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Assessment of alcohol use disorder and its associated factors among alcohol users of medical and surgical outpatients attending a specialized hospital in Gondar, Ethiopia: a cross-sectional study. Int J Ment Health Syst 2021; 15:28. [PMID: 33771201 PMCID: PMC8004459 DOI: 10.1186/s13033-021-00454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 03/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background Alcohol use disorder increase the risk of physical harm, mental or social consequences for patients and others in the community. Studies on alcohol use disorder and associated factors among medical and surgical outpatients in Ethiopia are limited. Therefore, this study is meant to provide essential data on alcohol use disorder and associated factors among alcohol user medical and surgical outpatients to intervene in the future. Methods An institution-based cross-sectional study was conducted by using the systematic random sampling technique. Alcohol use disorders were assessed using the World Health Organization’s 10-item Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Bivariate and multivariate logistic regression analyses were performed, a P-value less than 0.05 were considered statistically significant in the multivariate analysis and the strength of association was measured at a 95% confidence interval. Results The prevalence of alcohol use disorder was 34.5% with a 95% CI (29.20, 39.80) among study participants. In the multivariate logistic regression analysis, male sex (AOR = 3.33, 95%CI: 1.40, 7.93), history of mental illness (AOR = 2.68, 95%CI: 1.12, 6.38), drinking for relaxation (AOR = 1.88, 95%CI: 1.02, 3.48) and history of lifetime tobacco use (AOR = 5.64, 95%CI: 1.95, 16.29) were factors significantly associated with alcohol use disorder. Conclusion The prevalence of alcohol use disorders among medical and surgical outpatients was found to be high. Male sex, history of mental illness, alcohol use for relaxation and lifetime cigarette smoking need more attention during the assessment of patients in the medical and surgical outpatient departments.
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Kuperman S, Chan G, Kramer J, Wetherill L, Acion L, Edenberg HJ, Foroud TM, Nurnberger J, Agrawal A, Anokhin A, Brooks A, Hesselbrock V, Hesselbrock M, Schuckit M, Tischfield J, Liu X. A GABRA2 polymorphism improves a model for prediction of drinking initiation. Alcohol 2017; 63:1-8. [PMID: 28847377 PMCID: PMC5657392 DOI: 10.1016/j.alcohol.2017.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/04/2017] [Accepted: 03/06/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Survival analysis was used to explore the addition of a single nucleotide polymorphism (SNP) and covariates (sex, interview age, and ancestry) on a previously published model's ability to predict onset of drinking. A SNP variant of rs279871, in the chromosome 4 gene encoding gamma-aminobutyric acid receptor (GABRA2), was selected due to its associations with alcoholism in young adults and with behaviors that increased risk for early drinking. METHODS A subsample of 674 adolescents (ages 14-17) participating in the Collaborative Study on the Genetics of Alcoholism (COGA) was examined using a previously derived Cox proportional hazards model containing: 1) number of non-drinking related conduct disorder (CD) symptoms, 2) membership in a high-risk alcohol-dependent (AD) family, 3) most best friends drank (MBFD), 4) Achenbach Youth Self Report (YSR) externalizing score, and 5) YSR social problems score. The above covariates along with the SNP variant of GABRA2, rs279871, were added to this model. Five new prototype models were examined. The most parsimonious model was chosen based on likelihood ratio tests and model fit statistics. RESULTS The final model contained four of the five original predictors (YSR social problems score was no longer significant and hence dropped from subsequent models), the three covariates, and a recessive GABRA2 rs279871 TT genotype (two copies of the high-risk allele containing thymine). The model indicated that adolescents with the high-risk TT genotype were more likely to begin drinking than those without this genotype. CONCLUSIONS The joint effect of the gene (rs279871 TT genotype) and environment (MBFD) on adolescent alcohol initiation is additive, but not interactive, after controlling for behavior problems (CD and YSR externalizing score). This suggests that the impact of the high-risk TT genotype on the onset of drinking is affected by controlling for peer drinking and does not include genotype-by-environment interactions.
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Affiliation(s)
- Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - Grace Chan
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - John Kramer
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Laura Acion
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Howard J Edenberg
- Department of Biochemistry & Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrey Anokhin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew Brooks
- Department of Genetics, Rutgers University, Piscataway, NJ, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Michie Hesselbrock
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Marc Schuckit
- Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Jay Tischfield
- Department of Genetics, Rutgers University, Piscataway, NJ, USA
| | - Xiangtao Liu
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Thoa LTK, Hoang DH, Vung ND, Tien PH, Plant MA. Alcohol Use, Risk Taking, Leisure Activities and Health Care Use Among Young People in Northern Vietnam. Cent Asian J Glob Health 2013; 2:10. [PMID: 29755877 PMCID: PMC5927737 DOI: 10.5195/cajgh.2013.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Alcohol consumption is associated with a wide range of health and social consequences. It is also associated with a number of risk taking behaviours. These include illicit drug use and unsafe sex. Alcohol consumption appears to be increasing in Vietnam. The purpose of this paper is to examine the patterns of alcohol consumption and its relationship with a number of other risk taking behaviours amongst young people. Information was also obtained concerning leisure activities and use of health care. The paper also sets out to examine possible gender differences in relation to alcohol consumption and risk behaviour and to propose the development and implementation of alcohol monitoring and prevention programs in Vietnam. The study involved a cross-sectional, community survey using a standardised interview. This was conducted during face-to-face interviews with 1,408 young people aged 10-19 years. Respondents were recruited randomly through the lists of the households from 12 selected communes in three areas in Northern Vietnam. The findings presented here were part of a larger health risk behaviour survey. Levels of alcohol use were low. Overall, 16.5% of participants were experienced drinkers, and only 4% of them were current drinkers. Males were significantly more likely than females to report drinking. This study also showed that rates of alcohol consumption were associated with age, education, geographical area, gender, tobacco smoking, involvement in violence, watching television, computer use and playing computer games, wearing safety helmets and use of health services. Alcohol consumption tended to increase with age for both males and females. Alcohol and its effects on young people are clearly a growing public health issue in Vietnam. Because of this, more detailed behavioral research should be conducted into the relationship between alcohol consumption and other risky behaviours amongst young people. It is also recommended that alcohol harm reduction policies should be implemented and integrated into measures to reduce levels of other health problems such as HIV/AIDS and non communicable diseases. Such policies should ideally be evidence-based and evaluated.
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Affiliation(s)
- Le Thi Kim Thoa
- Ha Noi Medical University, Vietnam.,Center for Health and Development in Vietnam
| | | | | | - Pham H Tien
- Center for Health and Development in Vietnam
| | - M A Plant
- Alcohol & Health Research Unit, University of the West of England, Bristol, United Kingdom
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Kuperman S, Chan G, Kramer JR, Wetherill L, Bucholz KK, Dick D, Hesselbrock V, Porjesz B, Rangaswamy M, Schuckit M. A model to determine the likely age of an adolescent's first drink of alcohol. Pediatrics 2013; 131:242-8. [PMID: 23296431 PMCID: PMC3557403 DOI: 10.1542/peds.2012-0880] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE With the use of a new cohort of adolescent subjects, predictors from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) interview and the Achenbach Youth Self Report (YSR) were combined to model age of first drink (AFD). METHODS Subjects consisted of 820 adolescents (ages 14-17) drawn from the current phase of the Collaborative Study on the Genetics of Alcoholism. Three Cox proportional hazards models were considered. Model 1 contained SSAGA variables equivalent to AFD predictors from our previous study: interview age, family history of alcohol dependence, and number of conduct disorder symptoms. Model 2 incorporated 2 additional SSAGA questions (best friends drink and smoked a cigarette before a reported AFD) plus 8 YSR-derived scale scores. Model 3 was a reduced version of model 2, retaining only significant predictors. RESULTS Model 2 was a significant improvement over model 1. Model 3 was the best and the most parsimonious of the 3 with respect to likelihood ratio and Wald χ(2) tests and retained only 5 variables from model 2. Included variables were the following: (1) best friends drink, (2) membership in a high-risk alcohol dependence family, (3) number of conduct disorder symptoms, (4) YSR externalizing score, and (5) YSR social problems score. CONCLUSIONS Adding variables to those from our original study improved our ability to model the likely age of alcohol initiation. In addition to the SSAGA, the YSR appears to have utility as a research tool to predict the age of alcohol initiation.
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Affiliation(s)
- Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Dr, RM 1873 JPP, Iowa City, IA 52242, USA.
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Yang S, Kramer MS. Paternal alcohol consumption, family transition and child development in a former Soviet country. Int J Epidemiol 2012; 41:1086-96. [DOI: 10.1093/ije/dys071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Leino J, Kauhanen L, Hokkinen L, Kurl S, Toriola AT, Voutilainen S, Lynch JW, Kauhanen J. Psychosocial problems in childhood and later alcohol consumption: a life course approach with historical information. Scand J Public Health 2011; 39:749-56. [PMID: 21948991 DOI: 10.1177/1403494811421056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Childhood psychosocial problems have been associated with poor alcohol habits in adulthood. The purpose of this study was to investigate further the association in men by using information from historical health records. METHODS As part of the epidemiological FinDrink Study, we examined the association between childhood psychosocial problems and total ethanol consumption, binge drinking, and abstinence in later life among Finnish men. The participants were a sample from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), a population-based cohort study in eastern Finland. The data on childhood psychosocial factors were collected from health records (n = 952, 35.5% of the entire study sample), mainly from the 1930s to the 1950s. Questionnaire data on alcohol consumption were obtained from the baseline examinations of the KIHD cohort in 1984-1989. RESULTS Controlling for age and examination year, the men who had been considered psychosocially disadvantaged by elementary school nurses had a 2.72-fold (95% confidence interval 1.30-5.65) risk of bingeing on fortified wine in later life. After adjustment for adulthood behavioural and socioeconomic factors the association (odds ratio 3.71, 95% confidence interval 1.56-8.84) appeared even stronger. Childhood psychosocial problems also contributed to abstinence, but did not appear to increase the total amount of ethanol consumed. CONCLUSIONS Psychosocial problems observed in boys seem to contribute to different alcohol habits in later life. However, the factors eventually involved in the manifestation of problematic drinking patterns through the life course still require further research.
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Affiliation(s)
- Janne Leino
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
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Trim RS, Schuckit MA, Smith TL. Predicting drinking onset with discrete-time survival analysis in offspring from the San Diego prospective study. Drug Alcohol Depend 2010; 107:215-20. [PMID: 19959300 PMCID: PMC2822001 DOI: 10.1016/j.drugalcdep.2009.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2009] [Revised: 10/27/2009] [Accepted: 10/28/2009] [Indexed: 11/28/2022]
Abstract
Previous research has shown that an early onset of drinking is associated with a range of problematic drinking outcomes in adulthood. However, earlier drinking is also linked to additional characteristics that themselves predict alcohol problems including male gender, a family history (FH) of alcoholism, age, race, parental alcoholism, depression symptoms, prior drug use, and conduct problems. This study tested the relationship between the age of first drink (AFD) and a range of risk factors that predict the onset of alcohol use. Participants were offspring from the San Diego Prospective Study (SDPS) who were at least 15 years old at the time of their most recent interview (n=147). Discrete-time survival analysis (DTSA) was used to relate multiple characteristics to the hazard function of alcohol onset across a relevant age range. The results demonstrated the predicted relationships to AFD for conduct problems, male gender, prior marijuana use, and a FH of alcoholism, even when these characteristics were estimated together. Furthermore, an interaction occurred such that offspring with both conduct problems and marijuana use were at substantially higher risk for alcohol use onset during this time period than would be predicted from the effect of these two risk factors alone. However, age at interview, ethnicity, parent education, and depressive symptoms did not predict the pattern of onset of drinking. Implications for future research and prevention efforts are discussed.
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Affiliation(s)
- Ryan S Trim
- Department of Psychiatry, University of California, San Diego, 8950 Villa La Jolla Drive, Suite B-218, La Jolla, CA 92037, USA
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Sakai JT, Risk NK, Tanaka CA, Price RK. Conduct disorder among Asians and Native Hawaiian/Pacific Islanders in the USA. Psychol Med 2008; 38:1013-1025. [PMID: 17803831 DOI: 10.1017/s0033291707001316] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Conduct disorder (CD) is a relatively common disorder of childhood and adolescence in the USA with substantial associated morbidity, yet little has been published on CD among Asians and Native Hawaiian/Pacific Islanders (NH/PI) in the USA. METHOD We used the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to examine the prevalence and correlates of retrospectively reported CD within Asians and NH/PI (18 years and older). We also completed logistic regressions to explore factors associated with CD within Asians (n=1093) and, separately, NH/PI (n=139) and to explain racial differences in CD prevalence. RESULTS Asians were about a third as likely [odds ratio (OR) 0.4, 95% confidence interval (CI) 0.22-0.58] whereas NH/PI were about two and half times more likely (OR 2.6, 95% CI 1.31-5.06) to have had CD compared with Caucasian respondents. Within Asians and NH/PI, CD was strongly associated with adult antisocial behavior, substance use and affective disorders. Demographic factors, the age that subjects came to the USA, measures of family environment and family history could not explain the observed differences in prevalence of CD for NH/PI relative to Caucasians. CONCLUSIONS Asian and NH/PI youth with CD represent a subgroup of Asian youth at very high risk for a number of serious psychiatric disorders. Further investigation is needed to explain the high CD prevalence among NH/PI.
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Affiliation(s)
- J T Sakai
- University of Colorado School of Medicine, Denver, CO, USA.
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Kuperman S, Chan G, Kramer JR, Bierut L, Bucholz KK, Fox L, Hesselbrock V, Numberger JI, Reich T, Reich W, Schuckit MA. Relationship of Age of First Drink to Child Behavioral Problems and Family Psychopathology. Alcohol Clin Exp Res 2005; 29:1869-76. [PMID: 16269917 DOI: 10.1097/01.alc.0000183190.32692.c7] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies have implicated a wide variety of variables as being associated with an early age of first drink (AFD). AFD in turn has been associated with a variety of negative outcomes in adolescence and early adulthood. This study is designed to quantify the contributions of these antecedent variables to prediction of AFD; in particular it will carefully examine the involvement of variables in four areas (child characteristics, family demographics, family psychopathology, and child behavior problems). METHODS Using data from a multicenter study on alcoholism, we first investigated the differences between two groups of children (ages 7 to 17 years), one from families heavily loaded for alcohol dependence and the other from population controls. Second, a multidomain, multistep regression model using child characteristics, family demographics, family psychopathology, and child behavior problems was performed to determine significant contributors to predicted AFD. RESULTS Five variables initially contributed to the prediction of AFD. These included gender, age at interview, the number of adult sibs with alcohol dependence, being held back a year in school, and conduct scale score. However, the number of conduct symptoms appeared to contain the contributions of gender and being held back a grade in school, and these two variables were subsequent removed from the model. The remaining three variables explained 45% of the model variance; age at interview accounted for 38.3%, conduct scale score accounted for 6.2%, and the number of alcohol-dependent adult sibs accounted for 0.5%. No family history measures of alcohol dependence or antisocial personality disorder were contributory to the prediction model for AFD. CONCLUSIONS Both the "number of conduct symptoms" and the "number of adult sibs with alcohol dependence" are inversely associated with predicted AFD. The latter variable appears marginally predictive of AFD and suggests a condition in which the child's household, regardless of strength of family history of AD (or antisocial personality disorder), appears conducive to early drinking. Thus, child and environmental factors are stronger predictors of age of first drink than family history.
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Affiliation(s)
- Samuel Kuperman
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1057, USA.
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Assanangkornchai S, Noi-pha K, Saunders JB, Ratanachaiyavong S. Aldehyde dehydrogenase 2 genotypes, alcohol flushing symptoms and drinking patterns in Thai men. Psychiatry Res 2003; 118:9-17. [PMID: 12759156 DOI: 10.1016/s0165-1781(03)00043-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The drinking behavior, alcohol-induced facial flushing and ALDH2 genotypes were determined in 283 Thai men comprising 85 who were alcohol-dependent, 62 hazardous/harmful drinkers and 136 non-drinkers or infrequent drinkers. A structured interview questionnaire, containing the 'tri-level' method and the Alcohol-Use Disorders and Associated Disabilities Schedule, was used to determine the quantity of drinking and the number of alcohol-related adverse experiences. The study revealed the mutant ALDH2*2 allele in 44 (15.5%) subjects. The risks of being alcohol-dependent and of having hazardous/harmful drinking were lower in individuals with heterozygous ALDH2*1/*2, compared with homozygous ALDH2*1/*1 [relative probability ratios (95% CI) 0.14 (0.05-0.41) and 0.23 (0.08-0.61), respectively]. Eighty percent of those who were heterozygous and 28% of those who were homozygous ALDH2*1 reported flush symptoms after drinking alcohol. Twenty-nine percent of homozygous ALDH2*1 individuals, but only 9% of heterozygous subjects, drank almost everyday (24-30 days/month). Similarly, higher percentages of people drinking beyond the safety limit (>60 g/day) and having alcohol-related problems were observed in homozygous ALDH2*1 compared with heterozygous individuals: 32% vs. 5% and 27% vs. 12%, respectively. Overall, the study supports the role of the mutant ALDH2*2 allele in preventing high alcohol consumption and the development of alcohol dependence in a Thai population.
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