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Alemu WG, Mwanri L, Due C, Azale T, Ziersch A. Quality of life among people with mental illness attending a psychiatric outpatient clinic in Ethiopia: a structural equation model. Front Psychiatry 2024; 15:1407588. [PMID: 39188522 PMCID: PMC11345643 DOI: 10.3389/fpsyt.2024.1407588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/22/2024] [Indexed: 08/28/2024] Open
Abstract
Background Mental illness is one of the most severe, chronic, and disabling public health problems that affects patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total study participants who had a follow-up appointment during the data collection period (2400), by the total sample size 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the quality of life (QoL) of people with mental illness. The domains of QoL were identified, and indirect and direct effects of variables were calculated using structural equation modelling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results A total of 636 (99.7%) participants agreed to participate and completed the data collection. The mean score of overall QoL of people with mental illness in the outpatient clinic was 49.6 ± 10 Sd. The highest QoL was found in the physical health domain (50.67 ± 9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41 ± 10 Sd). Rural residence, drug nonadherence, suicidal ideation, not getting counselling, moderate or severe subjective severity, family does not participate in patient care and a family history of mental illness had an indirect negative effect on QoL. Alcohol use and psychological health domain had direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having history of mental illness in the family had both direct and indirect effect on QoL. Furthermore, sociodemographic factors (rural residence, illiterate educational status, not married marital status), social support-related factors (poor self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use) and clinical factors (high objective and subjective severity of illness, not getting counselling, suicidal ideation, higher number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions In this study, the QoL of people with mental illness was poor, with the psychological health domain the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors, directly and indirectly affected QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the QoL of those with mental illness, including the development of policy and practice responses that address the above identified factors.
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Affiliation(s)
- Wondale Getinet Alemu
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- Research Centre for Public Health, Equity, and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Telake Azale
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
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Ezhumalai S. Outcome of Camp Approach in Treatment of Alcohol Use Disorder: A Non-randomized Controlled Study. JOURNAL OF PSYCHIATRY SPECTRUM 2024; 3:101-109. [PMID: 39119596 PMCID: PMC11308949 DOI: 10.4103/jopsys.jopsys_48_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Background Studies examining the outcome of the camp approach in the treatment of alcohol dependence are limited in India. Aim The aim of the study was to compare the outcomes of the community-based camp (CBC) approach and the hospital-based camp (HBC) approach in the treatment of persons with alcohol dependence. Methods The study used a non-randomized controlled study design (quasi-experimental research design before and after with a control group). In total, 60 respondents were selected through the census method (30 in the study group and 30 in the control group). Thirty respondents from the CBC formed the experimental group, and another 30 from the HBC formed the control group. The CBC was held for 7 days, and the HBC was held for 10 days. The tools used are the Alcohol Use Disorders Identification Test and the World Health Organization quality of life (QoL)-BREF. Statistical Analysis Independent t-test and effect size analysis were used. Kasturba Hospital Institute Ethics Committee, Manipal, had given the ethical clearance. Results The majority (73%) of the respondents in the CBC and 57% of the HBC participants maintained complete abstinence during the post-test. The relapse rate was lower in the CBC (27%) than in the HBC (43%). CBC is effective at increasing the number of follow-ups and decreasing alcohol intake during relapse. The effect of the camp intervention on increasing the number of follow-ups was medium (d = 0.36). The CBC had a small effect on enhancing the QoL of treated individuals with alcohol dependence syndrome during the post-test (d = 0.27). Conclusion The CBC approach is more effective than the hospital one at increasing follow-up and QoL and reducing the relapse rate.
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Affiliation(s)
- Sinu Ezhumalai
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Colaco AS, Mayya A, Noronha C, Mayya SS. Quality of life in patients with alcohol use disorders admitted to de-addiction centers using WHOQOL-BREF scale-A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:196. [PMID: 37546009 PMCID: PMC10402769 DOI: 10.4103/jehp.jehp_248_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/27/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Alcohol use disorders (AUDs) adversely affect a person's general health and the lives of their family and friends. These disorders are also the most undertreated mental illness with severe implications for public health. Hence, the present study aimed to employ the WHOQOL-BREF to assess the quality of life (QoL) of AUDs patients seeking treatment at de-addiction centers and identify the demographic variables associated with the QoL dimension scores. MATERIALS AND METHODS A cross-sectional study was conducted among alcohol dependents taking treatment in de-addiction centers in Dakshina Kannada District, Karnataka. The WHOQOL-BREF questionnaire was administered to 124 subjects. Multiple regression analysis was carried out to identify the demographic variables associated with the QoL dimension scores. RESULTS The domain mean scores were between 50 and 60 on the 0 to 100 scale. Age, social class, residential area, marital status, and years of drinking were the demographic variables found to be significantly associated with the dimension scores. CONCLUSIONS Physicians should monitor the effect of alcoholism on QoL, and a multidisciplinary treatment plan with elements from the medical, social, and psychiatric fields should be used. The demographic variables should be considered while managing patients with AUDs.
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Affiliation(s)
- Ashwini S. Colaco
- Department of Conservative Dentistry and Endodontics, A. J Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Arun Mayya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | | | - Shreemathi S. Mayya
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Córdoba-Mosqueda ME, Rasulić L, Savić A, Grujić J, Vitošević F, Lepić M, Mićić A, Radojević S, Mandić-Rajčević S, Jovanović I, Rodríguez-Aceves CA. Quality of life and satisfaction in patients surgically treated for cubital tunnel syndrome. Neurol Res 2023; 45:138-151. [PMID: 36130919 DOI: 10.1080/01616412.2022.2126163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Cubital tunnel syndrome (CuTS) results from compression of the ulnar nerve at the elbow, resulting in pain, weakness, and numbness of the hand and forearm. This work describes the Quality of Life (QoL) and satisfaction after CuTS surgery and identifies the factors associated with those outcomes. METHODS This cross-sectional study included patients surgically treated for CuTS from January 2011 to September 2021 at the Neurosurgery Clinic of the Clinic Center in Serbia. The questionnaires applied were the Short Form 36 (SF-36), EuroQol instrument (EQ-5D-5 L), Bishop's score and Patient-Rated Ulnar Nerve Evaluation (PRUNE). RESULTS Sixty-two patients met the inclusion criteria. Bishop's score: The median score was 10 (7.75-11), 54.8% of the cases presented excellent results. PRUNE: The median score for symptoms was 19 (6-38.5); for functional, was 14 (0.75-38); and the total was 18.25 (5.87-34.12). SF-36: The subscale with the best result was social functioning (84.68 ± 22.79). The scale with the worst value was emotional well-being (49.35 ± 7.87). EQ-5D-5L: Over 50% patients did not present problems with mobility, self-care, activity, and anxiety. The average EQ-VAS was 72.77 ± 18.70; and 0.72 ± 0.21 of the EQ-index, revealing a good QoL. Models for QoL and satisfaction: Ten models showed statistical significance. The variables with major involvement were body mass index and time evolution of the symptoms. CONCLUSION Surgical decompression has proved to diminish the symptoms, improving QoL and satisfaction. Many fixed and changeable factors can affect the satisfaction levels after surgery.
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Affiliation(s)
- María Elena Córdoba-Mosqueda
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Lukas Rasulić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Andrija Savić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Jovan Grujić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Filip Vitošević
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Neuroradiology Department, Center for Radiology and MRI, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan Lepić
- Clinic for Neurosurgery, Military Medical Academy, Belgrade, Serbia
| | - Aleksa Mićić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Stefan Mandić-Rajčević
- School of Public Health and Health Management and Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Jovanović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
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Neumann A, Soltmann B, Kliemt R, Weinhold I, Schmitt J, Pfennig A, Baum F. Health-related quality of life among patients with treated alcohol use disorders, schizophreniform disorders or affective disorders and the influence of flexible and integrative psychiatric care models in Germany (PsychCare). Front Psychiatry 2023; 14:1068087. [PMID: 37065884 PMCID: PMC10102371 DOI: 10.3389/fpsyt.2023.1068087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Flexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity. Methods We undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation. Results During measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, p = 0.003) and comparable HUWs at measurement II (0.581 vs. 0.586, p = 0.584). Symptom severity was comparable between both groups (I: 21.4 vs. 21.1, p = 0.936; II: 18.8 vs. 19.8, p = 0.122). We found lowest HRQoL and highest symptom severity in participants with affective disorders. HRQoL increased and symptom severity decreased over time in both groups. The QWB-SA dimension acute and chronic symptoms was associated with highest detriments in HRQoL. We identified risk/protective factors that were associated with lower quality of life and higher symptom severity in both groups. We confirmed that HRQoL was negatively associated with symptom severity. Discussion Health-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups.
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Affiliation(s)
- Anne Neumann
- Center of Evidence-Based Health Care, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- *Correspondence: Anne Neumann,
| | - Bettina Soltmann
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Roman Kliemt
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Ines Weinhold
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Jochen Schmitt
- Center of Evidence-Based Health Care, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Fabian Baum
- Center of Evidence-Based Health Care, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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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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Armoon B, Bayat AH, Bayani A, Mohammadi R, Ahounbar E, Fakhri Y. Quality of life and its associated factors among patients with substance use disorders: A systematic review and meta-analysis. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2069612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Amir-Hossien Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Azadeh Bayani
- School of Allied Medical Sciences, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Yadollah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Simirea M, Baumann C, Bisch M, Rousseau H, Di Patrizio P, Viennet S, Bourion-Bédès S. Health-related quality of life in outpatients with substance use disorder: evolution over time and associated factors. Health Qual Life Outcomes 2022; 20:26. [PMID: 35172824 PMCID: PMC8848823 DOI: 10.1186/s12955-022-01935-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health-related quality of life (HRQoL) is an important element of patient care and clinical research. The aim of this study was to describe HRQoL changes and identify associated factors during a 6-month follow-up of outpatients starting care for alcohol or opioid dependence. Methods HRQoL was measured at baseline and 3 and 6 months later using the SF-12. Data on the patients’ sociodemographics, clinical characteristics and levels of anxiety and depression were collected using the Hospital Anxiety and Depression Scale (HADS). Repeated-measures analyses were performed to assess factors associated with global HRQoL differences and the evolution of HRQoL indicated by both physical and mental scores (PCS and MCS, respectively). Results The mean PCS and MCS scores were initially low at 45.4 (SD = 8.6) and 36.0 (SD = 10.9), respectively. The improvement in HRQoL was rapid in the first 3-month period and then slowed and remained stable over the subsequent 3-month period. Being employed (p = 0.012), having no comorbidities (p = 0.014) and having no depression (p = 0.004) were associated with significant differences in the average PCS scores at the 3 time points. Patients who had lower overall HRQoL MCS scores on average were those for whom a medication was initiated (p = 0.009), as was the case for patients with anxiety (p < 0.001) and depression (p < 0.001). Patients with depression at baseline were also those for whom a significantly greater increase in MCS score during the 6 months of follow-up was observed. Conclusion Our findings highlight the importance of screening early psychological distress and considering other factors associated with HRQoL changes in outpatients after the first 3-month period of treatment for substance use disorder.
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Affiliation(s)
- Melexima Simirea
- Centre Psychothérapique de Nancy, CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), 54 520, Laxou, France.
| | - Cédric Baumann
- UMDS (Unit of Methodology, Data Management and Statistics), University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France.,EA4360 APEMAC (Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches) MICS Team, University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France
| | - Michael Bisch
- Centre Psychothérapique de Nancy, CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), 54 520, Laxou, France
| | - Hélène Rousseau
- UMDS (Unit of Methodology, Data Management and Statistics), University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France
| | - Paolo Di Patrizio
- Centre Psychothérapique de Nancy, CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), 54 520, Laxou, France
| | - Sarah Viennet
- Centre Psychothérapique de Nancy, CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), 54 520, Laxou, France
| | - Stéphanie Bourion-Bédès
- EA4360 APEMAC (Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches) MICS Team, University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France.,Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, 78150, Versailles, France
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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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10
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Olickal JJ, Saya GK, Selvaraj R, Chinnakali P. Association of alcohol use with quality of life (QoL): A community based study from Puducherry, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Berghöfer A, Martin L, Hense S, Weinmann S, Roll S. Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model. Qual Life Res 2020; 29:2073-2087. [PMID: 32170584 PMCID: PMC7363717 DOI: 10.1007/s11136-020-02470-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL. METHODS This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation's generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group. RESULTS A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation. CONCLUSION Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care.
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Affiliation(s)
- Anne Berghöfer
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Luise Martin
- Klinik f. Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Hense
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Stefan Weinmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Stephanie Roll
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
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12
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Thorberg FA, Hasking P, Huang YL, Lyvers M, Young RM, Connor JP, London ED, Feeney GFX. The Influence of Alexithymia on Alcohol Craving, Health-Related Quality of Life and Gender in Alcohol-Dependent Outpatients. J Psychoactive Drugs 2020; 52:366-376. [PMID: 32429771 DOI: 10.1080/02791072.2020.1762022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Alexithymia is a vulnerability factor for physical and mental illness that can significantly influence the daily function of alcohol-dependent patients. The aim of this study was to examine the indirect effect of obsessive thoughts and compulsive behaviors involving alcohol craving on the relationship between alexithymia, quality of life (QoL) of psychological well-being and health status. Three hundred and eighty-one outpatients (263 males and 118 females) in treatment for alcohol dependence completed self-report measures of alexithymia, alcohol craving, GHQ-28 (QoL-psychological well-being) and SF-36 (QoL-health status). Males scored significantly higher than females on aspects of alexithymia, and females reported significantly higher levels of alcohol craving. Path analysis showed an indirect effect of alcohol craving on the relationship between alexithymia, QoL-psychological well-being and self-reported QoL-health status for males only. The current study provides important new information about impaired self-reported health status and well-being among male alcohol-dependent treatment seekers with alexithymia.
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Affiliation(s)
- Fred Arne Thorberg
- School of Psychology and Counselling, Queensland University of Technology , Brisbane, QLD, Australia.,School of Psychology, Bond University , Gold Coast, QLD, Australia.,School of Psychology, The University of Queensland , Brisbane, QLD, Australia.,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles , Los Angeles, CA, USA
| | | | - Ya-Ling Huang
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital , Gold Coast, QLD, Australia.,Department of Respiratory Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital , Gold Coast, QLD, Australia
| | - Michael Lyvers
- School of Psychology, Bond University , Gold Coast, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Queensland University of Technology , Brisbane, QLD, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland , Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland , Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, The Princess Alexandra Hospital , Brisbane, QLD, Australia
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles , Los Angeles, CA, USA
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland , Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, The Princess Alexandra Hospital , Brisbane, QLD, Australia
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13
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Müller O, Baumann C, Di Patrizio P, Viennet S, Vlamynck G, Collet L, Clerc-Urmès I, Schwan R, Bourion-Bédès S. Patient's early satisfaction with care: a predictor of health-related quality of life change among outpatients with substance dependence. Health Qual Life Outcomes 2020; 18:6. [PMID: 31910879 PMCID: PMC6947996 DOI: 10.1186/s12955-019-1267-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/23/2019] [Indexed: 12/03/2022] Open
Abstract
Background Although research on health-related quality of life (HRQoL) has increased in the addiction field, few studies have focused on the determinants of HRQoL changes. This study aimed to describe dependent patients’ HRQoL changes at a 3-month follow-up and to assess whether satisfaction with care can predict those changes among outpatients starting care for alcohol or opioid dependence. Methods HRQoL was measured with the SF-12 at baseline and 3 months later in a prospective cohort of dependent outpatients. Satisfaction was assessed with the EQS-C early after inclusion. Data on sociodemographics, clinical characteristics and patients’ levels of anxiety and depression were also collected. A multivariable analysis was performed to identify factors associated with HRQoL changes in both the physical and mental component summary scores (PCS and MCS, respectively). Results Of the 172 patients included at baseline, a total of 136 patients assessed their satisfaction with care. The mean PCS and MCS scores were initially low, and HRQoL improvement was significant after 3 months for both the PCS and MCS. Never having been married (β = 5.5; p = 0.001) and a lower baseline PCS score (β = − 0.6; p < 0.0001) were associated with significant PCS improvement, whereas being legally compelled to undergo drug treatment (β = − 5.9; p = 0.02) was associated with less PCS change. Higher early satisfaction with care (β = 0.1; p = 0.02) and a lower baseline MCS score (β = − 0.7; p < 0.0001) were associated with significant MCS improvement. Conclusion The study supported the hypothesis that greater satisfaction with care may predict HRQoL improvement among dependent outpatients. Further studies are needed to understand the factors that affect patients’ early satisfaction to identify areas of improvement and thus improve HRQoL.
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Affiliation(s)
- Ophélie Müller
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Cédric Baumann
- Unit of Methodology, Data Management and Statistics, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France.,EA4360 APEMAC (Health adjustment, measurement and assessment, interdisciplinary approaches) MICS team, University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France
| | - Paolo Di Patrizio
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Sarah Viennet
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Guillaume Vlamynck
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Laura Collet
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Isabelle Clerc-Urmès
- Unit of Methodology, Data Management and Statistics, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France
| | - Raymund Schwan
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Stéphanie Bourion-Bédès
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France. .,EA4360 APEMAC (Health adjustment, measurement and assessment, interdisciplinary approaches) MICS team, University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France. .,Service médico-psychologique régional, 1, Rue Seulhotte B.P, 15082 57073, Metz, France.
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14
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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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15
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Hamdan-Mansour AM, Al-Sagarat AY, Al-Sarayreh F, Nawafleh H, Arabiat DH. Prevalence and correlates of substance use among psychiatric inpatients. Perspect Psychiatr Care 2018; 54:149-155. [PMID: 28233913 DOI: 10.1111/ppc.12214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/17/2016] [Accepted: 02/04/2017] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed at examining correlates of substance use among patients diagnosed with psychiatric disorders in Jordan. METHODS This study used a nonexperimental descriptive survey design. Data were collected through using DUSI-R scale obtained through a self-designed questionnaire. A total of (203) subjects satisfied the inclusion criteria. RESULTS Most used substances prior to admission were caffeine (78.2%), cigarette (60.9%), and alcohol (22.2%), while the least were heroin (1.2%) and inhalants (0.08%). Patients diagnosed with schizophrenia had higher percentages among all other disorders (n = 16, 21.9%), although there was no statistical difference among patients related to their psychiatric disorders. CONCLUSION We recommend that mental health professionals be equipped with necessary skills to manage substance use among patients with psychiatric disorders.
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Affiliation(s)
| | - Ahmad Y Al-Sagarat
- Community Mental Health Nursing Department, Faculty of Nursing, Mu'tah University, AL-Karak, Jordan
| | - Faris Al-Sarayreh
- Community Mental Health Nursing Department, Faculty of Nursing, Mu'tah University, AL-Karak, Jordan
| | - Hani Nawafleh
- Princess Aisha Bint Al-Hussien Faculty of Nursing, Al-Hussein Bin Talal University, Ma'an, Jordan
| | - Diana H Arabiat
- School of Nursing, the University of Jordan, Amman, Jordan & School of Nursing and Midwifery, Edith Cowan University, Perth/WA Australia
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16
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Brezing CA, Choi CJ, Pavlicova M, Brooks D, Mahony AL, Mariani JJ, Levin FR. Abstinence and reduced frequency of use are associated with improvements in quality of life among treatment-seekers with cannabis use disorder. Am J Addict 2018; 27:101-107. [PMID: 29457671 DOI: 10.1111/ajad.12660] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 12/06/2017] [Accepted: 12/09/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Many patients with cannabis use disorder (CUD) do not achieve or do not have abstinence as a goal of treatment, rather they reduce their use. Assessing outcome measures as they relate to functioning and reductions in cannabis use is an important area of study. Quality of life (QoL) shows promise as one such measure. Past studies have demonstrated gender differences in QoL and CUD. We aim to assess (1) the relationship between cannabis use and QoL and (2) gender effects in an outpatient medication treatment study for CUD. METHODS Data from an 11-weeks, double-blind, placebo-controlled trial of lofexidine and dronabinol for CUD (n = 62) was analyzed. Pearson's correlations between baseline QoL as measured with the Quality of Life, Enjoyment, and Satisfaction Questionnaire-Short Form (QLES-Q-SF) and cannabis use assessed with modified timeline follow-back (TLFB) were examined. Multiple linear regression models of cannabis use on end of study QLES-Q-SF were analyzed, while adjusting for baseline QLES-Q-SF, study arm, and gender. Moderation effects with gender were also tested. RESULTS No significant association between baseline cannabis use and QoL was found. End of study abstinence (F1,47 = 8.34, p = .006) and reduced proportion of using days (F1,47 = 9.48, p = .004) were each significantly associated with end of study QoL. Reduction in grams (F1,27 = 0.25, p = .62) was not associated with QoL at end of study. Gender was not a significant moderator. DISCUSSION AND CONCLUSIONS Abstinence and lower frequency of use are associated with higher QoL, regardless of gender. SCIENTIFIC SIGNIFICANCE This is the first time QoL has been demonstrated to change over the course of CUD medication treatment. QoL is an important outcome in CUD treatment. TRIAL REGISTRATION NCT01020019. (Am J Addict 2018;27:101-107).
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Affiliation(s)
- Christina A Brezing
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - C Jean Choi
- Division of Biostatistics, New York State Psychiatric Institute, New York, New York
| | - Martina Pavlicova
- Department of Biostatistics, Columbia University, New York, New York
| | - Daniel Brooks
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York
| | - Amy L Mahony
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York
| | - John J Mariani
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Medical Center, New York, New York
| | - Frances R Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Medical Center, New York, New York
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17
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Gür F, Can Gür G, Okanlı A. The Effect of the Cognitive-behavioral Model-based Psychoeducation and Exercise Intervention on Quality of Life in Alcohol Use Disorder. Arch Psychiatr Nurs 2017; 31:541-548. [PMID: 29179818 DOI: 10.1016/j.apnu.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/12/2017] [Accepted: 07/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to assess the effect of the cognitive behavior model (CBM)-based psychoeducation and exercise intervention on quality of life (QoL) in alcohol use disorder (AUD). DESIGN This study was a non-randomized controlled trial. METHODS CBM-based psychoeducation and exercise intervention was applied to the experimental group four times a week for 6weeks; no intervention was applied to the control group. FINDINGS No difference was seen between the points of pretest QoL of the experimental and control groups (p>0.05). However, according to the posttest, the experimental group's mean score of QoL was higher than the control groups (p<0.05). CONCLUSION It was found that CBM-based psychoeducation and exercise intervention applied to individuals with AUD affected the QoL positively. CLINICAL RELEVANCE CBM-based psychoeducation and exercise intervention can be used by nurses to improve AUD individuals' quality of life.
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Affiliation(s)
- Fatih Gür
- University of Karadeniz Technical, Faculty of Sport Science, Trabzon 61000, Turkey.
| | - Ganime Can Gür
- University of Atatürk, Faculty of Health Science, Department of Psychiatric Nursing, Erzurum 25000, Turkey.
| | - Ayşe Okanlı
- University of Medeniyet, Faculty of Health Science, Department of Psychiatric Nursing, İstanbul 34710, Turkey
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18
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Cheng HY, Elbers RG, Higgins JPT, Taylor A, MacArthur GJ, McGuinness L, Dawson S, López-López JA, Cowlishaw S, Hickman M, Kessler D. Therapeutic interventions for alcohol dependence in non-inpatient settings: a systematic review and network meta-analysis (protocol). Syst Rev 2017; 6:77. [PMID: 28399899 PMCID: PMC5387199 DOI: 10.1186/s13643-017-0462-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/21/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Alcohol dependence is common and serious cause of social and physical harm. However, the optimal management of those with moderate and severe alcohol dependence in primary and community care after detoxification remains unclear. The aim of this review is to evaluate the effectiveness of interventions for maintaining abstinence in people with alcohol dependence following detoxification. METHODS We will systematically search electronic databases and clinical trial registries for randomized controlled trials (RCTs) examining the effectiveness of pharmacological and/or psychosocial interventions for maintaining abstinence in recently detoxified, alcohol-dependent adults. The searches will be complemented by checking references and citations from included studies and other relevant systematic reviews. No limitation on language, year, or publication status will be applied. RCTs will be selected using prespecified criteria. Descriptive information, study characteristics, and results of eligible RCTs will be extracted. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed. DISCUSSION This network meta-analysis aims to appraise and summarize the total evidence of therapeutic interventions for alcohol-dependent patients that require support for detoxification and can be treated in the community. The evidence will determine which combination of interventions are most promising for current practice and further investigation. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016049779.
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Affiliation(s)
- Hung-Yuan Cheng
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Roy G Elbers
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Julian P T Higgins
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) on Evaluation of Interventions, University of Bristol, Bristol, UK
| | - Abigail Taylor
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Georgina J MacArthur
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Luke McGuinness
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Sarah Dawson
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - José A López-López
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Sean Cowlishaw
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) on Evaluation of Interventions, University of Bristol, Bristol, UK
| | - David Kessler
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,NIHR School of Primary Care Research, Bristol, UK
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19
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Osilla KC, Watkins KE, Kulesza M, Flórez K, Lara-Greenberg M, Miles JNV. Study design to evaluate cognitive behavioral therapy among a diverse sample of adults with a first-time DUI offense. Addict Sci Clin Pract 2016; 11:7. [PMID: 27036221 PMCID: PMC4815153 DOI: 10.1186/s13722-016-0053-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Driving under the influence (DUI) of alcohol is a major public health concern, and many individuals continue to drink and drive even after being convicted of a DUI offense. Latinos, in particular, are disproportionately likely to be arrested for a DUI, have higher rates of recidivism, and are more likely to die in alcohol-related accidents than non-Latino Whites. Latinos also experience significant disparities in accessing alcohol-related treatment. METHODS/DESIGN This study protocol paper describes a randomized trial of cognitive behavioral therapy (CBT) compared to usual care in DUI programs for individuals with a first-time offense and at-risk drinking. We will utilize a two-group randomized design where individuals enrolled in a DUI program with a first-time conviction will be randomized to CBT (n = 150) or usual care (n = 150). Participants will be assessed at baseline, immediately post-treatment, and 6-months post-treatment. Recidivism data will be collected using administrative data within 2 years post-treatment. DISCUSSION This project has the potential to benefit a large population of vulnerable individuals who are at risk of DUI recidivism. It also develops a new model of care by providing treatment in DUI programs to reduce disparities associated with poor treatment access. Trial registration NCT02588703.
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Affiliation(s)
- Karen Chan Osilla
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 USA
| | - Katherine E. Watkins
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 USA
| | - Magdalena Kulesza
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 USA
| | - Karen Flórez
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 USA
| | | | - Jeremy N. V. Miles
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 USA
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20
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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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Stein MD, Risi MM, Flori JN, Conti MT, Anderson BJ, Bailey GL. Gender Differences in the Life Concerns of Persons Seeking Alcohol Detoxification. J Subst Abuse Treat 2016; 63:34-8. [PMID: 26810131 DOI: 10.1016/j.jsat.2015.12.005] [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: 08/05/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study explored the life concerns of persons seeking alcohol detoxification, a group with multiple life and psychosocial challenges. Gender may be an important contributor to the particular life concerns of persons with alcohol use disorders. METHODS Using a 32-item, previously-validated life concerns survey that captures ten conceptual domains, we interviewed persons entering inpatient alcohol detoxification asking them to rate their level of concern about health and welfare items. RESULTS Participants (n=189) were 27% female, with a mean age of 43.5 years. Overall, concern about alcohol problems was perceived as the most serious, followed by mental health, cigarette smoking, financial, and relationship problems. Men were significantly more concerned than women about six of the ten domains including money, drug use, transmissible diseases, and physical illness. CONCLUSIONS Recognition of the daily worries of persons seeking inpatient alcohol detoxification persons could allow providers to better tailor their services to the context of their patients' lives. Focusing on pressing life concerns such as mental health, financial, relationship problems, and other drug use may influence detoxification services and aftercare treatment choices.
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Affiliation(s)
- Michael D Stein
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906; Warren Alpert Medical School of Brown University, Providence, RI 02912.
| | - Megan M Risi
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906
| | - Jessica N Flori
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906
| | - Micah T Conti
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906
| | | | - Genie L Bailey
- Warren Alpert Medical School of Brown University, Providence, RI 02912; Stanley Street Treatment and Resources, Inc., Fall River, MA 02720
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Alcohol craving in relation to coping with stress and satisfaction with life in the addicted. HEALTH PSYCHOLOGY REPORT 2015. [DOI: 10.5114/hpr.2016.54399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
<b>Background</b><br />
The present study aimed at finding any relation between alcohol craving and strategies of coping with stress and satisfaction with life in the addicted. Until now, studies have shown that generalized deficits in coping with stress, and the dominance of avoidance strategies, are significantly related to the increase of the risk of addiction and the course of this disease. This relation, which could link strategies of coping with stress and quality of life with experiencing alcohol craving, has only been explained to a small extent. Also, the role of gender in explaining these relations is ambiguous.<br />
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<b>Participants and procedure</b><br />
The study was conducted in a group of 550 addicted subjects in out-patient or in-patient treatment (396 men and 114 women). In the present study the following instruments were used: the Craving Typology Questionnaire by Marinotti et al., the Yale-Brown Obsessive-Compulsive Drinking Scale by Modell et al., the Mini-Cope by Carver et al., SADD by Reistrick et al., and the Satisfaction with Life Scale by Diener et al. Statistical correlational analysis and structural equations were applied, namely partial least squares path modelling (PLS-PM).<br />
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<b>Results</b><br />
There are two types of links between craving and strategies of coping with stress among the addicted. The first dominating type is pointing at casual link between ineffective strategies of coping with stress and craving. The other weaker type indicates the diminishing influence of effective strategies of coping with stress on alcohol craving. Life satisfaction lowers alcohol craving.<br />
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<b>Conclusions</b><br />
Effective strategies of reacting to stress, together with life satisfaction, protect against increase of alcohol craving. Severity of dependence is an important factor which moderates the influence of strategies of coping with stress on alcohol craving.
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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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Quality of life, alcohol detoxification and relapse: is quality of life a predictor of relapse or only a secondary outcome measure? Qual Life Res 2014; 23:2757-67. [PMID: 24929832 DOI: 10.1007/s11136-014-0735-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To estimate variations in Overall Quality Of Life (OQOL) within 12 months following alcohol detoxification and to evaluate the predictive value of OQOL for relapse and alcohol use severity. METHODS Alcohol use disorders and four OQOL domains (physical health, psychological health, social relationships and environment) were assessed in 199 patients entering in-patient alcohol detoxification. Follow-up assessments were performed at 6 and 12 months after discharge. Cross-sectional and longitudinal analyses explored the relationship between OQOL and alcohol use severity, examining differences between abstinent and relapsed patients. The predictive value of OQOL was analyzed by logistic and linear regression. RESULTS Correlation between OQOL and Alcohol Use Disorders Identification Test scores was confirmed at all stages of observation. Abstinent patients showed a significant improvement in all OQOL domains at 6 months after discharge, whereas OQOL domains did not undergo any significant change in relapsed patients. Baseline OQOL did not prove to be predictive of either relapse or alcohol use severity. CONCLUSIONS Overall quality of life changed in parallel with alcohol use severity throughout the duration of the study, confirming it to be a useful and sensitive measure of secondary outcome for alcohol detoxification. Conversely, none of the OQOL baseline scores functioned as predictors of relapse within 12 months following discharge or alcohol use severity in relapsed patients.
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Daeppen JB, Faouzi M, Sanchez N, Rahhali N, Bineau S, Bertholet N. Quality of life depends on the drinking pattern in alcohol-dependent patients. Alcohol Alcohol 2014; 49:457-65. [PMID: 24863264 DOI: 10.1093/alcalc/agu027] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIMS In patients with alcohol dependence, health-related quality of life (QOL) is reduced compared with that of a normal healthy population. The objective of the current analysis was to describe the evolution of health-related QOL in adults with alcohol dependence during a 24-month period after initial assessment for alcohol-related treatment in a routine practice setting, and its relation to drinking pattern which was evaluated across clusters based on the predominant pattern of alcohol use, set against the influence of baseline variables METHODS The Medical Outcomes Study 36-Item Short-Form Survey (MOS-SF-36) was used to measure QOL at baseline and quarterly for 2 years among participants in CONTROL, a prospective observational study of patients initiating treatment for alcohol dependence. The sample consisted of 160 adults with alcohol dependence (65.6% males) with a mean (SD) age of 45.6 (12.0) years. Alcohol use data were collected using TimeLine Follow-Back. Based on the participant's reported alcohol use, three clusters were identified: 52 (32.5%) mostly abstainers, 64 (40.0%) mostly moderate drinkers and 44 (27.5%) mostly heavy drinkers. Mixed-effect linear regression analysis was used to identify factors that were potentially associated with the mental and physical summary MOS-SF-36 scores at each time point. RESULTS The mean (SD) MOS-SF-36 mental component summary score (range 0-100, norm 50) was 35.7 (13.6) at baseline [mostly abstainers: 40.4 (14.6); mostly moderate drinkers 35.6 (12.4); mostly heavy drinkers 30.1 (12.1)]. The score improved to 43.1 (13.4) at 3 months [mostly abstainers: 47.4 (12.3); mostly moderate drinkers 44.2 (12.7); mostly heavy drinkers 35.1 (12.9)], to 47.3 (11.4) at 12 months [mostly abstainers: 51.7 (9.7); mostly moderate drinkers 44.8 (11.9); mostly heavy drinkers 44.1 (11.3)], and to 46.6 (11.1) at 24 months [mostly abstainers: 49.2 (11.6); mostly moderate drinkers 45.7 (11.9); mostly heavy drinkers 43.7 (8.8)]. Mixed-effect linear regression multivariate analyses indicated that there was a significant association between a lower 2-year follow-up MOS-SF-36 mental score and being a mostly heavy drinker (-6.97, P < 0.001) or mostly moderate drinker (-3.34 points, P = 0.018) [compared to mostly abstainers], being female (-3.73, P = 0.004), and having a Beck Inventory scale score ≥8 (-6.54, P < 0.001), at baseline. The mean (SD) MOS-SF-36 physical component summary score was 48.8 (10.6) at baseline, remained stable over the follow-up and did not differ across the three clusters. Mixed-effect linear regression univariate analyses found that the average 2-year follow-up MOS-SF-36 physical score was increased (compared with mostly abstainers) in mostly heavy drinkers (+4.44, P = 0.007); no other variables tested influenced the MOS-SF-36 physical score. CONCLUSION Among individuals with alcohol dependence, a rapid improvement was seen in the mental dimension of QOL following treatment initiation, which was maintained during 24 months. Improvement was associated with the pattern of alcohol use, becoming close to the general population norm in patients classified as mostly abstainers, improving substantially in mostly moderate drinkers and improving only slightly in mostly heavy drinkers. The physical dimension of QOL was generally in the normal range but was not associated with drinking patterns.
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Affiliation(s)
- Jean-Bernard Daeppen
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Mohamed Faouzi
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Nathalie Sanchez
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Nora Rahhali
- International Epidemiology Department, Lundbeck, Issy les Moulineaux, France
| | - Sébastien Bineau
- International Epidemiology Department, Lundbeck, Issy les Moulineaux, France
| | - Nicolas Bertholet
- Alcohol Treatment Centre, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
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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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Abstract
BACKGROUND Quality of life has emerged as an important treatment outcome measure for alcohol dependence whose natural course comprises of remission and relapse. MATERIALS AND METHODS The purpose of this study was to examine the prospective change in Quality of life (QoL) in 56 patients aged 18-45 years of alcohol dependence over a three months' period and compare it with QoL of 150 age- and gender- matched healthy controls using WHOQoL-BREF. Severity of alcohol dependence and drinking parameters were assessed. RESULTS Significant improvement in QoL of patients of alcohol dependence over three months' abstinence. The physical, psychological, social, and environment domains of QoL in alcohol dependence subjects were significantly lower before treatment initiation than the healthy controls. Alcoholic liver disease emerged as a predictor of improvement in psychological and social domains of QoL. CONCLUSION The study confirms poor quality of life in patients of alcohol dependence before intervention. The regular follow-up with the family members in out-patient setting enables the patients achieve complete abstinence, thereby improving their quality of life.
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Affiliation(s)
- Shruti Srivastava
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Manjeet S Bhatia
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, India
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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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Beccaria F, Rolando S, Ascani P. Alcohol consumption and quality of life among young adults: a comparison among three European countries. Subst Use Misuse 2012; 47:1214-23. [PMID: 22780839 DOI: 10.3109/10826084.2012.698689] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study aims to investigate the relationship between alcohol consumption and quality of life (QoL) on a representative sample of adults aged 25-34 living in France, Italy, and the Netherlands (4,841 subjects). The data was collected in 2008 using telephone interviews and analyzed with cluster analysis using Ward's method. Results show that the impact of alcohol consumption on QoL depends mainly on predominant consumption style and drinking culture that should be investigated further to identify protective factors.
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Prisciandaro JJ, DeSantis SM, Bandyopadhyay D. Simultaneous modeling of the impact of treatments on alcohol consumption and quality of life in the COMBINE study: a coupled hidden Markov analysis. Alcohol Clin Exp Res 2012; 36:2141-9. [PMID: 22551231 DOI: 10.1111/j.1530-0277.2012.01823.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 02/27/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Clinical trials for alcoholism have historically regarded alcohol consumption as the primary outcome. In a subset of trials, quality of life (QOL) has been considered as a secondary outcome. Joint latent-variable modeling techniques may provide a more accurate and powerful simultaneous analysis of primary and secondary outcomes in clinical trials. The goal of this study was to evaluate longitudinal associations between treatment status, alcohol consumption, and QOL in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study. METHODS A total of 1,383 alcohol-dependent patients were randomized to 9 treatment groups. Percent heavy drinking days (PHDD) and health-related QOL from the 30 days preceding baseline, week 16, and week 52 were calculated using the Form 90 and the Medical Outcomes Study Health Survey Short Form-12 (SF-12), respectively. Latent profile analysis (LPA) was conducted to determine an appropriate number of latent states to represent PHDD and QOL. Subsequently, univariate and coupled hidden Markov models (for PHDD and SF-12 mental health, and PHDD and SF-12 physical) were fit to the data. RESULTS LPA suggested that PHDD should be represented by 3 latent states and that each SF-12 scale should be represented by 2 states. Joint modeling results suggested that (i) naltrexone significantly predicted decreased PHDD (p < 0.05), and marginally predicted improved mental health QOL via decreased PHDD (p < 0.10), and (ii) that the combinations of naltrexone and combined behavioral intervention (CBI), and acamprosate and CBI, each predicted significantly improved physical QOL (p < 0.05), and marginally predicted decreased PHDD via improved physical QOL (p < 0.10). CONCLUSIONS This study illustrates a powerful and novel statistical approach for simultaneously evaluating the impact of treatments on primary and secondary outcomes in clinical trials. This study also suggests that behavioral interventions may impact drinking behavior through their ameliorative effects on QOL.
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Affiliation(s)
- James J Prisciandaro
- Clinical Neuroscience Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
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Effects of Family Support on Quality of Life among Alcohol Dependent Patients : Moderating Effect of Abstinence Self-Efficacy. ACTA ACUST UNITED AC 2012. [DOI: 10.4306/jknpa.2012.51.5.277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Extended-release naltrexone (XR-NTX; Vivitrol), developed to address poor adherence in addictive disorders, is approved for use in alcohol and opioid-dependence disorders. In alcohol-dependent adults with ≥ 4-day initial abstinence, XR-NTX increased initial and 6-month abstinence. An fMRI study found that XR-NTX attenuated the salience of alcohol visual and olfactory cues in the absence of alcohol, and post hoc analyses demonstrated efficacy even during high cue-exposure holiday periods. Safety and tolerability have generally been good, without adverse hepatic impact or intractable acute pain management. XR-NTX use appears feasible in primary care and public systems, and retrospective claims analyses have found cost savings and decreased intensive service utilization relative to oral agents. In opioid dependence, following detoxification, XR-NTX shows efficacy for maintaining abstinence, improving retention, decreasing craving, and preventing relapse. Trials are also exploring its use for the treatment of stimulant dependence. XR-NTX appears compatible with counseling and self-help attendance. While more research is needed, current findings suggest that a formulation of naltrexone that was sought beginning over three decades ago is fulfilling its promise as an extended-release pharmacotherapeutic.
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Guan B, Cohen P, Deng Y, Chen H. Relative impact of Axis I mental disorders on quality of life among adults in the community. J Affect Disord 2011; 131:293-8. [PMID: 21570579 PMCID: PMC3433573 DOI: 10.1016/j.jad.2011.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 12/17/2010] [Accepted: 01/13/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known about the relative impact of different mental disorders on adult quality of life (QOL). This study estimated associations between several mental disorders and QOL in a representative American community sample. METHODS The QOL instrument was administered to 640 adult participants in the Children in the Community Study, a population-based longitudinal study. DSM-Axis I and Axis II mental disorder diagnoses were assessed by psychiatric interview. RESULTS Poorer QOL was strongly associated with having a mood disorder, especially major depression disorder (MDD) (effect size, ES = -0.57, p < 0.01), whereas poorer quality social relationships were associated with having dysthymia and bipolar disorders (ES = -0.92, p < 0.01; ES = -0.80, p < 0.05, respectively). Most anxiety disorders were not independently related to QOL with the exception of post traumatic stress disorder (PTSD), which was significantly related to poorer physical health (ES = -0.78, p < 0.01) and psychological well-being (ES = -0.73, p < 0.01) and to less overall QOL (ES = -0.57, p < 0.01). CONCLUSIONS MDD and PTSD are independently related to impaired QOL and dysthymia and bipolar disorder negatively influence social relationships.
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Affiliation(s)
- Bingqing Guan
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University. Tongzipo Road, Changsha, Hunan, China
| | - Patricia Cohen
- New York State Psychiatric Institute
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University
| | - Yunlong Deng
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University. Tongzipo Road, Changsha, Hunan, China
| | - Henian Chen
- New York State Psychiatric Institute
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University
- Office of Health Outcome Research, Winthrop University Hospital. Stony Brook University School of Medicine
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Pettinati HM, Silverman BL, Battisti JJ, Forman R, Schweizer E, Gastfriend DR. Efficacy of extended-release naltrexone in patients with relatively higher severity of alcohol dependence. Alcohol Clin Exp Res 2011; 35:1804-11. [PMID: 21575016 DOI: 10.1111/j.1530-0277.2011.01524.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Because some literature reviews have suggested that naltrexone's benefit may be limited to less-severe alcohol dependence, and exclusively to reduction in heavy drinking rather than abstinence, we examined the efficacy of once per month, injectable extended-release naltrexone (XR-NTX 380 mg) in patients with relatively higher severity alcohol dependence. METHODS Post hoc analyses examined data from a multicenter, placebo-controlled, 24-week randomized trial of XR-NTX for alcohol dependence (N = 624). We analyzed treatment effects in alcohol-dependent patients who had higher baseline severity, as measured by: (i) the Alcohol Dependence Scale (ADS) or (ii) having been medically detoxified in the week before randomization. Efficacy was also examined via the relationship between pretreatment severity indices and reporting at least 4 days of lead-in abstinence prior to treatment-a major predictor of good outcome in the original study. RESULTS Higher severity alcohol-dependent patients, defined by the ADS, when receiving XR-NTX 380 mg (n = 50) compared with placebo (n = 47), had significantly fewer heavy-drinking days in-trial (hazard ratio=0.583; p = 0.0049) and showed an average reduction of 37.3% in heavy-drinking days compared with 27.4% for placebo-treated patients (p = 0.039). Among those who had a detoxification just prior to randomization, these reductions were 48.9% (XR-NTX 380 mg; n = 11) and 30.9% (placebo; n = 15) (p = 0.004). Subjects with at least 4 days of pretreatment abstinence (n = 82) versus those without (n = 542) had significantly higher pretreatment ADS scores (p = 0.002) and were more likely to require detoxification prior to randomization (p < 0.001). Patients with lead-in abstinence experienced significantly better maintenance of initial and 6-month abstinence. CONCLUSIONS These secondary analyses support the efficacy of XR-NTX 380 mg in relatively higher severity alcohol dependence for both reduction in heavy drinking and maintenance of abstinence, with implications for the role of adherence pharmacotherapy.
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Affiliation(s)
- Helen M Pettinati
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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Lindahl ML, Ojehagen A, Berglund M. Commitment to coercive care in relation to substance abuse reports to the social services. A 2-year follow-up. Nord J Psychiatry 2010; 64:372-6. [PMID: 20337568 DOI: 10.3109/08039481003710204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In Sweden, a person with substance abuse can be reported to the social services for an investigation about commitment to coercive care. After a change in legislation, municipalities varied greatly in the ratio of commitments/reports compared with the period before the legislation was amended. AIMS The primary aims of this study were first, to investigate whether subjects from municipalities with a high ratio of commitments/reports have a better outcome compared with subjects from municipalities with a low ratio and second, if a high ratio has an impact on mortality. METHODS The study involved two municipalities with high ratio of commitments/reports with 56 cases reported for substance abuse including 31 committed cases (55%). It also included two municipalities with a low ratio, 50 reported cases including six committed cases (12%). Two social service inspectors at the country administrative board assessed the cases in terms of severity of addiction according to legal criteria (κ(s)=0.66), indicating good inter-rater agreement. A global index based on information about substance abuse, employment and housing was used as outcome measure at the 2-year follow-up. RESULTS Global outcome did not differ between cases from high- and low-ratio municipalities. Seven subjects had deceased because of causes related to substance abuse. None of the deceased had been committed to coercive care. CONCLUSIONS AND CLINICAL IMPLICATIONS In conclusion, the different ratios of commitments/reports did not influence global outcome. Commitment may reduce substance-related deaths.
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Ginieri-Coccossis M, Triantafillou E, Tomaras V, Liappas IA, Christodoulou GN, Papadimitriou GN. Quality of life in mentally ill, physically ill and healthy individuals: the validation of the Greek version of the World Health Organization Quality of Life (WHOQOL-100) questionnaire. Ann Gen Psychiatry 2009; 8:23. [PMID: 19825155 PMCID: PMC2770035 DOI: 10.1186/1744-859x-8-23] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 10/13/2009] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The World Health Organization Quality of Life (WHOQOL-100) questionnaire is a generic quality of life (QoL) measurement tool used in various cultural and social settings and across different patient and healthy populations. The present study examines the psychometric properties of the Greek version, with an emphasis on the ability of the instrument to capture QoL differences between mentally ill, physically ill and healthy individuals. METHODS A total of 425 Caucasian participants were tested, as to form 3 groups: (a) 124 psychiatric patients (schizophrenia n = 87, alcohol abuse/dependence n = 37), (b) 234 patients with physical illness (hypertension n = 139, cancer n = 95), and (c) 67 healthy control individuals. RESULTS Confirmatory factor analysis was performed indicating that a four-factor model can provide an adequate instrument structure for the participating groups (GFI 0.92). Additionally, internal consistency of the instrument was shown to be acceptable, with Cronbach's alpha values ranging from 0.78 to 0.90 regarding the four -domain model, and from 0.40 to 0.90 regarding the six-domain one. Evidence based on Pearson's r and Independent samples t-test indicated satisfactory test/retest reliability, as well as good convergent validity tested with the General Health Questionnaire (GHQ-28) and the Life Satisfaction Inventory (LSI). Furthermore, using Independent samples t-test and one-way ANOVA, the instrument demonstrated good discriminatory ability between healthy, mentally ill and physically ill participants, as well as within the distinct patient groups of schizophrenic, alcohol dependent, hypertensive and cancer patients. Healthy individuals reported significantly higher QoL, particularly in the physical health domain and in the overall QoL/health facet. Mentally ill participants were distinctively differentiated from physically ill in several domains, with the greatest difference and reduction observed in the social relationships domain and in the overall QoL/health facet. Within the four distinct patient groups, alcohol abuse/dependence patients were found to report the most seriously compromised QoL in most domains, while hypertensive and cancer patients did not report extensive and significant differences at the domain level. However, significant differences between patient groups were observed at the facet level. For example, regarding the physical domain, physically ill participants reported more compromised scores in the pain/discomfort facet, while mentally ill participants in the facets of energy/fatigue, daily living activities and dependence on medication. CONCLUSION The findings of the study indicate that the Greek version of WHOQOL-100 provided satisfactory psychometric properties supporting its use within general and pathological populations and in the context of national and crosscultural QoL measurement.
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Affiliation(s)
| | | | - Vlasis Tomaras
- First Department of Psychiatry, Medical School, University of Athens, Greece
| | - Ioannis A Liappas
- First Department of Psychiatry, Medical School, University of Athens, Greece
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Jepsen P, Vilstrup H, Andersen PK, Sørensen HT. Socioeconomic status and survival of cirrhosis patients: a Danish nationwide cohort study. BMC Gastroenterol 2009; 9:35. [PMID: 19450284 PMCID: PMC2688507 DOI: 10.1186/1471-230x-9-35] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 05/18/2009] [Indexed: 12/15/2022] Open
Abstract
Background Low socioeconomic status is a risk factor for liver cirrhosis, but it is unknown whether it is a prognostic factor after cirrhosis diagnosis. We examined whether marital status, employment, and personal income were associated with the survival of cirrhosis patients. Methods Using registry-data we conducted a population-based cohort study of 1,765 Danish cirrhosis patients diagnosed in 1999–2001 at age 45–59 years. Follow-up ended on 31 December 2003. With Cox regression we examined the associations between marital status (never married, divorced, married), employment (employed, disability pensioner, unemployed), personal income (0–49, 50–99, 100+ percent of the national average) and survival, controlling for gender, age, cirrhosis severity, comorbidity, and substance abuse. Results Five-year survival was higher for married patients (48%) than for patients who never married (40%) or were divorced (34%), but after adjustment only divorced patients had poorer survival than married patients (adjusted hazard ratio for divorced vs. married = 1.22, 95% CI 1.04–1.42). Five-year survival was lower for disability pensioners (31%) than for employed (46%) or unemployed patients (48%), also after adjustment (adjusted hazard ratio for disability pensioners vs. employed = 1.35, 95% CI 1.09–1.66). Personal income was not associated with survival. Conclusion Marital status and employment were associated with the survival of cirrhosis patients. Specifically, divorced cirrhosis patients and cirrhosis patients who never married had a poorer survival than did married cirrhosis patients, and cirrhosis patients who were disability pensioners had a poorer survival than did employed or unemployed cirrhosis patients. The poorer survival for the divorced and for the disability pensioners could not be explained by differences in other socioeconomic factors, gender, age, cirrhosis severity, substance abuse, or comorbidity. Personal income was not associated with survival.
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Affiliation(s)
- Peter Jepsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
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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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Dawson DA, Li TK, Chou SP, Grant BF. Transitions in and out of alcohol use disorders: their associations with conditional changes in quality of life over a 3-year follow-up interval. Alcohol Alcohol 2009; 44:84-92. [PMID: 19042925 PMCID: PMC2605522 DOI: 10.1093/alcalc/agn094] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 10/06/2008] [Accepted: 10/22/2008] [Indexed: 01/26/2023] Open
Abstract
AIMS The aim of this study was to investigate longitudinal changes in quality of life (QOL) as a function of transitions in alcohol use disorders (AUD) over a 3-year follow-up of a general US population sample. METHODS The analysis is based on individuals who drank alcohol in the year preceding the Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions and were reinterviewed at Wave 2 (n = 22,245). Using multiple linear regression models, changes in SF-12 QOL were estimated as a function of DSM-IV AUD transitions, controlling for baseline QOL and multiple potential confounders. RESULTS Onset and offset of AUD were strongly associated with changes in mental/psychological functioning, with significant decreases in mental component summary (NBMCS) scores among individuals who developed dependence and significant increases among those who achieved full and partial remission from dependence. The increases in overall NBMCS and its social functioning, role emotional and mental health components were equally great for abstinent and nonabstinent remission from dependence, but improvements in bodily pain and general health were associated with nonabstinent remission only. Onset of abuse was unrelated to changes in QOL, and the increase in NBMCS associated with nonabstinent remission from abuse only was slight. Individuals with abuse only or no AUD who stopped drinking had significant declines in QOL. CONCLUSIONS These results suggest the possible importance of preventing and treating AUD for maintaining and/or improving QOL. They are also consistent with the sick quitter hypothesis and suggest that abuse is less a mental disorder than a maladaptive pattern of behavior.
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Affiliation(s)
- Deborah A Dawson
- Laboratory of Biometry and Epidemiology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA.
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Pettinati HM, Gastfriend DR, Dong Q, Kranzler HR, O'Malley SS. Effect of extended-release naltrexone (XR-NTX) on quality of life in alcohol-dependent patients. Alcohol Clin Exp Res 2008; 33:350-6. [PMID: 19053979 DOI: 10.1111/j.1530-0277.2008.00843.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Extended-release naltrexone (XR-NTX) is a once-a-month injectable formulation for the treatment of alcohol dependence previously shown to reduce drinking and heavy drinking relative to placebo (Garbutt et al., 2005). A 24-week, randomized, double-blind, placebo-controlled study established the efficacy and safety of XR-NTX in this patient population. In this report, the effect of XR-NTX on quality of life (QOL) was examined. METHODS Alcohol-dependent patients were randomly assigned to receive XR-NTX 380 mg (N = 205), XR-NTX 190 mg (N = 210), or placebo (N = 209), combined with a standardized psychosocial intervention. QOL was assessed using the Medical Outcomes Study 36-item short-form health survey, administered at baseline and at 4-week intervals during 24 weeks of treatment. RESULTS Compared with U.S. population norms, patients showed initial impairment in the health-related QOL domains of mental health, social functioning, and problems with work or other daily activities due to emotional problems. Adherence to all 6 injections was 65% for XR-NTX 190 mg, 63% for XR-NTX 380 mg, and 64% for placebo. Generalized estimating equations analyses using an intention-to-treat sample revealed that XR-NTX 380 mg was associated with significantly greater improvements from baseline in mental health (p = 0.0496), social functioning (p = 0.010), general health (p = 0.048), and physical functioning (p = 0.028), compared with placebo. Linear regression analyses revealed that reductions from baseline in drinking (percentage of drinking days and percentage of heavy drinking days in the last 30 days) were significantly (p < 0.05) correlated with improvements in quality of life. CONCLUSION Extended-release naltrexone 380 mg in combination with psychosocial intervention was associated with improvements in QOL, specifically in the domains of mental health, social functioning, general health, and physical functioning.
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Affiliation(s)
- Helen M Pettinati
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, 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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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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Feeney GFX, Connor JP, McD Young R, Tucker J, McPherson A. Is acamprosate use in alcohol dependence treatment reflected in improved subjective health status outcomes beyond cognitive behavioural therapy alone? J Addict Dis 2007; 25:49-58. [PMID: 17088225 DOI: 10.1300/j069v25n04_05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine whether the addition of acamprosate to Cognitive Behavioural Therapy (CBT) outpatient alcohol dependence treatment impacted on subjective health status. METHOD Among 268 patients consecutively treated for alcohol dependence, 149 chose CBT alone. A matched design was used. From a possible pool of 119 Acamprosate + CBT and 149 CBT-only patients, 86 Acamprosate + CBT subjects were individually matched with 86 CBT-only patients on parameters of gender, age, prior detoxification and alcohol dependence severity. Health Status (SF-36) and Psychological Well-Being (GHQ-28) was assessed pre- and post-treatment. RESULTS Pre-treatment, both self-reported health status and psychological well-being was markedly below normative (community) ranges. Program completers significantly improved across both measures over 12 weeks of treatment and some health domains approximated community levels. No treatment group differences were observed. CONCLUSIONS Participants who completed the CBT-based treatment showed significant improvement in self-reported health status. The use of acamprosate did not register additional improvement on either SF-36 or GHQ-28, beyond CBT alone.
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Affiliation(s)
- Gerald F X Feeney
- Department of Psychiatry, The University of Queensland, Brisbane, Australia.
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Stewart SH, Hutson A, Connors GJ. Exploration of the relationship between drinking intensity and quality of life. Am J Addict 2007; 15:356-61. [PMID: 16966191 DOI: 10.1080/10550490600860122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
This work explored the association between quality of life and drinking intensity in the Project MATCH sample. Tobit regression models were evaluated to assess the relationship between quality of life indicators (eg, measures of depression, adverse consequences, and others) and drinks per drinking day (DDD), and to assess modification or confounding of DDD by subject characteristics and treatment type. Each quality of life indicator improved with decreased DDD. Gender and ethnicity modified the DDD effect for some outcomes, with DDD exerting a greater influence on quality of life in women and non-Hispanic whites.
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Affiliation(s)
- Scott H Stewart
- Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
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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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Ohmura Y, Takahashi T, Kitamura N, Wehr P. Three-month stability of delay and probability discounting measures. Exp Clin Psychopharmacol 2006; 14:318-28. [PMID: 16893275 DOI: 10.1037/1064-1297.14.3.318] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psychopharmacologists are interested in delay and probability discounting because the tendency to discount the value of future and uncertain rewards has been linked with drug dependency. However, relatively little is known about the long-term stability of discounting measures typically studied in clinical psychopharmacology. To evaluate the stability of discounting over a 3-month period, the authors compared points of subjective equality (indifference points) with those collected from the same subjects 3 months earlier. Seven delay periods, ranging from 1 week to 25 years, and 7 probability values, ranging from .95 to .05, were assessed in an undergraduate sample (n=22, delay discounting; n=18, probability discounting). The authors examined both differential stability (stability of individual differences) and absolute stability (stability of the group mean) of delay and probability discounting measures as well as their respective indifference points. The results demonstrate that standard delay and probability discounting parameters (e.g., hyperbolic k and area under the curve) had both differential stability and absolute stability across 3 months. Moreover, most indifference points in the delay and probability discounting tasks demonstrated both differential and absolute stability. All together, these results suggest that delay and probability parameters are stable enough to predict future behavior, such as substance abuse. Additional findings indicated that a hyperbolic function fitted the data better than an exponential function and that delay and probability discounting parameters were not significantly correlated.
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Affiliation(s)
- Yu Ohmura
- Department of Behavioral Science, Graduate School of Letters, Hokkaido University, Sapporo, Japan
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Abstract
BACKGROUND Alcoholics Anonymous (AA) is an international organization of recovering alcoholics that offers emotional support through self-help groups and a model of abstinence for people recovering from alcohol dependence, using a 12-step approach. Although it is the most common, AA is not the only 12-step intervention available there are other 12-step approaches (labelled Twelve Step Facilitation (TSF)). OBJECTIVES To assess the effectiveness of AA or TSF programmes compared to other psychosocial interventions in reducing alcohol intake, achieving abstinence, maintaining abstinence, improving the quality of life of affected people and their families, and reducing alcohol associated accidents and health problems. SEARCH STRATEGY We searched the Specialized Register of Trials of the Cochrane Group on Drugs and Alcohol, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE from 1966, EMBASE from 1980, CINAHL from 1982, PsychINFO from 1967. Searches were updated in February 2005. We also inspected lists of references for relevant studies. SELECTION CRITERIA Studies involving adults (<18) of both genders with alcohol dependence attending on a voluntary or coerced basis AA or TSF programmes comparing no treatment, other psychological interventions, 12-step variants. DATA COLLECTION AND ANALYSIS One reviewer (MF) assessed studies for inclusion and extracted data using a pre-defined data extraction form. Studies were evaluated for methodological quality and discussed by all reviewers. MAIN RESULTS Eight trials involving 3417 people were included. AA may help patients to accept treatment and keep patients in treatment more than alternative treatments, though the evidence for this is from one small study that combined AA with other interventions and should not be regarded as conclusive. Other studies reported similar retention rates regardless of treatment group. Three studies compared AA combined with other interventions against other treatments and found few differences in the amount of drinks and percentage of drinking days. Severity of addiction and drinking consequence did not seem to be differentially influenced by TSF versus comparison treatment interventions, and no conclusive differences in treatment drop out rates were reported. Included studies did not allow a conclusive assessment of the effect of TSF in promoting complete abstinence. AUTHORS' CONCLUSIONS No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems. One large study focused on the prognostic factors associated with interventions that were assumed to be successful rather than on the effectiveness of interventions themselves, so more efficacy studies are needed.
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Affiliation(s)
- M Ferri
- Agency of Public Health, Project Unit: EBM and Models of Health Assistance, Via di Santa Costanza 53, Rome, Italy 00198.
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