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Lewandowski ME, Delawalla CN, Butcher TJ, Oberlin BG. Changes in substance use, recovery, and quality of life during the initial phase of the COVID-19 pandemic. PLoS One 2024; 19:e0300848. [PMID: 38776315 PMCID: PMC11111065 DOI: 10.1371/journal.pone.0300848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/05/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted lives on a massive scale. While the pandemic appeared to worsen mental health outcomes broadly, its effects on alcohol/substance use and recovery are unclear. Many studies convolved the sociopolitical unrest beginning in May 2020 with the pandemic. We assessed pandemic-related changes in substance use, recovery involvement, and quality of life among US adults at two specified time periods that isolated pandemic effects from potentially confounding sociopolitical factors. OBJECTIVES We tested the following hypotheses: the pandemic and consequent policies (1) increased use of alcohol and illicit substances in active users; (2) increased use of alcohol/substances among people in early recovery; (3) reduced participation in recovery activities among those in early recovery, and that (4) use amount and use events correlated with impulsivity in both groups and that (5) substance use and abstinence correlated with resilience. METHODS We recruited 1,685 participants through Amazon's Mechanical Turk (MTurk). We assessed demographics, quality of life, alcohol/substance use, recovery activities, and measures of impulsivity and resilience at two time points, pre-pandemic and (early) during-pandemic. Only n = 45 (Active Users; males n = 32) and n = 34 (Recovery; males n = 20) passed data quality checks and were included in the primary analyses. RESULTS Among Active Users, weekly alcohol consumption and days spent using alcohol and illicit substances decreased during the pandemic. Resilience negatively correlated with pandemic-related substance use in early recovering participants. Significant reduction in the quality of life was coincident with a trend of lower recovery activity participation (31% decline) during the pandemic. CONCLUSIONS The reduced alcohol/substance use and participation in recovery activities might be expected from conditions that promote social isolation. The high prevalence of low-quality data from MTurk cautions for careful use of online data sourcing.
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Affiliation(s)
- Megayn E. Lewandowski
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Colette N. Delawalla
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States of America
- Department of Psychological Science, Ball State University, Muncie, Indiana, United States of America
| | - Tarah J. Butcher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Brandon G. Oberlin
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States of America
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Tan J, Chen N, Bai J, Yan P, Ma X, Ren M, Maitland E, Nicholas S, Cheng W, Leng X, Chen C, Wang J. Ambient air pollution and the health-related quality of life of older adults: Evidence from Shandong China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 336:117619. [PMID: 36924708 DOI: 10.1016/j.jenvman.2023.117619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Ambient air pollution is a major public health concern impacting all aspects of human health. There is a lack of studies on the impact of ambient air pollution on health-related quality of life (HRQoL) of older Chinese adults. Our study answers two questions: How concentrations of ambient air pollutants are associated with HRQoL among older adults in China and, second, what are the possible mechanisms through which ambient air pollution affects HRQoL. From the 2018 National Health Service Survey, we sampled 5717 aged 65 years or older residents for the eastern province of Shandong, China. Data on individual exposures to PM2.5 and PM10 (particulate matter with diameter less than or equal to 2.5 μm and 10 μm) and sulfur dioxide (SO2) were collected from the ChinaHighAirPollutants (CHAP) datasets. Mixed-effects Tobit regression models and mixed-effects ordered Probit regression models were employed to examine the associations of long-term exposure to ambient air pollution with the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) scale comprising mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Socioeconomic, demographic and behavioral factors relating to HRQoL were also examined. The results show that for each 1 μg/m3 increase, EQ-5D-3L scores fell 0.002 for PM2.5; 0.001 for PM10 and 0.002 for SO2. Long term exposure to PM2.5, PM10 and SO2 were also associated with increased prevalence of pain/discomfort and anxiety/depression. The reduced HRQoL effects of ambient air pollution were exacerbated by higher socioeconomic status (affluent, urban and higher level of education). Our findings suggested that HRQoL of older Chinese adults was not only associated with demographic, socioeconomic, and health-related factors, but also negatively correlated with air pollution, especially through increased pain/discomfort and anxiety/depression. The paper proposes policy recommendations.
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Affiliation(s)
- Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Nuo Chen
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Jing Bai
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Peizhe Yan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Xinyu Ma
- Economics and Management School, Wuhan University, Wuhan, China
| | - Meiling Ren
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, England, United Kingdom
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, New South Wales, Australia; Newcastle Business School, University of Newcastle, Newcastle, New South Wales, Australia
| | - Wenjing Cheng
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Xue Leng
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Chen Chen
- School of Public Health, Wuhan University, Wuhan, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China; Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Wuhan, China.
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Olickal JJ, Saya GK, Selvaraj R, Chinnakali P. Association of alcohol use with quality of life (QoL): A community based study from Puducherry, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Veldhoven DTV, Roozen H, Vingerhoets A. The Association between Reward Sensitivity and Activity Engagement: the Influence of Delay Discounting and Anhedonia. Alcohol Alcohol 2020; 55:215-224. [PMID: 31998950 PMCID: PMC7082492 DOI: 10.1093/alcalc/agz105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/24/2019] [Accepted: 11/27/2019] [Indexed: 11/26/2022] Open
Abstract
Aim Reward sensitivity affects individuals’ motivation to engage in goal-directed behavior. Other concepts, critical for reward appraisal, that potentially influence activity participation encompass delay discounting and anhedonia. The aim of this study was to test the hypothesis that anhedonia and delay discounting influence the relationship between reward sensitivity and activity engagement. Methods In total, 37 inpatient patients with an alcohol use disorder (AUD) and 37 matched healthy controls completed the behavioral activation system scale (BAS scale), the Pleasant Activities List (PAL), the Snaith–Hamilton Pleasure Scale (SHAPS) and the Delay Discounting Task (DDT). Results Patients differed from controls on SHAPS, DDT-k, PAL substance-related activities (SRA), but not BAS and PAL non-substance-related activities (non-SRA). Correlational analyses revealed a strong correlation between BAS and PAL non-SRA in both patients (r = 0.53) and controls (r = 0.47), but also with PAL-SRA in patients (r = 0.40), although not controls (r = 0.09). BAS was negatively correlated with SHAPS in both groups and with DDT in controls. SHAPS was negatively linked to PAL non-SRA in both groups. The BAS-PAL non-SRA relationship was influenced by discount rates in controls. Conclusion A strong link exists between reward sensitivity and engagement in non-SRA in both groups. Delay discounting affects the reward sensitivity and non-SRA association in healthy controls, while anhedonia did not impact the association between reward sensitivity and engagement in (non-)SRA in both conditions.
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Affiliation(s)
| | | | - Ad Vingerhoets
- Tilburg University, Department of Developmental Psychology, Warandelaan 2, 5000 LE Tilburg, The Netherlands
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Ekmekci Ertek I, Taner ME, Nazik Yüksel R, Ozan Kotan V, Göka E. Quality of life and pain perception in alcohol dependence: A comparative examination of patients, their relatives, and healthy controls. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1612473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Irem Ekmekci Ertek
- Department of Psychiatry, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Ender Taner
- Department of Psychiatry, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Rabia Nazik Yüksel
- Department of Psychiatry, Numune Education and Research Hospital, Ankara, Turkey
| | - Vahap Ozan Kotan
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Erol Göka
- Department of Psychiatry, Numune Education and Research Hospital, Ankara, Turkey
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Gabriels CM, Macharia M, Weich L. Psychiatric comorbidity and quality of life in South African alcohol use disorder patients. Qual Life Res 2018; 27:2975-2981. [PMID: 30088122 DOI: 10.1007/s11136-018-1951-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding the psychopathology accompanying alcohol use disorder (AUD) is important as it impacts negatively on quality of life (QoL) with subsequent implications for treatment and recovery. We evaluated the association of psychiatric comorbidity with QoL among treatment-seeking South African AUD patients. METHODS Cross-sectional assessment of 101 (Male, n = 65; 64.5%) patients with AUD was done using the World Health Organisation Quality of Life (WHOQoL)-Bref, the World Health Organisation Disability Assessment Scale (WHODAS) and Mini-International Neuropsychiatric Interview (MINI) to collect QoL, disability and psychopathology data, respectively. RESULTS Psychiatric comorbidity was noted in 63 (62.3%) of the patients with most (55.6%) having more than one disorder. Mood (39; 61.9%) and anxiety (33; 52.4%) were the most common co-occurring disorders. Disability scores were not significantly different between comorbidity and gender groups However, QoL scores were significantly lower for participants with comorbidity in three of the four WHOQOL domains and declined with increasing number of psychiatric disorders. Focussing on the two main psychopathologies, participants with anxiety alone consistently had the lowest QoL scores compared to those with neither or both disorders (p < 0.05). CONCLUSION The results confirm the well-known high rate of psychiatric comorbidity in patients with AUD and the negative impact it has on QoL. The results should alert clinicians managing AUD patients to screen for comorbid psychopathology and include findings into their treatment plan as this may impact on the patient's QoL.
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Affiliation(s)
- Charnotte M Gabriels
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Second Floor, Clinical Building, Tygerberg Medical Campus, Francie van Zijl Drive, Cape Town, 7505, South Africa
| | - Muiruri Macharia
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Second Floor, Clinical Building, Tygerberg Medical Campus, Francie van Zijl Drive, Cape Town, 7505, South Africa.
| | - Lize Weich
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Second Floor, Clinical Building, Tygerberg Medical Campus, Francie van Zijl Drive, Cape Town, 7505, South Africa
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Quality of life, alcohol detoxification and relapse: is quality of life a predictor of relapse or only a secondary outcome measure? Qual Life Res 2014; 23:2757-67. [PMID: 24929832 DOI: 10.1007/s11136-014-0735-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To estimate variations in Overall Quality Of Life (OQOL) within 12 months following alcohol detoxification and to evaluate the predictive value of OQOL for relapse and alcohol use severity. METHODS Alcohol use disorders and four OQOL domains (physical health, psychological health, social relationships and environment) were assessed in 199 patients entering in-patient alcohol detoxification. Follow-up assessments were performed at 6 and 12 months after discharge. Cross-sectional and longitudinal analyses explored the relationship between OQOL and alcohol use severity, examining differences between abstinent and relapsed patients. The predictive value of OQOL was analyzed by logistic and linear regression. RESULTS Correlation between OQOL and Alcohol Use Disorders Identification Test scores was confirmed at all stages of observation. Abstinent patients showed a significant improvement in all OQOL domains at 6 months after discharge, whereas OQOL domains did not undergo any significant change in relapsed patients. Baseline OQOL did not prove to be predictive of either relapse or alcohol use severity. CONCLUSIONS Overall quality of life changed in parallel with alcohol use severity throughout the duration of the study, confirming it to be a useful and sensitive measure of secondary outcome for alcohol detoxification. Conversely, none of the OQOL baseline scores functioned as predictors of relapse within 12 months following discharge or alcohol use severity in relapsed patients.
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Daeppen JB, Faouzi M, Sanchez N, Rahhali N, Bineau S, Bertholet N. Quality of life depends on the drinking pattern in alcohol-dependent patients. Alcohol Alcohol 2014; 49:457-65. [PMID: 24863264 DOI: 10.1093/alcalc/agu027] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIMS In patients with alcohol dependence, health-related quality of life (QOL) is reduced compared with that of a normal healthy population. The objective of the current analysis was to describe the evolution of health-related QOL in adults with alcohol dependence during a 24-month period after initial assessment for alcohol-related treatment in a routine practice setting, and its relation to drinking pattern which was evaluated across clusters based on the predominant pattern of alcohol use, set against the influence of baseline variables METHODS The Medical Outcomes Study 36-Item Short-Form Survey (MOS-SF-36) was used to measure QOL at baseline and quarterly for 2 years among participants in CONTROL, a prospective observational study of patients initiating treatment for alcohol dependence. The sample consisted of 160 adults with alcohol dependence (65.6% males) with a mean (SD) age of 45.6 (12.0) years. Alcohol use data were collected using TimeLine Follow-Back. Based on the participant's reported alcohol use, three clusters were identified: 52 (32.5%) mostly abstainers, 64 (40.0%) mostly moderate drinkers and 44 (27.5%) mostly heavy drinkers. Mixed-effect linear regression analysis was used to identify factors that were potentially associated with the mental and physical summary MOS-SF-36 scores at each time point. RESULTS The mean (SD) MOS-SF-36 mental component summary score (range 0-100, norm 50) was 35.7 (13.6) at baseline [mostly abstainers: 40.4 (14.6); mostly moderate drinkers 35.6 (12.4); mostly heavy drinkers 30.1 (12.1)]. The score improved to 43.1 (13.4) at 3 months [mostly abstainers: 47.4 (12.3); mostly moderate drinkers 44.2 (12.7); mostly heavy drinkers 35.1 (12.9)], to 47.3 (11.4) at 12 months [mostly abstainers: 51.7 (9.7); mostly moderate drinkers 44.8 (11.9); mostly heavy drinkers 44.1 (11.3)], and to 46.6 (11.1) at 24 months [mostly abstainers: 49.2 (11.6); mostly moderate drinkers 45.7 (11.9); mostly heavy drinkers 43.7 (8.8)]. Mixed-effect linear regression multivariate analyses indicated that there was a significant association between a lower 2-year follow-up MOS-SF-36 mental score and being a mostly heavy drinker (-6.97, P < 0.001) or mostly moderate drinker (-3.34 points, P = 0.018) [compared to mostly abstainers], being female (-3.73, P = 0.004), and having a Beck Inventory scale score ≥8 (-6.54, P < 0.001), at baseline. The mean (SD) MOS-SF-36 physical component summary score was 48.8 (10.6) at baseline, remained stable over the follow-up and did not differ across the three clusters. Mixed-effect linear regression univariate analyses found that the average 2-year follow-up MOS-SF-36 physical score was increased (compared with mostly abstainers) in mostly heavy drinkers (+4.44, P = 0.007); no other variables tested influenced the MOS-SF-36 physical score. CONCLUSION Among individuals with alcohol dependence, a rapid improvement was seen in the mental dimension of QOL following treatment initiation, which was maintained during 24 months. Improvement was associated with the pattern of alcohol use, becoming close to the general population norm in patients classified as mostly abstainers, improving substantially in mostly moderate drinkers and improving only slightly in mostly heavy drinkers. The physical dimension of QOL was generally in the normal range but was not associated with drinking patterns.
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Affiliation(s)
- Jean-Bernard Daeppen
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Mohamed Faouzi
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Nathalie Sanchez
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Nora Rahhali
- International Epidemiology Department, Lundbeck, Issy les Moulineaux, France
| | - Sébastien Bineau
- International Epidemiology Department, Lundbeck, Issy les Moulineaux, France
| | - Nicolas Bertholet
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
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Wojtalik JA, Barch DM. An FMRI study of the influence of a history of substance abuse on working memory-related brain activation in schizophrenia. Front Psychiatry 2014; 5:1. [PMID: 24478729 PMCID: PMC3896871 DOI: 10.3389/fpsyt.2014.00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/03/2014] [Indexed: 11/18/2022] Open
Abstract
There has been little investigation of the effects of past substance abuse (SA) on working memory (WM) impairments in schizophrenia. This study examined the behavioral and neurobiological impact of past SA (6 months or longer abstinence period) on WM in schizophrenia. Thirty-seven schizophrenia patients (17 with past SA and 20 without) and 32 controls (12 with past SA and 20 without) completed two versions of a two-back WM task during fMRI scanning on separate days. Analyses focused on regions whose patterns of activation replicated across both n-back tasks. Schizophrenia patients were significantly less accurate than controls on both n-back tasks. No main effects or interactions with past SA on WM performance were observed. However, several fronto-parietal-thalamic regions showed an interaction between diagnostic group and past SA. These regions were significantly more active in controls with past SA compared to controls without past SA. Schizophrenia patients with or without past SA either showed no significant differences, or patients with past SA showed somewhat less activation compared to patients without past SA during WM. These results suggest robust effects of past SA on WM brain functioning in controls, but less impact of past SA in schizophrenia. This is consistent with previous literature indicating less impaired neurocognition in schizophrenia with SA.
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Affiliation(s)
- Jessica A Wojtalik
- Department of Psychiatry, Washington University School of Medicine , St. Louis, MO , USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine , St. Louis, MO , USA ; Department of Psychology, Washington University in St. Louis , St. Louis, MO , USA ; Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine , St. Louis, MO , USA
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Abstract
BACKGROUND Quality of life has emerged as an important treatment outcome measure for alcohol dependence whose natural course comprises of remission and relapse. MATERIALS AND METHODS The purpose of this study was to examine the prospective change in Quality of life (QoL) in 56 patients aged 18-45 years of alcohol dependence over a three months' period and compare it with QoL of 150 age- and gender- matched healthy controls using WHOQoL-BREF. Severity of alcohol dependence and drinking parameters were assessed. RESULTS Significant improvement in QoL of patients of alcohol dependence over three months' abstinence. The physical, psychological, social, and environment domains of QoL in alcohol dependence subjects were significantly lower before treatment initiation than the healthy controls. Alcoholic liver disease emerged as a predictor of improvement in psychological and social domains of QoL. CONCLUSION The study confirms poor quality of life in patients of alcohol dependence before intervention. The regular follow-up with the family members in out-patient setting enables the patients achieve complete abstinence, thereby improving their quality of life.
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Affiliation(s)
- Shruti Srivastava
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Manjeet S Bhatia
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, India
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Peltzer K, Pengpid S. Alcohol use and health-related quality of life among hospital outpatients in South Africa. Alcohol Alcohol 2012; 47:291-5. [PMID: 22319061 DOI: 10.1093/alcalc/ags001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS This study examined the association of alcohol use and health-related quality of life (HRQOL) in a clinic population in South Africa. METHODS A probability sample of 1532 (56.4% men and women 43.6%) patients from different hospital outpatient departments completed the Alcohol Use Disorder Identification Test and the social functioning (SF)-12 Health Survey. Physical and Mental Health Component Summaries and primary scales of the SF-12 were used as measures of HRQOL. RESULTS The study did not find a significant association between alcohol-use disorders and HRQoL [Physical Component Summary (PCS) and Mental health Component Summary (MCS)] in this clinic population. However, probable alcohol dependence was associated with poorer quality of life in three areas of functioning measured by the SF-12 (physical functioning, general health and mental health) compared with patients not meeting the criteria of alcohol dependence. The magnitude of the decrement in the PCS and MCS for daily or almost daily tobacco use, severe psychological distress and the number of other chronic conditions was significantly greater than for alcohol abuse or dependence. CONCLUSION It appears that hospital outpatients in this study did not experience a diminished quality of life related to their alcohol use compared with other attenders at these clinics. Also, intervention studies with hazardous drinkers may not be able to identify treatment-related changes in global HRQoL.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS/SIT/and TB, Human Sciences Research Council, Pretoria, South Africa.
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Ilgen MA, Perron B, Czyz EK, McCammon RJ, Trafton J. The Timing of Onset of Pain and Substance Use Disorders. Am J Addict 2010; 19:409-15. [DOI: 10.1111/j.1521-0391.2010.00065.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Mark A. Ilgen
- VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, Michigan
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan
| | - Brian Perron
- VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, Michigan
- University of Michigan School of Social Work, Ann Arbor, Michigan
| | - Ewa K. Czyz
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan
| | - Ryan J. McCammon
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan
| | - Jodie Trafton
- Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Stanford University School of Medicine, Palo Alto, California
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Lahmek P, Berlin I, Michel L, Berghout C, Meunier N, Aubin HJ. Determinants of improvement in quality of life of alcohol-dependent patients during an inpatient withdrawal programme. Int J Med Sci 2009; 6:160-7. [PMID: 19461935 PMCID: PMC2684678 DOI: 10.7150/ijms.6.160] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Accepted: 05/15/2009] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To investigate the improvement in quality of life (QoL) of alcohol-dependent patients during a 3-week inpatient withdrawal programme, and to identify the sociodemographic, clinical and alcohol-related variables associated with baseline QoL on admission and with improvement of QoL during residential treatment. METHODS This prospective, observational study included 414 alcohol-dependent patients, hospitalised for a period of 3 weeks. QoL was measured on admission and at discharge using the French version of the Medical Outcome Study SF-36. The mean scores for each dimension and for the Physical and Mental Component Summary scores were calculated. RESULTS The mean scores per dimension and the mean Physical and Mental Component Summary scores were significantly lower on admission than at discharge; the lowest scores being observed for social functioning and role limitations due to emotional problems. At discharge, the mean scores per dimension were similar to those observed in the French general population. Female gender, age > 45 years, living alone, working as a labourer or employee, somatic comorbidity, and the existence of at least five criteria for alcohol dependence according to the DSM-IV classification were associated with a low Physical Component Summary score on admission; psychiatric comorbidity, the presence of at least five DSM-IV dependence criteria, smoking and suicidality were associated with a low Mental Component Summary score on admission. The increase in Physical and Mental Component Summary scores during hospitalisation was more marked when the initial scores were low. Apart from the initial score, the greatest improvement in Physical Component Summary score was seen in patients with a high alcohol intake and in those without a somatic comorbidity; the increase in Mental Component Summary score was greatest in patients without psychotic symptoms and in those who abused or were dependent on illegal drugs. CONCLUSION QoL improvement after a residential treatment was related to low QoL scores at admission. Improvement in physical component of QoL was related to baseline alcohol intake and good somatic status. Improvement in mental component of QoL was related to other drugs abuse/dependence.
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Affiliation(s)
- Pierre Lahmek
- Centre de Traitement des Addictions, Hôpital Emile Roux, Assistance Publique-Hôpitaux de Paris, 94450 Limeil-Brévannes, France
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Malet L, Llorca PM, Beringuier B, Lehert P, Falissard B. ALQOL 9 FOR MEASURING QUALITY OF LIFE IN ALCOHOL DEPENDENCE. Alcohol Alcohol 2006; 41:181-7. [PMID: 16455795 DOI: 10.1093/alcalc/agl001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Quality of life (QoL) is an important factor of outcome tracking and treatment in alcohol misuse. A 9-item QoL scale, AlQoL 9, obtained from the generic SF 36, is proposed as a measure that characterizes the QoL of alcohol-dependent patients. Our objective was to study the psychometric properties of this subscale. METHODS AlQoL 9 was evaluated in two study groups of patients with DSM-IV diagnosis of dependence: 104 inpatients, and 114 outpatients. Severity of dependence, alcohol consumption, psychiatric, and somatic comorbidities were assessed. We studied the global properties of AlQoL 9 and its structure. RESULTS Cronbach alpha-coefficients in both populations indicated good internal consistency (0.71 and 0.85). Test-retest intraclass coefficients for a 2-day interval in hospital were in the range 0.57-0.78. Principal component analysis found a unidimensional scale. This subscale has properties that are consistent with the concept of QoL in alcohol dependence, i.e. lowered QoL compared with the general population, influenced by gender, and depression. CONCLUSIONS AlQoL 9 epitomizes QoL in alcohol-dependence. It gives a global measurement with good psychometric properties. It could be used in clinical practice as a diagnosis and management support instrument and may also be useful in research for evaluating treatment efficacy.
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Affiliation(s)
- Laurent Malet
- Centre Hospitalier Universitaire, Department of Psychiatry-B, rue Montalembert BP 69, 63003 Clermont-Ferrand cedex 1, France.
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Feeney GFX, Connor JP, Young RMD, Tucker J, McPherson A. Alcohol dependence: the impact of cognitive behaviour therapy with or without naltrexone on subjective health status. Aust N Z J Psychiatry 2004; 38:842-8. [PMID: 15369544 DOI: 10.1080/j.1440-1614.2004.01469.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To examine the health-related quality of life of alcohol-dependent patients across a 12-week cognitive behaviour treatment (CBT) program and identify whether the patient selection of the anticraving medication naltrexone further enhanced these outcomes. METHOD One hundred and thirty-six consecutive alcohol-dependent subjects voluntarily participated and were offered naltrexone, of which 73 (54%) participants declined medication. A matched design was used. Of the 136 subjects, 86 (43 naltrexone and CBT; 43 CBT only) could be individually matched (blind to outcome measures) for gender, age, prior alcohol detoxification and dependence severity. Measures of health status and mental health wellbeing included the Rand Corporation Medical Outcomes Short Form 36 Health Survey (SF-36) and the General Health Questionnaire (GHQ-28). RESULTS Pre-treatment, all had SF-36 and GHQ-28 scores markedly below national norms. Post-treatment, significant improvement in seven of the eight SF-36 subscales and all of the GHQ-28 subscales occurred, approximating national normative levels. Patients in the CBT + naltrexone group were significantly more likely to have increased days abstinent (p=0.002) and to complete the program abstinent (p=0.051). The adjunctive use of naltrexone did not provide additional benefit as reflected in SF-36 and GHQ-28 scores, beyond CBT alone. CONCLUSIONS Patients who completed the CBT-based treatment program reported significant improvements in self-reported health status (SF-36) and wellbeing (GHQ-28). The adjunctive use of naltrexone demonstrated no additional improvement in these measures.
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Affiliation(s)
- Gerald F X Feeney
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, Queensland 4102, Australia.
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16
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Morgan MY, Landron F, Lehert P. Improvement in Quality of Life After Treatment for Alcohol Dependence With Acamprosate and Psychosocial Support. Alcohol Clin Exp Res 2004; 28:64-77. [PMID: 14745303 DOI: 10.1097/01.alc.0000108652.73143.4b] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The impact of disease on health-related quality of life is now well recognized, as is the importance of this variable as a measure of treatment efficacy. METHODS Patients from five European countries were enrolled in an open, multicenter, prospective study designed to observe outcome in dependent drinkers treated for 6 months with acamprosate and psychosocial support. Version 1 of the 36-item Short Form Health Profile (SF-36v1) questionnaire was administered at inclusion and at 3 and 6 months. Responses were described as handicaps compared with an appropriately matched, healthy reference population. One-way fixed ANOVA and simultaneous stepwise linear regression analysis were used to identify potential predictors of quality of life at baseline and after treatment. RESULTS Baseline SF-36v1 data were obtained from 1216 patients (mean age, 43 +/- 9 years; 77% male). Mean values for all SF-36v1 dimensions were significantly lower in the patient population than in the normative reference population; the most important deficits were observed in physical and emotional role limitations and in social functioning. The most important predictors of baseline quality of life were severity of alcohol dependence, employment status, psychiatric history, quantity and frequency of alcohol consumption, attendance at Alcoholics Anonymous, global alcohol health status, age, gender, and education. SF-36v1 data were obtained from 686 patients at 3 months and from 497 at 6 months. Significant improvements were observed in all SF-36v1 dimensional and summary scores after 3 months of treatment (p < 0.001); further marginal improvements were observed between 3 and 6 months. The most important predictors of quality of life following treatment were the SF-36v1 profile at baseline, followed by abstinence duration; patients who completed the trial and remained abstinent throughout showed the greatest improvement. CONCLUSIONS Health-related quality of life is severly impaired in dependent drinkers. Treatment with acamprosate and psychosocial support, by promoting abstinence, improves the quality of life profile to levels comparable to those observed in healthy individuals.
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Affiliation(s)
- Marsha Y Morgan
- Centre for Hepatology, Royal Free Campus, Royal Free and University College Medical School, University College London, London, United Kingdom.
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Foster JH, Marshall EJ, Peters TJ. Application of a Quality of Life Measure, the Life Situation Survey (LSS), to Alcohol-Dependent Subjects in Relapse and Remission. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb01970.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Foster JH, Powell JE, Marshall EJ, Peters TJ. Quality of life in alcohol-dependent subjects--a review. Qual Life Res 1999; 8:255-61. [PMID: 10472156 DOI: 10.1023/a:1008802711478] [Citation(s) in RCA: 135] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although alcohol misuse is a major cause of morbidity and mortality and an important health care burden, the Quality of Life (QoL) of alcohol misusing subjects has been little studied to date. For example, only 5 out of 442 accepted abstracts at a recent international QoL conference concerned alcohol-dependent subjects. This paper reviews the ongoing and published work in the area focusing upon QoL characteristics of alcohol-dependent subjects, the link between QoL comorbidity and alcoholism, QoL alcohol dependency and social environment, changes in QoL status as a result of abstinence, minimal or controlled drinking, QoL as a predictor of relapse to heavy drinking and the importance of using a QoL measure when assessing treatment outcomes together with some of the present difficulties with existing measures. The main conclusions from the review were that the QoL of alcohol-dependent subjects is very poor but improved as a result of abstinence, controlled or minimal drinking. The important factors in the QoL of alcohol-dependent subjects are psychiatric comorbidity, social environment and disturbed sleep.
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Affiliation(s)
- J H Foster
- Department of Clinical Biochemistry, Kings College, London, UK
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Rudolf H, Priebe S. Subjective quality of life in female in-patients with depression: a longitudinal study. Int J Soc Psychiatry 1999; 45:238-46. [PMID: 10689607 DOI: 10.1177/002076409904500402] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated Subjective Quality of Life (SQOL) in 42 women with depression, 70 women with alcoholism, and 73 women with schizophrenia within 3 weeks after hospital admission. Twenty-eight of the depressive patients were re-examined after 6 months. SQOL was assessed using the German version of the Lancashire Quality of Life Profile. On average, depressive women expressed dissatisfaction with life as a whole and with 4 out of 8 life domains, and had a lower SQOL than the other two diagnostic groups. Differences remain statistically significant when the influence of age and anxiety/depression is controlled for. SQOL in depressive women improved significantly within the follow up period. Positive SQOL change was moderately correlated with an improvement of depressive symptoms. The results indicate that depressive women after hospital admission express an unusually low SQOL, which seems to have some diagnostic specificity and improves over time. Changes in depressive symptoms do not fully explain SQOL changes.
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Affiliation(s)
- H Rudolf
- Clinic for Psychiatry and Psychotherapy, University Hospital Aachen, Germany
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20
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FOSTER JH, MARSHALL EJ, PETERS TJ. Predictors of relapse to heavy drinking in alcohol dependent subjects following alcohol detoxification-the role of quality of life measures, ethnicity, social class, cigarette and drug use. Addict Biol 1998; 3:333-43. [PMID: 26734927 DOI: 10.1080/13556219872146] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Sixty DSM-IV alcohol dependent adults (39 males, 21 females) admitted to a voluntary sector alcohol detoxification unit in South London were studied. Socio-demographic data and information on level of alcohol dependence, quality of life, family history, cigarette smoking and the use of prescription/illicit drugs were collected. The subjects were followed-up at 12 weeks and subdivided into two groups, relapse and non-relapse. A relapse was defined as drinking 21 units or more per week for males and 14 units or more per week for females. Data were analysed for baseline and 12-week follow-up comparisons. At 12 weeks, 58 (97%) subjects (38 males, 20 females) were successfully followed-up and 36/58 (62%) had relapsed. After controlling for a Type I error there were significant differences between the relapse and non-relapse subgroups at 12-week followup on the following outcome measures; depression, life situation, withdrawal symptoms, energy, emotional reactions and social isolation. There were no significant differences at baseline between the relapse and nonrelapse subgroups for most of the socio-demographic variables, but Irish nationality and membership of lower social classes (IV and V) were associated with relapse. Major predictors of relapse at baseline after a forward stepwise logistic regression were (in order of increasing statistical significance) Irish nationality, lower social class, greater number of cigarettes smoked and disturbed sleep. The findings are discussed with reference to their consistency with existing research and potential clinical implications.
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FOSTER JH, MARSHALL EJ, HOOPER R, PETERS TJ. Quality of life measures in alcohol dependent subjects and changes with abstinence and continued heavy drinking. Addict Biol 1998; 3:321-32. [PMID: 26734926 DOI: 10.1080/13556219872137] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This study evaluates the quality of life status of 39 male and 21 female Caucasian subjects admitted to a voluntary sector community alcohol detoxification unit. Baseline data including socio-demographics, severity of alcohol dependence and alcohol problems were collected 4-5 days following admission. In addition, the following measures were obtained: Rotterdam Symptoms Checklist, the Beck Depression Inventory, the General Health Questionnaire 12, Chubon's Life Situation Survey and the Nottingham Health Profile. Subjects were followed up at 12 weeks, and subdivided into two groups: relapsers and non-relapsers. A relapse was defined as drinking 21 or more units per week for men and 14 units or more per week for women over 7 consecutive days (1 unit is the equivalent of 8-10 g of absolute ethanol). Fifty-eight (97%) subjects were successfully followed-up, with 36 (62%) of the group relapsing to heavy drinking within 12 weeks. The results show that alcohol dependence is associated with a poor quality of life. Subjects rated poorly on the standardized questionnaires compared with the normative values for their reference populations. Relapsers and non-relapsers differed significantly in their life situation, depression, physical and psychological symptom total scores and the Nottingham Health Profile sub-score energy at 12 weeks compared with baseline, and these changes were investigated for each group. Within the relapse group a linear regression showed no association between any of the quality of life measures and time to relapse. Individual sub-score analysis of the Nottingham Health Profile results point to the importance of sleep, social isolation, pain, physical mobility and anergia in alcohol dependency. There was little change as a result of either not remitting or returning to heavy drinking and overall these findings confirm that alcohol dependent subjects have a poor quality of life.
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Berzon RA, Simeon GP, Simpson RL, Donnelly MA, Tilson HH. Quality of life bibliography and indexes: 1993 update. Qual Life Res 1995; 4:53-74. [PMID: 7711692 DOI: 10.1007/bf00434384] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- R A Berzon
- Burroughs Wellcome Co., Research Triangle Park, NC, USA
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