Depression in alcoholics by the NIMH-Diagnostic Interview Schedule and Zung Self-Rating Depression Scale

Posttraumatic stress disorder and its comorbidities among American Indian veterans

Goal consists of describing the demographic and comorbid characteristics associated with Posttraumatic Stress Disorder (PTSD) among American Indian veterans with any lifetime Axis 1 disorder. Sample included 252 American Indian veterans, obtained from a community sample of 557, using targeted sampling designed to provide a representative sample, structured to include equal numbers of rural and urban veterans and a twofold over sample of women. Data collection involved lifetime diagnoses based on the Diagnostic Interview Schedule/Quick Version/DSM-III-R, demographic characteristics, and combat exposure. Findings Bivariate comparisons showed positive relationships of PTSD with combat exposure, mood disorder and anxiety disorders (excluding PTSD), but a negative relationship with substance use disorder. Binary logistic regression analyses showed an independent association of PTSD with mood and anxiety disorders as well as combat exposure.

Abstinence and well-being among members of Alcoholics Anonymous: personal experience and social perceptions

The authors examined the subjective experience of well-being (WB) among abstinent Alcoholics Anonymous (AA) members and social perceptions of an abstinent alcoholic's WB among 3 nonalcoholic French-Canadian samples: male police officers, Catholic nuns, and university women. The short-term abstinent AA members, along with the university women, reported the lowest self-ratings of WB, whereas the Catholic nuns reported the highest. However, among the abstinent AA members, the level of WB was positively related to the length of abstention. The 3 nonalcoholic groups evaluated an abstinent AA member more positively than a nonabstinent alcoholic. These evaluations of an abstinent AA member converged with the AA members' self-evaluations on the measure of WB.

Baclofen administration for the treatment of affective disorders in alcoholic patients

Ninety alcoholic patients with the secondary affective disorders (anxiety, depression) were divided into four groups. Patients in the first group received GABAB receptor ligands (baclofen), those in the second group, diazepam, those in the third group, amitriptyline and those in the fourth group, placebo. The results of clinical, psychological (tests of Spielberger, Zung and MMPI), and electrophysiological (superslow omega-potential) investigations showed that baclofen is an effective drug for affective disturbances in alcoholic patients, with efficacy superior to placebo and equal to diazepam and amitriptyline. At the same time baclofen does not have the side-effects and complications of the latter. Significant changes in platelet MAOB activity and the dopamine, serotonin and GABA concentrations in blood after treatment were not found in the four patient groups. The peripheral matabolism of GABA and monoamines do not seem to be related to the development of secondary affective disorders in alcoholic patients. This investigation encourages the search for drugs acting on the affective psychopathology of GABAB receptor ligands.

Comparison of million personality profiles of chronic residential substance abusers and a general outpatient population

Several theories and studies have suggested that particular personality disorders or psychiatric symptoms should be associated with substance abuse. The current study was done to clarify these relationships by comparing scale profiles on the Millon Clinical Multiaxial Inventory obtained by 144 inpatient residentially treated substance-abuse clients and 1000 general clinical outpatient clients in psychotherapy. A surprisingly large number of significant differences were noted. Substance-abuse clients displayed relative elevations on scales for Alcohol and Drug Abuse, Hypomania, Antisocialism, Narcissism, Schizoidism, Paranoia, Psychotic Thinking, and Psychotic Delusions. General clinical outpatients showed relative elevations on Anxiety, Somatoform, Dysthymia, Borderline, and Compulsive scales. Some possible meanings of these findings were explored and suggestions for research given.

Social support and depression in men during alcoholism treatment

Psychiatric comorbidities have been shown to be important predictors of the outcome of alcoholism treatment. This study examines whether perceived lack of social support can be identified as an independent predictor of symptoms of depression experienced during alcoholism treatment over and above the effects of personality characteristics and the severity of alcohol and psychiatric history. We studied 189 alcoholic men in treatment at a rural midwestern Department of Veterans Affairs medical center. Multiple regression analyses found that reduced social support significantly predicted depression (measured by the Beck Depression Inventory) during treatment while controlling for personality characteristics and the alcoholism and psychiatric subscales of the Addiction Severity Index. Although self-esteem, neuroticism, and psychiatric severity also were significantly associated with depression in the hierarchical regression model, social support demonstrated the strongest unique contribution to depression of any of the predictors. These results suggest that social support has an independent association with depression and perhaps may play an important role in improving treatment compliance and the outcome of alcoholism treatment.

Individual mood profiles in alcohol withdrawal

Daily self-reports of moods, using a Swedish Mood Adjective Check List with six bipolar dimensions, were performed in patients with alcohol dependence. One group (n = 13), consisting of inpatients in late withdrawal at a home for addicts, was studied for 6 weeks; another group (n = 12), consisting of outpatients in full remission, was studied for 1 week. The results of the ratings on the check-list were used to test a statistical model for its capacity to describe the individual courses of mood states during the recovery process. Time Series Analysis revealed that the individual courses of moods fitted an autoregressive statistical model and could thereby be summarized in numerical measures for individual baselines, amplitudes, and lengths of recovery. Such individual profiles of the alcohol recovery process, may be useful for both clinical and research purposes, making it possible, for instance, to predict points in time for an individual's recovery with respect to his total well-being, as well as the various dimensions of his mood states.

The administration of transcranial electric treatment for affective disturbances therapy in alcoholic patients

In a double blind placebo-controlled investigation it was shown that transcranial electric treatment (TET), comprising the combination of a constant current with a pulse current of square impulses of 70-80 Hz is an effective method to correct affective disturbances (anxiety, depression) in alcoholic patients. The medical effects of TET are accompanied by changes in the metabolism of GABA and monoamines, but not of beta-endorphin, and also by a decrease in the latency of alpha-rhythm appearance after closing of the eyes.

Overall functioning and criteria of progress in rehabilitation of alcohol abusers: longitudinal analyses of changes

The aim was to compare alcohol consumption and vocational adjustment as criteria of rehabilitation progress of alcoholics, with regard to links to concomitant changes in functioning in other life areas. Thirty-four advanced alcohol abusers in rehabilitation were examined twice with an interval of 2 years between each examination. Change scores in alcohol consumption and work capacity were correlated with change scores in social network, activities, life-satisfaction, psychological well-being, psychiatric symptoms, and biomedical functioning. Improved drinking habits were connected with some changes in overall functioning, however not solely in a favorable direction. Negative mood changes were especially noteworthy. Improvements in vocational adjustment, on the other hand, appeared to be somewhat more unequivocally and encompassingly associated with amelioration in the wider range of functioning. The results indicate that drinking measures alone are not sufficient indicators of progress in rehabilitation and underscores the need of more global criteria of general adjustment.