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Dyer A, Böhnke JR, Curran D, McGrath K, Toner P. A systematic review of quality of life and health-related quality of life as outcomes in substance and behavioural addictions. Drug Alcohol Rev 2023; 42:1680-1700. [PMID: 37439397 DOI: 10.1111/dar.13717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/30/2023] [Accepted: 06/19/2023] [Indexed: 07/14/2023]
Abstract
ISSUES Consideration of an individual's quality of life (QoL) can benefit assessment and treatment of addictive disorders, however, uncertainty remains over operationalisation of the construct as an outcome and the appropriateness of existing measures for these populations. This systematic review aimed to identify and evaluate QoL and health-related QoL outcome instruments used in addiction-related risk and harm research and map their conceptualised domains. APPROACH Three electronic databases and a specialised assessment library were searched on 1 February 2022 for QoL or health-related QoL outcome instruments used with addiction-related risk and harm populations. PRISMA reporting guidance was followed and included outcome instruments were appraised using mixed methods. Psychometric evidence supporting their use was summarised. The COSMIN risk of bias tool was used to assess validation studies. KEY FINDINGS A total of 298 articles (330 studies) used 53 outcome instruments and 41 unique domains of QoL. Eleven instruments' psychometric properties were evaluated. No instrument was assessed for any parameter in at least five studies for meta-analytic pooling. Cronbach's alpha (α) internal consistency was the most widely assessed parameter with the AQoLS, WHOQOL-BREF, ALQoL-9, Q-LES-Q-SF, SF-12, DUQoL, QLI and SF-36 displaying promising statistics (α > 0.70). IMPLICATIONS AND CONCLUSION Many instruments have been utilised. However, a significant proportion of studies applied a small number of instruments with minimal high-quality validation evidence supporting their use within addiction-related risk and harm. Promising instruments are recommended, however, the paucity of supporting evidence limits confidence in the reliability and validity of QoL measurement in these populations.
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Affiliation(s)
- Andrew Dyer
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Jan R Böhnke
- School of Health Sciences, University of Dundee, Dundee, UK
| | - David Curran
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Katie McGrath
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Paul Toner
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
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Lahbairi N, Laniepce A, Segobin S, Cabé N, Boudehent C, Vabret F, Rauchs G, Pitel AL. Determinants of health-related quality of life in recently detoxified patients with severe alcohol use disorder. Health Qual Life Outcomes 2022; 20:149. [PMID: 36310156 PMCID: PMC9620657 DOI: 10.1186/s12955-022-02058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/04/2022] Open
Abstract
Background Health-related quality of life (HRQoL) is an important clinical outcome in Alcohol Use Disorder (AUD) and is considered as a relevant indicator of treatment success. While a better understanding of the factors affecting HRQoL would enable to adjust patients’ care to favour treatment outcome, the determinants of HRQoL in AUD remain unclear. This study aims at describing HRQoL in AUD patients and at identifying its best predictors. Methods 53 recently detoxified patients with severe AUD (sAUD) underwent a cognitive assessment and filled in a HRQoL questionnaire dedicated to AUD patients (Alcohol Quality of Life Scale; AQoLS), as well as questionnaires concerning socio-demographics, alcohol history, sleep quality, depression, anxiety and impulsivity. 38 healthy controls (HC) underwent the same assessment (except AQoLS) in order to identify the altered cognitive and clinical variables that could potentially be determinants of HRQoL in sAUD. Results sAUD patients reported that alcohol affects their HRQoL mainly in the “negative emotions”, “control”, “relationships”, and “sleep” domains. Compared to HC, they were impaired on episodic memory, working memory, executive functions, and processing speed tasks. They also reported lower sleep quality, higher depression, anxiety and impulsivity. No association was found between AQoLS total score and socio-demographics, cognitive performance, or sleep quality in patients. We found a significant correlation between HRQoL and depression/anxiety as well as impulsivity. Anxiety and impulsivity were indeed the only significant predictors of HRQoL, explaining 47.7% of the variance. Conclusion Anxiety and impulsivity are crucial determinants of HRQoL in recently detoxified sAUD patients. Since anxiety and impulsivity are frequent issues in addiction and especially in AUD, they should be particularly considered by clinicians to favour treatment outcomes.
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Affiliation(s)
- Najlaa Lahbairi
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France
| | - Alice Laniepce
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.460771.30000 0004 1785 9671Normandie Univ, UNIROUEN, CRFDP (EA 7475), 76000 Rouen, France
| | - Shailendra Segobin
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France
| | - Nicolas Cabé
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Céline Boudehent
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - François Vabret
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Géraldine Rauchs
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Anne-Lise Pitel
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
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Aubin HJ, Dureau-Pournin C, Falissard B, Paille F, Rigaud A, Micon S, Pénichon M, Andersohn F, Truchi C, Blin P. Use of Nalmefene in Routine Practice: Results from a French Prospective Cohort Study and a National Database Analysis. Alcohol Alcohol 2021; 56:545-555. [PMID: 33969378 PMCID: PMC8406069 DOI: 10.1093/alcalc/agab029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/22/2021] [Accepted: 03/20/2021] [Indexed: 11/13/2022] Open
Abstract
Aims Two complementary studies were used to assess the real-life use of nalmefene in alcohol-dependent patients and its impact on alcohol use health status. Methods USE-PACT was a prospective cohort study designed to evaluate the real-life effectiveness of nalmefene in the management of alcohol dependence, as assessed by total alcohol consumption (TAC) and number of heavy drinking days (HDD) at 1 year. USE-AM was a cohort study using data from the French nationwide claims database and was used to evaluate the external validity of the population in the prospective study. Results Overall, 256 of 700 new nalmefene users enrolled in the USE-PACT study had valid data at 1 year. After 1 year, patients treated with nalmefene showed a mean ± SD reduction from baseline in TAC (−41.5 ± 57.4 g/day) and number of HDD (−10.7 ± 11.7 days/4 weeks). Patients took a mean ± SD of 20.0 ± 12.0 tablets/4 weeks (median of 1 tablet/day) for the first 3 months and then reduced the dose. The proportion of patients who no longer took nalmefene gradually increased from 5% at 1 month to 52% at 1 year. The USE-AM study identified 486 patients with a first reimbursement for nalmefene in 2016; baseline characteristics confirmed external validity of the USE-PACT study. Overall, 46.3% of initial USE-AM prescriptions were made by GPs; most (91.8%) patients stopped treatment during follow-up. However, 15.2% of patients resumed treatment after stopping. Conclusions In this analysis of French routine practice, patients with alcohol dependence treated with nalmefene showed reduced alcohol consumption, and nalmefene was generally well tolerated.
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Affiliation(s)
- Henri-Jean Aubin
- Université Paris-Saclay, Inserm, CESP, AP-HP. Université Paris Saclay, 12, avenue Paul-Vaillant-Couturier, 94804 Villejuif, France
| | - Caroline Dureau-Pournin
- Université de Bordeaux, INSERM CIC-P 1401, Bordeaux PharmacoEpi, Rue Eugène Jacquet, Bordeaux 33000, France
| | - Bruno Falissard
- CESP/INSERM U1018, Centre de Recherche en Epidémiologie et Santé des Populations, Hôpital Paul Brousse Bat 15/16, 16 av PV Couturier - 94807 Villejuif, France
| | - François Paille
- Université de Lorraine, 34 Cours Léopold, 54000 Nancy, France
| | - Alain Rigaud
- Ancien chef du pôle d'Addictologie de l'EPSM Marne, Psychiatre des hôpitaux honoraire, 28 bis, rue de Courcelles 51100 Reims, France
| | - Sophie Micon
- Université de Bordeaux, INSERM CIC-P 1401, Bordeaux PharmacoEpi, Rue Eugène Jacquet, Bordeaux 33000, France
| | - Marine Pénichon
- Université de Bordeaux, INSERM CIC-P 1401, Bordeaux PharmacoEpi, Rue Eugène Jacquet, Bordeaux 33000, France
| | - Frank Andersohn
- Frank Andersohn Consulting and Research Services, Mandelstrasse 16, 10409 Berlin, Germany
| | - Christine Truchi
- Lundbeck SAS, 102 Terrasse Boieldieu 92085 Paris La Défense, France
| | - Patrick Blin
- Université de Bordeaux, INSERM CIC-P 1401, Bordeaux PharmacoEpi, Rue Eugène Jacquet, Bordeaux 33000, France
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Combining behavioral harm-reduction treatment and extended-release naltrexone for people experiencing homelessness and alcohol use disorder in the USA: a randomised clinical trial. Lancet Psychiatry 2021; 8:287-300. [PMID: 33713622 PMCID: PMC9875110 DOI: 10.1016/s2215-0366(20)30489-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND The rate of alcohol-related mortality in people experiencing homelessness and alcohol use disorder is high and necessitates accessible and effective treatment for alcohol use disorder. However, typical abstinence-based treatments do not optimally engage this population. Recent studies have shown that harm-reduction treatment, which does not require abstinence, but instead aims to incrementally reduce alcohol-related harm and improve health-related quality of life, is acceptable to and effective for this population. The aim of this study was to test the efficacy of combined pharmacological and behavioural harm-reduction treatment for alcohol use disorder (HaRT-A) in people experiencing homelessness and alcohol use disorder. METHODS This randomised clinical trial was done at three community-based service sites (low-barrier shelters and housing programmes) in Seattle (WA, USA). Eligible participants were adults (aged 21-65 years) who met the DSM-IV-TR criteria for alcohol use disorder and who experienced homelessness in the past year. Participants were randomly assigned (1:1:1:1) by permuted block randomisation, stratified by site, to receive either HaRT-A plus intramuscular injections of 380 mg extended-release naltrexone (XR-NTX; HaRT-A plus XR-NTX group); HaRT-A plus placebo injection (HaRT-A plus placebo group); HaRT-A alone (HaRT-A alone group); or community-based supportive services as usual (services-as-usual control group). Patients assigned to receive HaRT-A attended sessions at baseline (week 0) and in weeks 1, 4, 8, and 12. XR-NTX and placebo injections were administered in weeks 0, 4, and 8. During the study, participants, interventionists, and investigators were masked to group assignment in the two injection arms. All participants were invited to follow-up assessments at weeks 4, 8, 12, 24, and 36. The primary outcomes were self-reported alcohol use quantity (ie, alcohol quantity consumed on peak drinking occasion, as measured with the Alcohol Quantity Use Assessment questionnaire) and frequency (measured with the Addiction Severity Index), alcohol-related harm (measured with the Short Inventory of Problems-2R questionnaire), and physical and mental health-related quality of life (measured with the Short Form-12 survey). Using piecewise growth modelling and an intention-to-treat model, we compared the effects of the three active treatment groups with the services-as-usual control group, and the HaRT-A plus XR-NTX group with the HaRT-A plus placebo group, over the 12-week treatment course and during the 24 weeks following treatment withdrawal. Safety analyses were done on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, NCT01932801. FINDINGS Between Oct 14, 2013, and Nov 30, 2017, 417 individuals experiencing homelessness and alcohol use disorder were screened, of whom 308 were eligible and randomly assigned to the HaRT-A plus XR-NTX group (n=74), the HaRT-A plus placebo group (n=78), the HaRT-A alone group (n=79), or the services-as-usual control group (n=77). Compared with the services-as-usual control group, the HaRT-A plus XR-NTX group showed significant improvements from baseline to 12 weeks post-treatment across four of the five primary outcomes: peak alcohol quantity (linear B -0·48 [95% CI -0·79 to -0·18] p=0·010; full model Cohen's d=-0·68), alcohol frequency (linear B -4·42 [-8·09 to -0·76], p=0·047; full model Cohen's d=-0·16), alcohol-related harm (linear B -2·22 [-3·39 to -1·06], p=0·002; full model Cohen's d=-0·56), and physical health-related quality of life (linear B 0·66 [0·23 to 1·10], p=0·012; full model Cohen's d=0·43). Compared with the services-as-usual control group, the HaRT-A plus placebo group showed significant improvements in three of the five primary outcomes: peak alcohol quantity (linear B -0·41 [95% CI -0·67 to -0·15] p=0·010; full model Cohen's d=-0·23), alcohol frequency (linear B -5·95 [-9·72 to -2·19], p=0·009; full model Cohen's d=-0·13), and physical health-related quality of life (linear B 0·53 [0·09 to 0·98], p=0·050; full model Cohen's d=0·35). Compared with the services-as-usual control group, the HaRT-A alone group showed significant improvements in two of the five primary outcomes: alcohol-related harm (linear B -1·58 [95% CI -2·73 to -0·42] p=0·025; full model Cohen's d=-0·40) and physical health-related quality of life (linear B 0·63 [0·18 to 1·07], p=0·020; full model Cohen's d=0·41). After treatment discontinuation at 12 weeks, the active treatment groups plateaued, whereas the services-as-usual group showed improvements. Thus, during the post-treatment period (weeks 12 to 36), the services-as-usual control group showed greater reductions in alcohol-related harm compared with both the HaRT-A plus XR-NTX group (linear B 0·96 [0·24 to 1·67], p=0·028; full model Cohen's d=0·24) and the HaRT-A alone group (linear B 1·02 [0·35 to 1·70], p=0·013; full model Cohen's d=0·26). During the post-treatment period, the services-as-usual control group significantly improved on mental health-related quality of life compared with the HaRT-A alone group (linear B -0·46 [-0·79 to -0·12], p=0·024; full model Cohen's d=-0·28), and on physical health-related quality of life compared with the HaRT-A plus XR-NTX group (linear B -0·42 [-0·67 to -0·17], p=0·006; full model Cohen's d=-0·27), the HaRT-A plus placebo group (linear B -0·42 [-0·69 to -0·15], p=0·009; full model Cohen's d=-0·27), and the HaRT-A alone group (linear B -0·47 [-0·72 to -0·22], p=0·002; full model Cohen's d=-0·31). For all other primary outcomes, there were no significant linear differences between the services-as-usual and active treatment groups. When comparing the HaRT-A plus placebo group with the HaRT-A plus XR-NTX group, there were no significant differences for any of the primary outcomes. Missing data analysis indicated that participants were more likely to drop out in the services-as-usual control group than in the active treatment groups; however, primary outcome findings were found to be robust to attrition. Participants in the HaRT-A plus XR-NTX, HaRT-A plus placebo, and HaRT-A alone groups were not more likely to experience adverse events than those in the services-as-usual control group. INTERPRETATION Compared with existing services, combined pharmacological and behavioural harm-reduction treatment resulted in decreased alcohol use and alcohol-related harm and improved physical health-related quality of life during the 12-week treatment period for people experiencing homelessness and alcohol use disorder. Although not as consistent, there were also positive findings for behavioural harm-reduction treatment alone. Considering the non-significant differences between participants receiving HaRT-A plus placebo and HaRT-A plus XR-NTX, the combined pharmacological and behavioural treatment effect cannot be attributed to XR-NTX alone. Future studies are needed to further investigate the relative contributions of the pharmacological and behavioural components of harm-reduction treatment for alcohol use disorder, and to ascertain whether a maintenance treatment approach could extend these positive outcome trajectories. FUNDING National Institute on Alcohol Abuse and Alcoholism.
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von Hammerstein C, Cornil A, Rothen S, Romo L, Khazaal Y, Benyamina A, Billieux J, Luquiens A. Psychometric properties of the transaddiction craving triggers questionnaire in alcohol use disorder. Int J Methods Psychiatr Res 2020; 29:e1815. [PMID: 31884724 PMCID: PMC7051841 DOI: 10.1002/mpr.1815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/28/2019] [Accepted: 11/08/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES We aimed to develop the transaddiction craving triggers questionnaire (TCTQ), which assesses the propensity of specific situations and contexts to trigger craving and to test its psychometric properties in alcohol use disorder (AUD). METHODS This study included a sample of 111 AUD outpatients. We performed exploratory factor analysis (EFA) and calculated item-dimension correlations. Internal consistency was measured with Cronbach's alpha coefficient. Construct validity was assessed through Spearman correlations with craving, emotional symptoms, impulsivity, mindfulness, and drinking characteristics. RESULTS The EFA suggested a 3-factor solution: unpleasant affect, pleasant affect, and cues and related thoughts. Cronbach's coefficient alpha ranged from .80 to .95 for the three factors and the total score. Weak positive correlations were identified between the TCTQ and drinking outcomes, and moderate correlation were found between the TCTQ and craving strength, impulsivity, anxiety, depression, and impact of alcohol on quality of life. CONCLUSIONS The 3-factor structure is congruent with the well-established propensity of emotions and cues to trigger craving. Construct validity is supported by close relations between the TCTQ and psychological well-being rather than between the TCTQ and drinking behaviors. Longitudinal validation is warranted to assess sensitivity to change of the TCTQ and to explore its psychometric properties in other addictive disorders.
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Affiliation(s)
- Cora von Hammerstein
- Department of Psychiatry and Addictology, University Paris‐Saclay, University Paris‐Sud, UVSQ, CESP, INSERM U 1178, APHPPaul Brousse HospitalVillejuifFrance
- EA 4430 CLIPSYDUniversity Paris NanterreNanterreFrance
| | - Aurélien Cornil
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research InstituteUniversité catholique de LouvainLouvain‐la‐NeuveBelgium
| | - Stéphane Rothen
- Research Center for Statistics, Geneva School of Economics and ManagementUniversity of GenevaGenevaSwitzerland
| | - Lucia Romo
- EA 4430 CLIPSYDUniversity Paris NanterreNanterreFrance
- Inserm, U894Center for Psychiatry and NeuroscienceParisFrance
| | - Yasser Khazaal
- Addiction Medecine, Department of psychiatryLausanne University HospitalsLausanneSwitzerland
| | - Amine Benyamina
- Department of Psychiatry and Addictology, University Paris‐Saclay, University Paris‐Sud, UVSQ, CESP, INSERM U 1178, APHPPaul Brousse HospitalVillejuifFrance
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and BehaviourUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
- Institute of PsychologyUniversity of LausanneLausanneSwitzerland
| | - Amandine Luquiens
- Department of Psychiatry and Addictology, University Paris‐Saclay, University Paris‐Sud, UVSQ, CESP, INSERM U 1178, APHPPaul Brousse HospitalVillejuifFrance
- Universitary Hospital of NîmesParisFrance
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Higuchi S, Moriguchi Y, Tan KHX. Psychometric validation of the Japanese version of Alcohol Quality of Life Scale (AQoLS-Japan) in the treatment of patients with alcohol use disorder. Qual Life Res 2020; 29:223-235. [PMID: 31586271 PMCID: PMC6962253 DOI: 10.1007/s11136-019-02310-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2019] [Indexed: 11/02/2022]
Abstract
Abstract
Purpose
The Alcohol Quality of Life Scale (AQoLS) is accepted as a useful measure in assessing impact of alcohol use disorders (AUD) on health-related quality of life (HR-QoL) in Western cultures. We aimed to assess the psychometric properties of the Japanese version of the AQoLS (AQoLS-Japan).
Methods
This was a 3-month, observational cohort study in patients undergoing routine treatment for AUD in Japan. HR-QoL was assessed using the AQoLS-Japan (34 items, 7 dimensions). Scale psychometrics were analyzed using correlative techniques.
Results
Data from 132 patients were analyzed. Inter-item and item-scale correlations for the AQoLS-Japan scale were moderate to strong. Confirmatory factor analysis results supported the AQoLS-Japan structure but there was evidence of interdependency among some items and factors. Cronbach’s alpha coefficients for internal consistency ranged from 0.73 to 0.97, and intraclass correlation coefficients for scores between test (baseline) and retest (2 weeks) ranged from 0.65 to 0.82. Convergent and divergent validity and known-groups validity were supported. Evaluation of within-group change demonstrated that the AQoLS-Japan total and domains consistently demonstrated statistically significant improvement (p < 0.001 in all cases) in HR-QoL over time. Estimates for minimal clinically important difference on the AQoLS-Japan total score ranged from 13.2 to 18.2 for group-level change and from 2.4 to 15.7 for a group-level difference.
Conclusions
The AQoLS-Japan is a reliable and valid measure of HR-QoL that is able to demonstrate benefits associated with the routine treatment of AUD in Japan.
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Macfarlane VFH, Prentice DA, Walsh MS. The Auckland alcohol detoxification outcome study: Measuring changes in quality of life in individuals completing a medicated withdrawal from alcohol in a detoxification unit. Drug Alcohol Depend 2019; 202:156-161. [PMID: 31352304 DOI: 10.1016/j.drugalcdep.2018.11.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 11/17/2018] [Accepted: 11/21/2018] [Indexed: 11/27/2022]
Abstract
AIM To measure outcomes in Quality of Life in alcohol dependent patients' following a medicated withdrawal from alcohol. METHODS 79 patients that were admitted to a detoxification unit in Auckland, New Zealand between March 2016 and September 2016 were assessed for severity of alcohol dependence using the Alcohol Use Disorders Identification Test (AUDIT) and Severity of Alcohol Dependency Questionnaire (SADQ) and Quality of Life (QOL) using the World Health Organisation Quality of Life-abbreviated version of the WHOQOL 100 New Zealand version (WHOQOL-BREF NZ). Patients were followed up at three months and 12 months and an estimate of drinking behavior and the WHO-QOL BREF NZ were completed via telephone interview. QOL domain scores were assessed from baseline to three months and baseline to 12 months in both relapse and abstinent groups. At three months, a single question was asked in order to collect qualitative data. RESULTS At baseline, the study population had statistically significantly lower mean QOL domain scores than scores reported from the general population. QOL improved in patients following detoxification at three months and 12 months in both the relapse and abstinent groups; however, the change in scores from baseline was greater in the abstinent group compared to the relapse group. The majority of patients reported that the admission had been a positive experience. CONCLUSION QOL improves in individuals following a medicated withdrawal from alcohol regardless of whether individual's relapse; however, those that remain abstinent have greater improvements in quality of life.
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Affiliation(s)
- Vicki F H Macfarlane
- Community Alcohol and Drug Services, Waitemata District Health Board, 50 Carrington Rd, Auckland, 1025, New Zealand.
| | - David A Prentice
- Community Alcohol and Drug Services, Waitemata District Health Board, 50 Carrington Rd, Auckland, 1025, New Zealand.
| | - Michael S Walsh
- Planning, Funding and Outcomes, Waitemata and Auckland District Health Boards, 44 Taharoto Rd, Auckland, New Zealand.
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Bonfils NA, Aubin HJ, Benyamina A, Limosin F, Luquiens A. Quality of life instruments used in problem gambling studies: A systematic review and a meta-analysis. Neurosci Biobehav Rev 2019; 104:58-72. [PMID: 31271803 DOI: 10.1016/j.neubiorev.2019.06.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/26/2019] [Accepted: 06/29/2019] [Indexed: 01/22/2023]
Abstract
The purpose of this systematic review was to identify the instruments used in original articles to measure quality of life (QOL) or health-related QOL (HRQOL) in gambling-disorder patients and to assess their suitability. The systematic literature search to identify QOL/HRQOL instruments used among gambling-disorder patients was performed in PubMed, Embase and PsycINFO databases up to November 2018. A meta-analysis was performed to study the effect size of the QOL/HRQOL instruments and gambling outcomes after an intervention. Thirty-five studies were included. Seven types of instruments aiming at measuring QOL/HRQOL were identified. These instruments explored twenty-six domains. The instruments used were not properly validated in the studies. Most of the clinical trials reported a significant difference in QOL/HRQOL between pre- and post-intervention. These results were concordant with gambling outcomes but had a smaller effect size than gambling outcomes. The currently used general instruments are efficient to measure a significant change after an intervention but might not evaluate specific areas of health related QOL impacted by gambling disorders.
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Affiliation(s)
- Nicolas A Bonfils
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry and Addictology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France.
| | - Henri-Jean Aubin
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France; Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
| | - Amine Benyamina
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France; Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
| | - Frédéric Limosin
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry and Addictology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Amandine Luquiens
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France; Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
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9
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von Hammerstein C, Khazaal Y, Dupuis M, Aubin HJ, Benyamina A, Luquiens A, Romo L. Feasibility, acceptability and preliminary outcomes of a mindfulness-based relapse prevention program in a naturalistic setting among treatment-seeking patients with alcohol use disorder: a prospective observational study. BMJ Open 2019; 9:e026839. [PMID: 31154307 PMCID: PMC6550005 DOI: 10.1136/bmjopen-2018-026839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Cultural differences between the USA and France led us to examine the feasibility, acceptability and preliminary efficacy data on craving, quality of life and psychological flexibility of the add-on Mindfulness-Based Relapse Prevention (MBRP) programme in alcohol use disorder (AUD) in France. DESIGN We conducted a prospective observational study with a 6-month follow-up. SETTING The study was performed in a naturalistic setting with adult outpatients from an addiction department. PARTICIPANTS We included all patients with a current AUD who participated in the MBRP programme (n=52). There was no non-inclusion criterion. INTERVENTIONS The intervention was an 8-week MBRP programme, combining elements of traditional relapse prevention cognitive behavioural therapy and mindfulness meditation training. This was an eight-session closed-group programme. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were the number of attended treatment sessions, home practice frequency and dropout rate. Secondary outcomes were changes in craving, quality of life, psychological flexibility, drinking outcomes, depression, anxiety and mindfulness levels. RESULTS The average number of completed sessions was 6.6 (SD: 1.9). Most participants introduced mindfulness meditation into their everyday lives: 69% and 49% of included patients maintained formal practice at 3 and 6 months, respectively, and 80% and 64% maintained informal practice at 3 and 6 months, respectively. Most participants used mindfulness techniques to face high-risk situations (56% at 6 months). Participants reported a significant reduction in craving, days of alcohol use, depression and anxiety and an increase in mindfulness and psychological flexibility at 6 months. CONCLUSIONS The MBRP programme showed good acceptability and feasibility. MBRP seemed to improve craving, mindfulness and psychological flexibility. Comparative studies are needed to evaluate the programme's efficacy in AUD. TRIAL REGISTRATION NUMBER 2200863 v 0.
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Affiliation(s)
- Cora von Hammerstein
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
- EA 4430 CLIPSYD, Universite Paris-Nanterre, Nanterre, France
| | - Yasser Khazaal
- Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Mathilde Dupuis
- EA 4430 CLIPSYD, Universite Paris-Nanterre, Nanterre, France
| | - Henri-Jean Aubin
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
| | - Amine Benyamina
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
| | - Amandine Luquiens
- Psychiatry and Addictology, University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM U 1178, APHP, Hopital Paul Brousse, Villejuif, France
- CMAP, Ecole Polytechnique, Palaiseau Cedex, France
| | - Lucia Romo
- EA 4430 CLIPSYD, Universite Paris-Nanterre, Nanterre, France
- Centre Hospitalier Sainte Anne, Inserm, U894, Center for Psychiatry and Neuroscience, Paris, France
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10
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Collins SE, Clifasefi SL, Nelson LA, Stanton J, Goldstein SC, Taylor EM, Hoffmann G, King VL, Hatsukami AS, Cunningham ZL, Taylor E, Mayberry N, Malone DK, Jackson TR. Randomized controlled trial of harm reduction treatment for alcohol (HaRT-A) for people experiencing homelessness and alcohol use disorder. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 67:24-33. [PMID: 30851620 PMCID: PMC6488431 DOI: 10.1016/j.drugpo.2019.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 12/05/2018] [Accepted: 01/01/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND People experiencing homelessness are disproportionately affected by alcohol use disorder (AUD). Abstinence-based treatment, however, does not optimally engage or treat this population. Thus, harm reduction treatment for alcohol (HaRT-A) was developed together with people with lived experience of homelessness and AUD and community-based agencies that serve them. HaRT-A is a compassionate and pragmatic approach that aims to help people reduce alcohol-related harm and improve quality of life (QoL) without requiring abstinence or use reduction. A three-month, two-arm randomized controlled trial was conducted to test the initial efficacy of HaRT-A compared to a services-as-usual control condition. METHODS People experiencing homelessness and AUD (N = 168; 24% women) were recruited in community-based clinical and social services settings. Self-reported alcohol use, alcohol-related harm, motivation, and QoL as well as urinary ethyl glucuronide were assessed over a 3-month follow-up. Participants were randomized to receive HaRT-A or services as usual. Over four sessions, HaRT-A interventionists delivered three components: a) collaborative tracking of participant-preferred alcohol metrics, b) elicitation of harm-reduction and QoL goals, and c) discussion of safer-drinking strategies. RESULTS Compared to control participants, HaRT-A participants reported significantly greater increases in confidence to engage in harm reduction and decreases in peak alcohol use, alcohol-related harm, AUD symptoms, and positive urinary ethyl glucuronide tests (ps < .05). Findings were inconclusive regarding group differences on QoL (ps > .12). CONCLUSION A low-barrier, low-intensity, patient-driven, harm-reduction approach has at least short-term efficacy in improving AUD outcomes in this population. Future studies are needed to establish its longer-term efficacy.
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Affiliation(s)
| | | | | | - Joey Stanton
- University of Washington, United States; Downtown Emergency Service Center, United States
| | | | | | | | | | | | | | | | | | | | - T Ron Jackson
- University of Washington, United States; Evergreen Treatment Services - REACH
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11
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Dormal V, Bremhorst V, Lannoy S, Lorant V, Luquiens A, Maurage P. Binge drinking is associated with reduced quality of life in young students: A pan-European study. Drug Alcohol Depend 2018; 193:48-54. [PMID: 30340145 DOI: 10.1016/j.drugalcdep.2018.08.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Binge drinking (BD) is frequently observed in youth, with psychological and cognitive consequences, but its link with quality of life has been scarcely explored. METHODS Sociodemographic and alcohol consumption characteristics were collected in a cross-sectional survey including 15,020 European students. Health-related quality of life was assessed using the Alcohol Quality of Life Scale (AQoLS) measuring the self-reported negative impact of alcohol consumption. A flexible link function, using Bayesian P-splines, was used to study the relationship between alcohol-related quality of life and alcohol consumption. RESULTS A non-linear relationship between BD and AQoLS scores was identified, showing that: (1) For students presenting moderate BD pattern, alcohol consumption is related to a robust reduction in quality of life, this link remaining stable for students with more intense BD patterns; (2) BD are not strongly associated with social, personal, and work activities, but are linked to an increase in perceived loss of control over consumption; (3) Harmful or hazardous consumption is also related with a massive decrease in quality of life; (4) The strongest relationship between BD and impacted quality of life is found among males and Eastern European students. CONCLUSIONS These results demonstrate the importance of measuring the perceived relation between alcohol and quality of life, beyond the classically assessed consequences, as this relation is strong among young students. Prevention programs should take this into account, notably regarding the perceived loss of control over alcohol consumption, which constitutes a key factor for the emergence of severe alcohol-use disorders.
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Affiliation(s)
- Valérie Dormal
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Vincent Bremhorst
- Institute of Statistics, Biostatistics and Actuarial Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Statistical Methodology and Computing Service, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Séverine Lannoy
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Vincent Lorant
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
| | - Amandine Luquiens
- Paul Brousse Hospital, APHP Villejuif, France; Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
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12
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Luquiens A, Said AB, Sadik H, Ferrer Sánchez Del Villar E, Le Manach A, Ambrosino B, Tzourio C, Benyamina A, Aubin HJ. Alcohol consumption, drinker identity, and quality of life among students: why there cannot be one prevention strategy for all. Qual Life Res 2018; 27:2629-2637. [PMID: 29934797 DOI: 10.1007/s11136-018-1923-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The objective for this study was to combine drinking characteristics and two subjective measures, drinker identity and alcohol-related quality of life, i.e., negative impact of alcohol on quality of life, to determine relevant profiles for indicated prevention programs. In particular, we hypothesized that different profiles of students with high level of alcohol consumption exist when exploring subjectivity. METHODS We performed an online survey among 16,930 students. We collected sociodemographics and environmental data, including alcohol-related quality of life, drinker identity, and drinking characteristics. We performed a hierarchical clustering on principal components. We described all variables in each cluster and explored between clusters differences by Kruskal-Wallis tests. RESULTS We identified five clusters as regarding drinker identity, drinking characteristics, and alcohol-related quality of life. Among these five clusters, three clusters presented high drinking characteristics. A very vulnerable cluster showed high level of alcohol consumption, impact on quality of life and on academic results, and strong drinker identity. An egodystonic cluster showed high level of consumption, mild impact on quality of life and on academic results, but low drinker identity. A cluster seemed short-term super-adapted in heavy drinking environment, showing high level of alcohol consumption and drinker identity, but low impact on quality of life and on academic results (all between clusters p values < 0.001 with Kruskal-Wallis tests). CONCLUSION The subjective experience of students from these clusters was significantly different (p value < 0.001), and could explain some inadequacy of certain prevention strategies, considering binge drinker student as a homogeneous group. Prospective studies are needed to explore changes over time of these clusters.
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Affiliation(s)
- Amandine Luquiens
- Addiction department, Hôpital Paul Brousse, APHP, 12 avenue Paul Vaillant-Couturier, 94804, Villejuif cedex, France. .,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France. .,CMAP, Ecole Polytechnique, Palaiseau, France.
| | | | - Haïm Sadik
- Ecole Centrale-Supélec Paris, Paris, France
| | | | | | | | - Christophe Tzourio
- Team HEALTHY, Bordeaux Population Health Research Center, INSERM, Univ. Bordeaux, UMR 1219, CHU Bordeaux, 33000, Bordeaux, France
| | - Amine Benyamina
- Addiction department, Hôpital Paul Brousse, APHP, 12 avenue Paul Vaillant-Couturier, 94804, Villejuif cedex, France.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Henri-Jean Aubin
- Addiction department, Hôpital Paul Brousse, APHP, 12 avenue Paul Vaillant-Couturier, 94804, Villejuif cedex, France.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
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13
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Luquiens A, Falissard B, Aubin HJ. Students worry about the impact of alcohol on quality of life: Roles of frequency of binge drinking and drinker self-concept. Drug Alcohol Depend 2016; 167:42-8. [PMID: 27590745 DOI: 10.1016/j.drugalcdep.2016.07.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/18/2016] [Accepted: 07/20/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of this study was to clarify the impact of binge drinking, its intensity and frequency, and drinker self-concept on health-related quality-of-life (HRQOL) in students. METHODS This cross-sectional online survey included 16,930 students. We collected sociodemographics, environmental data, and drinking behaviors. We assessed HRQOL using the Alcohol Quality-of-Life scale, which explicitly explores the subjective negative impact on quality of life one attributes to his relationship with alcohol and the degree to which drinking is a part of an individual's self-concept. Data analyses were performed in 2015 and 2016. We described and compared binge drinkers and non-binge drinkers. Using a regression model we identified the independent factors associated with HRQOL. RESULTS The impact on HRQOL attributed to alcohol was significantly greater among binge drinkers. Factors of impact on HRQOL subjectively attributed to alcohol by students were: AUDIT-C score, interaction between gender and AUDIT-C score, strong individual identity as a drinker, binge-drinking frequency, financial difficulties, being a foreigner, fewer years since diploma, chronic condition, recent use of cannabis, psychostimulant, poppers or gambling. Sleep quality, ability to work, expenditure on alcohol, shame, and health-related concerns were the most strongly impacted quality of life areas. CONCLUSIONS Binge-drinking frequency should be considered as an important target in prevention programs. In addition, integrating findings on students' subjective perceptions of impairment of HRQOL by alcohol could enable the development of more acceptable and more relevant prevention messages.
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Affiliation(s)
- A Luquiens
- Hôpital Paul Brousse, APHP Villejuif, France; Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
| | - B Falissard
- Hôpital Paul Brousse, APHP Villejuif, France; Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - H J Aubin
- Hôpital Paul Brousse, APHP Villejuif, France; Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
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