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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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Foster JH, Rankin S. Self-Reported Sleep during the COVID Lockdown in a Sample of UK University Students and Staff. Healthcare (Basel) 2022; 10:healthcare10102083. [PMID: 36292528 PMCID: PMC9601904 DOI: 10.3390/healthcare10102083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
The link between disturbed sleep and the extended lockdown period resulting from COVID-19 is well established. Data from an online survey of 2341 of university students (n = 1972, 84.2%) and staff were reported. Overall (n = 1710, 73.1%) were female and the mean age for the sample was 29.26 (SD = 12.86). 1799 (76.8%) provided self-reported data from the Nottingham Health Profile (NHP) Sleep Subscale that allowed sleep to be compared prior to the lockdown period and during the lockdown period. Sociodemographic data which included, gender, age, whether an individual was a student or member of the university staff, ethnicity, caring responsibilities, and highest educational level were collected. Other data included, the NHP Sleep Sub-scale, change in alcohol consumption during the lockdown period, routine behaviours during the lockdown period, self-efficacy and health and wellbeing. There was a significant deterioration in NHP Sleep scores (p < 0.001) and all areas of sleep that were assessed significantly deteriorated during the lockdown period. These included indicators of sleep quality, sleep latency, sleep duration, sleep disturbance and increased use of sleep medication. Following a multinomial logit regression with change of NHP sleep scores entered as the dependent variable there were several significant predictors. Women had greater sleep dysfunction than men. Increased alcohol consumption, lower educational status and a deterioration in health and well-being scores were associated with greater sleep dysfunction. Not having a designated area to work in and not putting on clothes and make-up were both associated with greater sleep dysfunction during the lockdown period. These findings confirm the importance of taking steps to maintain sleep hygiene during extended lockdown periods.
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Affiliation(s)
- John H. Foster
- Alcohol Policy and Mental Health Studies, School of Health Sciences, University of Greenwich, London SE10 9LS, UK
- Correspondence: ; Tel.: +44-0208-331-8757
| | - Sandra Rankin
- School of Human Sciences, University of Greenwich, Old Royal Naval College, 150 Dreadnought, Park Row, London SE10 9LS, UK
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Bozdağ N, Çuhadar D. Internalized stigma, self-efficacy and treatment motivation in patients with substance use disorders. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Neslihan Bozdağ
- Medicine Faculty, Şahinbey Research and Practice Hospital, Gazantep University, Gaziantep, Turkey
| | - Döndü Çuhadar
- Health Science Faculty, Psychiatric Nursing Department, Gaziantep University, Gaziantep, Turkey
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Abstract
BACKGROUND Although people who sleep poorly may attempt to relieve anxiety for better sleep quality, whether daily alcohol consumption is a factor that moderates anxiety and sleep disturbance is not known. PURPOSE The aim of the study was to explore (a) the association between anxiety and sleep quality and (b) whether daily alcohol consumption acted as a moderator between anxiety and sleep quality in those who reported sleeping poorly. METHODS Eighty-four participants aged 20-80 years who reported poor sleep (Pittsburgh Sleep Quality Index > 5) in northern Taiwan were enrolled in this cross-sectional study. A structured questionnaire covering demographics (including daily alcohol consumption), level of anxiety, level of depression, and perceived sleep quality was used to collect data. RESULTS The participants were mostly women (72.6%). The mean age was 41.81 (SD = 12.62) years; 51.2%, 19.0%, 13.1%, and 14.3%, respectively, had minimal, mild, moderate, and severe anxiety. After adjusting for factors related to sleep quality using multiple regression analysis, receiving sleep therapy, consuming alcohol on a daily basis, and having anxiety were found to be predictors of poor sleep quality. Moreover, daily alcohol consumption was found to moderate the relationship between anxiety and sleep quality. CONCLUSIONS/IMPLICATIONS FOR PRACTICE People who sleep poorly should avoid misusing alcohol to self-treat poor sleep quality or anxiety and should instead utilize sleep hygiene education and mental healthcare. Daily alcohol consumption may be a moderator between anxiety status and sleep quality.
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Huang H, Shen H, Ning K, Zhang R, Sun W, Li B, Jiang H, Wang W, Du J, Zhao M, Yi Z, Li J, Zhu R, Lu S, Xie S, Wang X, Fu W, Gao C, Hao W. Quality of Life and Its Correlates in Alcohol Use Disorder Patients With and Without Depression in China. Front Psychiatry 2020; 11:627338. [PMID: 33551885 PMCID: PMC7862321 DOI: 10.3389/fpsyt.2020.627338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023] Open
Abstract
Objective: Alcohol use disorder (AUD) is a serious issue worldwide and frequently co-occurs with depression. However, the quality of life (QOL) of AUD patients with and without depression is not well studied in the Chinese Han population. The aim of this study was to investigate QOL and its correlates in AUD patients with and without depression in China. Methods: Five hundred and fifteen psychiatric patients diagnosed with AUD were recruited. All these patients completed the Beck Depression Inventory (BDI) to assess depression, the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) to evaluate QOL and the Alcohol Use Disorders Identification Test (AUDIT) to measure the severity of drinking. Results: Compared with AUD patients without depression, those with depression had a lower QOL in all eight domains of the SF-36 (all P < 0.001), but were more willing to have alcohol-related treatment (P < 0.05). Negative correlations were noted between (i) the BDI total score and all eight domains of the SF-36 (all P < 0.001); and (ii) between the AUDIT total score and six domains of the SF-36 (all P < 0.05). Conclusions: Depression impairs QOL in patients with AUD in China. Early intervention in comorbid depression to improve QOL is needed.
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Affiliation(s)
- Hui Huang
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hongxian Shen
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Kui Ning
- Henan Mental Hospital, Xinxiang, China
| | | | - Wei Sun
- Peking University Sixth Hospital, Beijing, China
| | - Bing Li
- Peking University Sixth Hospital, Beijing, China
| | | | | | - Jiang Du
- Shanghai Mental Health Center, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai, China
| | - Zhihua Yi
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | | | - Wei Fu
- The First Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Chengge Gao
- The First Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Wei Hao
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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Jackson CL, Gaston SA, Liu R, Mukamal K, Rimm EB. The Relationship between Alcohol Drinking Patterns and Sleep Duration among Black and White Men and Women in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030557. [PMID: 29558409 PMCID: PMC5877102 DOI: 10.3390/ijerph15030557] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/21/2018] [Accepted: 03/02/2018] [Indexed: 12/25/2022]
Abstract
In the United States, racial minorities generally experience poorer cardiovascular health compared to whites, and differences in alcohol consumption and sleep could contribute to these disparities. With a nationally representative sample of 187,950 adults in the National Health Interview Survey from 2004 to 2015, we examined the relationship between alcohol-drinking patterns and sleep duration/quality by race and sex. Using Poisson regression models with robust variance, we estimated sex-specific prevalence ratios for each sleep duration/quality category among blacks compared to whites within categories of alcohol-drinking pattern, adjusting for socioeconomic status and other potential confounders. Across alcohol drinking patterns, blacks were less likely than whites to report recommended sleep of 7-<9 h/day. Short (PR = 1.30 [95% CI: 1.22-1.39]) and long (PR = 1.30 [95% CI: 1.07-1.58]) sleep were 30% more prevalent among black-male infrequent heavy drinkers compared to white-male infrequent heavy drinkers. Short (PR = 1.27 [95% CI: 1.21-1.34]) sleep was more prevalent among black-female infrequent heavy drinkers compared to white-female infrequent heavy drinkers, but there was no difference for long sleep (PR = 1.09 [95% CI: 0.97-1.23]). Black female infrequent moderate drinkers, however, had a 16% higher (PR = 1.16 [95% CI: 1.01-1.33]) prevalence of long sleep compared to their white counterparts. Environmental, social, and biological factors contributing to these findings, along with their impact on disparate health outcomes, should be studied in greater detail.
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Affiliation(s)
- Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, NC 27709, USA.
| | - Rui Liu
- Social & Scientific Systems, Inc., Research Triangle Park, NC 27703, USA.
| | - Kenneth Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
- Nutrition Department, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Eric B Rimm
- Nutrition Department, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA.
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Balhara YPS, Singh S, Modak T, Sarkar S. A Cross-sectional Study to Assess Disability and Its Correlates among Treatment Seeking Individuals with Alcohol Use Disorders. Indian J Psychol Med 2017; 39:40-45. [PMID: 28250557 PMCID: PMC5329990 DOI: 10.4103/0253-7176.198941] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Alcohol use is a major risk factor for global disease burden, and excessive use leads to disability in the individual. This study aimed to assess the disability and its correlates among individuals with alcohol use disorders (AUDs). In addition, it assessed the quality of life measures in this population group. METHODOLOGY A cross-sectional study on a sample (N = 62) from among treatment seekers for alcohol dependence. Diagnostic and Statistical Manual, Fifth Edition (DSM-5) criteria were used to assess disorder severity. The WHO Disability Assessment Schedule (WHODAS) 2.0 and World Health Organization Quality of Life-BREF were used to assess disability and quality of life, respectively. Descriptive statistics, correlation analysis, and linear regression analysis were used for comparative assessments. The level of statistical significance was kept at P < 0.05 for all the tests. RESULTS DSM-5 diagnosis of the individuals suggested a high severity of substance use disorder as an average of 8.8 (±1.8) criteria were fulfilled. WHODAS 2.0 revealed maximum disability in the domains of "participation in the society," "household and work-related activities" and "cognitive functioning." The quality of life measures indicate poor physical health, reduced work capacity, and cognitive dysfunction. A negative correlation was seen between the social dimensions of disability (getting along) and quality of life measures of psychological health (P = 0.026) and social relationships (P = 0.046), work domain of disability schedule and physical health score on quality of life evaluation (P = 0.001). Older age had greater impairment in the work domain (P = 0.040), and unemployment was associated with higher disability (P = 0.001). Unemployment and duration of alcohol use were the independent predictors of greater disability. CONCLUSIONS Disability assessment using WHODAS 2.0 shows significant impairment in individuals with AUDs that is negatively correlated with quality of life measures.
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Affiliation(s)
- Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Shalini Singh
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Tamonud Modak
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
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Oztasan N, Ozyrek P, Kilic I. FACTORS ASSOCIATED WITH HEALTH-RELATED QUALITY OF LIFE AMONG UNIVERSITY STUDENTS IN TURKEY. Mater Sociomed 2016; 28:210-4. [PMID: 27482164 PMCID: PMC4949046 DOI: 10.5455/msm.2016.28.210-214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/15/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction: Purpose of this descriptive study is to determine the mental health problems and quality of life levels of college students and examine the relationship between them. Methods: The sample of the study consisted of 429 students continuing their education in Health School at Afyon Kocatepe University. Data were collected by using information form, Brief Symptom Inventory (BSI), SF 36 Quality of Life Scale questionnaires. In the analysis of obtained data, descriptive statistics, t-test, ANOVA and correlation analyses were used. Findings: Mental symptoms which the students got the highest scores from the subscales of BSI were respectively, depression (1.31±0.75), hostility (1.22±0.67) and anxiety (1.00±0.65). Discomfort severity index which is the overall score of the scale was found 1.07±0.61. Relation between state of mind and quality of life was found statistically significant (F: 70.894; p<0.000). When quality of life summary scores examined, it was found out that physical health summary score (48.92±7.93) and mental health summary score (43.44±9.52) points were low. Conclusions: Consequently, according to averages of scores, it can be said that frequency of the mental symptoms of students are high but their quality of life is low. It was found that when students’ quality of life decreased, their mental symptoms increased.
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Affiliation(s)
- Nuray Oztasan
- Department of Physiology, Faculty of Medicine, Afyonkarahisar Kocatepe University, Afyonkarahisar, Turkey
| | - Pakize Ozyrek
- Department of Surgery Nursing, Health Sciences High School, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ibrahim Kilic
- Department of Biostatistics, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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Perceived quality of life, 6 months after detoxification: Is abstinence a modifying factor? Qual Life Res 2016; 25:2315-22. [PMID: 26995560 PMCID: PMC4980398 DOI: 10.1007/s11136-016-1272-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/08/2022]
Abstract
Purpose Patients with a substance use disorder (SUD), admitted for detoxification, often suffer from a poor quality of life (QoL). We set out to monitor QoL, together with substance use, in a departure from the usual norm of measuring substance use alone as a treatment outcome. Literature searches revealed scant knowledge of how QoL is influenced. With this in mind, we aimed to investigate whether total abstinence, prior to follow-up, could influence QoL. Methods We studied a prospective cohort of 140 patients admitted for inpatient detoxification treatment at Sørlandet Hospital (Norway), from September 2008 to August 2010. QoL was measured by a generic five-item questionnaire, the QoL-5. The extremes of this scale ranged from the worst possible rating of 0.1 to 0.9, as the best. A norm for the general population was benchmarked at 0.69. Change in QoL was calculated by subtracting baseline QoL from that achieved at the 6-month follow-up interview; linear regression modeling was used to study the influence of individual QoL predictors. Results The mean QoL at baseline was 0.46, 39 % below that of the general reference population. By applying the clinical interpretation of the scale, we found a modest overall mean improvement in QoL at follow-up (0.11 points); the greatest increases were seen for patients with the lowest baseline QoL scores. Abstinence prior to follow-up correlated with improved QoL, while living alone and psychological distress were negative influences. Conclusions For patients with a SUD, clinicians should emphasize that abstinence may help to improve their QoL.
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Saengcharnchai P, Likhitsathian S, Yingwiwattanapong J, Wittayanookulluk A, Uttawichai K, Boonchareon H, Srisurapanont M. Correlates of health-related quality of life in Thai patients with alcohol dependence. J Ethn Subst Abuse 2015; 15:210-20. [PMID: 26422548 DOI: 10.1080/15332640.2015.1022628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study aimed to examine the correlates of health related quality of life in Thai patients with alcohol dependence. The amount of alcohol intake was calculated by timeline followback chart and the health related quality of life was determined by Short Form-36 Health Survey. The means of the Short Form-36 Physical Component and Mental Component Summary were 67.43 (18.74) and 64.45 (20.90), respectively. Stepwise linear regression models showed the number of heavy drinking days was significantly correlated with the Physical Component Summary and Mental Component Summary. Such moderate correlations suggest that drinking and health related quality of life measures might tap different aspects of alcohol outcomes and should be concurrently administered.
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Affiliation(s)
- Pichai Saengcharnchai
- a Department of Psychiatry and Neurology , Phramongkutklao Hospital , Bangkok , Thailand
| | - Surinporn Likhitsathian
- b Department of Psychiatry, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
| | | | | | | | | | - Manit Srisurapanont
- b Department of Psychiatry, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
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François C, Rahhali N, Chalem Y, Sørensen P, Luquiens A, Aubin HJ. The Effects of as-Needed Nalmefene on Patient-Reported Outcomes and Quality of Life in Relation to a Reduction in Alcohol Consumption in Alcohol-Dependent Patients. PLoS One 2015; 10:e0129289. [PMID: 26053024 PMCID: PMC4460126 DOI: 10.1371/journal.pone.0129289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/06/2015] [Indexed: 11/15/2022] Open
Abstract
Background The objective of this article was to investigate the effect of as-needed nalmefene on health-related quality of life (HRQoL) in patients with alcohol dependence, and to relate changes in drinking behavior and status to HRQoL outcomes. Methods This post hoc analysis was conducted on a pooled subgroup of patients with at least a high drinking risk level (men: >60 g/day; women: >40 g/day) who participated in one of two randomized controlled 6-month studies, ESENSE 1 and ESENSE 2. Patients received nalmefene 18 mg or placebo on an as-needed basis, in addition to a motivational and adherence-enhancing intervention (BRENDA). At baseline and after 12 and 24 weeks questionnaires for the Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36), European Quality of life-5 Dimensions (EQ-5D) and the Drinker Inventory of Consequences (DrInC-2R) were completed. Results The pooled population consisted of 667 patients (nalmefene: 335; placebo: 332), with no notable between-group differences in baseline patient demographics/characteristics. At week 24, nalmefene had a superior effect compared to placebo in improving SF-36 mental component summary scores (mean difference [95% CI], p-value: 3.09 [1.29, 4.89]; p=0.0008), SF-36 physical component summary scores (1.23 [0.15, 2.31]; p=0.026), EQ-5D utility index scores (0.03 [0.00, 0.06]; p=0.045), EQ-5D health state scores (3.46 [0.75, 6.17]; p=0.012), and DrInC-2R scores (-3.22 [-6.12, 0.33]; p=0.029). The improvements in SF-36 mental component summary scores at week 24, and the DrInC-2R total score change from baseline to week 24, were significantly correlated to reductions in heavy drinking days and total alcohol consumption at week 24. Conclusions As-needed nalmefene significantly improved almost all patient-reported HRQoL measures included in SF-36 and EQ-5D compared with placebo. These HRQoL gains were significantly correlated to reduced drinking behavior, as determined by reductions in heavy drinking days and total alcohol consumption.
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Affiliation(s)
| | - Nora Rahhali
- H. Lundbeck A/S, Issy les Moulineaux Cedex, France
| | - Ylana Chalem
- H. Lundbeck A/S, Issy les Moulineaux Cedex, France
| | | | - Amandine Luquiens
- Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, INSERM U669, Villejuif Cedex, France
| | - Henri-Jean Aubin
- Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, INSERM U669, Villejuif Cedex, France
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Kim K, Kim JS. The association between alcohol consumption patterns and health-related quality of life in a nationally representative sample of South Korean adults. PLoS One 2015; 10:e0119245. [PMID: 25786249 PMCID: PMC4365041 DOI: 10.1371/journal.pone.0119245] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 01/19/2015] [Indexed: 11/24/2022] Open
Abstract
This study examined the relationship between alcohol consumption and health-related quality of life (HRQOL) in a nationally representative sample of middle-aged to older South Koreans. Data collected from 3,408 men and 3,361 women aged ≥ 40 years were obtained from the 2010 and 2011 Korea National Health and Nutrition Examination Survey. Based on the World Health Organization guidelines, the participants were categorized into zones I (0–7), II (8–15), III (16–19), or IV (20–40) according to their Alcohol Use Disorders Identification Test (AUDIT) scores, with a higher zone indicating a higher level of alcohol consumption. Data collected from the AUDIT and EuroQol 5-Dimension (EQ-5D) test were subjected to multiple regression analysis in order to examine the relationship between alcohol consumption patterns and health-related quality of life, and to identify intersex and interzone differences. Significant intersex differences were found for the mean total AUDIT and EQ-5D scores and the proportion of participants rating their pain/discomfort and impairment in mobility and usual activities as “moderate” or “severe” (p < 0.001). The analysis of the EQ-5D scores by alcohol consumption pattern and sex suggested the existence of an inverted U-shaped relationship between the total AUDIT and EQ-5D scores. The HRQOL of moderate alcohol drinkers was higher than that of non-drinkers and heavy drinkers. The results of this study will be valuable in designing appropriate interventions to increase the HRQOL impaired by the harmful use of alcohol, in comparing HRQOL among different countries, and in implementing alcohol-related health projects.
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Affiliation(s)
- KyungHee Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Ji-Su Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
- * E-mail:
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Seixas AA, Nunes JV, Airhihenbuwa CO, Williams NJ, Pandi-Perumal SR, James CC, Jean-Louis G. Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey. Neuropsychiatr Dis Treat 2015; 11:2425-30. [PMID: 26442563 PMCID: PMC4590582 DOI: 10.2147/ndt.s77909] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). METHODS Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. PARTICIPANTS A total of 27,731 participants (age range 18-85 years) from the NHIS 2009 dataset were interviewed. MEASURES Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7-8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. RESULTS Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). CONCLUSION Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis).
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Affiliation(s)
- Azizi A Seixas
- Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA
| | - Joao V Nunes
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY, USA
| | - Collins O Airhihenbuwa
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
| | - Natasha J Williams
- Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA
| | - Seithikurippu Ratnas Pandi-Perumal
- Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA
| | - Caryl C James
- Department of Sociology, Psychology and Social Work, The University of the West Indies, Mona, Jamaica
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA
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Abstract
BACKGROUND Alcohol dependence is a multi-dimensional and chronic disorder which affects the physical, psychological, social, sexual health and thus the quality of life of the individual. OBJECTIVES This research was designed in order to determine the effect of alcohol dependence on the quality of life and sexual life of women. METHODS The research was a cross-sectional and comparative relation study, consisting of a case study group constituted of women who consulted Prof. Dr. Mazhar Osman Mental Health and Disorders Training and Research Hospital's Alcohol and Substance Research, Treatment, Education Center between July 2009 and July 2010 and who were diagnosed as alcohol addicted and a healthy group, constituted of women who consulted the Gynecology Clinic of the same hospital (alcohol dependent group = 71, healthy group = 183). The data were collected using 'World Health Organization Quality of Life Scale Brief Form' (WHOQOL-BREF TR), Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI). Data were analyzed by percentage, mean, chi-square, student's t-test, and multivariate analysis by use of SPSS 13.0 program. RESULTS It was determined that the alcohol-dependent women presented lower WHOQOL-BREF-TR sub-dimensions and lower FSFI total scores and sub-dimensions but higher scores in BDI scale in comparison to the healthy group. CONCLUSIONS The alcohol dependence negatively affects the quality of life and sexual life in women.
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Affiliation(s)
- Melike Dişsiz
- a Department of Alcohol-Substance Research, Treatment and Education Center , Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery , Bakirkoy , Istanbul , Turkey
| | - Nezihe Beji
- b Health Science, Department of Obstetric and Gynecologic Nursing , Florence Nightingale College of Nursing , Istanbul , Turkey
| | - Ümran Oskay
- b Health Science, Department of Obstetric and Gynecologic Nursing , Florence Nightingale College of Nursing , Istanbul , Turkey
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Essex HN, White IR, Khadjesari Z, Linke S, McCambridge J, Murray E, Parrott S, Godfrey C. Quality of life among hazardous and harmful drinkers: EQ-5D over a 1-year follow-up period. Qual Life Res 2013; 23:733-43. [PMID: 24026632 DOI: 10.1007/s11136-013-0521-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2013] [Indexed: 11/21/2022]
Abstract
PURPOSE To investigate the ability of the EQ-5D to discriminate between levels of alcohol risk in a large sample of hazardous and harmful drinkers, and to explore the relationship between transitions between alcohol risk levels and changes in EQ-5D up to 12 months. METHODS This is a web-based randomised controlled trial evaluating a novel intervention for hazardous and harmful alcohol consumption. EQ-5D scores were compared among groups of drinkers at baseline (low/medium/high risk according to self-reported past week alcohol consumption), and changes in EQ-5D scores were estimated as a function of changes in alcohol consumption level. RESULTS Baseline EQ-5D scores were dominated by problems with anxiety/depression, which increased with alcohol risk level, whilst high-risk drinkers also experienced more problems with physical HRQoL dimensions. However, the tool demonstrated a considerable ceiling effect. At follow-up, despite considerable reductions in alcohol consumption across the sample, significant changes in aggregated EQ-5D index scores were only observed for high-risk drinkers at baseline who reduced their drinking, with small improvements (0.04-0.06) compared to those who did not reduce. CONCLUSIONS Our results suggest that the three-option EQ-5D may not be an optimal primary end point for measuring clinical and cost-effectiveness in randomised controlled trials of interventions among hazardous and harmful alcohol users, although further testing of the sensitivity of the tool in these populations is needed.
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Affiliation(s)
- Holly N Essex
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK,
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Zhabenko O, Krentzman AR, Robinson EAR, Brower KJ. A longitudinal study of drinking and depression as predictors of insomnia in alcohol-dependent individuals. Subst Use Misuse 2013; 48:495-505. [PMID: 23566203 DOI: 10.3109/10826084.2013.781182] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Insomnia and depressive symptoms are common symptoms among alcohol-dependent (AD) patients. AD individuals (N = 364) were assessed during 2004-2009 in the Midwestern United States at baseline and 6-month intervals with the Sleep Problems Questionnaire, Time-Line Follow-Back interview, and the depression subscale of the Brief Symptom Inventory. Hierarchical Linear Modeling was used to analyze the data in this longitudinal study. When modeled separately, both quantity of drinking (p < .01) and depression (p < .001) predicted insomnia severity, controlling for time, age, and gender. Drinking also predicted depressive symptoms (p < .001), and its effect on insomnia was mediated by depression severity (p < .001).
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Affiliation(s)
- Olena Zhabenko
- Ukrainian Research Institute of Social and Forensic Psychiatry and Drug Abuse, Kiev, Ukraine.
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Colpaert K, De Maeyer J, Broekaert E, Vanderplasschen W. Impact of addiction severity and psychiatric comorbidity on the quality of life of alcohol-, drug- and dual-dependent persons in residential treatment. Eur Addict Res 2013; 19:173-83. [PMID: 23257413 DOI: 10.1159/000343098] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/29/2012] [Indexed: 01/28/2023]
Abstract
BACKGROUND Substance users' quality of life (QoL) is influenced by several variables, including psychiatric comorbidity and addiction severity. Thus far, the impact of the type of dependence (alcohol, drug or dual dependence) remains unclear. Therefore, the objectives of the study were to evaluate QoL in a clinical sample of alcohol-, drug- and dual-dependent patients and to assess the independent impact of psychiatric comorbidity, addiction severity and type of dependence on QoL. METHODS Face-to-face interviews with 274 patients admitted to residential substance abuse treatment were conducted using the European Addiction Severity Index (EuropASI), the Mini-International Neuropsychiatric Interview and the Assessment of Personality Disorders self-report questionnaire. RESULTS Multivariate analyses showed that anxiety, mood or personality disorder, employment status and the severity rating on the EuropASI domain alcohol use were associated with overall QoL. Gender, anxiety disorder and the severity ratings on the EuropASI domains alcohol use, drug use, physical health and emotional and psychological health were associated with overall perception of health. CONCLUSION Addiction severity and psychiatric comorbidity explained the greatest amount of QoL variance, whereas the type of dependence did not play a central role.
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Affiliation(s)
- Kathy Colpaert
- Department of Orthopedagogics, Ghent University, BE–9000 Ghent, Belgium.
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Abstract
LEARNING OBJECTIVES After participating in this educational activity, the reader should be better able to identify the instruments that are currently being used to measure quality of life (QoL) in alcohol abuse and dependence; determine the impact of alcohol abuse and dependence on QoL; and evaluate the impact of treating alcohol abuse and dependence on QoL. OBJECTIVE Quality of life, which consists of the physical, mental, and social domains, has been shown to be negatively affected by alcohol abuse and dependence. This review aims to examine QoL in alcohol abuse and dependence by reviewing the instruments used to measure it and by analyzing the impact of alcohol abuse and dependence and of treatment on QoL. METHODS Studies were identified using a database search of PubMed and PsycINFO from the past 40 years (1971-2011) using the following keywords: abuse OR dependence, OR use AND alcohol, AND Quality of Life, QoL, Health-related quality of life, HRQOL. Two authors agreed independently on including 50 studies that met specific selection criteria. RESULTS Although several global measures of QoL have established reliability and validity, many alcohol-specific measures of QoL have not yet been validated. Nevertheless, QoL has been shown to be significantly impaired in those with alcohol abuse and dependence, particularly in the domains of mental health and social functioning, the very areas that show the greatest improvement with abstinence and its maintenance. Moreover, the literature demonstrates the utility of using QoL measures throughout assessment and treatment as a motivational tool and as a marker for treatment efficacy. CONCLUSIONS Measuring and monitoring QoL during assessment and treatment can add important value to patient recovery, for QoL improves with treatment and successful abstinence. Therefore, targeted, disease-specific assessments of QoL are warranted to address the impairments in the physical, mental, and social domains in alcohol abuse and dependence, thereby improving long-term outcomes.
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Sleep Disturbance in Alcoholism: Proposal of a Simple Measurement, and Results from a 24-Week Randomized Controlled Study of Alcohol-Dependent Patients Assessing Acamprosate Efficacy. Alcohol Alcohol 2012; 47:133-9. [DOI: 10.1093/alcalc/agr160] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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SAATCIOGLU OMER, YAPICI ASLIHAN, CAKMAK DURAN. Quality of life, depression and anxiety in alcohol dependence. Drug Alcohol Rev 2009; 27:83-90. [DOI: 10.1080/09595230701711140] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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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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LoCastro JS, Youngblood M, Cisler RA, Mattson ME, Zweben A, Anton RF, Donovan DM. Alcohol treatment effects on secondary nondrinking outcomes and quality of life: the COMBINE study. J Stud Alcohol Drugs 2009; 70:186-96. [PMID: 19261230 DOI: 10.15288/jsad.2009.70.186] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the full range of alcohol treatment effectiveness, it is important to assess secondary nondrinking outcome dimensions in addition to primary alcohol consumption outcomes. METHOD We used a large sample (n=1,226) of alcohol-dependent participants entering the National Institute on Alcohol Abuse and Alcoholism-sponsored COMBINE (Combining Medications and Behavioral Interventions) Study, a multisite clinical trial of pharmacological (naltrexone [ReVia] and acamprosate [Campral]) and behavioral interventions, to examine the effects of specific treatment combinations on nondrinking functional outcomes. We assessed the outcomes at baseline and at the end of 16 weeks of alcohol treatment and again at the 26-week and/or 52-week postrandomization follow-ups. RESULTS (1) Drinking and secondary outcomes were significantly related, especially at the follow-up periods. A higher percentage of heavy drinking days, more drinks per drinking day, and lower percentage of days abstinent were associated with lower quality-of-life measures. (2) All nondrinking outcomes showed improvement at the end of 16 weeks of treatment and most maintained improvement over the 26-week and 52-week follow-ups. Only two measures returned to pretreatment levels at 52 weeks: percentage of days paid for work and physical health. Improvements of nondrinking outcomes remained even after adjusting for posttreatment heavy drinking status. (3) Although nondrinking outcomes showed overall improvement, specific pharmacological and behavioral treatment combinations were not differentially effective on specific secondary outcomes. CONCLUSIONS In the current study, changes that resulted from treatment were multidimensional, and improvements in nondrinking outcomes reflected the overall significant improvement in drinking but they were not differentiated between treatment combination groups. Findings from this study support the importance of including secondary nondrinking outcomes in clinical alcohol-treatment trials.
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Affiliation(s)
- Joseph S LoCastro
- Department of Psychiatry, Boston University School of Medicine and Veterans Affairs Boston Healthcare System, Boston, Massachusetts 02130, USA.
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Reaney MD, Martin C, Speight J. Understanding and Assessing the Impact of Alcoholism on Quality of Life. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2008; 1:151-63. [DOI: 10.2165/1312067-200801030-00002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Saarni SI, Joutsenniemi K, Koskinen S, Suvisaari J, Pirkola S, Sintonen H, Poikolainen K, Lönnqvist J. Alcohol consumption, abstaining, health utility, and quality of life – a general population survey in finland. Alcohol Alcohol 2008; 43:376-86. [DOI: 10.1093/alcalc/agn003] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Günther OH, Roick C, Angermeyer MC, König HH. Responsiveness of EQ-5D utility indices in alcohol-dependent patients. Drug Alcohol Depend 2008; 92:291-5. [PMID: 17888587 DOI: 10.1016/j.drugalcdep.2007.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 07/16/2007] [Accepted: 07/16/2007] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The EQ-5D provides community-based preference weights (utilities) for calculating quality adjusted life years (QALYs) in cost-utility analysis. This study aimed to analyze the responsiveness of EQ-5D-based utilities in patients with alcohol dependence. METHODS In an observational longitudinal cohort study of alcohol-dependent patients (N=52), three different EQ-5D-based utilities (EQ-Index United Kingdom, United States, and Germany) were calculated and compared with the scores of the WHOQOL-BREF (mental domain), HoNOS (total score), and GAF at baseline and at 18 months. Patients were categorized with more/same/less problems according to their self reported consumption of alcohol (patient-based anchor) and their problem status due to alcohol consumption using a question of the HoNOS scale (clinician-based anchor). Effect sizes (ES) were used to compare longitudinal changes in scores within each group; regression analysis was used to derive difference scores in health status associated with a shift from "same" to "less" problems according to the two anchors. RESULTS ES were rather trivial to medium for all EQ-5D indices (ranging from |0.10| to |0.59|) related to a shift from "same" to "less" problems in the two anchors. Differences in scores of the EQ-5D indices revealing a shift from "same" to "less" problems according to the two anchors were not significant. CONCLUSIONS These results suggest that the EQ-5D indices are less responsive and require larger patient samples to detect meaningful clinical differences compared to the other used instruments. Additional research is needed to compare societal and clinical views on relevant change in health status in this patient group.
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Affiliation(s)
- Oliver H Günther
- Health Economics Research Unit, University of Leipzig, Johannisallee 20, 04317 Leipzig, Germany.
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Saarni SI, Suvisaari J, Sintonen H, Pirkola S, Koskinen S, Aromaa A, Lönnqvist J. Impact of psychiatric disorders on health-related quality of life: general population survey. Br J Psychiatry 2007; 190:326-32. [PMID: 17401039 DOI: 10.1192/bjp.bp.106.025106] [Citation(s) in RCA: 243] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Measurement of health-related quality of life (HRQoL) with generic preference-based instruments enables comparisons of severity across different conditions and treatments. This is necessary for rational public health policy. AIMS To measure HRQoL decrement and loss of quality-adjusted life-years (QALYs) associated with pure and comorbid forms of depressive and anxiety disorders and alcohol dependence. METHOD A general population survey was conducted of Finns aged 30 years and over. Psychiatric disorders were diagnosed with the Composite International Diagnostic Interview and HRQoL was measured with the 15D and EQ-5D questionnaires. RESULTS Dysthymia, generalised anxiety disorder and social phobia were associated with the largest loss of HRQoL on the individual level before and after adjusting for somatic and psychiatric comorbidity. On the population level, depressive disorders accounted for 55%, anxiety disorders 30%, and alcohol dependence for 15% of QALY loss identified in this study. CONCLUSIONS Chronic anxiety disorders and dysthymia are associated with poorer HRQoL than previously thought.
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Affiliation(s)
- Samuli I Saarni
- Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki, Finland.
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Günther O, Roick C, Angermeyer MC, König HH. The EQ-5D in alcohol dependent patients: relationships among health-related quality of life, psychopathology and social functioning. Drug Alcohol Depend 2007; 86:253-64. [PMID: 16930855 DOI: 10.1016/j.drugalcdep.2006.07.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Revised: 07/07/2006] [Accepted: 07/07/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The EQ-5D, a short generic health-related quality of life (HRQOL) questionnaire, can derive preference-based index scores (e.g. EQ VAS, British and German EQ-5D indices) for economic evaluation. This study examined if the EQ-5D could be a valid measure describing and valuing HRQOL in alcohol dependent individuals. METHODS In a sample of 103 individuals diagnosed with alcohol dependence (ICD-10 F10.2), we compared the EQ-5D against a quality of life measure (WHOQoL-BREF), a utility scale (TTO), measures of psychopathology (SCL-90R, CGI-S) and measures of social functioning (GAF, GARF, SOFAS, HoNOS). RESULTS The response rate to EQ-5D dimensions was > 98%. Twelve percent of the individuals indicated "extreme problems" in at least one dimension. Different response levels in the dimension "anxiety/depression" were associated with largest effect sizes (absolute value(d)) of differences in mean scores of the WHOQoL-BREF domain "mental" (absolute value(d) = 1.17), the SCL-90R scales "obsessive-compulsive" (absolute value(d) = 1.15), "depression" (absolute value(d) = 1.16), "anxiety" (absolute value(d) = 1.10) and "GSI" (absolute value(d) = 1.09) indicating a similarity between the underlying constructs; concerning the dimensions "self-care", "usual activities", "pain/discomfort" and "mobility" effect sizes were generally lower (0.74 < absolute value(d) < 1.07) or insignificant. The EQ-5D VAS score (mean 58.0), the British EQ-5D index (mean 0.74) and the German EQ-5D index (mean 0.85) showed moderate correlations with other scales (0.28 < r < 0.60). CONCLUSION Seventeen out of 30 hypothesized relationships between similar constructs of the EQ-5D and measures used for comparison were confirmed, possibly favoring EQ-5D's validity. However, the EQ-5D showed a moderate ceiling effect. Further confirmatory research is needed to support the EQ-5D suitability for economic evaluation in alcohol dependent populations.
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Affiliation(s)
- Oliver Günther
- Health Economics Research Unit, University of Leipzig, Johannisallee 20, 04317 Leipzig, Germany.
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Morales-Manrique C, Castellano-Gómez M, Valderrama-Zurián J, Aleixandre-Benavent R. Medición de la calidad de vida e importancia de la atención a las necesidades autopercibidas en pacientes drogodependientes. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s1575-0973(06)75126-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Teplin D, Raz B, Daiter J, Varenbut M, Tyrrell M. Screening for substance use patterns among patients referred for a variety of sleep complaints. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2006; 32:111-20. [PMID: 16450646 DOI: 10.1080/00952990500328695] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Virtually all psychiatric and substance use disorders are associated with sleep disruption. Studies indicate that psychiatric disorders are related closely to chronic insomnia and that psychoactive substances have acute and chronic effects on sleep architecture. Several aspects of sleep are compromised in individuals taking these substances, ranging from difficulty initiating sleep to difficulty maintaining sleep and hypersomnia. Sleep disturbances are apparent in person taking psychoactive drugs or alcohol and have been found to persist long after withdrawing from these drugs. For some, sleep disturbance can be so severe as to reverse treatment success and precipitate relapse to addiction or dependence. There is increasing evidence that primary insomnia without a concurrent psychiatric disorder is a risk factor for later developing substance use disorders. Patients were asked to complete two brief screening tools, the Michigan Alcohol Screening Test and Drug Abuse Screening Test, to examine substance use patterns among patients referred for a variety of sleep complaints in a sleep disorders clinic. We found that patients who demonstrated a variety of sleep complaints were more likely to have alcohol and drug problems than those in the general populations.
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Affiliation(s)
- David Teplin
- York Region Sleep Disorders Centre, Ontario, Canada.
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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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John U, Meyer C, Rumpf HJ, Hapke U. Relationships of psychiatric disorders with sleep duration in an adult general population sample. J Psychiatr Res 2005; 39:577-83. [PMID: 16157160 DOI: 10.1016/j.jpsychires.2005.01.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2004] [Revised: 12/17/2004] [Accepted: 01/25/2005] [Indexed: 11/26/2022]
Abstract
The objective was to explore psychiatric disorders as potential predictors of sleep duration. A cross-sectional survey study with a probability sample of residents of a northern German area was carried out. There were 4075 study participants, aged 18--64 years, with a participation rate of 70.2%. Face-to-face in-home computer-aided interviews (Composite International Diagnostic Interview) provided diagnoses of nicotine and alcohol dependence, alcohol abuse, depressive, anxiety and somatoform disorders according to the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV), and included questions about sleep duration. Results show that subjects with a short sleep duration of 5h or less had significantly increased odds ratios (OR) for current nicotine dependence (OR 1.9,; confidence interval, CI, 1.2--2.9), alcohol dependence (OR 2.6, CI 1.2--5.6), depressive disorder (OR 3.0, CI 1.7--5.4) or anxiety disorder (OR 2.1, CI 1.3--3.4) compared to individuals who never had the respective psychiatric disorder after adjustment for sex, age, and school education in a multinomial regression analysis. The conclusion is drawn that current nicotine or alcohol dependence, depressive, and anxiety disorders may add to short sleep duration in this random adult general population sample.
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Affiliation(s)
- Ulrich John
- University of Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau-Strass 48, D-17487 Greifswald, Germany.
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Crum RM, Ford DE, Storr CL, Chan YF. Association of sleep disturbance with chronicity and remission of alcohol dependence: data from a population-based prospective study. Alcohol Clin Exp Res 2005; 28:1533-40. [PMID: 15597086 DOI: 10.1097/01.alc.0000141915.56236.40] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We assessed the association of three types of self-reported sleep disturbances (insomnia, hypersomnia, and sleep disturbance caused by worry) among individuals with chronic and remitted alcohol dependence, using prospectively gathered data from a population-based sample. METHODS Probability samples of area residents were selected by census tracks and households in Baltimore, MD, in 1981, as part of the Epidemiologic Catchment Area program (n = 3481). Between 1993 and 1996, the original cohort was traced, and 73% of the survivors were re-interviewed (n = 1920). Three groups for alcohol dependence status were identified: (1) chronic, (2) remitted, and (3) no lifetime or current history of dependence. Logistic regression models were used to assess the association between alcohol dependence status for each type of sleep disturbance. RESULTS Of the 248 individuals with alcohol dependence, most had achieved remission of dependence by the time of the median 13-year follow-up interview (n = 211). A total of 37 met criteria for chronic dependence. After holding constant potential confounders (age, sex, race, educational level, marital status, psychiatric and illicit drug disorder history, health services use, and age of onset of first alcohol-related problem), we found that chronic dependence was associated with insomnia (odds ratio = 2.60; 95% confidence interval = 1.11-6.08; p = 0.03), relative to those without a history of dependence. Remitted dependence was not associated with sleep disturbance in the models adjusted for covariates. In supplemental analyses, we assessed the association of drinking status with alcohol dependence remission. CONCLUSIONS Individuals with persistent alcohol dependence have greater odds of insomnia than those whose alcohol dependence remits. The need for prospectively gathered data from community-based samples to assess further the temporal relationships of sleep disturbance, alcohol dependence, and alcohol consumption level is discussed.
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Affiliation(s)
- Rosa M Crum
- Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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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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Cohn TJ, Foster JH, Peters TJ. Sequential studies of sleep disturbance and quality of life in abstaining alcoholics. Addict Biol 2003; 8:455-62. [PMID: 14690882 DOI: 10.1080/13556210310001646439] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Previous studies in recently detoxified dependent alcoholics have shown severely disturbed sleep and impaired quality of life. Although this association has been found to predict short-term relapse to heavy drinking, no sequential studies have been conducted to monitor significant changes in sleep quality and quality of life in abstaining alcoholics. Fifty-seven inpatients at a voluntary sector 12-Step alcohol detoxification unit in South London were administered a series of questionnaires assessing sleep (Pittsburgh Sleep Quality Index, PSQI), Quality of Life (Euro-Qol) and Depression and Anxiety (Hospital Anxiety and Depression Scales, HADS). Questionnaires were administered at baseline and for 12 weeks at monthly intervals. At baseline, PSQI scores showed that 52 of the 57 participants suffered from impaired sleep. The scores, however, did not correlate significantly with any of the other measurements. All except two participants acknowledged impaired Quality of Life in at least one area. With respect to the follow-up measurements 23 (40%) participants completed the study. Quality of life and depression scores improved significantly over a 12-week period but sleep and anxiety scores did not. At 12 weeks the mean PSQI score was still above the cut-off point for 'sleep caseness'. Quality of life and depression show a significant improvement over a 3-month period of abstinence, although at this point the subjects are still experiencing difficulties with sleep and anxiety. This information could help in the planning of future rehabilitation and treatment programmes.
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Affiliation(s)
- T J Cohn
- Departments fo Clinical Biochemistry and Psychological Medicine, King's College, Denmark Hill, London, UK.
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