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Hardee JE, Weigard AS, Heitzeg MM, Martz ME, Cope LM. Sex differences in distributed error-related neural activation in problem-drinking young adults. Drug Alcohol Depend 2024; 263:112421. [PMID: 39208693 DOI: 10.1016/j.drugalcdep.2024.112421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 07/18/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Detecting and responding to errors is central to goal-directed behavior and cognitive control and is thought to be supported by a network of structures that includes the anterior cingulate cortex and anterior insula. Sex differences in the maturational timing of cognitive control systems create differential periods of vulnerability for psychiatric conditions, such as substance use disorders. METHODS We examined sex differences in error-related activation across an array of distributed brain regions during a Go/No-Go task in young adults with problem alcohol use (N=69; 34 females; M=19.4 years). Regions of interest previously linked to error-related activation, including anterior cingulate cortex, insula, and frontoparietal structures, were selected in a term-based meta-analysis. Individual differences in their responses to false alarm (FA) inhibitory errors relative to "go" trials (FA>GO) and correct rejections (FA>CR) were indexed using multivariate summary measures derived from principal components analysis. RESULTS FA>GO and FA>CR activation both revealed a first component that explained the majority of the variance across error-associated regions and displayed the strongest loadings on salience network structures. Compared to females, males exhibited significantly higher levels of the FA>GO component but not the FA>CR component. CONCLUSIONS Males exhibit greater salience network activation in response to inhibitory errors, which could be attributed to sex differences in error-monitoring processes or to other functions (e.g., novelty detection). The findings are relevant for the further characterization of sex differences in cognitive control and may have implications for understanding individual differences in those at risk for substance use or other cognitive control disorders.
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Affiliation(s)
- Jillian E Hardee
- Department of Psychiatry and Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA.
| | - Alexander S Weigard
- Department of Psychiatry and Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Mary M Heitzeg
- Department of Psychiatry and Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Meghan E Martz
- Department of Psychiatry and Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Lora M Cope
- Department of Psychiatry and Addiction Center, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
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Rovira A, Lambe S, Beckwith H, Ahmed M, Hudson F, Haynes P, Yu CJ, Williams K, Saidel S, Iredale E, McBride S, Waite F, Pan X, Freeman D. A randomized controlled experiment testing the use of virtual reality to trigger cigarette craving in people who smoke. Sci Rep 2024; 14:19445. [PMID: 39169108 PMCID: PMC11339269 DOI: 10.1038/s41598-024-70113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024] Open
Abstract
Automated delivery of therapy in virtual reality (VR) has the potential to be used for smoking cessation. Most obviously, it could be used to practise and establish alternative reactions to smoking cues. The first step in treatment development is to show that VR environments can trigger sufficient cravings in smokers. We evaluated a new VR public house outdoor scenario with 100 individuals who smoked daily. Participants were randomly assigned to the VR scenario with smoking cues or a neutral experience in VR. The VR experiences were presented in a standalone VR headset. Before and after VR, we collected self-reported craving scores for cigarettes and alcohol using the Tobacco Craving Questionnaire (TCQ) and visual analogue scales (VAS). Physiological data were also collected. Compared to the neutral condition, exposure to the smoking cues led to a large increase in craving for a cigarette (TCQ β = 11.44, p < 0.0001, Cohen's d = 1.10) and also a moderate increase in craving for alcohol ( β = 0.7 , p = 0.017 , d = 0.50 ) . There were no significant physiological differences between the two conditions. These results provide good evidence that VR experiences can elicit strong craving for cigarettes. The programming can be part of developing a new VR cognitive therapy to help people reduce smoking.
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Affiliation(s)
- Aitor Rovira
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
- Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Sinéad Lambe
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Helen Beckwith
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Memoona Ahmed
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Felicity Hudson
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Phoebe Haynes
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Kira Williams
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Simone Saidel
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Ellen Iredale
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Sapphira McBride
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Felicity Waite
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Daniel Freeman
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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3
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Jiang L, McCord E, Liu H, Liu Y, Jiang F, Tang YL. Prevalence of work hour alcohol use and associated factors among psychiatrists in China. Alcohol Alcohol 2024; 59:agae058. [PMID: 39172459 DOI: 10.1093/alcalc/agae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Since 2012, work-hour alcohol use (WHAU) has been prohibited in China. However, there is a lack of national data on WHAU among healthcare workers, including psychiatrists. METHODS We collected data from psychiatrists in 41 tertiary psychiatric hospitals using an online questionnaire, which included demographics, work-related factors, WHAU, and the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). RESULTS Out of 2911 psychiatrists who completed the survey, 4.29% reported having heard (3.13%) or witnessed (1.17%) WHAU among colleagues, and .51% (95% CI: .26%-.78%) admitted to their own WHAU. Most participants (95.57%) reported awareness of the policy against WHAU. Poisson regression demonstrated the unawareness of WHAU policy (incidence-rate ratios [IRR] 11.08; 95% CI: 3.56-34.52; P < .001), lower income (IRR .87; 95% CI: .79-0.96; P = .008), and higher AUDIT-C scores (IRR 1.48; 95% CI: 1.22-1.80; P < .001) were significantly associated with WHAU occurrences. CONCLUSIONS The survey indicates that WHAU among psychiatrists is more prevalent than expected, correlating with insufficient awareness of hospital policies. This suggests a need for targeted educational interventions.
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Affiliation(s)
- Licong Jiang
- Big one health development research insitute, Wenzhou Medical University, Wenzhou, 325035, China
| | - Elizabeth McCord
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30084, USA
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 238000, China
- Anhui Psychiatric Center, Hefei, 238000, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 200030, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, 200030, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, 200030, China
- Institute of Health Policy, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30084, USA
- Substance Abuse Treatment Program, Atlanta Veterans Affairs Medical Center, Decatur, GA 30084, USA
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Rycyk-Bojarzynska A, Kasztelan-Szczerbinska B, Cichoz-Lach H, Surdacka A, Rolinski J. Neutrophil PAD4 Expression and Its Pivotal Role in Assessment of Alcohol-Related Liver Disease. Int J Mol Sci 2024; 25:7597. [PMID: 39062840 PMCID: PMC11276781 DOI: 10.3390/ijms25147597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Neutrophils release neutrophil extracellular traps (NETs) as a defense strategy in response to broad-spectrum infections and sterile triggers. NETs consist of a DNA scaffold decorated with antimicrobial peptides (AMPs) and enzymatically active proteases, including peptidyl arginine deiminase type 4 (PAD4). Susceptibility to infections and inflammatory dysregulation are hallmarks of alcohol-related liver disease (ALD). Sixty-two patients with ALD were prospectively recruited, and they were followed for 90 days. Twenty-four healthy volunteers served as the control group. PAD4 concentrations were quantified using immunoenzymatic ELISAs. Correlation coefficients between PAD4 blood concentrations and markers of systemic inflammation; liver dysfunction severity scores; and ALD complications were calculated. The receiver operating curves (ROCs) and their areas under the curve (AUCs) were checked in order to assess the accuracy of PAD4 expression in predicting the degree of liver failure and the development of ALD complications. Systemic concentrations of PAD4 were significantly increased in the patients with ALD in comparison with controls. PAD4 levels correlated with the standard markers of inflammation and revealed a good predictive AUC (0.76) for survival in the whole ALD group. PAD4 seems to be an inflammatory mediator and may be potentially applied as a predictor of patient survival in ALD.
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Affiliation(s)
- Anna Rycyk-Bojarzynska
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, 20-090 Lublin, Poland
| | | | - Halina Cichoz-Lach
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, 20-090 Lublin, Poland
| | - Agata Surdacka
- Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Jacek Rolinski
- Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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Fodstad EC, Erga AH, Pallesen S, Ushakova A, Erevik EK. Personality traits as predictors of recovery among patients with substance use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 162:209360. [PMID: 38631658 DOI: 10.1016/j.josat.2024.209360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 02/22/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Substance use disorder (SUD) is often considered a chronic illness in which prolonged recovery, in terms of abstinence, is uncommon. Personality has been found to predict recovery, but not much is known about its long-term predictive ability as the majority of previous studies have had short follow-up periods (≥ one year). The current longitudinal cohort study therefore investigated whether personality traits predict short- (STR) as well as long-term recovery (LTR) in SUD patients. METHODS Treatment-seeking patients with SUD (n = 123) completed the NEO Personality Inventory - Revised. STR and LTR categories were defined as scoring <8 on the Alcohol Use Disorders Identification Test - C and <2 on the Drug Use Disorder Identification Test - C at the one-year and 6-8-year follow-up, respectively. Whether personality traits predicted outcome was investigated by two-tailed independent samples t-tests, α < 0.05. Additional analysis was conducted with latent growth curve model. RESULTS Neuroticism (inversely, p = .004, d = 0.55) and Extraversion (p = .04, d = 0.38) predicted STR (n = 114). Although not significant the effect size for Conscientiousness was above the cut-off for a practical significant effect (d = 0.31). No traits predicted LTR category. Still, the effect sizes for LTR regarding Neuroticism (d = 0.36), Extraversion (d = 0.21) and Conscientiousness (d = 0.27) indicated that these traits have relevance for LTR. The latent growth curve model indicated that these traits predicted the short-term use of drugs and long-term use of alcohol in this cohort dominated by patients suffering from severe poly-SUD. CONCLUSION Personality traits predict recovery. The effect sizes indicate that more studies with larger samples on personality traits and LTR are required to understand their possible influences on the recovery process.
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Affiliation(s)
- Elise Constance Fodstad
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway; Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway.
| | - Aleksander Hagen Erga
- Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway; Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anastasia Ushakova
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Eilin Kristine Erevik
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Gabriel W, Sazonova Y, Kulchynska R, LaMonaca K, Salyuk T, Smyrnov P, Altice FL. Alcohol Use Disorder and HIV Risk in a National Survey of Men Who Have Sex with Men in Ukraine. Int J Behav Med 2024:10.1007/s12529-024-10272-8. [PMID: 38914921 DOI: 10.1007/s12529-024-10272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Problematic alcohol consumption is associated with risk behaviors associated with HIV transmission. Despite the high prevalence of problematic alcohol consumption in Ukraine, however, there are little empirical data examining its association with risk behaviors also associated with HIV transmission in men who have sex with men (MSM), a key population where HIV incidence is increasing, METHOD: Correlates of prevalent HIV infection and their association between drinking severity levels and behaviors also associated with increased likelihood of HIV acquisition were analyzed from a 2017 nationally representative survey (IBBS) of 4938 MSM in Ukraine using bivariate analyses and multivariate regression. RESULTS Overall, 42.6% of MSM participants met screening criteria for alcohol use disorder (AUD), with 24.2%, 12.0%, and 6.3% meeting criteria for moderate, high, and severe risk of harm from alcohol consumption, respectively. Multivariate regression revealed that these risk categories were correlated with behaviors associated with increased HIV transmission risk, including reports of (1) > 5 sexual partners; (2) sex with a partner of unknown HIV status; (3) sex work; (4) any drug use; and (5) not testing for HIV (past year). HIV testing was infrequent, with only 44.1% having been tested in the previous year. CONCLUSION The high prevalence of problematic alcohol use in Ukrainian MSM and its association with behaviors also associated with HIV transmission supports the importance of routine screening of MSM for AUD. Moreover, among those screening positive for a potential AUD, targeted HIV prevention strategies to scale-up pre-exposure prophylaxis, consistent condom use, and treatment for AUD are needed.
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Affiliation(s)
- Walter Gabriel
- Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - Yana Sazonova
- Monitoring and Evaluation Unit, ICF "Alliance for Public Health", Kiev, Ukraine
| | - Roksolana Kulchynska
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Kiev, Ukraine
| | - Katherine LaMonaca
- Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Tatiana Salyuk
- Monitoring and Evaluation Unit, ICF "Alliance for Public Health", Kiev, Ukraine
| | - Pavlo Smyrnov
- Monitoring and Evaluation Unit, ICF "Alliance for Public Health", Kiev, Ukraine
| | - Frederick L Altice
- Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, 06510, USA
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Landa-Blanco M, Vásquez G, Portillo G, Sproviero F, Echenique Y. The impact of adverse childhood experiences on mental health, sexual risk behaviors, and alcohol consumption in adulthood. Front Psychiatry 2024; 15:1352824. [PMID: 38659462 PMCID: PMC11039929 DOI: 10.3389/fpsyt.2024.1352824] [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: 12/08/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
The purpose of the study was to determine how Adverse Childhood Experiences (ACE) relate to adulthood flourishing, symptoms of depression, anxiety, somatization, self-reported health, sexual risk behaviors, and alcohol consumption. A quantitative cross-sectional methodology was used. A total of 452 adults completed the survey. The most prevalent ACE include physical abuse (44.69%), separation/divorce of parents (41.81%), living with someone with alcohol problems (39.38%), and being sworn, insulted, or humiliated by adults at home (35.62%). Almost one out of every four respondents (24.34%) reported being touched by an adult, 17.92% reported that an adult tried to manipulate the respondent into touching them, and 8.19% were forced to have sexual intercourse. Results indicate that women reported a higher number of ACE than men. The number of ACE is inversely related to flourishing and self-reported health; while being positively associated with participant's scores in depression, anxiety, somatization, sexual risk behaviors, and alcohol use. The regression model, including the eleven ACE and respondents' sex and age, achieved medium effect sizes for somatization, depression, and anxiety symptoms and small effect sizes for flourishing, self-reported health, sexual risk behaviors, and alcohol consumption. Specific ACE have a particularly significant negative impact on mental health outcomes: forced intercourse, witnessing familial violence, verbal humiliation, and living with individuals struggling with mental health issues and drug consumption or who were incarcerated. In conclusion, the study highlights the alarming prevalence of ACE among the Honduran population and their significant negative impact on mental health outcomes during adulthood.
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Affiliation(s)
- Miguel Landa-Blanco
- School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
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Chen AS, Xiao X, Yang DA. A Bayesian finite mixture model approach to evaluate dichotomization method for correlated ELISA tests. Prev Vet Med 2024; 225:106144. [PMID: 38367332 DOI: 10.1016/j.prevetmed.2024.106144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
In diagnostic accuracy studies, a commonly employed approach involves dichotomizing continuous data and subsequently analyzing them using a Bayesian latent class model (BLCM), often relying on binomial or multinomial distributions, rather than preserving their continuous nature. However, this procedure can inadvertently lead to less reliable outcomes due to the inherent loss of information when converting the original continuous measurements into binary values. Through comprehensive simulations, we demonstrated the limitations and disadvantages of dichotomizing continuous biomarkers from two correlated tests. Our findings highlighted notable disparities between the true values and the model estimates as a result of dichotomization. We discovered the crucial significance of selecting a reference test with high diagnostic accuracy in test evaluation in order to obtain reliable estimates of test accuracy and prevalences. Our study served as a call to action for veterinary researchers to exercise caution when utilizing dichotomization.
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Affiliation(s)
- Alex Siyi Chen
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Xun Xiao
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Danchen Aaron Yang
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China.
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Rycyk-Bojarzyńska A, Kasztelan-Szczerbińska B, Cichoż-Lach H, Surdacka A, Roliński J. Human Neutrophil Alpha-Defensins Promote NETosis and Liver Injury in Alcohol-Related Liver Cirrhosis: Potential Therapeutic Agents. J Clin Med 2024; 13:1237. [PMID: 38592082 PMCID: PMC10931661 DOI: 10.3390/jcm13051237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/12/2024] [Accepted: 02/20/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Neutrophils are thought to play a pivotal role in the pathogenesis of many inflammatory diseases, such as hepatitis, liver cirrhosis, etc. Activated human neutrophils release human neutrophil peptides (HNP1-3) or alpha-defensins that are antimicrobial peptides in azurophil granules. Furthermore, HNP1-3 build a scaffold of neutrophil extracellular traps (NETs) and promote the process of programmed cell death called NETosis. Our study aimed to investigate the role of alpha-defensins in the pathogenesis of alcohol-related liver cirrhosis (ALC). Methods: The concentrations of alpha-defensins in the plasma of 62 patients with ALC and 24 healthy subjects were measured by ELISA. The patients with ALC were prospectively recruited based on the severity of liver dysfunction according to the Child-Pugh and Model of End-Stage Liver Disease-Natrium (MELD-Na) scores, modified Maddrey's Discriminant Function (mDF), and the presence of ALC complications. Results: The concentrations of alpha-defensins in plasma were significantly higher in the ALC patients than in the controls. The plasma levels of HNP1-3 correlated with the MELD and mDF scores. ALC subgroups with MELD > 20 and mDF > 32 displayed significantly higher HNP1-3 concentrations. The plasma levels of HNP1-3 revealed a good predictive AUC for hepatic encephalopathy and ascites development (0.81 and 0.74, respectively) and for patient survival (0.87) in those over 40 years of age. Conclusion: These findings suggest that alpha-defensins play an important role in the assessment of ALC.
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Affiliation(s)
- Anna Rycyk-Bojarzyńska
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, 20-059 Lublin, Poland; (B.K.-S.); (H.C.-L.)
| | - Beata Kasztelan-Szczerbińska
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, 20-059 Lublin, Poland; (B.K.-S.); (H.C.-L.)
| | - Halina Cichoż-Lach
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, 20-059 Lublin, Poland; (B.K.-S.); (H.C.-L.)
| | - Agata Surdacka
- Department of Clinical Immunology, Medical University of Lublin, 20-059 Lublin, Poland; (A.S.); (J.R.)
| | - Jacek Roliński
- Department of Clinical Immunology, Medical University of Lublin, 20-059 Lublin, Poland; (A.S.); (J.R.)
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Morris J, Tattan-Birch H, Albery IP, Heather N, Moss AC. Look away now! Defensive processing and unrealistic optimism by level of alcohol consumption. Psychol Health 2024:1-19. [PMID: 38379336 DOI: 10.1080/08870446.2024.2316681] [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: 04/04/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Health risk information is insufficient as a means of reducing alcohol use, particularly when it evokes negative emotional states amongst those for whom it is most personally relevant. Appraisal biases, or 'defensive processing', may be employed to mitigate the psychological discomfort posed by such information. Few studies have evaluated the role of defensive processing in people with different levels of alcohol consumption. DESIGN Online participants (n = 597) completed measures of defensive processing of a health risk infographic, perceived susceptibility and severity of alcohol use, efficacy for resisting alcohol use, unrealistic optimism, the Alcohol Use Disorder Identification Test - Consumption (AUDIT-C) and demographics. RESULTS AUDIT-C scores were positively and linearly associated with all defensive processing measures (Pearson's correlation r from.16 to .36), threat and susceptibility (r = .16) and unrealistic optimism (r = .50). AUDIT-C scores were also negatively associated with efficacy for controlling alcohol use (r = -0.48). CONCLUSION People with alcohol use disorder (AUD) engaged in much more defensive processing of alcohol-related messages, offering an explanation for why such messages are limited at eliciting behaviour change. High levels of unrealistic optimism in people with alcohol use disorder may reflect low problem recognition in order to maintain a problem-free drinking identity.
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Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, United Kingdom
| | | | - I P Albery
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - N Heather
- University of Northumbria, Newcastle upon Tyne, United Kingdom
| | - A C Moss
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, United Kingdom
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11
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Bertholet N, Schmutz E, Studer J, Adam A, Gmel G, Cunningham JA, McNeely J, Daeppen JB. Effect of a smartphone intervention as a secondary prevention for use among university students with unhealthy alcohol use: randomised controlled trial. BMJ 2023; 382:e073713. [PMID: 37586742 PMCID: PMC10428135 DOI: 10.1136/bmj-2022-073713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE To estimate the effects of providing access to an alcohol intervention based on a smartphone. DESIGN Randomised controlled trial.. SETTING Four higher education institutions in Switzerland. PARTICIPANTS 1770 students (≥18 years) who screened positive for unhealthy alcohol use (ie, a score on the alcohol use disorders identification test-consumption (AUDIT-C) of ≥4 for men and ≥3 for women) were randomly assigned by 1:1 allocation ratio in blocks of 10. INTERVENTION Providing access to a brief, smartphone based alcohol intervention. OUTCOME MEASURES The primary outcome studied was number of standard drinks per week at six months and the secondary outcome was number of heavy drinking days (past 30 days). Additional outcomes were maximum number of drinks consumed on one occasion, alcohol related consequences, and academic performance. Follow-up assessments occurred at months three, six, and 12. Data were analysed by intention to treat and by using generalised linear mixed models with random intercepts for the recruitment site and participants nested within the recruitment site, and with intervention (v control), time (three months v six months; 12 months v six months), and baseline outcome values as fixed effects. RESULTS Between 26 April 26 2021 and 30 May 2022, 1770 participants (intervention group (n=884); control group (n=886)) were included. Mean age was 22.4 years (standard deviation 3.07); 958 (54.1%) were women; and 1169 (66.0%) were undergraduate students, 533 (30.1%) were studying for a master's degree, 43 (2.4%) were studying for a doctorate, and 25 (1.4%) were students of other higher education programme. The baseline mean number of standard drinks per week was 8.59 (standard deviation 8.18); the baseline number of heavy drinking days was 3.53 (4.02). Of 1770 participants, follow-up rates were 1706 (96.4%) at three months, 1697 (95.9%) at six months, and 1660 (93.8%) at 12 months. Of 884 students randomly assigned to the intervention group, 738 (83.5%) downloaded the smartphone application. The intervention had a significant overall effect on the number of standard drinks per week (incidence rate ratio 0.90 (95% confidence interval 0.85 to 0.96)), heavy drinking days (0.89 (0.83 to 0.96)), and the maximum number of drinks consumed on one occasion (0.96 (0.93 to 1.00), P=0.029), indicating significantly lower drinking outcomes in the intervention group than in the control group during the follow-up period. The intervention did not affect alcohol related consequences or academic performance. CONCLUSIONS Providing access to the smartphone application throughout the 12 month follow-up was effective at limiting the average drinking volume of university students who had self-reported unhealthy alcohol use at baseline. TRIAL REGISTRATION ISRCTN 10007691.
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Affiliation(s)
- Nicolas Bertholet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elodie Schmutz
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Angéline Adam
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John A Cunningham
- National Addiction Centre, King's College, London, UK
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer McNeely
- New York University Grossman School of Medicine, New York, NY, USA
| | - Jean-Bernard Daeppen
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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12
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Li W, Chen L, Hsu M, Mo D, Xia L, Min K, Jiang F, Liu T, Liu Y, Liu H, Tang YL. The association between workload, alcohol use, and alcohol misuse among psychiatrists in China. Front Psychiatry 2023; 14:1171316. [PMID: 37426098 PMCID: PMC10325676 DOI: 10.3389/fpsyt.2023.1171316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Aim Survey alcohol use and workload among Chinese psychiatrists and explore their associations. Methods We conducted an online questionnaire among psychiatrists working in large psychiatric institutions across the country. We collected data including demographic factors, alcohol use, and workload. Alcohol use was assessed using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and workload-related questions included working hours, night shifts, and caseloads. Results In total, 3,549 psychiatrists completed the survey. Nearly half (47.6%) reported alcohol use, and the percentage of alcohol use in males (74.1%) was significantly higher than in females. 8.1% exceeded the AUDIT-C cutoff scores for probable alcohol misuse (19.6%in males and 2.6%in females). AUDIT-C scores were significantly correlated with working hours per week (p = 0.017) and the number of outpatient visits per week (p = 0.006). Regressional analysis showed that alcohol use was significantly associated with the following factors: longer working hours (Working more than 44 h/week, OR = 1.315), having an administrative position (OR = 1.352), being male (OR = 6.856), being single (OR = 1.601), being divorced or widowed (OR = 1.888), smoking (OR = 2.219), working in the West (OR = 1.511) or the Northeast (OR = 2.440). Regressional analysis showed that alcohol misuse was significantly associated with the following factors: fewer night shifts (Three to four night shifts/month, OR = 1.460; No more than 2 night shifts/month, OR = 1.864), being male (OR = 4.007), working in the Northeast (OR = 1.683), smoking (OR = 2.219), frequent insomnia (OR = 1.678). Conclusion Nearly half of the psychiatrists in China reported alcohol use and 8.1% had probable AUD. Alcohol consumption is significantly associated with several workload-related factors, such as long working hours, heavy caseload, and administrative duties. Alcohol misuse was inversely associated with the number of night shifts per month. While the direction of causality is unclear, our findings may help identify vulnerable professional groups and develop more targeted interventions to improve healthcare professionals' well-being.
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Affiliation(s)
- Wenzheng Li
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Long Chen
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Michael Hsu
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Daming Mo
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Yi-lang Tang
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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13
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Seon Q, Mady N, Yang M, Karia M, Lashley M, Sescu C, Lalonde M, Puskas S, Outerbridge J, Parent-Racine E, Pagiatakis C, Gomez-Cardona L, Jiang D, Bouchard S, Linnaranta O. A Virtual Reality-Assisted Cognitive Behavioral Therapy for and With Inuit in Québec: Protocol for a Proof-of-Concept Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40236. [PMID: 37223973 PMCID: PMC10248771 DOI: 10.2196/40236] [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: 06/14/2022] [Revised: 12/19/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Emotion regulation is an ability related to psychological well-being; when dysregulated, individuals may have psychiatric symptoms and maladapted physiological responses. Virtual reality-assisted cognitive behavioral therapy (VR-CBT) is an effective psychotherapy to target and strengthen emotion regulation; however, it currently lacks cultural sensitivity and can be improved by adapting it to the cultural context of service users. During previous participatory research, we co-designed a culturally adapted cognitive behavioral therapy (CBT) manual and 2 virtual reality (VR) environments to function as a complement to therapy (VR-CBT) for Inuit who would like to access psychotherapy. Emotion regulation skill building will occur in virtual environments that have interactive components such as heart rate biofeedback. OBJECTIVE We describe a protocol for a proof-of-concept 2-arm randomized controlled trial (RCT) with Inuit (n=40) in Québec. The primary aims of this research are to investigate the feasibility, benefits, and challenges of the culturally adapted VR-CBT intervention versus an established VR self-management that is available commercially. We will also investigate self-rated mental well-being and objective psychophysiological measures. Finally, we will use proof-of-concept data to identify suitable primary outcome measures, conduct power calculations in a larger trial for efficacy, and collect information about preferences for on-site or at-home treatment. METHODS Trial participants will be randomly assigned to an active condition or active control condition in a 1:1 ratio. Inuit aged 14 to 60 years will receive a culturally adapted and therapist-guided VR-CBT with biofeedback or a VR relaxation program with nonpersonalized guided components over a 10-week period. We will collect pre- and posttreatment measures of emotion regulation and biweekly assessments over the treatment and at 3-month follow-up. The primary outcome will be measured by the Difficulties in Emotion Regulation Scale (DERS-16) and a novel psychophysiological reactivity paradigm. Secondary measures include psychological symptoms and well-being via rating scales (eg, anxiety or depressive symptoms). RESULTS As this is the prospective registration of an RCT protocol, we do not yet report any results from the trial. Funding was confirmed in January 2020, and recruitment is expected to start in March 2023 and is set to finish in August 2025. The expected results are to be published in spring 2026. CONCLUSIONS The proposed study responds to the community's desire for accessible and appropriate resources for psychological well-being, as it was developed in active collaboration with the Inuit community in Québec. We will test feasibility and acceptance by comparing a culturally adapted, on-site psychotherapy with a commercial self-management program while incorporating novel technology and measurement in the area of Indigenous health. We also aim to fulfill the needs for RCT evidence of culturally adapted psychotherapies that are lacking in Canada. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN) 21831510; https://www.isrctn.com/ISRCTN21831510. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40236.
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Affiliation(s)
- Quinta Seon
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Noor Mady
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Michelle Yang
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Maharshee Karia
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Myrna Lashley
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | | | | | | | | | | | | | - Di Jiang
- National Research Council, Montreal, QC, Canada
| | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Outaouais, QC, Canada
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14
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Duffy FF, Sudom K, Jones M, Fear NT, Greenberg N, Adler AB, Hoge CW, Wilk JE, Riviere LA. Calibrating the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) for detecting alcohol-related problems among Canadian, UK and US soldiers: cross-sectional pre-deployment and post-deployment survey results. BMJ Open 2023; 13:e068619. [PMID: 37130676 PMCID: PMC10163557 DOI: 10.1136/bmjopen-2022-068619] [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] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES Excessive alcohol use can bring about adverse health and work-related consequences in civilian and military populations. Screening for excessive drinking can help identify individuals at risk for alcohol-related problems who may require clinical interventions. The brief validated measures of alcohol use such as the Alcohol Use Disorders Identification Test (AUDIT), or abbreviated AUDIT-Consumption (AUDIT-C), are often included in military deployment screening and epidemiologic surveys, but appropriate cut-points must be used to effectively identify individuals at risk. Although the conventional AUDIT-C cut-points ≥4 for men and ≥3 for women are commonly used, recent validation studies of veterans and civilians recommend higher cut-points to minimise misclassification and overestimation of alcohol-related problems. This study aims to ascertain optimal AUDIT-C cut-points for detecting alcohol-related problems among serving Canadian, UK and US soldiers. DESIGN Cross-sectional pre/post-deployment survey data were used. SETTINGS Comprised Army locations in Canada and UK, and selected US Army units. PARTICIPANTS Included soldiers in each of the above-mentioned settings. OUTCOME MEASURES Soldiers' AUDIT scores for hazardous and harmful alcohol use or high levels of alcohol problems served as a benchmark against which optimal sex-specific AUDIT-C cut-points were assessed. RESULTS Across the three-nation samples, AUDIT-C cut-points of ≥6/7 for men and ≥5/6 for women performed well in detecting hazardous and harmful alcohol use and provided comparable prevalence estimates to AUDIT scores ≥8 for men and ≥7 for women. The AUDIT-C cut-point ≥8/9 for both men and women performed fair-to-good when benchmarked against AUDIT ≥16, although inflated AUDIT-C-derived prevalence estimates and low positive predictive values were observed. CONCLUSION This multi-national study provides valuable information regarding appropriate AUDIT-C cut-points for detecting hazardous and harmful alcohol use, and high levels of alcohol problems among soldiers. Such information can be useful for population surveillance, pre-deployment/post-deployment screening of military personnel, and clinical practice.
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Affiliation(s)
- Farifteh Firoozmand Duffy
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- TechWerks LLC, Arlington Heights, Illinois, USA
| | - Kerry Sudom
- Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, Ontario, Canada
| | - Margaret Jones
- King's Centre for Military Health Research, King's College London, London, UK
| | - Nicola T Fear
- King's Centre for Military Health Research, King's College London, London, UK
- ADMMH, King's College London, London, UK
| | - Neil Greenberg
- King's Centre for Military Health Research, King's College London, London, UK
| | - Amy B Adler
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Charles W Hoge
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Joshua E Wilk
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Lyndon A Riviere
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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15
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Lewańczyk AM, Langham-Walsh E, Edwards L, Branney P, Walters ER, Mitchell P, Vaportzis E. Back Onside protocol: A physical activity intervention to improve health outcomes in people who are unemployed or at risk of unemployment. EVALUATION AND PROGRAM PLANNING 2023; 97:102204. [PMID: 36529025 DOI: 10.1016/j.evalprogplan.2022.102204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/24/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Given the effects of physical activity on people's mental and physical health, a better understanding is needed of how physical activity interventions may impact the health of people who are unemployed or at risk of unemployment. This has added urgency in the context of rising rates of poverty-related unemployment in the UK in 2022. The current paper details the protocol used in the evaluation of the Back Onside Programme; a community-based programme delivered by the Bradford Bulls Foundation in the Bradford District. The Programme supports people from low socio-economic backgrounds who are unemployed or at risk of unemployment to maintain regular physical activity through a ten-week physical activity intervention. This pilot study evaluates how a physical activity intervention may impact the mental and physical health of people who are unemployed or at risk of unemployment in an uncontrolled pragmatic pilot study. Four cohorts run back-to-back between May 2021 and May 2022, with separate groups for men (N = 100) and women (N = 60). Physical and wellbeing assessment at baseline and post-intervention is conducted. If the intervention works in this context for these individuals, it will be a promising low-cost community-based intervention for people who are unemployed or at risk of unemployment.
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Affiliation(s)
| | | | - Lisa Edwards
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | - Peter Branney
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | - Elizabeth R Walters
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | | | - Eleftheria Vaportzis
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK.
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16
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Bertholet N, Schmutz E, Cunningham JA, McNeely J, Gmel G, Daeppen JB, Grazioli VS. Development of a Secondary Prevention Smartphone App for Students With Unhealthy Alcohol Use: Results From a Qualitative Assessment. JMIR Hum Factors 2023; 10:e41088. [PMID: 36881448 PMCID: PMC10031438 DOI: 10.2196/41088] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/28/2022] [Accepted: 01/01/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Despite considerable efforts devoted to the development of prevention interventions aiming at reducing unhealthy alcohol use in tertiary students, their delivery remains often challenging. Interventions including information technology are promising given their potential to reach large parts of the population. OBJECTIVE This study aims to develop a secondary prevention smartphone app with an iterative qualitative design involving the target population. METHODS The app development process included testing a first prototype and a second prototype, developed based on the results of 2 consecutive qualitative assessments. Participants (aged ≥18 years, screened positive for unhealthy alcohol use) were students from 4 tertiary education institutions in the French-speaking part of Switzerland. Participants tested prototype 1 or prototype 2 or both and provided feedback in 1-to-1 semistructured interviews after 2-3 weeks of testing. RESULTS The mean age of the participants was 23.3 years. A total of 9 students (4/9 female) tested prototype 1 and participated in qualitative interviews. A total of 11 students (6/11 female) tested prototype 2 (6 who tested prototype 1 and 5 new) and participated in semistructured interviews. Content analysis identified 6 main themes: "General Acceptance of the App," "Importance of the Targeted and Relevant App Content," "Importance of Credibility," "Importance of the App Usability," "Importance of a Simple and Attractive Design," "Importance of Notifications to Ensure App Use over Time." Besides a general acceptance of the app, these themes reflected participants' recommendations toward increased usability; to improve the design; to include useful and rewarding contents; to make the app look serious and credible; and to add notifications to ensure its use over time. A total of 11 students tested prototype 2 (6 who tested prototype 1 and 5 new) and participated in semistructured interviews. The 6 same themes emerged from the analysis. Participants from phase 1 generally found the design and content of the app improved. CONCLUSIONS Students recommend prevention smartphone apps to be easy to use, useful, rewarding, serious, and credible. These findings may be important to consider when developing prevention smartphone apps to increase the likelihood of app use over time. TRIAL REGISTRATION ISRCTN registry 10007691; https://www.isrctn.com/ISRCTN10007691. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-020-4145-2.
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Affiliation(s)
- Nicolas Bertholet
- Addiction Medicine Unit, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Elodie Schmutz
- Addiction Medicine Unit, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - John A Cunningham
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer McNeely
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States
| | - Gerhard Gmel
- Addiction Medicine Unit, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Addiction Medicine Unit, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Véronique S Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
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17
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Kim SY, Jeong SH, Park EC. Age at onset of alcohol consumption and its association with alcohol misuse in adulthood. Neuropsychopharmacol Rep 2023; 43:40-49. [PMID: 36577509 PMCID: PMC10009427 DOI: 10.1002/npr2.12302] [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: 07/21/2022] [Revised: 10/30/2022] [Accepted: 11/10/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE This study aimed to explore the association between early age onset of alcohol consumption and alcohol misuse in adulthood. METHODS The study sample consisted of 16 829 individuals' (8349 males, 8435 females) survey responses obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 through 2019. Alcohol dependence was measured using the AUDIT-C (Alcohol Use Disorder Identification Test-Consumption), and the ages at which alcohol consumption began were grouped into four categories: under 16, 16 to 18, 19 to 23, and over 24. Multiple logistic regression was used to examine the association between current alcohol misuse and age at onset of alcohol consumption. RESULTS Compared to individuals who started drinking alcohol after the age of 24, those who began drinking alcohol before the age of 16 were more likely to score 8 or more on AUDIT-C questions (under 16: males, odds ratio [OR] 2.50, confidence interval [CI] 1.97-3.17; females, OR: 1.66, CI: 1.18-2.33). Similar to the main analysis, the earlier the onset of alcohol assumption starts, the more likely one is to develop alcohol misuse in adulthood according to subgroup analysis stratified by independent variables in both gender. CONCLUSION The lower the age at the onset of alcohol consumption, the higher the likelihood of alcohol misuse in adulthood. While both males and females showed the same trend in response to the AUDIT-C questions, males tended to have a stronger association between early onset alcohol consumption and alcohol misuse.
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Affiliation(s)
- Soo Y Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sung H Jeong
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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18
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Kastaun S, Garnett C, Wilm S, Kotz D. Prevalence and characteristics of hazardous and harmful drinkers receiving general practitioners' brief advice on and support with alcohol consumption in Germany: results of a population survey. BMJ Open 2022; 12:e064268. [PMID: 36167398 PMCID: PMC9516087 DOI: 10.1136/bmjopen-2022-064268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The German treatment guideline on alcohol-related disorders recommends that general practitioners (GPs) offer brief advice on, and support with, reducing alcohol consumption to hazardous (at risk for health events) and harmful (exhibit health events) drinking patients. We aimed to estimate the implementation of this recommendation using general population data. DESIGN Cross-sectional analysis of data (2021/2022) of a nationwide, population-based household survey. SETTING Germany. PARTICIPANTS Population-based sample of 2247 adult respondents who reported hazardous or harmful drinking according to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C; score women: 4-12 and men: 5-12). MAIN OUTCOME MEASURE Ever receipt of 'brief GP advice on, or support with, reducing alcohol consumption'. Differences in the likelihood of ever receiving advice and/or support (yes/no) relative to respondents' sociodemographic, smoking and alcohol consumption characteristics were estimated using logistic regressions. RESULTS Ever receipt of GP advice on/support with reducing drinking was reported among 6.3% (95% CI=5.3% to 7.4%), and the offer of support among 1.5% (95% CI=1.1% to 2.1%) of the hazardous and harmful drinking respondents. The likelihood of having ever received advice/support was positively associated with being older (OR=1.03 per year, 95% CI=1.01 to 1.04), a current or former (vs never) smoker (OR=2.36, 95% CI=1.46 to 3.80; OR=2.17, 95% CI=1.23 to 3.81) and with increasing alcohol consumption (OR=1.76 per score, 95% CI=1.59 to 1.95). One in two harmful drinking respondents (AUDIT-C score 10-12) reported appropriate advice/support. The likelihood was negatively associated with being woman (eg, OR=0.32, 95% CI=0.21 to 0.48), having a medium or high (vs low) education and with increasing household income. CONCLUSIONS A small proportion of hazardous and harmful drinking people in Germany report having ever received GP advice on, or support with, reducing alcohol consumption. The implementation of advice/support seems to be linked to specific socio-demographic characteristics, tobacco smoking and alcohol consumption level. Health policy measures should aim to increase alcohol screening, brief intervention rates and awareness for at-risk populations in primary care. TRIAL REGISTRATION NUMBER DRKS00011322, DRKS00017157.
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Affiliation(s)
- Sabrina Kastaun
- Institute of General Practice, Patient-Physician Communication Research Unit, Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - Stefan Wilm
- Institute of General Practice, Patient-Physician Communication Research Unit, Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Daniel Kotz
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Behavioural Science and Health, University College London, London, UK
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19
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Poppe M, Duffy L, Marchant NL, Barber JA, Hunter R, Bass N, Minihane AM, Walters K, Higgs P, Rapaport P, Lang IA, Morgan-Trimmer S, Huntley J, Walker Z, Brodaty H, Kales HC, Ritchie K, Burton A, Wenborn J, Betz A, Cooper C. The APPLE Tree programme: Active Prevention in People at risk of dementia through Lifestyle, bEhaviour change and Technology to build REsiliEnce-randomised controlled trial. Trials 2022; 23:596. [PMID: 35883143 PMCID: PMC9315085 DOI: 10.1186/s13063-022-06557-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large-scale trials of multidomain interventions show that modifying lifestyle and psychological risk factors can slow cognitive decline. We aim to determine if a lower intensity, personally tailored secondary dementia prevention programme for older people with subjective or mild objective memory decline, informed by behaviour change theory, reduces cognitive decline over 2 years. METHODS A multi-site, single-blind randomised controlled trial recruiting 704 older adults at high dementia risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Participants are randomised using 1:1 allocation ratio to the APPLE Tree intervention versus control arm (dementia prevention information), stratified by site. The intervention explores and implements strategies to promote healthy lifestyle, increase pleasurable activities and social connections and improve long-term condition self-management. Two facilitators trained and supervised by a clinical psychologist deliver ten, 1-h group video call sessions over 6 months (approximately every fortnight), video-call 'tea breaks' (less structured, facilitated social sessions) in intervening weeks and individual goal-setting phone calls every 2 weeks. From 6 to 12 months, participants meet monthly for 'tea breaks', with those not attending receiving monthly goal-setting phone calls. Participants receive a food delivery, pedometer and website access to cognitive training and information about lifestyle modification. Follow-ups for all outcome measures are at 12 and 24 months. The primary outcome is cognition (Neuropsychological Test Battery (NTB) score) at 24 months. Secondary outcomes are quality of life, cost per quality-adjusted life year (QALY) and wellbeing and lifestyle factors the intervention targets (diet, vascular risk, body weight, activity, sleep, anxiety, depression, social networks and loneliness, alcohol intake and smoking). Participants from purposively selected sites participate in qualitative process evaluation interviews, which will be analysed using thematic analytic methods. DISCUSSION If effective, the intervention design, involving remote delivery and non-clinical facilitators, would facilitate intervention roll-out to older people with memory concerns. TRIAL REGISTRATION ISRCTN17325135 . Registration date 27 November 2019.
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Affiliation(s)
- M Poppe
- UCL Division of Psychiatry, University College London, London, UK
| | - L Duffy
- UCL Division of Psychiatry, University College London, London, UK
| | - N L Marchant
- UCL Division of Psychiatry, University College London, London, UK
| | - J A Barber
- Department of Statistical Science, University College London, London, UK
| | - R Hunter
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - N Bass
- UCL Division of Psychiatry, University College London, London, UK
| | - A M Minihane
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Walters
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - P Higgs
- UCL Division of Psychiatry, University College London, London, UK
| | - P Rapaport
- UCL Division of Psychiatry, University College London, London, UK
| | - I A Lang
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - S Morgan-Trimmer
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - J Huntley
- UCL Division of Psychiatry, University College London, London, UK
| | - Z Walker
- UCL Division of Psychiatry, University College London, London, UK
| | - H Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - H C Kales
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA
| | - K Ritchie
- Institut de Neurosciences de Montpellier (INM), Montpellier, France
| | - A Burton
- Department of Behavioural Science and Health, University College London, London, UK
| | - J Wenborn
- UCL Division of Psychiatry, University College London, London, UK
| | - A Betz
- Queen Mary University London, Centre for Psychiatry and Mental Health, Wolfson Institute for Population Health, London, UK
| | - C Cooper
- Queen Mary University London, Centre for Psychiatry and Mental Health, Wolfson Institute for Population Health, London, UK.
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Abstract
AIMS Current information about the prevalence of various mental health disorders in the general adult population of the Republic of Ireland is lacking. In this study, we examined the prevalence of 12 common mental disorders, the proportion of adults who screened positive for any disorder, the sociodemographic factors associated with meeting criteria for a disorder and the associations between each disorder and history of attempted suicide. METHODS A non-probability nationally representative sample (N = 1110) of adults living in Ireland completed self-report measures of 12 mental health disorders. Effect sizes were calculated using odds ratios from logistic regression models, and population attributable risk fractions (PAFs) were estimated to quantify the associations between each disorder and attempted suicide. RESULTS Prevalence rates ranged from 15.0% (insomnia disorder) to 1.7% (histrionic personality disorder). Overall, 42.5% of the sample met criteria for a mental health disorder, and 11.1% had a lifetime history of attempted suicide. Younger age, being a shift worker and trauma exposure were independently associated with a higher likelihood of having a mental health disorder, while being in university was associated with a lower likelihood of having a disorder. ICD-11 complex posttraumatic stress disorder, borderline personality disorder and insomnia disorder had the highest PAFs for attempted suicide. CONCLUSIONS Mental health disorder prevalence in Ireland is relatively high compared to international estimates. The findings are discussed in relation to important mental health policy implications.
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21
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Vowles KE, Schmidt ZS, Ford CG. Opioid and Alcohol Misuse in Veterans with Chronic Pain: A Risk Screening Study. THE JOURNAL OF PAIN 2022; 23:1790-1798. [PMID: 35753662 DOI: 10.1016/j.jpain.2022.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 10/17/2022]
Abstract
In United States military veterans, chronic pain represents a risk factor for opioid and alcohol misuse, yet few studies have examined interactions among chronic pain, opioid prescription, and opioid and alcohol misuse. Previous work found substantial risk of co-morbid alcohol and opioid misuse in a community sample of opioid-prescribed individuals with chronic pain, a finding expanded upon here. Specifically, 211 veterans assessed within a chronic pain treatment service for opioid-prescribed individuals completed self-report measures of opioid misuse, alcohol misuse, pain intensity, depression, pain catastrophizing, and post-traumatic stress symptoms (PTS). Based on the substance misuse measures, 32% (n = 68) were misusing neither opioids nor alcohol, 23% (n = 48) were misusing both opioids and alcohol, 40% (n = 84) were misusing opioids alone, and 5% (n = 11) were misusing alcohol alone. Group comparisons indicated that individuals not misusing either substance were less distressed in comparison to those who were misusing opioids alone or both substances. The latter groups differed in PTS. Overall, misuse frequencies mirrored previous work, with approximately 1 of 3 misusing opioids and approximately 1 of 5 misusing both substances. There is a need for increased focus on both polysubstance misuse and the development of integrated treatment.
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Affiliation(s)
- Kevin E Vowles
- School of Psychology, Queen's University Belfast & Belfast Centre for Chronic Pain Rehabilitation, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom.
| | - Zachary S Schmidt
- Raymond G. Murphy Veterans Affairs Medical Center, New Mexico VA Healthcare System, Albuquerque, New Mexico, United States of America
| | - C Graham Ford
- Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
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22
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Roux P, Jauffret-Roustide M, Donadille C, Briand Madrid L, Denis C, Célérier I, Chauvin C, Hamelin N, Maradan G, Carrieri MP, Protopopescu C, Lalanne L, Auriacombe M. Impact of drug consumption rooms on non-fatal overdoses, abscesses and emergency department visits in people who inject drugs in France: results from the COSINUS cohort. Int J Epidemiol 2022; 52:562-576. [PMID: 35690956 DOI: 10.1093/ije/dyac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 05/17/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The effectiveness of drug consumption rooms (DCRs) for people who inject drugs (PWID) has been demonstrated for HIV and hepatitis C virus risk practices, and access to care for substance use disorders. However, data on other health-related complications are scarce. Using data from the French COSINUS cohort, we investigated the impact of DCR exposure on non-fatal overdoses, abscesses and emergency department (ED) visits, all in the previous 6 months. METHODS COSINUS is a 12-month prospective cohort study of 665 PWID in France studying DCR effectiveness on health. We collected data from face-to-face interviews at enrolment, and at 6 and 12 months of follow-up. After adjusting for other correlates (P-value < 0.05), the impact of DCR exposure on each outcome was assessed using a two-step Heckman mixed-effects probit model, allowing us to adjust for potential non-randomization bias due to differences between DCR-exposed and DCR-unexposed participants, while taking into account the correlation between repeated measures. RESULTS At enrolment, 21%, 6% and 38% of the 665 participants reported overdoses, abscesses and ED visits, respectively. Multivariable models found that DCR-exposed participants were less likely to report overdoses [adjusted coefficient (95% CI): -0.47 (-0.88; -0.07), P = 0.023], abscesses [-0.74 (-1.11; -0.37), P < 0.001] and ED visits [-0.74 (-1.27; -0.20), P = 0.007]. CONCLUSION This is the first study to show the positive impact of DCR exposure on abscesses and ED visits, and confirms DCR effectiveness in reducing overdoses, when adjusting for potential non-randomization bias. Our findings strengthen the argument to expand DCR implementation to improve PWID injection environment and health.
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Affiliation(s)
- P Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - M Jauffret-Roustide
- Cermes3, Inserm U988/CNRS UMR 8211/EHESS/Université de Paris, Paris, France
- British Columbia Center on Substance Use, Vancouver, Canada
- Baldy Center on Law and Social Policy, Buffalo University, Buffalo, NY, USA
| | - C Donadille
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - L Briand Madrid
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - C Denis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Univ. Bordeaux, Bordeaux, France
- Sleep, Addiction and Neuropsychiatry research laboratory (SANPSY), CNRS UMR 6033, Bordeaux, France
- Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - I Célérier
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - C Chauvin
- Cermes3, Inserm U988/CNRS UMR 8211/EHESS/Université de Paris, Paris, France
| | - N Hamelin
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - G Maradan
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - M P Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - C Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - L Lalanne
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - M Auriacombe
- Univ. Bordeaux, Bordeaux, France
- Sleep, Addiction and Neuropsychiatry research laboratory (SANPSY), CNRS UMR 6033, Bordeaux, France
- Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
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Association between Bar Closing Time, Alcohol Use Disorders and Blood Alcohol Concentration: A Cross-Sectional Observational Study of Nightlife-Goers in Perth, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127026. [PMID: 35742275 PMCID: PMC9223176 DOI: 10.3390/ijerph19127026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023]
Abstract
Introduction and aims: Associations between bar trading hours, a government lever for controlling alcohol availability, nightlife-goer intoxication levels and their likelihood of alcohol use disorder (AUD) have not been explored. We investigated whether: (i) participant AUD was associated with blood alcohol concentration (BAC); and, (ii) any association between AUD and BAC was moderated by participant preferred bar (i.e., venue spent most time at) closing time. Design and methods: A cross-sectional observational study using a sample of nightlife-goers who went out drinking in Perth, Western Australia, on weekends in 2015-16. Participants who reported alcohol use that night and spent most time in a bar (n = 667) completed street intercept surveys including AUDIT-C (n = 459) and provided a breath sample to estimate BAC (n = 651). We used gender-specific multinomial logistic regression models to explore associations between participant AUDIT-C score (1−4, lower risk; 5−7, hazardous; 8−12, active AUD), preferred bar type (standard vs. late closing time based on absence or presence of an extended trading permit) and BAC (male: 0−0.049, 0.05−0.099, ≥0.1 g/100 mL; female: 0−0.049, 0.05−0.079, ≥0.08 g/100 mL). Results: Males with active AUD (RR = 3.31; 95% CI 1.30−8.42; p = 0.01) and females with hazardous/active AUD (RR = 9.75; 95% CI 2.78−34.21; p < 0.001) were both more likely to have high-range BAC than their counterparts typically drinking at lower risk. We also found preferred bar type moderated the association between AUDIT-C score and BAC for some males but no females. Males with active AUD and high-range BAC were less likely to prefer late closing bars than males usually drinking at lower risk and high-range BAC (RR = 0.12; 95% CI 0.02−0.96; p = 0.046). Discussion and conclusions: Our study provides evidence of positive associations between AUD and acute intoxication among nightlife-goers and on the moderating effect of bar closing times among males.
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24
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Mahler L, Sebo P, Favrod-Coune T, Moussa A, Cohidon C, Broers B. The prevalence of five lifestyle risk factors in primary care physicians: A cross-sectional study in Switzerland. Prev Med Rep 2022; 26:101740. [PMID: 35251911 PMCID: PMC8889261 DOI: 10.1016/j.pmedr.2022.101740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/18/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Liv Mahler
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
- Corresponding author at: Institute for Family Medicine and Paediatrics, University of Geneva, Rue Michel-Servet, 1, 1211 Geneva 4, Switzerland.
| | - Paul Sebo
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
| | | | - Amir Moussa
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
| | - Christine Cohidon
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Barbara Broers
- Primary Care Division, Geneva University Hospital, Geneva, Switzerland
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25
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Sundström C, Edmonds M, Soucy JN, Titov N, Dear BF, Hadjistavropoulos HD. Alcohol and drug use among clients receiving internet-delivered cognitive behavior therapy for anxiety and depression in a routine care clinic - Demographics, use patterns, and prediction of treatment completion and outcomes. Internet Interv 2022; 27:100490. [PMID: 34987979 PMCID: PMC8693421 DOI: 10.1016/j.invent.2021.100490] [Citation(s) in RCA: 2] [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: 03/18/2021] [Revised: 11/25/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research shows that alcohol and drug use among mental health clients is common and has the potential to negatively impact treatment outcomes. Internet-delivered cognitive behavior therapy (ICBT) as a treatment for anxiety and depression is on the rise, but little is known about the prevalence of alcohol and drug use among clients and how this use affects treatment completion and outcomes. OBJECTIVE The objective of the current study was to explore the prevalence of alcohol and drug use among clients in ICBT for depression and anxiety, and to investigate the impact of alcohol and drug use on treatment completion and symptom outcomes. MATERIAL AND METHODS Data was collected from 1155 clients who participated in two randomized ICBT trials for depression and anxiety, conducted in a routine care clinic. Thirty-five individuals reporting severe substance use when applying to the trials were excluded. Demographic variables, and alcohol and drug use were measured at screening, and measures of depression and anxiety were administered at pre- and post-treatment. RESULTS Four out of five clients reported having used alcohol in the past year, while one in five reported having used drugs in the past year. Around a third of clients had reported either problematic alcohol use, drug problems, or both. The analyses showed that drug problems, and combined alcohol and drug problems were negatively associated with treatment completion, but neither alcohol nor drug use had an impact on depression and anxiety outcomes. CONCLUSIONS Alcohol and drug problems are likely to be present among a large proportion of patients using ICBT for anxiety and depression. This may not be a barrier to treatment benefit, at least when those with severe alcohol and drug problems have been excluded.
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Affiliation(s)
- Christopher Sundström
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, 113 64, Stockholm, Sweden
- Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden
| | - Michael Edmonds
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Joelle N. Soucy
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Nickolai Titov
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
| | - Blake F. Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
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26
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Pyne JM, Kelly PA, Fischer EP, Miller HJ, Connolly SL, Wright P, Zamora K, Koenig CJ, Seal KH, Fortney JC. Initial concurrent and convergent validity of the Perceived Access Inventory (PAI) for mental health services. Psychol Serv 2022; 19:118-124. [PMID: 33030947 PMCID: PMC8552404 DOI: 10.1037/ser0000504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Access to high-quality health care, including mental health care, remains a high priority for the Department of Veterans Affairs and civilian health care systems. Increased access to mental health care is associated with improved outcomes, including decreased suicidal behavior. Multiple policy changes and interventions are being developed and implemented to improve access to mental health care. The Perceived Access Inventory (PAI) is a patient-centered questionnaire developed to understand the veteran perspective about access to mental health services. The PAI is a self-report measure that includes 43 items across 5 domains: Logistics (6 items), Culture (4 items), Digital (9 items), Systems of Care (13 items), and Experiences of Care (11 items). This article is a preliminary examination of the concurrent and convergent validity of the PAI with respect to the Hoge Perceived Barriers to Seeking Mental Health Services scale (concurrent) and the Client Satisfaction Questionnaire (CSQ; convergent). Telephone interviews were conducted with veterans from 3 geographic regions. Eligibility criteria included screening positive for posttraumatic stress disorder, alcohol use disorder, or depression in the past 12 months. Data from 92 veterans were analyzed using correlation matrices. PAI scores were significantly correlated with the Hoge total score (concurrent validity) and CSQ scores (convergent validity). The PAI items with the strongest correlation with CSQ were in the Systems of Care domain and the weakest were in the Logistics domain. Future efforts will evaluate validity using larger data sets and utilize the PAI to develop and test interventions to improve access to care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Jeffrey M. Pyne
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,Center for Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham, #554, Little Rock, AR
| | - P. Adam Kelly
- Southeast Louisiana Veterans Healthcare System, New Orleans, LA,Tulane University School of Medicine, New Orleans, LA
| | - Ellen P. Fischer
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,Center for Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham, #554, Little Rock, AR
| | - hristopher J. Miller
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Samantha L. Connolly
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Patricia Wright
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Kara Zamora
- San Francisco VA Healthcare System, 4150 Clement Street, San Francisco, CA,Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco, CA
| | - Christopher J. Koenig
- Department of Communication Studies, San Francisco State University, 1600 Holloway Avenue, Humanities Building, Room 282, San Francisco, CA,Center from Innovation to Implementation, Palo Alto Healthcare System, 795 Willow Road (152-MPD), Menlo Park, CA
| | - Karen H. Seal
- San Francisco VA Healthcare System, 4150 Clement Street, San Francisco, CA
| | - John C. Fortney
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle WA,Division of Population Health, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
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27
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Amos N, Bourne A, Hill AO, Power J, McNair R, Mooney-Somers J, Pennay A, Carman M, Lyons A. Alcohol and tobacco consumption among Australian sexual minority women: Patterns of use and service engagement. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103516. [PMID: 34753044 DOI: 10.1016/j.drugpo.2021.103516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sexual minority women consume both alcohol and tobacco at higher rates than heterosexual women. However, various sociodemographic and cultural factors associated with these practices among sexual minority women in Australia are not well understood, nor are the factors associated with seeking alcohol-related support. METHODS This study utilised data from cisgender sexual minority women respondents of Private Lives 3: a national, online, cross-sectional survey of the health and wellbeing of LGBTIQ adults in Australia aged 18+ conducted in 2019. Multivariable analyses were performed to identify co-existing smoking and alcohol use, sociodemographic factors associated with smoking, alcohol consumption and seeking alcohol-related support. RESULTS Of 2,647 sexual minority women respondents, 16.90% were currently smoking tobacco, 7.67% smoking tobacco daily and 60.50% reported potentially risky patterns of alcohol consumption. Tobacco and potentially risky alcohol consumption were found to frequently co-occur. Women who identified as queer were more likely than lesbian identifying women to currently smoke tobacco and to smoke tobacco daily. Tobacco consumption was associated with increased age, unemployment, low-mid range income and secondary-school education, while potential risky drinking was associated with living in outer urban or rural areas and being Australian born . Self-reporting having struggled with alcohol in the past twelve months was associated with residential location. Less than 3% of the sample has sought help for alcohol use. Seeking support was more likely as women aged, and with potentially risky drinking, and much more likely with self-perceived struggles with alcohol. CONCLUSIONS The findings highlight the need for future alcohol and tobacco use health promotion strategies focussing on sexual minority women to attend to within group differences that relate to risk of higher consumption. They also highlight the need for approaches that empower sexual minority women to self-identify when they are struggling with alcohol use and encourage seeking support with organisations that are affirming of sexual minority women.
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Affiliation(s)
- Natalie Amos
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia.
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Adam O Hill
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Level 3, 780 Elizabeth St, Melbourne, Victoria, 3004, Australia
| | - Julie Mooney-Somers
- University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics, Level 1 Medical Foundation Building, 91-97 Parramatta Road, Camperdown, NSW, 2050, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Building NR1, Bundoora, Victoria, 3086, Australia
| | - Marina Carman
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
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Morris J, Moss A, Albery I, Heather N. The "alcoholic other": Harmful drinkers resist problem recognition to manage identity threat. Addict Behav 2022; 124:107093. [PMID: 34500234 DOI: 10.1016/j.addbeh.2021.107093] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Harmful drinkers represent an important Alcohol Use Disorder (AUD) group in public health terms, accounting for significant health and social costs. However, harmful drinkers are characterized by low problem recognition; they tend to construct their drinking identity as positive and problem-free, actively setting themselves apart from the stigmatised 'alcoholic other'. As such, harmful drinkers rarely engage in treatment and represent an important opportunity for lower threshold interventions and self-change. The present study sought to explore AUD problem framing and stigma effects on problem recognition. METHODS Harmful drinkers without perceived addiction experience recruited online (n = 244, 54% male, 46% female, 96% British) were randomised to one of six conditions comprising beliefs about alcohol problems (control, continuum, binary disease model) and stigma (stigma, non-stigma), and completed measures relating to problem recognition. RESULTS As predicted, results found that harmful drinkers exposed to binary disease model beliefs and stigmatising language had significantly lower problem recognition than those in other conditions. However, no support was found for the prediction that continuum beliefs would be associated with higher problem recognition. Results suggest that the interaction of binary disease model beliefs and stigma prompted alcoholic label avoidance. CONCLUSION These findings suggest that problem framing has important consequences for harmful drinkers. Implications for behaviour change amongst harmful drinkers through mechanisms of problem framing and identity are discussed.
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Berndt S, Rosenkranz M, Martens MS, Verthein U. Amphetamine-Type Stimulant Dependence and Association with Concurrent Use of Cocaine, Alcohol, and Cannabis: A Cross-Sectional Study. Eur Addict Res 2022; 28:113-121. [PMID: 34788752 DOI: 10.1159/000519541] [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: 01/23/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Amphetamine-type stimulants (ATSs) are the second most commonly used class of illegal substances in Europe. Although concurrent substance use has been subject to research, little is known about associations between concurrent use of cocaine, alcohol, or cannabis and ATS dependence. We expect that the concurrent use of any of the substance, especially cannabis and cocaine, is associated with ATS dependence. METHODS Cross-sectional data were gathered within the European ATTUNE study in 2018/2019. Participants (N = 721) were asked about their consumption patterns and social, psychological, and economic situation. Multivariate logistic regressions were carried out for associations between ATS dependence and use combinations of frequent cocaine, alcohol, or cannabis, with the reference group of no frequent concurrent use (model 1). Model 2 calculated associations for ATS dependence with lifetime methamphetamine use for respective use combinations. RESULTS The study population was on average 28.9 years old (SD = 7.7), with the majority being male (63.5%). In model 1, the adjusted odds ratio (aOR) for frequent alcohol use was 0.70 (confidence interval [CI] 0.41-1.20). Similar results were shown for model 2 (aOR 0.82, CI 0.42-1.62). Frequent cannabis use significantly reduced the chance for ATS dependence by 50% in adjusted model 1 (aOR 0.50, CI 0.28-0.89) and by 62% in model 2 (aOR 0.38, CI 0.18-0.82). For frequent cocaine use, models 1 and 2 report an aOR at 1.37 (CI 0.58-3.25) and 2.39 (CI 0.77-7.43), although not statistically significant. Frequent users of all 3 substances had a significant 3-fold chance for ATS dependence (model 1: aOR 2.98, CI 1.16-7.63; model 2: aOR 2.95, CI 1.02-8.58). DISCUSSION Against initial hypotheses, frequent concurrent use of alcohol or cannabis generally decreased chances for ATS dependence. An explanation could be the study population, which consists of many irregular users of ATS, who mainly consume alcohol or cannabis. Cocaine generally increased chances, although results were not significant. The frequent use of all 3 substances together with ATS in the last year was significantly associated with dependence, thus reporting important information for treatment services. Further research is needed for disentangling causal relationships underlying these associations and for pinpointing consequences for relapse prevention and retention success.
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Affiliation(s)
- Sarah Berndt
- Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Moritz Rosenkranz
- Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marcus-Sebastian Martens
- Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Verthein
- Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Mo D, Min K, Gluck R, Jiang F, Tao R, Geng F, Xia L, Liu T, Liu Y, Liu H, Tang YL. Alcohol Use and Misuse Among Chinese Psychiatrists During the Early COVID-19 Pandemic. Front Psychiatry 2022; 13:933814. [PMID: 35815044 PMCID: PMC9258332 DOI: 10.3389/fpsyt.2022.933814] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
AIM Survey alcohol use and misuse among Chinese psychiatrists during the Coronavirus diseases 2019 (COVID-19) pandemic. METHODS We conducted a large-scale, nationwide online survey of psychiatrists regarding their alcohol use during the pandemic. The Alcohol Use Disorder Identification Test-Concise (AUDIT-C) was used to assess alcohol use and misuse. RESULTS Of 3,815 psychiatrists who completed the survey, alcohol use and misus were 47.5% and 8.2%, respectively, and both were significantly higher in males. The majority (59%) reported no change in alcohol use during the pandemic, one-third (34.5%) reported a decrease, and 6.5% reported an increase. Alcohol misuse was associated with middle-age (OR = 1.418), male sex (OR = 5.089), Northeast China (OR = 1.507), cigarette-smoking (OR = 2.335), insomnia (OR = 1.660), and regular exercise (OR = 1.488). A master's degree (OR = 0.714) and confidence in clinical work (OR = 0.610) were associated with less alcohol misuse. Those who reported a decrease in alcohol use during the pandemic were more likely to be male (OR = 2.011), located in Northeast China (OR = 1.994), and feel confident in their clinical work (OR = 1.624). Increased alcohol use was significantly associated with insomnia (OR = 3.139). CONCLUSIONS During the COVID-19 pandemic, alcohol use and misuse among Chinese psychiatrists declined. While males were more likely to misuse alcohol, they were also more likely to have reduced their intake. Age, location, and lifestyle factors also predicted alcohol use and misuse. Further examination of specific factors that reduced alcohol use and misuse may help guide public health efforts to sustain the lower rates beyond the pandemic.
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Affiliation(s)
- Daming Mo
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Psychiatry, Hefei Fourth People's Hospital, Hefei, China
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rachel Gluck
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Tao
- Department of Psychiatry, Hefei Fourth People's Hospital, Hefei, China
| | - Feng Geng
- Department of Psychiatry, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Association between Nightlife Goers' Likelihood of an Alcohol Use Disorder and Their Preferred Bar's Closing Time: A Cross-Sectional Observational Study in Perth, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413040. [PMID: 34948660 PMCID: PMC8700896 DOI: 10.3390/ijerph182413040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
Introduction and aims: Associations between longer-term alcohol-related conditions and licensed outlet trading hours are not well understood. We investigated the association between nightlife-goers’ likelihood of an alcohol use disorder (AUD) and their preference for bars with special permits to remain open ‘late’ (i.e., spent more time there compared to any other venue) until 2 a.m. or 3 a.m. (Friday; Saturday) or midnight (Sunday) compared to bars with ‘standard’ closing times of midnight (Friday; Saturday) or 10 p.m. (Sunday). Design and methods: A cross-sectional observational study was conducted in four major nightlife areas of Perth, Australia, in 2015–2016. We conducted weekend street intercept surveys outside bars between 8 p.m. and 3 a.m. and screened participants who reported alcohol use prior to the survey and spent more time in a bar than any other venue type (n = 667) regarding their past year drinking pattern using AUDIT-C (n = 459). We used gender-specific logistic regression models to estimate associations between AUDIT-C categories (1–4, low risk; 5–7, hazardous; 8–12, active AUD) and preference for bars with different closing times (late vs. standard). Results: A large proportion of participants were hazardous drinkers or had active AUD (83% males; 65% females), and over half preferred a late to a standard closing bar. We found evidence of a positive association between preference for late closing bars and hazardous drinking females (OR = 3.48; 95% CI 1.47–8.23; p = 0.01), but not for females with active AUD, male hazardous drinkers, nor males with active AUD. Discussion and conclusions: Our study adds new evidence on associations between likelihood of AUD among nightlife-goers and trading hours. With increasing international relaxation of trading hours, evidence that late closing bars may be preferred by hazardous drinking females will be of concern to policymakers wanting to curb alcohol-related harms in the community.
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Alcohol Consumption during the COVID-19 Lockdown Period: Predictors of At-Risk Drinking at Different AUDIT-C Cut-Off Thresholds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413042. [PMID: 34948646 PMCID: PMC8701825 DOI: 10.3390/ijerph182413042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/26/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, alcohol consumption was largely confined to drinking in the home. There has been little research examining variables associated with risk in home drinking. The study employed an online survey of (n = 1128) individuals who had been recruited for their face recognition skills (n = 838, 70.9% females, mean age 45.05 (12.3 SD)). The main dependent variables were three different AUDIT-C cut-off scores for at-risk drinking: (a) 5 for both genders as recommended by Public Health England, (b) 7 for females and 8 for males (cut-off for students and young people) and (c) 8 for both genders (individuals seeking online help for their drinking). Among the independent variables were gender and age, motivations for home drinking using the Home Drinking Assessment Scale (HDAS), purchasing patterns, context of drinking and health and wellbeing. The predictors following hierarchical logistic regressions were for (a) purchasing alcohol online or at a supermarket and emotional HDAS scores, (b) purchasing alcohol online or at a supermarket and for parties, drinking alone and with other members of the household and emotional and practical reason HDAS scores, (c) as for b with the addition that men were more likely to be at-risk drinkers. At-risk drinking in the pandemic was explained by motivational reasons, purchasing patterns and situational factors.
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A randomized controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website (EFAR Spain). Internet Interv 2021; 26:100446. [PMID: 34522625 PMCID: PMC8424207 DOI: 10.1016/j.invent.2021.100446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Brief interventions (BI) for risky drinkers in primary healthcare have been demonstrated to be cost-effective but they are still poorly implemented. Digital BI seems to be a complementary strategy to overcome some barriers to implementation but there is a scarcity of studies in clinical environments. We present the results of a randomized controlled non-inferiority trial which tests the non-inferiority of facilitated access to a digital intervention (experimental condition) for risky drinkers against a face-to-face BI (control condition) provided by primary healthcare professionals. METHOD In a non-inferiority randomized controlled trial, unselected primary healthcare patients (≥ 18 years old) were given a brief introduction and asked to log on to the study website to fill in the 3-item version of the Alcohol Use Disorders Identification Test. Positively screened patients (4+ for women and 5+ for men) received further online assessment (AUDIT, socio-demographic characteristics and EQ-5D-5L) and were automatically randomized to either face-to-face or digital BI (1:1). The primary outcome was the proportion of patients classified as risky drinkers by the digitally administered AUDIT at month 3. A multiple imputation approach for the missing data was performed. RESULTS Of the 4499 patients approached by 115 healthcare professionals, 1521 completed the AUDIT-C. Of the 368 positively screened patients, 320 agreed to participate and were randomized to either intervention. At month 3, there were more risky drinkers in the experimental group (59.8%) than in the control group (52%), which was similar to the distribution at baseline and less than the pre-specified margin of 10%. The difference was not significant when accounting for possible confounders. CONCLUSION Digital BI was not inferior to face-to-face BI, in line with previous findings and the a priori hypothesis. However, the low power of the final sample, due to the low recruitment and loss to follow-up, limits the interpretation of the findings. New approaches in this field are required to ensure the effective implementation of digital interventions in actual practice.
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Chemhaka GB, Simelane MS, Moyo S, Shongwe MC. Prevalence and sociodemographic determinants of alcohol consumption among adults living with HIV in Eswatini. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 20:132-140. [PMID: 33985423 DOI: 10.2989/16085906.2021.1895236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aim: Alcohol consumption contributes to a significant burden of illnesses, health conditions and premature deaths globally. There is limited knowledge of alcohol consumption among people living with HIV (PLWH) in Eswatini. This study sought to determine the prevalence, and examine the sociodemographic determinants of alcohol consumption among adult people living with HIV in Eswatini.Methods: Using the Swaziland HIV Incidence Measurement Survey 2, a recent national representative cross-sectional survey conducted in Eswatini between August 2016 and March 2017, a subsample of 2 832 adults (aged 18 and older) living with HIV was extracted. Multinomial logistic regression was used to assess the sociodemographic factors associated with alcohol consumption (i.e. use or misuse).Results: The prevalence of alcohol misuse (hazardous drinking) was 10.9% (23% male v 4.5% female), whereas alcohol use (moderate drinking) was estimated at 8.5% (14.7% male v 5.2% female). Men were more likely to engage in alcohol use (adjusted relative risk ratio [aRRR] = 3.46 [95% CI 3.46-6.62]) and misuse (aRRR = 6.12 [95% CI 6.12-11.47]) than females. Those who reported HIV stigma had a higher likelihood of alcohol misuse compared to those who did not report HIV stigma (aRRR = 1.43 [95% CI 1.04-1.98]).Conclusion: Our findings highlight a notable prevalence of alcohol use or misuse among PLWH in Eswatini. Males, those with no education, never married and those who reported HIV stigma were more likely to report alcohol misuse. The study thus recommends innovative policies and strategies to curb alcohol-related harm in the Eswatini population, specifically among PLWH.
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Affiliation(s)
- Garikayi B Chemhaka
- Department of Statistics and Demography, University of Eswatini, Kwaluseni, Eswatini
| | - Maswati S Simelane
- Department of Statistics and Demography, University of Eswatini, Kwaluseni, Eswatini
| | - Stanzia Moyo
- Demography Settlement and Development, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
| | - Mduduzi C Shongwe
- Department of Midwifery Science, University of Eswatini, Mbabane, Eswatini
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Stewart D, Hewitt C, McCambridge J. Exploratory Validation Study of the Individual AUDIT-C Items among Older People. Alcohol Alcohol 2021; 56:258-265. [PMID: 32860051 DOI: 10.1093/alcalc/agaa080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/01/2020] [Accepted: 07/19/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS The AUDIT-C is a brief and commonly used alcohol screening tool, with few data available on the relative validity of the three individual items in older adult populations. The aim of this study was to explore the validity of the AUDIT-C items in identifying unhealthy drinking among older people, with a view to developing a single-item screener. METHODS A sample of 143 older adults (mean age = 71) were recruited from non-clinical settings in the UK. AUDIT-C scores were compared to an unhealthy drinking reference category of consuming more than the UK recommended weekly units of alcohol. Standard analyses were conducted for men and women, and for those prescribed medications for long term conditions. RESULTS The AUDIT-C items performed well in identifying unhealthy drinking in this sample of older people, with generally high sensitivity, specificity and area under the ROC curve. No significant differences were found in the validity of the three items, though the combined sensitivity and specificity scores and ROC values for item 3 were consistently slightly lower than for items 1 and 2. The findings were similar for men and women, and for participants prescribed medications for long-term conditions. CONCLUSIONS AUDIT-C items 1 and 2 performed as well as item 3 in identifying unhealthy drinking among older people in this study. Both are reasonable single-item screener candidates, especially given relative ease of administration, with further validation study needed to examine psychometrics and how alcohol screening for older people can best be implemented in clinical settings.
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Affiliation(s)
- Duncan Stewart
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Catherine Hewitt
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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Chandra A, Kumar R, Kant S, Krishnan A. Costs of TB care incurred by adult patients with newly diagnosed drug-sensitive TB in Ballabgarh block in northern India. Trans R Soc Trop Med Hyg 2021; 116:63-69. [PMID: 33836537 DOI: 10.1093/trstmh/trab060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/02/2021] [Accepted: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND India's National Tuberculosis Elimination Programme (NTEP) provides free diagnosis and treatment services but does not monitor TB-related costs. This study aimed to estimate the direct and indirect costs borne by adult patients with newly diagnosed TB. METHODS A longitudinal study in Ballabgarh block, Haryana (North India) was conducted. A total of 110 patients were interviewed and data regarding costs were collected at three points of time (after diagnosis, at the end of intensive phase and at the end of the treatment) using a semistructured questionnaire. The total direct (out-of-pocket expenses) and indirect (income lost) costs before and during treatment were calculated for patients who completed the treatment. RESULTS We enrolled 110 patients with drug-sensitive TB; 6 patients could not complete the treatment. The TB-related median total cost was US$150 (IQR 65-335). The median prediagnosis and postdiagnosis costs were US$42 (IQR 19-313) and US$63 (IQR 10.2-190), respectively. The median direct and indirect costs were US$75 (IQR 36-148) and US$16 (IQR 0-197), respectively. A catastrophic cost was experienced by 18% (95% CI 12 to 27%) of households. CONCLUSION Despite free diagnosis and treatment services, there is a substantial TB-related cost for TB care under the NTEP. Accelerated efforts are needed to achieve the target of zero catastrophic cost.
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Affiliation(s)
- Ankit Chandra
- Centre for Community Medicine (CCM), Old OT Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Rakesh Kumar
- Centre for Community Medicine (CCM), Old OT Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Shashi Kant
- Centre for Community Medicine (CCM), Old OT Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Anand Krishnan
- Centre for Community Medicine (CCM), Old OT Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
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Chandra A, Kumar R, Kant S, Krishnan A. Diagnostic Pathways and Delays in Initiation of Treatment among Newly Diagnosed Tuberculosis Patients in Ballabgarh, India. Am J Trop Med Hyg 2021; 104:1321-1325. [PMID: 33617478 DOI: 10.4269/ajtmh.20-1297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/05/2021] [Indexed: 11/07/2022] Open
Abstract
A delay in diagnosis and initiation of treatment in patients with tuberculosis (TB) can affect the period of communicability and cost of treatment. We aimed to describe the diagnostic pathways and delays in initiation of treatment among drug-sensitive newly diagnosed TB patients in Ballabgarh, India. In May 2019, we interviewed 110 TB patients who were put on treatment in the past 2 months. It was a cross-sectional study where data collection was conducted by a physician. We used a structured questionnaire to collect the information on care-seeking practices, delays, and patient's cost. Descriptive analysis was carried out for the pathways, delays, and patient cost. The mean number of health facility contacted before the diagnosis of TB was 2.8 (SD: 1.3); 76% of patients first sought care at a private health facility. The median total delay was 34.5 (IQR: 21-60) days; median patient delay seven (IQR: 2-21) days, median health system delay 16 (IQR: 8-45) days, median diagnostic delay 32.5 (IQR: 18-57) days, and median treatment delay two (IQR: 1-3) days. Health system delay was 2.2 times longer than patient delay; the health system delay was primarily due to delay in diagnosis. Patients contacting private health facility first had 1.7 times total delay, 2.4 times longer health system delay, and 3.4 times of direct cost compared with patients contacting a public health facility first. Accelerated efforts are needed to achieve India's target to eliminate TB by 2025.
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Functional-Belief-Based Alcohol Use Questionnaire (FBAQ) as a Pre-Screening Tool for High-Risk Drinking Behaviors among Young Adults: A Northern Thai Cross-Sectional Survey Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041536. [PMID: 33562789 PMCID: PMC7915812 DOI: 10.3390/ijerph18041536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND an alcohol-use disorders identification test (AUDIT) is a standard screening tool for high-risk drinking behavior. Standard drink calculation is difficult to comprehend and may lead to inaccurate estimates. This study intended to develop a practical pre-screening tool for the identification of high-risk drinkers among young adults. METHODS a cross-sectional survey was conducted in Northern Thailand from July 2016 to December 2016. Data was collected on relevant characteristics and health beliefs about drinking. The 12-month AUDIT was used as the reference standard. Logistic regression was used for the score derivation. The discriminative ability was measured with an area under the receiver operating characteristic curve (AuROC). RESULT a total of 1401 young adults were included. Of these, 791 people (56.5%) were current drinkers. Three functional-belief items were identified as independent predictors of high-risk drinking and were used to develop the functional-belief-based alcohol-use questionnaire (FBAQ). The FBAQ demonstrated an acceptable discriminative ability-AuROC 0.74 (95% confidence interval (CI) 0.70, 0.77). CONCLUSION The FBAQ contains only three simple belief questions and does not require unintelligible standard drink calculation. Implementing the FBAQ score and the AUDIT in a serial manner might be a more effective method in a mass-screening program for alcohol-use disorder in young adults.
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Alpers SE, Skogen JC, Mæland S, Pallesen S, Rabben ÅK, Lunde LH, Fadnes LT. Alcohol Consumption during a Pandemic Lockdown Period and Change in Alcohol Consumption Related to Worries and Pandemic Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031220. [PMID: 33572994 PMCID: PMC7908087 DOI: 10.3390/ijerph18031220] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022]
Abstract
Whether lockdown related to the COVID-19 pandemic influences alcohol consumption is not well known. This study assesses alcohol consumption and hazardous drinking behavior during the initial phase of pandemic measures in Norway and identifies potential risk factors. A cross-sectional study (N = 25,708) was conducted in Bergen, Norway, following the first six weeks of strict infection control measures. In a model of self-assessed increased alcohol consumption, logistic regression analysis was conducted with independent variables for COVID-19-related worries, joblessness, quarantine, self-reported drinking behavior, age, gender, and occupational situation. These are reported with odds ratios (ORs) with 95% confidence intervals. Fifty-one percent of respondents reported economic or health-related worries due to COVID-19, 16% had been in quarantine, 49% worked/studied from home, 54% reported hazardous drinking behavior, and 13% reported increased alcohol consumption. People aged 30–39 years had elevated odds of increased alcohol consumption during lockdown (OR 3.1, 2.4−3.8) compared to the oldest adults. Increased drinking was more frequent among people reporting economic worries (OR 1.6, 1.4−1.8), those quarantined (OR 1.2, 1.1−1.4), and those studying or working at home (OR 1.4, 1.3−1.6). More than half of respondents reported hazardous drinking behavior. Increased alcohol consumption during lockdown was common among people with economic worries, people in quarantine, and people studying or working at home. These data could be important when adjusting pandemic measures.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (L.-H.L.); (L.T.F.)
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway
- Correspondence:
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway;
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway
- Alcohol & Drug Research Western Norway, Stavanger University Hospital, 4010 Stavanger, Norway
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway;
- Research Unit for General Practice in Bergen, The Norwegian Research Centre, NORCE, 5008 Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway;
- Optentia Research Focus Area, North-West University, Vanderbijlpark 1900, South Africa
| | | | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (L.-H.L.); (L.T.F.)
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway
| | - Lars Thore Fadnes
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (L.-H.L.); (L.T.F.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway;
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López-Pelayo H, Matrai S, Balcells-Olivero M, Campeny E, Braddick F, Bossong MG, Cruz OS, Deluca P, Dom G, Feingold D, Freeman TP, Guzman P, Hindocha C, Kelly BC, Liebregts N, Lorenzetti V, Manthey J, Matias J, Oliveras C, Pons MT, Rehm J, Rosenkranz M, Swithenbank Z, van Deurse L, Vicente J, Vuolo M, Wojnar M, Gual A. Supporting Future Cannabis Policy - Developing a Standard Joint Unit: A Brief Back-Casting Exercise. Front Psychiatry 2021; 12:675033. [PMID: 34093282 PMCID: PMC8172797 DOI: 10.3389/fpsyt.2021.675033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/06/2021] [Indexed: 01/05/2023] Open
Abstract
The standardization of cannabis doses is a priority for research, policy-making, clinical and harm-reduction interventions and consumer security. Scientists have called for standard units of dosing for cannabis, similar to those used for alcohol. A Standard Joint Unit (SJU) would facilitate preventive and intervention models in ways similar to the Standard Drink (SD). Learning from the SD experiences allows researchers to tackle emerging barriers to the SJU by applying modern forecasting methods. During a workshop at the Lisbon Addictions Conference 2019, a back-casting foresight method was used to address challenges and achieve consensus in developing an SJU. Thirty-two professionals from 13 countries and 10 disciplines participated. Descriptive analysis of the workshop was carried out by the organizers and shared with the participants in order to suggest amendments. Several characteristics of the SJU were defined: (1) core values: easy-to use, universal, focused on THC, accurate, and accessible; (2) key challenges: sudden changes in patterns of use, heterogeneity of cannabis compounds as well as in administration routes, variations over time in THC concentrations, and of laws that regulate the legal status of recreational and medical cannabis use); and (3) facilitators: previous experience with standardized measurements, funding opportunities, multi-stakeholder support, high prevalence of cannabis users, and widespread changes in legislation. Participants also identified three initial steps for the implementation of a SJU by 2030: (1) Building a task-force to develop a consensus-based SJU; (2) Expanded available national-level data; (3) Linking SJU consumption to the concept of "risky use," based on evidence of harms.
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Affiliation(s)
- Hugo López-Pelayo
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Matrai
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mercè Balcells-Olivero
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eugènia Campeny
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Fleur Braddick
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Matthijs G Bossong
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Olga S Cruz
- Social Sciences Department, Instituto Universitário da Maia (ISMAI), Maia, Portugal.,University Interdisciplinary Research Centre for Human Rights - JusGov, University of Minho, Maia, Portugal and JusGov - Escola de Direito, Braga, Portugal
| | - Paolo Deluca
- Addictions Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Geert Dom
- Adult Psychiatry Department, Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.,European Federation of Addiction Societies, Boechout, Belgium
| | | | - Tom P Freeman
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, United Kingdom
| | - Pablo Guzman
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, University College London, London, United Kingdom.,National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Brian C Kelly
- Departament of Sociology, Purdue University, West Lafayette, IN, United States
| | - Nienke Liebregts
- Bonger Institute of Criminology, University of Amsterdam, Amsterdam, Netherlands
| | - Valentina Lorenzetti
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research of Hamburg University (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - João Matias
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Clara Oliveras
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Teresa Pons
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Canada Epidemiological Research Unit, Canada Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto (UofT), Toronto, ON, Canada.,Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M.Sechenov First Moscow State Medical University, Moscow, Russia
| | - Moritz Rosenkranz
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research of Hamburg University (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Zoe Swithenbank
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Luc van Deurse
- Student Governance and Leadership in European Public Health, Maastricht University, Maastricht, Netherlands
| | - Julian Vicente
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Mike Vuolo
- Department of Sociology, The Ohio State University, Columbus, OH, United States
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Antoni Gual
- Institut Clínic de Neurociències, Psychiatry and Psychology Service, Grup Recerca Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain
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41
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Macdonald JA, Greenwood CJ, Francis LM, Harrison TR, Graeme LG, Youssef GJ, Di Manno L, Skouteris H, Fletcher R, Knight T, Williams J, Milgrom J, Olsson CA. Profiles of Depressive Symptoms and Anger in Men: Associations With Postpartum Family Functioning. Front Psychiatry 2020; 11:578114. [PMID: 33329118 PMCID: PMC7719778 DOI: 10.3389/fpsyt.2020.578114] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Evidence suggests that men commonly experience depression as feelings of anger; yet, research has not investigated what this means for the manifestation of depressive symptoms in the early years of fatherhood and for key indicators of family functioning. Methods: Using data from a longitudinal cohort study of men at the normative age for entering fatherhood (28-32 years), we conducted latent class analyses to identify patterns of depressive symptoms and 3 sub-types of state anger (feeling; verbal; physical). We then assessed whether class membership was associated with paternity status (n = 535). In a subsample of fathers of infants aged up to 18 months (n = 162), we prospectively assessed associations with paternal-infant bonding, co-parenting, perceived social support, paternal involvement in childcare and alcohol use up to 2 years later. Results: Five classes emerged that differentiated men by anger and depressive symptom severity and by the degree to which men endorsed the feeling of wanting to express anger physically. Compared to the reference class with minimal symptoms, fathers had a higher probability of being in either the mild or most severe symptom classes. Men in symptomatic classes were at higher risk of lower levels of social support, co-parenting problems, and paternal-infant bonds. Class membership was not associated with alcohol use or paternal involvement in childcare. Conclusions: Our results reveal patterns of co-existing symptoms of depression and anger in fathers of infants that will be relevant to men's own need for support, their family safety, partner mental health and child developmental outcomes.
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Affiliation(s)
- Jacqui A. Macdonald
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Lauren M. Francis
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Tessa R. Harrison
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Liam G. Graeme
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - George J. Youssef
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Laura Di Manno
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Richard Fletcher
- Faculty of Health and Medicine, Family Action Centre, University of Newcastle, Callaghan, NSW, Australia
| | - Tess Knight
- Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Craig A. Olsson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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42
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Mujcic A, Linke S, Hamilton F, Phillips A, Khadjesari Z. Engagement With Motivational Interviewing and Cognitive Behavioral Therapy Components of a Web-Based Alcohol Intervention, Elicitation of Change Talk and Sustain Talk, and Impact on Drinking Outcomes: Secondary Data Analysis. J Med Internet Res 2020; 22:e17285. [PMID: 32870162 PMCID: PMC7492976 DOI: 10.2196/17285] [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] [Received: 12/03/2019] [Revised: 04/16/2020] [Accepted: 06/03/2020] [Indexed: 01/13/2023] Open
Abstract
Background Down Your Drink (DYD) is a widely used unguided web-based alcohol moderation program for the general public based on cognitive behavioral therapy (CBT) and motivational interviewing (MI); it provides users with many opportunities to enter free-text responses. Objective The aim of this study was to assess participants’ use of key CBT and MI components, the presence of change talk and sustain talk within their responses, and whether these data are associated with drinking outcomes after 3 months. Methods An exploratory secondary data analysis was conducted on data collected in 2008 from the definitive randomized trial of DYD (N=503). Past week alcohol use at baseline and 3-month follow-up were measured with the TOT-AL. Covariates included baseline alcohol use, age, gender, education level, and word count of the responses. Use of MI and CBT components and presence of change talk and sustain talk were coded by two independent coders (Cohen κ range 0.91-1). Linear model regressions on the subsample of active users (n=410) are presented along with a negative binomial regression. Results The most commonly used component was the listing of pros and cons of drinking. The number of listed high-risk situations was associated with lower alcohol use at 3-month follow-up (Badj −2.15, 95% CI −3.92 to −0.38, P=.02). Findings on the effects of the percentage of change talk and the number of listed strategies to deal with high-risk situations were inconsistent. Conclusions An unguided web-based alcohol moderation program can elicit change talk and sustain talk. This secondary analysis suggests that the number of listed high-risk situations can predict alcohol use at 3-month follow-up. Other components show inconsistent findings and should be studied further.
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Affiliation(s)
- Ajla Mujcic
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands.,Trimbos Institute, The Netherlands National Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Stuart Linke
- Camden and Islington Mental Health Trust, London, United Kingdom.,eHealth Unit, Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Fiona Hamilton
- eHealth Unit, Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | | | - Zarnie Khadjesari
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
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43
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Olusanya OA, Barry AE. Dissemination of Prenatal Drinking Guidelines: A Preliminary Study Examining Personal Alcohol Use Among Midwives in a Southwestern US State. J Midwifery Womens Health 2020; 65:634-642. [PMID: 32844544 DOI: 10.1111/jmwh.13146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 05/30/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The constellation of birth defects seen in fetuses exposed to alcohol in utero have been described as fetal alcohol spectrum disorders. Evidence suggests that health care providers' communication practices regarding prenatal alcohol use could have beneficial outcomes. There is a paucity of investigations, however, that have examined the health professionals' personal alcohol use and prenatal alcohol recommendations they provide. METHODS This study sought to examine and compare midwives' personal alcohol use and communication practices regarding prenatal alcohol consumption. Certified nurse-midwives (CNMs) and certified professional midwives (CPMs) in a southwestern US state participated. Inclusion criteria included training in prenatal care, labor, birth, and membership in a midwife professional organization. Personal drinking behaviors were assessed with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). RESULTS All midwives (N = 61; 100%) reported they typically screened a patient for alcohol use during an initial prenatal visit. However, 5 (8.2%) respondents opted for recommendations that advised patients to drink once in a while. Similarly, 4 (6.6%) midwives counseled no more than one drink per day. In the cohort of participants (n = 40) with AUDIT-C scores, 25 (62.5%) engaged in nonrisky drinking (AUDIT-C scores <3). Most respondents (n = 39 of 40; 97.5%) typically consumed 1 to 2 standard drinks on the day they drank. There was no statistically significant difference in mean overall AUDIT-C scores between CNMs and CPMs (P = .42). When examining midwives' (1) responses on the AUDIT-C questionnaire, (2) nonrisky or risky drinking behaviors, and 3) communication practices regarding prenatal alcohol use, Fisher's exact test showed no statistically significant differences between CNMs and CPMs. DISCUSSION Results of this study highlight the importance of advocating healthy lifestyles among health care professionals while also promoting communication practices that align with national alcohol guidelines. Future investigations that examine associations between health care professionals' personal alcohol use and type or effectiveness of services offered to patients may be beneficial.
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Affiliation(s)
| | - Adam E Barry
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
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44
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Tao R, Jiang F, Min K, Liu T, Liu Y, Xia L, Wang J, Liu H, Tang YL. Alcohol Use Among Mental Health Professionals in China: A Nationwide Cross-sectional Survey. Alcohol Alcohol 2020; 56:351-359. [PMID: 32696947 DOI: 10.1093/alcalc/agaa065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/12/2020] [Accepted: 06/12/2020] [Indexed: 01/31/2023] Open
Abstract
AIM To survey the use of alcohol, and its correlates by mental health professions in China, a nation where there is rapid increase in alcohol consumption and problems. METHODS As a part of a large-scale, nation-wide online survey of healthcare professionals, we collected demographic variables and other health-related variables anonymously. The Alcohol Use Disorder Identification Test-Concise (AUDIT-C) was used to collect data on alcohol use. RESULTS 13,980 mental health professionals completed the survey (4382 doctors, 9339 nurses and 259 clinical psychologists), representing 64% of the total targeted. Respondents were predominantly female (75.1%). Alcohol consumption was reported by 41.8% of participants (by 53.9% of doctors, 36.2% of nurses and 40.5% of clinical psychologists). Based on the cut-off scores of the AUDIT-C (≥3 for women and ≥4 for men), 7.5% were classified as probable alcohol misusers in the past year, and the rates were 10.2% in doctors, 6.3% in nurses and 5.8% in clinical psychologists. Multiple logistic regression showed that male sex (OR = 3.772; CI = 3.206-4.439), being a doctor (OR = 1.259; CI = 1.052-1.506), being divorced or widowed (OR = 1.979; CI = 1.467-2.666), having an associate degree or less (OR = 1.809; CI = 1.040-3.147), working in Northeast China (OR = 1.538; CI = 1.281-1.848) and the habit of smoking (OR = 3.345; CI = 2.280-3.967) were significantly associated with alcohol misuse. CONCLUSIONS Alcohol use and misuse were relatively common among mental health professionals in China, and male sex, being a doctor, with lower education, working in Northeast China and cigarette smoking were significant associations. Awareness and interventions are recommended to promote healthier use of alcohol in this professional group, especially among risk subgroups.
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Affiliation(s)
- Rui Tao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China.,Department of Substance-Related Disorders, Hefei Fourth People's Hospital, 316 Huangshan Road, Shushan District, Hefei, 230022, China
| | - Feng Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, China
| | - Kaiyuan Min
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Haidian District, Beijing, 100091, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China
| | - Juan Wang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, 30033, USA.,Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30329, USA
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45
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Fernandes GS, Lewis G, Hammerton G, Abeysekera K, Mahedy L, Edwards A, Lewis G, Hickman M, Heron J. Alcohol consumption and internalising disorders in young adults of ALSPAC: a population-based study. J Epidemiol Community Health 2020; 74:1023-1027. [PMID: 32631846 PMCID: PMC8886795 DOI: 10.1136/jech-2020-213922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/08/2020] [Accepted: 06/02/2020] [Indexed: 01/24/2023]
Abstract
Introduction Depression and harmful alcohol consumption contribute significantly to the global health burden, but in young adults, this relationship is under-researched and conflicted. The aim of this study was to determine the sex-based prevalence and the association between internalising disorders such as depression and alcohol use disorders. Method Using the Avon Longitudinal Study of Parents and Children, we assessed the sex-specific prevalence of International Classification of Diseases, Tenth Revision diagnosed generalised anxiety disorder (GAD), depression and fear-based anxieties (FBA) at 24 years (n=3572). We examined the association between internalising disorders and alcohol consumption using the Alcohol Use Disorder Identification Test for Consumption 5+ threshold and Diagnostic and Statistical Manual on Mental Disorders defined criteria for alcohol dependence. Results Women reported more GAD (11.6% vs 6.5%), depression (13.4% vs 6.9%) and FBA (1.3% vs 0.5%) than men (p<0.001). Harmful drinking, after adjustment for sex and socioeconomic status, was associated witha higher prevalence of depression (OR 1.8, 95% CI 1.3 to 2.4, p<0.001), anxiety (OR 1.4, 95% CI 1.0 to 2.0, p<0.001) and FBA (OR 2.4, 95% CI 1.04 to 5.56, p=0.009) compared with lower-risk drinkers. In contrast, hazardous drinking was associated with a lower prevalence of GAD (OR 0.69, 95% CI 0.54 to 0.88) and depression (OR 0.68, 95% CI 0.54 to 0.86) compared with lower-risk drinkers. Conclusions Young adults in the UK who drink harmfully are more likely to have depression and other internalising disorders. Further research should test whether there is a J-shaped relationship between alcohol consumption and mental health in young people and whether this varies across the life course.
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Affiliation(s)
- Gwen Sascha Fernandes
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | | | - Gemma Hammerton
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Kushala Abeysekera
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Liam Mahedy
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Alexis Edwards
- Virginia Institute for Psychiatric and Behavior Genetics, Richmond, Virginia, USA
| | | | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jonathan Heron
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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46
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Morris J, Albery IP, Heather N, Moss AC. Continuum beliefs are associated with higher problem recognition than binary beliefs among harmful drinkers without addiction experience. Addict Behav 2020; 105:106292. [PMID: 32007833 DOI: 10.1016/j.addbeh.2020.106292] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/03/2020] [Accepted: 01/05/2020] [Indexed: 11/18/2022]
Abstract
Low problem recognition may be an important barrier to opportunities for self-change or help-seeking in harmful drinkers. Little is known about how the beliefs harmful drinkers hold about the nature and causes of alcohol problems affect problem recognition and subsequent behaviour change processes. Participants (n = 597) recruited online were randomised to one of two conditions designed to promote beliefs according to (a) a continuum model of alcohol problems or (b) a binary disease model, or (c) a control condition. Participants completed measures of alcohol problem beliefs, problem recognition and other indices including the Alcohol Use Disorder Identification Test (AUDIT), addiction beliefs, addiction experience and demographics. Results showed that harmful drinkers without addiction experience exposed to the continuum condition had significantly higher problem recognition than those in binary disease model or control conditions. Continuum beliefs appear to offer self-evaluative benefits for harmful drinkers with low alcohol problem recognition, thus potentially facilitating help-seeking or self-change regarding alcohol use. Further research to understand the mechanisms by which continuum beliefs may promote more accurate drinking self-evaluation and its potential for behaviour change is warranted. The role of continuum beliefs may have important consequences for alcohol-related messaging and interventions seeking to promote self-change or help-seeking.
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Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom.
| | - I P Albery
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - N Heather
- Faculty of Health & Life Sciences, Northumbria University, United Kingdom
| | - A C Moss
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
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47
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Viswanath A, Barreveld AM, Fortino M. Assessment and Management of the High-Risk Dental Patient with Active Substance Use Disorder. Dent Clin North Am 2020; 64:547-558. [PMID: 32448458 DOI: 10.1016/j.cden.2020.02.004] [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
Every dentist cares for patients with a history of substance use disorder (SUD), regardless of a patient's socioeconomic status, education, or ethnicity. SUD is a global epidemic, with approximately 8% of the general US population meeting diagnostic criteria for a SUD and more than 20% of the global population experiencing a SUD. The importance of understanding how to identify substance use, manage patients with a SUD, and offer appropriate referral is essential for all dental professionals. In 2005, the American Dental Association published, "Statement on Provision of Dental Treatment for Patients with Substance Use Disorders."
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Affiliation(s)
- Archana Viswanath
- Department of Oral and Maxillofacial Surgery, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Antje M Barreveld
- Department of Anesthesiology, Tufts University School of Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Pain Management Services, Substance Use Services, Newton-Wellesley Hospital, Newton, MA, USA
| | - Matthew Fortino
- Department of Diagnostic Sciences, Center for Pain Medicine, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA; Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA.
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48
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Khan MR, Young KE, Caniglia EC, Fiellin DA, Maisto SA, Marshall BDL, Edelman EJ, Gaither JR, Chichetto NE, Tate J, Bryant KJ, Severe M, Stevens ER, Justice A, Braithwaite SR. Association of Alcohol Screening Scores With Adverse Mental Health Conditions and Substance Use Among US Adults. JAMA Netw Open 2020; 3:e200895. [PMID: 32163167 PMCID: PMC7068229 DOI: 10.1001/jamanetworkopen.2020.0895] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Alcohol screening may be associated with health outcomes that cluster with alcohol use (ie, alcohol-clustering conditions), including depression, anxiety, and use of tobacco, marijuana, and illicit drugs. OBJECTIVE To quantify the extent to which alcohol screening provides additional information regarding alcohol-clustering conditions and to compare 2 alcohol use screening tools commonly used for this purpose. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study used data from the Veterans Aging Cohort Study. Data were collected at 8 Veterans Health Administration facilities from 2003 through 2012. A total of 7510 participants were enrolled, completed a baseline survey, and were followed up. Veterans with HIV were matched with controls without HIV by age, race, sex, and site of care. Data were analyzed from January 2019 to December 2019. EXPOSURES The Alcohol Use Disorders Identification Test (AUDIT) and Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) were used to assess alcohol use, with 4 risk groups delineated for each test: score 0 to 7 (reference), score 8 to 15, score 16 to 19, and score 20 to 40 (maximum score) for the full AUDIT and score 0 to 3 (reference), score 4 to 5, score 6 to 7, and score 8 to 12 (maximum score) for the AUDIT-C. MAIN OUTCOMES AND MEASURES Alcohol-clustering conditions, including self-reported symptoms of depression and anxiety and use of tobacco, marijuana, cocaine, other stimulants, opioids, and injection drugs. RESULTS A total of 6431 US patients (6104 [95%] men; median age during survey years 2003-2004, 50 years [range, 28-86 years; interquartile range, 44-55 years]) receiving care in the Veterans Health Administration completed 1 or more follow-up surveys when the AUDIT was administered and were included in the present analyses. Of the male participants, 4271 (66%) were African American, 1498 (24%) were white, and 590 (9%) were Hispanic. The AUDIT and AUDIT-C scores were associated with each alcohol-clustering condition. In particular, an AUDIT score of 20 or higher (vs <8, the reference) was associated with symptoms of depression (odds ratio [OR], 8.37; 95% CI, 6.20-11.29) and anxiety (OR, 8.98; 95% CI, 6.39-12.60) and with self-reported use of tobacco (OR, 14.64; 95% CI, 8.94-23.98), marijuana (OR, 12.41; 95% CI, 8.61-17.90), crack or cocaine (OR, 39.47; 95% CI, 27.38-56.90), other stimulants (OR, 21.31; 95% CI, 12.73-35.67), and injection drugs (OR, 8.67; 95% CI, 5.32-14.13). An AUDIT score of 20 or higher yielded likelihood ratio (sensitivity / 1 - specificity) values greater than 3.5 for depression, anxiety, crack or cocaine use, and other stimulant use. Associations between AUDIT-C scores and alcohol-clustering conditions were more modest. CONCLUSIONS AND RELEVANCE Alcohol screening can inform decisions about further screening and diagnostic assessment for alcohol-clustering conditions, particularly for depression, anxiety, crack or cocaine use, and other stimulant use. Future studies using clinical diagnoses rather than screening tools to assess alcohol-clustering conditions may be warranted.
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Affiliation(s)
- Maria R. Khan
- Department of Population Health, New York University School of Medicine, New York
| | - Kailyn E. Young
- Department of Population Health, New York University School of Medicine, New York
| | - Ellen C. Caniglia
- Department of Population Health, New York University School of Medicine, New York
| | - David A. Fiellin
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | | | - E. Jennifer Edelman
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Julie R. Gaither
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Natalie E. Chichetto
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Janet Tate
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | - MacRegga Severe
- Department of Population Health, New York University School of Medicine, New York
| | - Elizabeth R. Stevens
- Department of Population Health, New York University School of Medicine, New York
| | - Amy Justice
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Scott R. Braithwaite
- Department of Population Health, New York University School of Medicine, New York
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49
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Bertholet N, Schmutz E, Grazioli VS, Faouzi M, McNeely J, Gmel G, Daeppen JB, Cunningham JA. Smartphone-based secondary prevention intervention for university students with unhealthy alcohol use identified by screening: study protocol of a parallel group randomized controlled trial. Trials 2020; 21:191. [PMID: 32066490 PMCID: PMC7027100 DOI: 10.1186/s13063-020-4145-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/05/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Unhealthy alcohol use is a leading cause of morbidity and mortality among young people, including university students. Delivering secondary prevention interventions against unhealthy alcohol use is challenging. Information technology has the potential to reach large parts of the general population. The present study is proposed to test a proactive secondary prevention smartphone-based intervention against unhealthy alcohol use. METHODS This is a parallel-group, randomized controlled trial (1:1 allocation ratio) among 1696 university students with unhealthy alcohol use, identified by screening and followed up at 3, 6, and 12 months. Participants will be randomized to receive access to a smartphone-based intervention or to a no intervention control condition. The primary outcome will be self-reported volume of alcohol drunk over the past 30 days, reported as the mean number of standard drinks per week over the past 30 days, measured at 6 months. Secondary outcomes will be number of heavy drinking days over the past 30 days, at 6 months. Additional outcomes will be maximum number of drinks on any day over the past 30 days, alcohol-related consequences (measured using the Short Inventory of Problems (SIP-2R), and academic performance. DISCUSSION The aim of this trial is to close the evidence gap on the efficacy of smartphone-based secondary prevention interventions. If proven effective, smartphone-based interventions have the potential to reach a large portion of the population, completing what is available on the Internet. TRIAL REGISTRATION ISRCTN, 10007691. Registered on 2 December 2019. Recruitment will start in April 2020.
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Affiliation(s)
- Nicolas Bertholet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Elodie Schmutz
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Véronique S Grazioli
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Mohamed Faouzi
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jennifer McNeely
- Department of Population Health, Section on Tobacco, Alcohol and Drug Use, New York University (NYU) Grossman School of Medicine, New York, NY, 10016, USA
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John A Cunningham
- Center for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Short-term risk of suicide attempt associated with patterns of patient-reported alcohol use determined by routine AUDIT-C among adults receiving mental healthcare. Gen Hosp Psychiatry 2020; 62:79-86. [PMID: 31874300 PMCID: PMC7047881 DOI: 10.1016/j.genhosppsych.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the association between alcohol use routinely reported during outpatient mental healthcare visits and short-term risk of subsequent suicide attempt. METHODS Using a longitudinal retrospective-cohort design, electronic health records identified adult outpatient visits to a mental health provider (1/1/2010-6/30/2015) at Kaiser Permanente Washington with a documented Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]. Suicide attempts within 90 days of AUDIT-C documentation were defined using death certificate cause-of-death and diagnosis codes (non-lethal). Visit-level analyses used generalized estimating equations to account for correlation between multiple AUDIT-Cs for individuals. Separate models evaluated the association between (1) level of consumption and (2) frequency of heavy drinking episodes and suicide attempts, adjusted for visit year, demographics, depressive symptom, and suicidal ideation. RESULTS Of 59,382 patient visits, 0.62% (N = 371) were followed by a suicide attempt within 90 days. Patients reporting high-level alcohol use were 1.77 times (95% CI, 1.22-2.57) more likely to attempt suicide than those reporting low-level use. Patients reporting daily or almost daily heavy drinking episodes were 2.33 times (95% CI, 1.38-3.93) more likely to attempt suicide than those reporting none. CONCLUSIONS AND RELEVANCE The AUDIT-C is a valuable tool for assessing patterns of patient-reported alcohol use associated with subsequent suicide attempt.
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