Testing both affordability-availability and psychological-coping mechanisms underlying changes in alcohol use during the COVID-19 pandemic

Diverging trends in alcohol-related harms: The role of comorbid mental health, suicide and self-harm behaviors in ambulance attendances for alcohol intoxication during the COVID-19 pandemic in Victoria, Australia

BACKGROUND

Alcohol harms changed significantly during COVID-19, but did not affect the population equally. Vulnerable groups including people with pre-existing mental health or suicidal behaviors may be at greater risk of alcohol-related harms, yet limited public health data are able to assess these.

METHODS

The present study utilised a novel, statewide surveillance system to examine ambulance attendances for alcohol intoxication over a four-year period prior to, and during the strictest lockdowns in Victoria, Australia.

RESULTS

While there was an overall reduction in alcohol-related attendances during lockdown (n = 15,064) compared to the 2018-19 period (n = 16,989), alcohol- intoxication attendances involving mental health symptoms increased by 40 % in Melbourne (IRR: 1.40 [1.30-1.51], p < 0.001), and by 25 % in regional Victoria (IRR: 1.25 [1.07-1.44], p = 0.005).There was also a 7 % increase in alcohol-intoxication attendances with co-morbid suicidal behaviors in Melbourne (IRR: 1.07 95%CI [1.02-1.13], p = 0.006), and a 21 % increase in regional Victoria (IRR: 1.21 [1.08-1.35], p = 0.001).

CONCLUSIONS

These findings suggest that extra services and supports for individuals with co-morbid alcohol-related harms are required to ensure their clinical care needs are being met.

Young adult drinking during the COVID-19 pandemic: Examining the role of anxiety sensitivity, perceived stress, and drinking motives

Studies have shown that those high in anxiety were at increased risk for alcohol use during the COVID-19 pandemic. Tension reduction theory points to anxiety sensitivity (AS) as a potential risk factor. Drinking to cope may further increase this risk. During the pandemic, those high in AS may have experienced increased stress and drank to cope, which may have put them at risk for misusing alcohol. Objective: The current study tested the association between AS and alcohol outcomes, mediated by perceived stress and drinking motives, among young adults during the COVID-19 pandemic. Participants and Methods: Young adults (N = 143) self-reported on AS, perceived stress, drinking motives, and alcohol outcomes (i.e., use and problems). Results: A mediation analysis revealed that AS positively predicted alcohol problems, via coping motives, and positively predicted alcohol use, via perceived stress and enhancement/sociability motives. Conclusion: These results confirm AS-risk for young adult alcohol use during the pandemic and highlight perceived stress and drinking motives as mechanisms of risk.

Social Isolation Mediates the Effects of Negative Emotionality and Resilience on Drinking to Cope and Drinking Alone

Objective: The purpose of this research was to test an extension of the incentive motivation model of alcohol by examining effects of personality traits on drinking motives and contexts, as mediated by social isolation. Methods: Participants were 1269 adults who resided in the United States (n = 618) or United Kingdom (n = 651) and completed an online questionnaire measuring the traits of negative emotionality and resilience, along with social isolation, drinking motives (coping, social) and drinking contexts (alone, at a party, at a bar/club). Six months later, 70% of the participants returned to complete a similar online questionnaire. Results: Path analysis was used to test the hypothesized models and revealed that negative emotionality had a prospective indirect effect on drinking to cope and drinking alone through increased social isolation over the 6-month period of observation. In contrast, the trait of resilience had a prospective indirect effect on reductions in the drinking to cope motive and reductions in drinking alone, through decreased social isolation. Conclusion: The findings suggest that personality traits that contribute to social isolation may be risk factors for dysfunctional drinking motives and contexts.

Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic

Rheumatic autoimmune diseases are associated with a myriad of comorbidities. Of particular importance due to their morbimortality are cardiovascular diseases. COVID-19 greatly impacted the world population in many different areas. Patients with rheumatic diseases had to face changes in their healthcare, in addition to unemployment, a decrease in physical activity, social isolation, and lack of access to certain medications. This review summarizes the impact of COVID-19 pandemic on cardiovascular risk factors, comorbidities, and unhealthy behaviors in patients with rheumatic inflammatory autoimmune diseases, particularly focused on rheumatoid arthritis and systemic lupus erythematosus. Searches were carried out in MEDLINE/PubMed and Scopus from August to December 2022. Four reviewers screened the title and abstract of retrieved records. Potentially eligible reports were then reviewed in full text. Differences were reconciled by either consensus or discussion with an external reviewer. During the COVID-19 pandemic, patients with rheumatic diseases showed an increase in the prevalence of mental health disorders (43.2-57.7%), reduced physical activity (56.8%), and a worsening in eating behaviors. Alcohol intake increased (18.2%), especially in early phases of the pandemic. Smoking prevalence decreased (28.2%). Dyslipidemia and hypertension showed no changes. The pandemic and lockdown affected rheumatic patients not only in disease-related characteristics but in the prevalence of their cardiovascular comorbidities and risk factors. Lifestyle changes, such as healthy eating, physical activity, and optimal management of their rheumatic diseases and comorbidities, are essential to manage the long-lasting consequences of the COVID-19 outbreak. Key Points • During the COVID-19 pandemic, anxiety, depression, sedentarism, obesity, and a worsening in eating behaviors increased. •Patients with rheumatic diseases and comorbidities have worse clinical outcomes and a higher cardiovascular disease burden than those without them. •Comparative studies are necessary to precisely elucidate the pandemic's impact on the prevalence of cardiovascular disease, risk factors, and comorbidities in patients with rheumatoid arthritis and systemic lupus erythematosus.

The Involvement of Age, Gender, and Personality Variables in Alcohol Consumption during the Start of the COVID-19 Pandemic in Romanian University Students

This study aimed to explore the age, gender, and personality variables involved in alcohol consumption (AC) at the start of the COVID-19 pandemic in Romania among 210 bachelor's and master's students aged between 19 and 25 years. The results of the Freiburg Personality Inventory-Revised and the Alcohol Use Disorders Identification Test were examined using a logistic model and cluster analysis. The prevalence of problematic AC was relatively low (10.5%). The risk of males being part of the problematic AC cluster was 5.223 times higher than that of females (p < 0.001). Increasing age was associated with a decrease in the risk of belonging to the problematic cluster by a factor of 0.733 (p = 0.001). Increasing scores on the Frankness and Somatic Complaints personality scales were associated with a decreased risk of belonging to the problematic cluster of AC, with factors of 0.738 (95% CI, 0.643 to 0.848), Wald χ²(1) = 18.424, and p < 0.001 and 0.901 (95% CI, 0.813 to 0.999), Wald χ²(1) = 3.925, and p = 0.048, respectively. More action to prevent AC is needed in men, especially in those at the beginning of their university studies. It is necessary to intervene to decrease the interest in making a good impression (low scores on the Frankness Scale) so as to increase healthy autonomy using critical thinking and find a balance between the internal and external loci of control. Students from faculties with profiles that deal with health and its promotion are less vulnerable to problematic alcohol consumption, even if they have a withdrawn, pessimistic personality (low scores on Somatic Complaints).

Substance Use Among Residents of Homeless Shelters During the COVID-19 Pandemic: Findings From France

Objectives: To record the prevalence and risk factors of substance use amongst homeless persons during the COVID-19 pandemic.

Methods: The ECHO study consisted in two independent cross-sectional waves of data collection in the regions of Paris, Lyon, and Strasbourg during the Spring of 2020 (n = 530) and 2021 (n = 319). Factors associated with substance use were explored using generalised logistic regression models.

Results: The most prevalent substance used was tobacco (38%–43%), followed by alcohol (26%–34%). The use of both substances positively associated with each other, although risk factors varied depending on the substance. The only factors consistently associated with alcohol and tobacco use were being male, exposure to theft/assault and participants’ region of origin. Whilst the rate of tobacco use was relatively stable between Spring 2020 and 2021, alcohol use was more common in 2021.

Conclusion: These findings highlight a high prevalence of substance use amongst homeless persons. People experiencing homelessness face specific challenges in the context of the pandemic, alongside greater vulnerability to illness and low healthcare access, therefore the need to improve prevention and support services for substance abuse within this population is vital.