectional relationship between post-traumatic stress disorder (PTSD) and sleep disturbances. Fragmented sleep induced by sleep-related breathing disorders, insomnia, and nightmares impacts recovery and treatment outcomes and worsens PTSD symptoms. Despite recent attention, management of these disorders has been unrewarding in the setting of PTSD. This review summarizes the evidence for empirically supported treatments of these sleep ailments as it relates to PTSD including psychotherapeutic and pharmacologic interventions. Recent advances in positive airway pressure technology have made treatment of OSA more acceptable however adherence to CPAP represents a significant challenge. The presence of concomitant insomnia, which engenders psychiatric and medical conditions including depression, suicide, alcohol and substance abuse, can be managed with cognitive behavioral therapy (CBT). Hypnotic agents are considered an alternative therapy but concerns about adverse events and lack of high level evidence supporting their efficacy in PTSD have limited their use to resistant cases or as adjunct to behavioral therapy when the response is less than desirable. Intrusion of nightmares can complicate PTSD treatment and exert serious strain on social, occupational and marital relations. Image rehearsal therapy has shown significant reduction in nightmares intensity and frequency. The success of noradrenergic blocking agents has not been consistent among studies with half reporting treatment failure. An integrated stepped care approach that includes components of both behavioral and pharmacologic interventions customized to patients sleep maladaptive behaviors may offer a solution to delivering accessible, effective, and efficient services for individuals with PTSD. Copyright © 2018. Published by Elsevier Inc.

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

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Idrus, Nirelia M; Thomas, Jennifer D

2011-01-01

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

Proposed pathways to problematic drinking via post-traumatic stress disorder symptoms, emotion dysregulation, and dissociative tendencies following child/adolescent sexual abuse.

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Klanecky, Alicia K; McChargue, Dennis E; Tuliao, Antover P

2016-01-01

The relationship between early sexual abuse and college problem drinking was examined using an integration of the self-medication and vulnerability-stress models. Baseline survey data from parti-cipants (N = 213; 135 men and 78 college women) completing a mandated, brief alcohol intervention were utilized. Representative of the self-medication model, post-traumatic stress disorder symptoms mediated the early sexual abuse/problem drinking relationship. Two psychological vulnerability factors-emotion dysregulation and dissociative tendencies-were incorporated into self-medication findings via more advanced mediational models. Results highlighted that problem drinking increased as dissociative tendencies increased, and relations between the vulnerability factors and post-traumatic stress disorder symptoms were in an unexpected direction.

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

NARCIS (Netherlands)

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

2017-01-01

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

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

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Kotov, Kimberly M

2006-01-01

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

Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

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Herrmann, Nathan; Eryavec, Goran

1994-01-01

Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Integrating Genetic and Gene Co-expression Analysis Identifies Gene Networks Involved in Alcohol and Stress Responses.

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Luo, Jie; Xu, Pei; Cao, Peijian; Wan, Hongjian; Lv, Xiaonan; Xu, Shengchun; Wang, Gangjun; Cook, Melloni N; Jones, Byron C; Lu, Lu; Wang, Xusheng

2018-01-01

Although the link between stress and alcohol is well recognized, the underlying mechanisms of how they interplay at the molecular level remain unclear. The purpose of this study is to identify molecular networks underlying the effects of alcohol and stress responses, as well as their interaction on anxiety behaviors in the hippocampus of mice using a systems genetics approach. Here, we applied a gene co-expression network approach to transcriptomes of 41 BXD mouse strains under four conditions: stress, alcohol, stress-induced alcohol and control. The co-expression analysis identified 14 modules and characterized four expression patterns across the four conditions. The four expression patterns include up-regulation in no restraint stress and given an ethanol injection (NOE) but restoration in restraint stress followed by an ethanol injection (RSE; pattern 1), down-regulation in NOE but rescue in RSE (pattern 2), up-regulation in both restraint stress followed by a saline injection (RSS) and NOE, and further amplification in RSE (pattern 3), and up-regulation in RSS but reduction in both NOE and RSE (pattern 4). We further identified four functional subnetworks by superimposing protein-protein interactions (PPIs) to the 14 co-expression modules, including γ-aminobutyric acid receptor (GABA) signaling, glutamate signaling, neuropeptide signaling, cAMP-dependent signaling. We further performed module specificity analysis to identify modules that are specific to stress, alcohol, or stress-induced alcohol responses. Finally, we conducted causality analysis to link genetic variation to these identified modules, and anxiety behaviors after stress and alcohol treatments. This study underscores the importance of integrative analysis and offers new insights into the molecular networks underlying stress and alcohol responses.

Integrating Genetic and Gene Co-expression Analysis Identifies Gene Networks Involved in Alcohol and Stress Responses

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Jie Luo

2018-04-01

Full Text Available Although the link between stress and alcohol is well recognized, the underlying mechanisms of how they interplay at the molecular level remain unclear. The purpose of this study is to identify molecular networks underlying the effects of alcohol and stress responses, as well as their interaction on anxiety behaviors in the hippocampus of mice using a systems genetics approach. Here, we applied a gene co-expression network approach to transcriptomes of 41 BXD mouse strains under four conditions: stress, alcohol, stress-induced alcohol and control. The co-expression analysis identified 14 modules and characterized four expression patterns across the four conditions. The four expression patterns include up-regulation in no restraint stress and given an ethanol injection (NOE but restoration in restraint stress followed by an ethanol injection (RSE; pattern 1, down-regulation in NOE but rescue in RSE (pattern 2, up-regulation in both restraint stress followed by a saline injection (RSS and NOE, and further amplification in RSE (pattern 3, and up-regulation in RSS but reduction in both NOE and RSE (pattern 4. We further identified four functional subnetworks by superimposing protein-protein interactions (PPIs to the 14 co-expression modules, including γ-aminobutyric acid receptor (GABA signaling, glutamate signaling, neuropeptide signaling, cAMP-dependent signaling. We further performed module specificity analysis to identify modules that are specific to stress, alcohol, or stress-induced alcohol responses. Finally, we conducted causality analysis to link genetic variation to these identified modules, and anxiety behaviors after stress and alcohol treatments. This study underscores the importance of integrative analysis and offers new insights into the molecular networks underlying stress and alcohol responses.

PER1 rs3027172 Genotype Interacts with Early Life Stress to Predict Problematic Alcohol Use, but Not Reward-Related Ventral Striatum Activity

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Baranger, David A. A.; Ifrah, Chloé; Prather, Aric A.; Carey, Caitlin E.; Corral-Frías, Nadia S.; Drabant Conley, Emily; Hariri, Ahmad R.; Bogdan, Ryan

2016-01-01

Increasing evidence suggests that the circadian and stress regulatory systems contribute to alcohol use disorder (AUD) risk, which may partially arise through effects on reward-related neural function. The C allele of the PER1 rs3027172 single nucleotide polymorphism (SNP) reduces PER1 expression in cells incubated with cortisol and has been associated with increased risk for adult AUD and problematic drinking among adolescents exposed to high levels of familial psychosocial adversity. Using data from undergraduate students who completed the ongoing Duke Neurogenetics Study (DNS) (n = 665), we tested whether exposure to early life stress (ELS; Childhood Trauma Questionnaire) moderates the association between rs3027172 genotype and later problematic alcohol use (Alcohol Use Disorders Identification Test) as well as ventral striatum (VS) reactivity to reward (card-guessing task while functional magnetic resonance imaging data were acquired). Initial analyses found that PER1 rs3027172 genotype interacted with ELS to predict both problematic drinking and VS reactivity; minor C allele carriers, who were also exposed to elevated ELS reported greater problematic drinking and exhibited greater ventral striatum reactivity to reward-related stimuli. When gene × covariate and environment × covariate interactions were controlled for, the interaction predicting problematic alcohol use remained significant (p < 0.05, corrected) while the interaction predicting VS reactivity was no longer significant. These results extend our understanding of relationships between PER1 genotype, ELS, and problematic alcohol use, and serve as a cautionary tale on the importance of controlling for potential confounders in studies of moderation including gene × environment interactions. PMID:27065929

PREVALENCE AND PSYCHOSOCIAL FACTORS OF ALCOHOL USE DISORDER– A PROSPECTIVE STUDY FROM A TERTIARY CARE CENTRE OF ASSAM, INDIA

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Pallab Kumar Bhattacharjee

2017-08-01

Full Text Available BACKGROUND Alcohol dependence, also known as alcoholism or alcohol use disorder, is a broad term for any drinking of alcohol that results in many diseases and various psychosocial problems. There are many complications in managing as well as critical treatment in the study area. The number of alcohol use disorder is increasing in Northeast India day by day. This study was conducted with an aim to study the prevalence and psychosocial factors of alcohol use disorder. MATERIALS AND METHODS Present study was a hospital-based, cross-sectional study from 1st December, 2015 to 30th November, 2016. A mixed research method of both qualitative and quantitative approaches, nonprobability purposive sampling and three different types of standard scales were applied among cases of age 20 and above. RESULTS 100 alcohol use disorder patients were assessed. Most of the patients were of 20-39 years age group. Majority (96% of total respondents were male. 48 percent of alcoholic dependence cases were from HSLC and HS standard, 98 percent of alcoholic dependence cases were from Hindu religion. Interestingly, 34 percent respondents were severely alcohol dependent, 48 percent of them suffered from high perceived stress, 66 percent of their families were problematic but the findings of hypotheses i.e., x2= 0.489 and x2= 0.097 depict there is no association between the levels of alcohol dependency and family functioning. It cannot be said ‘higher the level of stress higher the severity of alcohol dependency’. CONCLUSION There are many health and social problems which are related to alcohol use disorder. Alcohol use disorder leads to mental illnesses such as problems of stress, depression, aggression, anxiety, alienation, revenge, shock, indifference, frustration and sleeplessness.

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

NARCIS (Netherlands)

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

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

The relationship between excessive alcohol consumption and alcohol use disorders according to DSM-IV and DSM-5

NARCIS (Netherlands)

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

2014-01-01

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

Social Support and Relationship Satisfaction as Moderators of the Stress-Mood-Alcohol Link Association in US Navy Members.

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Kelley, Michelle L; Milletich, Robert J; Hollis, Brittany F; Veprinsky, Anna; Robbins, Allison T; Snell, Alicia K

2017-02-01

The present study examined associations between stress and problematic alcohol use among US Navy members anticipating deployment, whether depressive symptoms mediated the stress-alcohol link, and whether social support and relationship satisfaction moderated associations between stress, depressive symptoms, and problematic alcohol use. Participants were 108 US Navy members assigned to an Arleigh Burke-class destroyer anticipating an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Stress was indirectly related to problematic alcohol use such that higher levels of stress were associated with higher levels of depressive symptoms, which were further associated with higher levels of alcohol use. The indirect effect of stress to problematic alcohol use via depressive symptoms was tested at different levels of social support and relationship satisfaction. At higher levels of social support and relationship satisfaction, the association between stress and problematic alcohol use via depressive symptoms decreased. Results help identify targets for alcohol prevention efforts among current military members.

Depressed suicide attempters with posttraumatic stress disorder.

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Ramberg, Maria; Stanley, Barbara; Ystgaard, Mette; Mehlum, Lars

2015-01-01

Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.

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

Science.gov (United States)

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

2018-03-01

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

Physical activity as treatment for alcohol use disorders (FitForChange): study protocol for a randomized controlled trial.

Science.gov (United States)

Hallgren, Mats; Andersson, Victoria; Ekblom, Örjan; Andréasson, Sven

2018-02-14

Help-seeking for alcohol use disorders (AUDs) is low and traditional treatments are often perceived as stigmatizing. Physical activity has positive effects on mental and physical health which could benefit this population. We propose to compare the effects of aerobic training, yoga, and usual care for AUDs in physically inactive Swedish adults. This is a three-group, parallel, single-blind, randomized controlled trial (RCT). In total, 210 adults (aged 18-75 years) diagnosed with an AUD will be invited to participate in a 12-week intervention. The primary study outcome is alcohol consumption measure by the Timeline Follow-back method and the Alcohol Use Disorders Identification Test (AUDIT). Secondary outcomes include: depression, anxiety, perceived stress, sleep quality, physical activity levels, fitness, self-efficacy, health-related quality of life, and cognition. Blood samples will be taken to objectively assess heavy drinking, and saliva to measure cortisol. Acute effects of exercise on the urge to drink alcohol, mood, and anxiety will also be assessed. The treatment potential for exercise in AUDs is substantial as many individuals with the disorder are physically inactive and have comorbid health problems. The study is the first to assess the effects of physical activity as a stand-alone treatment for AUDs. Considerable attention will be given to optimizing exercise adherence. Both the feasibility and treatment effects of exercise interventions in AUDs will be discussed. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (DNR: 2017/1380-3). German Clinical Trials Register, ID: DRKS00012311. Registered on 26 September 2017.

Predicting an Alcohol Use Disorder in Urban American Indian Youths

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

2014-01-01

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

Psychiatric Comorbidity of Full and Partial Posttraumatic Stress Disorder among Older Adults in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

Science.gov (United States)

Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2011-01-01

Objectives To present findings on the prevalence, correlates, and psychiatric comorbidity of DSM-IV posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults. Design, Setting, and Participants Face-to-face interviews with 9,463 adults aged 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Measurements Sociodemographic correlates, worst stressful experiences, comorbid lifetime mood, anxiety, substance use, and personality disorders, psychosocial functioning, and suicide attempts. Results Lifetime prevalences±standard errors of PTSD and partial PTSD were 4.5%±0.25 and 5.5%±0.27, respectively. Rates were higher in women (5.7%±0.37 and 6.5%±0.39) than men (3.1%±0.31 and 4.3%±0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders, and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders, and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD. Conclusions PTSD among older adults in the United States is slightly more prevalent than previously reported and associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders. PMID:22522959

The impact of acculturation and acculturative stress on alcohol use across Asian immigrant subgroups.

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Park, So-Youn; Anastas, Jeane; Shibusawa, Tazuko; Nguyen, Duy

2014-06-01

Acculturation and acculturative stress are examined as predictors of alcohol use among Asian immigrants, using the 2004 National Latino and Asian Americans Survey (NLAAS). Separate regression analyses were conducted for Chinese (n = 600), Filipino (n = 508), and Vietnamese (n = 520) immigrants. Alcohol use varied for the three groups. English proficiency was associated with drinking for all groups. Family conflict was associated with drinking for Chinese immigrants. General acculturative stress and discrimination were associated with drinking for Vietnamese immigrants. Results underscore acculturation and acculturative stress as being contributors to alcohol consumption, and the importance of considering the heterogeneity of Asian immigrants in research on their alcohol use. The study's limitations are noted.

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

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Brown, Jason D.; Bednar, Lisa M.

2004-01-01

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

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

Directory of Open Access Journals (Sweden)

Fang Wang

2016-01-01

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

Conduct disorder, war zone stress, and war-related posttraumatic stress disorder symptoms in American Indian Vietnam veterans.

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Dillard, Denise; Jacobsen, Clemma; Ramsey, Scott; Manson, Spero

2007-02-01

This study examined whether conduct disorder (CD) was associated with war zone stress and war-related post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. Conduct disorder was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and if the association exists in other AI populations.

Pharmacotherapy for post-traumatic stress disorder- a systematic ...

African Journals Online (AJOL)

Post-traumatic stress disorder (PTSD) is a prevalent ... j (n:J:J Medical Research Council Unit on Anxiety and Stress Disorders, .... of the drugs used. ...... in the treatment of posttraumatic stress disorder related to childhood abuse in women.

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

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

2013-01-30

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

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

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

2015-08-12

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

Catecholamines in Post-Traumatic Stress Disorder

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2012-07-01

CONTRACT NUMBER Catecholamines in post - traumatic stress disorder 5b. GRANT NUMBER W81XWH-08-1-0327 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...emotionally arousing experiences are typically vivid and persistent. The recurrent, intrusive memories of traumatic events in post - traumatic stress disorder ...AD_________________ Award Number: W81XWH-08-1-0327 TITLE: Catecholamines in post - traumatic stress

Predictors of dropout in concurrent treatment of posttraumatic stress disorder and alcohol dependence: Rate of improvement matters.

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Zandberg, Laurie J; Rosenfield, David; Alpert, Elizabeth; McLean, Carmen P; Foa, Edna B

2016-05-01

The present study examined predictors and moderators of dropout among 165 adults meeting DSM-IV criteria for posttraumatic stress disorder (PTSD) and alcohol dependence (AD). Participants were randomized to 24 weeks of naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive AD counseling (the BRENDA manualized model). Logistic regression using the Fournier approach was conducted to investigate baseline predictors of dropout across the entire study sample. Rates of PTSD and AD symptom improvement were included to evaluate the impact of symptom change on dropout. Trauma type and rates of PTSD and AD improvement significantly predicted dropout, accounting for 76% of the variance in dropout. Accidents and "other" trauma were associated with the highest dropout, and physical assault was associated with the lowest dropout. For participants with low baseline PTSD severity, faster PTSD improvement predicted higher dropout. For those with high baseline severity, both very fast and very slow rates of PTSD improvement were associated with higher dropout. Faster rates of drinking improvement predicted higher dropout among participants who received PE. The current study highlights the influence of symptom trajectory on dropout risk. Clinicians may improve retention in PTSD-AD treatments by monitoring symptom change at regular intervals, and eliciting patient feedback on these changes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Predictors of dropout in concurrent treatment of posttraumatic stress disorder and alcohol dependence: Rate of improvement matters

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Zandberg, Laurie J.; Rosenfield, David; Alpert, Elizabeth; McLean, Carmen P.; Foa, Edna B.

2016-01-01

Objective The present study examined predictors and moderators of dropout among 165 adults meeting DSM-IV criteria for posttraumatic stress disorder (PTSD) and alcohol dependence (AD). Participants were randomized to 24 weeks of naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive AD counseling (the BRENDA manualized model). Method Logistic regression using the Fournier approach was conducted to investigate baseline predictors of dropout across the entire study sample. Rates of PTSD and AD symptom improvement were included to evaluate the impact of symptom change on dropout. Results Trauma type and rates of PTSD and AD improvement significantly predicted dropout, accounting for 76% of the variance in dropout. Accidents and “other” trauma were associated with the highest dropout, and physical assault was associated with the lowest dropout. For participants with low baseline PTSD severity, faster PTSD improvement predicted higher dropout. For those with high baseline severity, both very fast and very slow rates of PTSD improvement were associated with higher dropout. Faster rates of drinking improvement predicted higher dropout among participants who received PE. Conclusions The current study highlights the influence of symptom trajectory on dropout risk. Clinicians may improve retention in PTSD-AD treatments by monitoring symptom change at regular intervals, and eliciting patient feedback on these changes. PMID:26972745

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

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

2015-03-01

To examine the effect of physical activity on risk of developing alcohol use disorders in a large prospective cohort study with focus on leisure-time physical activity. Data came from the four examinations of the Copenhagen City Heart Study (CCHS), performed in 1976-1978, 1981-1983, 1991-1994 and 2001-2003. Information on physical activity (classified as Moderate/high, low or sedentary) and covariates was obtained through self-administered questionnaires, and information on alcohol use disorders was obtained from the Danish Hospital Discharge Register, the Danish Psychiatric Central Research Register and the Winalco database. In total, 18,359 people participated in the study, a mean follow-up time of 20.9 years. Cox proportional hazards model with delayed entry was used. Models were adjusted for available covariates (age, smoking habits, alcohol intake, education, income and cohabitation status) including updated time-dependent variables whenever possible. A low or moderate/high leisure-time physical activity was associated with almost half the risk of developing alcohol use disorder compared with a sedentary leisure-time physical activity. This translates into a 1.5- to 2-fold increased risk of developing alcohol use disorder (Hazard ratios for men 1.64; 95% CI 1.29-2.10 and women 1.45; 1.01-2.09) in individuals with a sedentary leisure-time physical activity, compared with a moderate to high level. However, when stratifying by presence of other psychiatric disorders, no association was observed in women with psychiatric comorbidity. Residual confounding may have been present in this study, especially according to rough measures of income and education. In both men and women, being sedentary in leisure time was a risk factor for developing an alcohol use disorder. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers.

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Campbell-Sills, Laura; Ursano, Robert J; Kessler, Ronald C; Sun, Xiaoying; Heeringa, Steven G; Nock, Matthew K; Sampson, Nancy A; Jain, Sonia; Stein, Murray B

2017-10-17

Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse. Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1-2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1-2×/week) and alcohol or substance use disorder (AUD/SUD). Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) - but not combat stress - was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06-1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25-1.89, p risk of alcohol-related problems post-deployment.

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

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

2016-05-01

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

The stress-response dampening hypothesis: how self-esteem and stress act as mechanisms between negative parental bonds and alcohol-related problems in emerging adulthood.

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Backer-Fulghum, Lindsey M; Patock-Peckham, Julie A; King, Kevin M; Roufa, Lindsay; Hagen, Leslie

2012-04-01

The stress dampening model (Marlatt, 1987; Sayette, 1993; Sher, 1987) suggests certain individuals may use alcohol to escape from their negative life experiences. Pathological reasons for drinking (e.g., using alcohol as a means to cope) reflect the degree to which individuals are motivated to use alcohol in order to dampen or alleviate the stress they are experiencing (Johnson, Schwitters, Wilson, Nagoshi, & McClearn, 1985). Direct and mediational links among parental bonds (rejection, care, overprotection, autonomy, and neglect), self-esteem, stress, pathological reasons for drinking, and alcohol-related problems were explored. A Structural Equation Model with (405 students; 164 women, 241 men) college students was examined. Three path mediational analyses revealed several mediated pathways. Greater feelings of perceived father/mother neglectfulness (i.e., offspring feeling parents do not show up for them) were indirectly linked to more alcohol-related problems (e.g., indicative of alcohol use or dependence in emerging adulthood) through increased stress and pathological reasons for drinking. Furthermore, higher levels of father rejection (i.e., perception of feeling unwanted) were indirectly linked to more pathological reasons for drinking through low self-esteem and increased stress. However, greater feelings of mother care (affectionate and attentive) were indirectly linked to fewer pathological reasons for drinking through higher self-esteem and lower levels of stress. Moreover, high self-esteem was found to be indirectly linked to fewer alcohol-related problems through decreased stress and pathological reasons for drinking. These findings suggest several specific pathways for using alcohol to self-medicate (i.e., consume alcohol for a specific purpose) or dampen feelings of stress. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychiatric morbidity in spouses of patients with alcohol related disorders

Directory of Open Access Journals (Sweden)

Aruna Dandu

2017-01-01

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

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

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Someki, Fumio

2011-01-01

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

The role of oxidative stress in the development of alcoholic liver disease.

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Galicia-Moreno, M; Gutiérrez-Reyes, G

2014-01-01

Alcohol is the most accepted addictive substance worldwide and its consumption is related to multiple health, economic, and social problems. The liver is the organ in charge of ethanol metabolism and it is susceptible to alcohol's toxic effects. To provide a detailed review of the role of oxidative stress in alcoholic liver disease and the mechanisms of damage involved, along with current information on the hepatoprotective effectiveness of the molecules that have been studied. A search of the PubMed database was conducted using the following keywords oxidative stress, alcoholic liver damage, alcoholic cirrhosis, and antioxidants. There was no time limit for gathering all available information on the subject at hand. According to the literature reviewed, oxidative stress plays an important role in the pathogenesis of alcoholic liver damage. Molecules such as reactive oxygen species (ROS) and reactive nitrogen species (RNS), formed during ethanol metabolism, structurally and functionally modify organic molecules. Consequently, biologic processes are altered and hepatocytes are sensitized to the action of cytokines like tumor necrosis factor-α, as well as to the action of endotoxins, activating signaling pathways such as those controlled by nuclear factor kappa B, extracellular signal regulated kinases, and mitogen activated protein kinase. Oxidative stress plays an important role in the development of liver damage resulting from alcohol consumption. The molecules that have currently displayed a hepatoprotective effect in preclinical and clinical trials must be studied further so that their effectiveness can be confirmed and they can possibly be used as adjuvant treatments for this disease. Copyright © 2014 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

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

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

2006-01-01

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

Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models.

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Danovitch, Itai

2016-01-01

Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.

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

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

2012-01-01

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

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

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

2017-07-01

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

Number of recent stressful life events and incident cardiovascular disease: Moderation by lifetime depressive disorder.

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Berntson, Jessica; Patel, Jay S; Stewart, Jesse C

2017-08-01

We investigated whether number of recent stressful life events is associated with incident cardiovascular disease (CVD) and whether this relationship is stronger in adults with a history of clinical depression. Prospective data from 28,583 U.S. adults (mean age=45years) initially free of CVD who participated in Waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Number of past-year stressful life events (Wave 1), lifetime depressive disorder (Wave 1), and incident CVD (Wave 2) were determined by structured interviews. There were 1069 cases of incident CVD. Each additional stressful life event was associated with a 15% increased odds of incident CVD [Odds Ratio (OR)=1.15, 95% Confidence Interval (CI): 1.11, 1.19]. As hypothesized, a stressful life events by lifetime depressive disorder interaction was detected (P=0.003). Stratified analyses indicated that stressful life events had a stronger association with incident CVD among adults with (OR=1.18, 95% CI: 1.10, 1.27, n=4908) versus without (OR=1.10, 95% CI: 1.07, 1.14, n=23,675) a lifetime depressive disorder. Our findings suggest that a greater number of recent stressful life events elevate the risk of new-onset CVD and that this risk is potentiated in adults with a history of clinical depression. Copyright © 2017 Elsevier Inc. All rights reserved.

Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: results from a longitudinal cohort of South African women who attend alcohol-serving venues.

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Abler, Laurie; Sikkema, Kathleen J; Watt, Melissa H; Pitpitan, Eileen V; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree

2015-03-01

In South Africa, alcohol contributes to the HIV epidemic, in part, by influencing sexual behaviors. For some, high levels of alcohol consumption may be driven by previous traumatic experiences that result in traumatic stress. The purpose of this study was to quantify the longitudinal association between traumatic stress and unprotected sex among women who attend drinking venues and to assess whether this association was explained by mediation through alcohol use. Data were collected in 4 waves over a year from a prospective cohort of 560 women who regularly attended alcohol-serving venues in a Cape Town township. Longitudinal mixed models examined (1) the relationship between traumatic stress and counts of unprotected sex and (2) whether alcohol use mediated the association between traumatic stress and unprotected sex. Most women reported elevated traumatic stress (80%) and hazardous alcohol use (88%) at least once during the study period. In models adjusted for covariates, traumatic stress was associated with unprotected sex (b = 0.28, SE = 0.06, t = 4.82, P traumatic stress was associated with alcohol use (b = 0.27, SE = 0.02, t = 14.25, P traumatic stress on unprotected sex. These results highlight the need to address traumatic stress among female venue patrons as an important precursor of HIV risk due to alcohol use.

Distress of Routine Activities and Perceived Safety Associated with Post-Traumatic Stress, Depression, and Alcohol Use: 2002 Washington, DC, Sniper Attacks.

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Fullerton, Carol S; Herberman Mash, Holly B; Benevides, K Nikki; Morganstein, Joshua C; Ursano, Robert J

2015-10-01

For over 3 weeks in October 2002, a series of sniper attacks in the Washington, DC, area left 10 people dead and 3 wounded. This study examined the relationship of distress associated with routine activities and perceived safety to psychological and behavioral responses. Participants were 1238 residents of the Washington, DC, metropolitan area (aged 18 to 90 years, mean=41.7 years) who completed an Internet survey including the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and items pertaining to distress related to routine activities, perceived safety, and alcohol use. Data were collected at one time point approximately 3 weeks after the first sniper shooting and before apprehension of the suspects. Relationships of distress and perceived safety to post-traumatic stress, depressive symptoms, and increased alcohol use were examined by using linear and logistic regression analyses. Approximately 8% of the participants met the symptom criteria for probable post-traumatic stress disorder, 22% reported mild to severe depression, and 4% reported increased alcohol use during the attacks. Distress related to routine activities and perceived safety were associated with increased post-traumatic stress and depressive symptoms and alcohol use. Distress and perceived safety are associated with specific routine activities and both contribute to psychological and behavioral responses during a terrorist attack. These findings have implications for targeted information dissemination and risk communication by community leaders.

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

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

2017-01-01

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

An investigation of vago-regulatory and health-behavior accounts for increased inflammation in posttraumatic stress disorder.

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Dennis, Paul A; Weinberg, J Brice; Calhoun, Patrick S; Watkins, Lana L; Sherwood, Andrew; Dennis, Michelle F; Beckham, Jean C

2016-04-01

Posttraumatic stress disorder (PTSD) has been linked to chronic inflammation, a condition that poses a risk for cardiovascular disease. Attenuated vagal activity has been proposed as a potential mediator of PTSD and inflammation, although associated behavioral health risks-namely cigarette smoking and alcohol dependence-might also account for that link. Inflammation was quantified by fasting serum concentrations of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-10, and thymus- and activation-regulated chemokine (TARC)/CCL17 collected from 85 participants with PTSD and 82 without PTSD. Latent variable modeling was used to assess the relationship between PTSD symptom severity and inflammation along with potential mediators vagal activity (respiratory sinus arrhythmia; RSA), smoking status, and lifetime alcohol dependence. PTSD symptom severity was associated with increased inflammation (β=.18, p=.02). However, this association was reduced in models that adjusted for RSA, smoking status, and lifetime alcohol dependence. Independent mediation effects were deemed significant via bootstrapping analyses. Together, RSA, smoking status, and lifetime alcohol dependence accounted for 95% of the effect of PTSD symptom severity on inflammation. Although RSA accounted for a modest proportion of the association between posttraumatic stress and pro-inflammatory responses, behavioral factors-specifically cigarette smoking and alcohol dependence-proved to be larger mediators. The benefits of PTSD treatment may be enhanced by additional interventions aimed at modifying these health behaviors. Published by Elsevier Inc.

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

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

2015-04-01

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

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

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

2014-01-01

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

Dissociative subtype of DSM-5 posttraumatic stress disorder in U.S. veterans.

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Tsai, Jack; Armour, Cherie; Southwick, Steven M; Pietrzak, Robert H

2015-01-01

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September-October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms. Published by Elsevier Ltd.

Exercise as adjunctive treatment for alcohol use disorder

DEFF Research Database (Denmark)

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

2017-01-01

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

Multimodal approach to identifying malingered posttraumatic stress disorder: a review.

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Ali, Shahid; Jabeen, Shagufta; Alam, Farzana

2015-01-01

The primary aim of this article is to aid clinicians in differentiating true posttraumatic stress disorder from malingered posttraumatic stress disorder. Posttraumatic stress disorder and malingering are defined, and prevalence rates are explored. Similarities and differences in diagnostic criteria between the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders are described for posttraumatic stress disorder. Possible motivations for malingering posttraumatic stress disorder are discussed, and common characteristics of malingered posttraumatic stress disorder are described. A multimodal approach is described for evaluating posttraumatic stress disorder, including interview techniques, collection of collateral data, and psychometric and physiologic testing, that should allow clinicians to distinguish between those patients who are truly suffering from posttraumatic disorder and those who are malingering the illness.

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

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

2012-11-01

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

Sleep quality during exam stress: the role of alcohol, caffeine and nicotine.

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Zunhammer, Matthias; Eichhammer, Peter; Busch, Volker

2014-01-01

Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms.

A family study of chronic post-traumatic stress disorder following rape trauma.

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Davidson, J R; Tupler, L A; Wilson, W H; Connor, K M

1998-01-01

There is evidence that familial factors serve as determinants of risk for post-traumatic stress disorder (PTSD), especially familial anxiety. This study investigates the relationship between chronic PTSD and family psychiatric morbidity. The sample was drawn from 81 female rape survivors with or without lifetime PTSD, 31 major depressive disorder controls, 20 anxiety disorder controls and 39 healthy controls. First-degree family members were directly interviewed (n = 285) and diagnoses assigned of major depressive, anxiety and alcohol or substance use disorder. Information was also available by family history for 639 relatives. In the directly interviewed sample, no consistently increased morbidity risk was observed for anxiety, PTSD, or alcohol/substance abuse in the rape survivor groups, but there was an increase in depression relative to the anxiety in healthy control groups. When comorbid depression in rape survivor probands was taken into account post hoc, an increased risk for depression was noted in family members of PTSD probands with depression, but not in relatives of PTSD probands without lifetime depression. Among rape survivor probands with non-comorbid PTSD, rates by history of familial anxiety and depression were negligible. In a logistic regression analysis, individual vulnerability to depression served as an independent predictor of chronic PTSD, along with specific trauma-related variables. In the family history group, results were consistent with those obtained from the directly interviewed group. Our findings clearly support the view that PTSD following rape is associated with familial vulnerability to major depression, which may thus serve as a risk factor for developing PTSD. The exact nature of this predisposition calls for further inquiry and there is a need to expand this study to include other PTSD populations. PTSD may on occasion represent a form of depression which is induced and/or modified neurobiologically and phenomenologically by

Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity.

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Kerr, Katelyn; Romaniuk, Madeline; McLeay, Sarah; Khoo, Andrew; Dent, Michael T; Boshen, Mark

2018-06-01

Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social

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

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

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

2018-04-16

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

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

Science.gov (United States)

Claussen, B

1999-01-01

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

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

Directory of Open Access Journals (Sweden)

Stefano Gitto

2016-01-01

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

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

Science.gov (United States)

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

2016-01-01

Alcohol use disorder is a significant health problem being a cause of increased morbidity and mortality worldwide. Alcohol-related illness has a relevant economic impact on the society and a negative influence on the life of patients and their family members. Psychosocial support might be useful in the management of people affected by alcohol use disorder since psychiatric and pharmaceutical approaches show some limits. In fact, many drugs are accessible for the treatment of alcohol disorder, but only Baclofen is functional as an anti-craving drug in patients with advanced liver disease. The alcohol-related liver damage represents the most frequent cause of advanced liver disease in Europe, and it is the main cause of death among adults with high alcohol consumption. The multidisciplinary action of clinical-psychologists, psychiatrics and hepatologists, is essential in the management of patients with alcohol liver disease especially in the case of liver transplantation. In general, the multidisciplinary approach is necessary in prevention, in framing patients and in the treatment. More resources should be used in prevention and research with the main aim of decreasing the harmful alcohol consumption. PMID:26784248

Executive function in cancer patients with posttraumatic stress disorder.

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Yang, Juan; Guo, Juncheng; Jiang, Xiangling

2017-03-01

Background Cancer patients with posttraumatic stress disorder can lead to their noncompliant behaviors. However, less is known about the neurocognitive functioning of posttraumatic stress disorder in general cancer types or patient populations. The current study attempted to examine the prevalence of posttraumatic stress disorder and their relationships with executive function in individuals with cancer. Methods A total of 285 cancer patients with posttraumatic stress disorder and 150 healthy individuals were recruited for the present study. The Clinician Administered PTSD Scale, Tower of Hanoi, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale-Revised Chinese revision were administered to all participants. Results Significant differences in the score of Tower of Hanoi, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale-Revised Chinese revision were observed between the posttraumatic stress disorder group and the healthy control group ( p posttraumatic stress disorder symptoms and executive function. Conclusions These findings suggest that individuals with cancer-related posttraumatic stress disorder exhibit more severe impairment in executive function than healthy controls do.

The effect of hydro alcoholic nettle (Urtica dioica) extract on oxidative stress in patients with type 2 diabetes: a randomized double-blind clinical trial.

Science.gov (United States)

Namazi, N; Tarighat, A; Bahrami, A

2012-01-15

Diabetes type 2 is a metabolic disorder that characterized by hyperglycemia and insulin resistance. Hyperglycemia and impairment of oxidant/antioxidant balance, can increase oxidative stress and increase risk of cardiovascular disease. In the present study, Effects of hydro alcoholic extract of Nettle on oxidative stress in type 2 diabetes were evaluated. Fifty patients (27 men, 23 women) with type 2 diabetes patients were studied. They received 100 mg kg(-1) of nettle extract of body weight hydro alcoholic for 8 weeks. At the baseline and end of 8th weeks of intervention blood levels of oxidative stress markers were measured. Data was analyzed by SPSS version 18, p nettle has increasing effects on TAC and SOD in patients with type 2 diabetes without no changes in Malondialdehyde (MDA) and Glutathione Peroxides (GPX) after eight weeks intervention.

Visual Defects in a Mouse Model of Fetal Alcohol Spectrum Disorder

OpenAIRE

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

2014-01-01

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

Alcohol Alert

Science.gov (United States)

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

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

Directory of Open Access Journals (Sweden)

Rafael C. Freire

2013-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

Stress and hazardous alcohol use: associations with early dropout from university.

Science.gov (United States)

Andersson, Claes; Johnsson, Kent O; Berglund, Mats; Ojehagen, Agneta

2009-09-01

The transition to studying at university is associated with increased levels of both stress and hazardous alcohol use. The aim of this study is to investigate the influence of these factors on first-year dropout from university studies. Two complete cohorts of university freshmen at two homogeneous universities, one in the north and one in the south of Sweden, were asked to participate in an intervention study. Participants responded to a baseline questionnaire including measures of stress and alcohol use. Official university records showing dropout over 12 months were collected. A multivariate analysis established that high stress and admission to the northern university were associated with dropout from university studies, while symptoms of depression and anxiety as well as hazardous drinking were not. There is a need to address the issue of stress associated with the start of university studies. It seems important to offer stress-reducing interventions, specifically aimed at reducing transitional stress, as soon as students start university.

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

Science.gov (United States)

Moos, Rudolf H.; Moos, Bernice S.

2004-01-01

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

Dimensionality of DSM-5 posttraumatic stress disorder and its association with suicide attempts: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III.

Science.gov (United States)

Chen, Chiung M; Yoon, Young-Hee; Harford, Thomas C; Grant, Bridget F

2017-06-01

Emerging confirmatory factor analytic (CFA) studies suggest that posttraumatic stress disorder (PTSD) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is best characterized by seven factors, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal. The seven factors, however, have been found to be highly correlated, suggesting that one general factor may exist to explain the overall correlations among symptoms. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III, a large, national survey of 36,309 U.S. adults ages 18 and older, this study proposed and tested an exploratory bifactor hybrid model for DSM-5 PTSD symptoms. The model posited one general and seven specific latent factors, whose associations with suicide attempts and mediating psychiatric disorders were used to validate the PTSD dimensionality. The exploratory bifactor hybrid model fitted the data extremely well, outperforming the 7-factor CFA hybrid model and other competing CFA models. The general factor was found to be the single dominant latent trait that explained most of the common variance (~76%) and showed significant, positive associations with suicide attempts and mediating psychiatric disorders, offering support to the concurrent validity of the PTSD construct. The identification of the primary latent trait of PTSD confirms PTSD as an independent psychiatric disorder and helps define PTSD severity in clinical practice and for etiologic research. The accurate specification of PTSD factor structure has implications for treatment efforts and the prevention of suicidal behaviors.

Comorbid Post-Traumatic Stress Disorder and Opioid Dependence.

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Patel, Rikinkumar S; Elmaadawi, Ahmed; Nasr, Suhayl; Haskin, John

2017-09-03

Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions. Since opioid withdrawal symptoms mimic hyper vigilance, this results in an exaggeration of the response of patients with post-traumatic stress disorder. This comorbidity is associated with worse health outcomes, as its pathophysiology involves a common neurobiological circuit. Opioid substitution therapy and psychotherapeutic medications in combination with evidence-based cognitive behavioral therapy devised for individuals with comorbid post-traumatic stress disorder and opioid dependence may improve treatment outcomes in this population. Therefore, we conclude that the screening for post-traumatic stress disorder in the opioid-abusing population is crucial. To understand the underlying mechanisms for this comorbidity and to improve the treatment response, further research should be encouraged.

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

Science.gov (United States)

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

2017-07-01

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

Genetic deficiency in neprilysin or its pharmacological inhibition initiate excessive stress-induced alcohol consumption in mice.

Directory of Open Access Journals (Sweden)

Björn Maul

Full Text Available Both acquired and inherited genetic factors contribute to excessive alcohol consumption and the corresponding development of addiction. Here we show that the genetic deficiency in neprilysin [NEP] did not change the kinetics of alcohol degradation but led to an increase in alcohol intake in mice in a 2-bottle-free-choice paradigm after one single stress stimulus (intruder. A repetition of such stress led to an irreversible elevated alcohol consumption. This phenomenon could be also observed in wild-type mice receiving an orally active NEP inhibitor. We therefore elucidated the stress behavior in NEP-deficient mice. In an Elevated Plus Maze, NEP knockouts crossed more often the area between the arms, implicating a significant stronger stress response. Furthermore, such animals showed a decreased locomotor activity under intense light in a locomotor activity test, identifying such mice to be more responsive in aversive situations than their wild-type controls. Since the reduction in NEP activity itself does not lead to significant signs of an altered alcohol preference in mice but requires an environmental stimulus, our findings build a bridge between stress components and genetic factors in the development of alcoholism. Therefore, targeting NEP activity might be a very attractive approach for the treatment of alcohol abuse in a society with increasing social and financial stress.

Genetic Deficiency in Neprilysin or Its Pharmacological Inhibition Initiate Excessive Stress-Induced Alcohol Consumption in Mice

Science.gov (United States)

Gembardt, Florian; Becker, Axel; Schultheiss, Heinz-Peter; Siems, Wolf-Eberhard; Walther, Thomas

2012-01-01

Both acquired and inherited genetic factors contribute to excessive alcohol consumption and the corresponding development of addiction. Here we show that the genetic deficiency in neprilysin [NEP] did not change the kinetics of alcohol degradation but led to an increase in alcohol intake in mice in a 2-bottle-free-choice paradigm after one single stress stimulus (intruder). A repetition of such stress led to an irreversible elevated alcohol consumption. This phenomenon could be also observed in wild-type mice receiving an orally active NEP inhibitor. We therefore elucidated the stress behavior in NEP-deficient mice. In an Elevated Plus Maze, NEP knockouts crossed more often the area between the arms, implicating a significant stronger stress response. Furthermore, such animals showed a decreased locomotor activity under intense light in a locomotor activity test, identifying such mice to be more responsive in aversive situations than their wild-type controls. Since the reduction in NEP activity itself does not lead to significant signs of an altered alcohol preference in mice but requires an environmental stimulus, our findings build a bridge between stress components and genetic factors in the development of alcoholism. Therefore, targeting NEP activity might be a very attractive approach for the treatment of alcohol abuse in a society with increasing social and financial stress. PMID:23185571

Stress Transmission and Failure in Disordered Porous Media

Science.gov (United States)

Laubie, Hadrien; Radjai, Farhang; Pellenq, Roland; Ulm, Franz-Josef

2017-08-01

By means of extensive lattice-element simulations, we investigate stress transmission and its relation with failure properties in increasingly disordered porous systems. We observe a non-Gaussian broadening of stress probability density functions under tensile loading with increasing porosity and disorder, revealing a gradual transition from a state governed by single-pore stress concentration to a state controlled by multipore interactions and metric disorder. This effect is captured by the excess kurtosis of stress distributions and shown to be nicely correlated with the second moment of local porosity fluctuations, which appears thus as a (dis)order parameter for the system. By generating statistical ensembles of porous textures with varying porosity and disorder, we derive a general expression for the fracture stress as a decreasing function of porosity and disorder. Focusing on critical sites where the local stress is above the global fracture threshold, we also analyze the transition to failure in terms of a coarse-graining length. These findings provide a general framework which can also be more generally applied to multiphase and structural heterogeneous materials.

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

NARCIS (Netherlands)

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

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

Alcohol consumption as a predictor of reactivity to smoking and stress cues presented in the natural environment of smokers.

Science.gov (United States)

Tomko, Rachel L; Saladin, Michael E; McClure, Erin A; Squeglia, Lindsay M; Carpenter, Matthew J; Tiffany, Stephen T; Baker, Nathaniel L; Gray, Kevin M

2017-02-01

The high prevalence of co-occurring alcohol and tobacco use underscores the importance of understanding the influence of alcohol consumption on risk factors for smoking and relapse. Alcohol has been shown to impact reactivity to smoking and stress-related cues, both of which are common antecedents to smoking and smoking relapse. The objective of the current study is to examine associations between alcohol use, cigarette craving, and stress reactivity following exposure to smoking and stress cues delivered in participants' daily lives. Using cue-reactivity ecological momentary assessment (CREMA), adult smokers (n = 138) reported cigarette craving, stress, and past hour alcohol use on a mobile device four times per day for 2 weeks, resulting in a range of 4493-5983 data points per analysis. Questions were followed by exposure to pictorial neutral, stressful, or smoking cues delivered via the mobile device. Craving and affect were re-assessed following cue exposure. Results showed that recent (past hour) alcohol use was significantly associated with increases in the following: (a) tonic (non-cue-elicited) cigarette craving, (b) stress cue-elicited cigarette craving, and (c) stress cue-elicited stress reactivity, in the context of high-baseline stress. There was no significant association between alcohol use and smoking cue-elicited craving. Alcohol use may increase risk for smoking and relapse to smoking by increasing cigarette craving and, in certain contexts, stress following stress cue exposure. Though alcohol is known for its anxiolytic properties, under some conditions, it may increase reactivity to stress cues.

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

Science.gov (United States)