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Colaco AS, Mayya A, Noronha C, Mayya SS. Quality of life in patients with alcohol use disorders admitted to de-addiction centers using WHOQOL-BREF scale-A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:196. [PMID: 37546009 PMCID: PMC10402769 DOI: 10.4103/jehp.jehp_248_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/27/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Alcohol use disorders (AUDs) adversely affect a person's general health and the lives of their family and friends. These disorders are also the most undertreated mental illness with severe implications for public health. Hence, the present study aimed to employ the WHOQOL-BREF to assess the quality of life (QoL) of AUDs patients seeking treatment at de-addiction centers and identify the demographic variables associated with the QoL dimension scores. MATERIALS AND METHODS A cross-sectional study was conducted among alcohol dependents taking treatment in de-addiction centers in Dakshina Kannada District, Karnataka. The WHOQOL-BREF questionnaire was administered to 124 subjects. Multiple regression analysis was carried out to identify the demographic variables associated with the QoL dimension scores. RESULTS The domain mean scores were between 50 and 60 on the 0 to 100 scale. Age, social class, residential area, marital status, and years of drinking were the demographic variables found to be significantly associated with the dimension scores. CONCLUSIONS Physicians should monitor the effect of alcoholism on QoL, and a multidisciplinary treatment plan with elements from the medical, social, and psychiatric fields should be used. The demographic variables should be considered while managing patients with AUDs.
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Affiliation(s)
- Ashwini S. Colaco
- Department of Conservative Dentistry and Endodontics, A. J Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Arun Mayya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | | | - Shreemathi S. Mayya
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Neumann A, Soltmann B, Kliemt R, Weinhold I, Schmitt J, Pfennig A, Baum F. Health-related quality of life among patients with treated alcohol use disorders, schizophreniform disorders or affective disorders and the influence of flexible and integrative psychiatric care models in Germany (PsychCare). Front Psychiatry 2023; 14:1068087. [PMID: 37065884 PMCID: PMC10102371 DOI: 10.3389/fpsyt.2023.1068087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Flexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity. Methods We undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation. Results During measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, p = 0.003) and comparable HUWs at measurement II (0.581 vs. 0.586, p = 0.584). Symptom severity was comparable between both groups (I: 21.4 vs. 21.1, p = 0.936; II: 18.8 vs. 19.8, p = 0.122). We found lowest HRQoL and highest symptom severity in participants with affective disorders. HRQoL increased and symptom severity decreased over time in both groups. The QWB-SA dimension acute and chronic symptoms was associated with highest detriments in HRQoL. We identified risk/protective factors that were associated with lower quality of life and higher symptom severity in both groups. We confirmed that HRQoL was negatively associated with symptom severity. Discussion Health-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups.
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Affiliation(s)
- Anne Neumann
- Center of Evidence-Based Health Care, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- *Correspondence: Anne Neumann,
| | - Bettina Soltmann
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Roman Kliemt
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Ines Weinhold
- WIG2 Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Jochen Schmitt
- Center of Evidence-Based Health Care, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Fabian Baum
- Center of Evidence-Based Health Care, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Armoon B, Fleury MJ, Bayat AH, Bayani A, Mohammadi R, Griffiths MD. Quality of life and its correlated factors among patients with substance use disorders: a systematic review and meta-analysis. Arch Public Health 2022; 80:179. [PMID: 35927697 PMCID: PMC9351239 DOI: 10.1186/s13690-022-00940-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Patients with substance use disorder (SUD) usually report lower quality of life (QoL) than other patients and as much as patients with other mental disorders. The present study investigated variables associated with QoL domains among patients with SUD. Methods Studies in English published before December 1st 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on factors associated with QoL domains among patients with SUD. After reviewing for study duplicates, the full-texts of selected papers were assessed for eligibility using PECO (Participants, Exposures, Comparison and Outcome) criteria: (a) participants: patients with SUD; (b) exposures: sociodemographic factors, clinical, and service use variables; (c) comparison: patient groups without SUD; and (d) outcomes: four domains of QoL (physical, mental, social, and environmental domains). Three researchers recorded the data independently using predefined Excel spreadsheets. The Newcastle–Ottawa Scale (NOS) was used for assessing risk of bias and rated each study in terms of exposure, outcome, and comparability. Pooled odds ratios (ORs) and β coefficient were utilized at a 95% confidence level, and because sampling methods differed between studies’ pooled estimates, a random effects model was utilized. Results After the assessment of over 10,230 papers, a total of 17 studies met the eligibility criteria. Five studies (1260 participants) found that patients with SUD who were older were less likely to have a good physical Qol (OR = 0.86, 95% CI = 0.78, 0.95). Two studies (1171 participants) indicated that patients with SUD who were homeless were less likely to have a good environmental Qol (β = -0.47, p = 0.003). However, a better mental QoL was observed in four studies (1126 participants) among those receiving support from their family or friends (social networks) (OR = 1.05, 95% CI = 1.04, 1.07). Two studies (588 participants) showed that those using cocaine were less likely to have a good mental QoL (OR = 0.83, 95% CI = 0.75, 0.93). Two studies (22,534 participants) showed that those using alcohol were less likely to have a good physical QoL (β = -2.21, p = 0.001). Two studies (956 participants) showed that those having severe substance use disorders were less likely to have a good mental (β = -5.44, p = 0.002) and environmental (β = -0.59, p = 0.006) QoL respectively. Four studies (3515 participants) showed that those having mental disorders were less likely to have a good physical QoL (β = -1.05, p = 0.001), and another three studies (1211 participants) that those having mental disorders were less likely to have a good mental QoL (β = -0.33, p = 0.001). Finally, two studies (609 and 682 participants) showed that individuals who experienced trauma symptoms or mental disorders were less likely to have good social and environmental QoL, respectively (OR = 0.78, 95% CI = 0.61, 1.00) and (OR = 0.92, 95% CI = 0.9, 0.94). Conclusions The findings suggest the need for mental health services to improve the QOL among patients with SUD but further study is needed. Cocaine may cause behavioral changes which can increase the possibility of reckless and suicidal behaviors. Therefore, identifying cocaine user access, adherence, and satisfaction with treatment is recommended as an important component of adaptive functioning. Interventions that help patients with SUD get support from people within their social networks who support their recovery are also essential to their QoL. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00940-0.
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Lahbairi N, Laniepce A, Segobin S, Cabé N, Boudehent C, Vabret F, Rauchs G, Pitel AL. Determinants of health-related quality of life in recently detoxified patients with severe alcohol use disorder. Health Qual Life Outcomes 2022; 20:149. [PMID: 36310156 PMCID: PMC9620657 DOI: 10.1186/s12955-022-02058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/04/2022] Open
Abstract
Background Health-related quality of life (HRQoL) is an important clinical outcome in Alcohol Use Disorder (AUD) and is considered as a relevant indicator of treatment success. While a better understanding of the factors affecting HRQoL would enable to adjust patients’ care to favour treatment outcome, the determinants of HRQoL in AUD remain unclear. This study aims at describing HRQoL in AUD patients and at identifying its best predictors. Methods 53 recently detoxified patients with severe AUD (sAUD) underwent a cognitive assessment and filled in a HRQoL questionnaire dedicated to AUD patients (Alcohol Quality of Life Scale; AQoLS), as well as questionnaires concerning socio-demographics, alcohol history, sleep quality, depression, anxiety and impulsivity. 38 healthy controls (HC) underwent the same assessment (except AQoLS) in order to identify the altered cognitive and clinical variables that could potentially be determinants of HRQoL in sAUD. Results sAUD patients reported that alcohol affects their HRQoL mainly in the “negative emotions”, “control”, “relationships”, and “sleep” domains. Compared to HC, they were impaired on episodic memory, working memory, executive functions, and processing speed tasks. They also reported lower sleep quality, higher depression, anxiety and impulsivity. No association was found between AQoLS total score and socio-demographics, cognitive performance, or sleep quality in patients. We found a significant correlation between HRQoL and depression/anxiety as well as impulsivity. Anxiety and impulsivity were indeed the only significant predictors of HRQoL, explaining 47.7% of the variance. Conclusion Anxiety and impulsivity are crucial determinants of HRQoL in recently detoxified sAUD patients. Since anxiety and impulsivity are frequent issues in addiction and especially in AUD, they should be particularly considered by clinicians to favour treatment outcomes.
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Affiliation(s)
- Najlaa Lahbairi
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France
| | - Alice Laniepce
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.460771.30000 0004 1785 9671Normandie Univ, UNIROUEN, CRFDP (EA 7475), 76000 Rouen, France
| | - Shailendra Segobin
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France
| | - Nicolas Cabé
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Céline Boudehent
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - François Vabret
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Géraldine Rauchs
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Anne-Lise Pitel
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
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Saffari M, Chen HP, Chang CW, Fan CW, Huang SW, Chen JS, Chang KC, Lin CY. Effects of sleep quality on the association between problematic internet use and quality of life in people with substance use disorder. BJPsych Open 2022; 8:e155. [PMID: 35946067 PMCID: PMC9380240 DOI: 10.1192/bjo.2022.557] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder. AIMS This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables. METHOD Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used. RESULTS The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media. CONCLUSIONS Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.
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Affiliation(s)
- Mohsen Saffari
- Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; and Health Education Department, School of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hsin-Pao Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan; and School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Wen Chang
- Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Florida, USA
| | - Shih-Wei Huang
- Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University, Kaohsiung, Taiwan; and Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan
| | - Kun-Chia Chang
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan; and Department of Natural Biotechnology, Nan Hua University, Chiayi, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Carlon HA, Hurlocker MC, Witkiewitz K. Mechanisms of quality-of-life improvement in treatment for alcohol use disorder. J Consult Clin Psychol 2022; 90:601-612. [PMID: 36066862 PMCID: PMC9899433 DOI: 10.1037/ccp0000750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE For individuals in alcohol use disorder (AUD) treatment, many argue that holistic indicators such as quality of life (QoL) should be more consistently used in addition to drinking-related indicators. QoL increases from pre- to post-AUD treatment, but the mechanisms are unclear. The present study examined the roles of positive and negative affect in QoL change during AUD treatment and additionally explored the relationship between QoL change and medication adherence. METHOD We examined the mediating roles of end-of-treatment positive affect (i.e., vigor) and negative affect (i.e., stress and tension) in the relationship between baseline (BL) and 26-week QoL among participants in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence study randomized to medication management (MM; n = 468) or medication management plus combined behavioral intervention (MMCBI; n = 479) for AUD. We also explored whether changes in QoL were associated with medication adherence. RESULTS Change in psychological health QoL was mediated by increased vigor (i.e., positive affect) and decreased stress, and change in environmental QoL was mediated by decreased stress. There were also differences by treatment group, with stress mediating changes in environmental QoL among participants in MM, and vigor mediating changes in psychological health QoL among participants in MMCBI. Medication adherence was not associated with greater QoL after controlling for posttreatment alcohol use. CONCLUSIONS The present study identified potential mechanisms of QoL change in AUD treatment, thus contributing to the growing knowledge surrounding alternative indicators of treatment success for AUD treatment and recovery. Targeting affective states and stress during treatment may improve QoL and recovery outcomes for persons with AUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Hannah A. Carlon
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Department of Psychology, Albuquerque, NM, 87131, USA
| | - Margo C. Hurlocker
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Department of Psychology, Albuquerque, NM, 87131, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Department of Psychology, Albuquerque, NM, 87131, USA
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Armoon B, Bayat AH, Bayani A, Mohammadi R, Ahounbar E, Fakhri Y. Quality of life and its associated factors among patients with substance use disorders: A systematic review and meta-analysis. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2069612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Amir-Hossien Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Azadeh Bayani
- School of Allied Medical Sciences, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Yadollah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Orji CC, Ghosh S, Nwaobia OI, Ibrahim KR, Ibiloye EA, Brown CM. Health Behaviors and Health-Related Quality of Life Among U.S. Adults Aged 18-64 Years. Am J Prev Med 2021; 60:529-536. [PMID: 33422396 DOI: 10.1016/j.amepre.2020.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/14/2020] [Accepted: 10/08/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This study aims to (1) describe the prevalence and clustering of 3 health behaviors, (2) examine the association between individual health behaviors and health-related quality of life, and (3) explore the association between the clustering of the health behaviors and health-related quality of life. METHODS Investigators analyzed a sample of U.S. adults aged 18-64 years using data from the 2016-2018 Behavioral Risk Factor Surveillance System survey in March 2020. Logistic regression models examined the associations among 3 healthy behaviors (currently not smoking, physical activity, and nonheavy alcohol consumption) and 4 indicators of health-related quality of life (general health, physical health, mental health, and activity limitation). Alpha was set at 0.01. RESULTS A total of 450,870 individuals were included in the analysis (weighted n=100,102,329). Of these, 82.0% were current nonsmokers, 92.8% were nonheavy drinkers, and 77.6% reported physical activity. The prevalence of having none, 1, 2, and 3 of the health behaviors was 0.7%, 7.7%, 30.1%, and 61.5%, respectively. Smoking status and physical activity status were significantly associated with all the 4 health-related quality of life indicators. Alcohol status was significantly associated with mental health and activity limitation. The associations demonstrated a higher health-related quality of life among individuals who reported healthy behaviors than among those who did not engage in healthy behaviors. Compared with respondents who reported none of the health behaviors, people with all 3 health behaviors were more likely to report higher health-related quality of life. CONCLUSIONS Health behaviors were significantly associated with health-related quality of life among U.S. adults. Healthy behaviors should be encouraged because adopting these behaviors may contribute to a higher health-related quality of life.
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Affiliation(s)
- Chinelo C Orji
- Division of Health Outcomes, College of Pharmacy, University of Texas at Austin, Austin, Texas.
| | - Somraj Ghosh
- Division of Health Outcomes, College of Pharmacy, University of Texas at Austin, Austin, Texas
| | - Oluchi I Nwaobia
- Department of Epidemiology, Human Genetics & Environmental Sciences, UT Health School of Public Health, Houston, Texas
| | - Kemi R Ibrahim
- Division of Health Outcomes, College of Pharmacy, University of Texas at Austin, Austin, Texas
| | - Elizabeth A Ibiloye
- Division of Health Outcomes, College of Pharmacy, University of Texas at Austin, Austin, Texas
| | - Carolyn M Brown
- Division of Health Outcomes, College of Pharmacy, University of Texas at Austin, Austin, Texas
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Saadati H, Tavakoli Ghouchani H, Asghari D, Gholizadeh N, Rahimi J, Valizadeh R. Comparison of the quality of life and general health in opium and non-opium users referred to the addiction treatment centers. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1838635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Hassan Saadati
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Tavakoli Ghouchani
- Addiction and Behavioral Sciences Research Center Health North Khorasan University of Medical Sciences, Bojnurd, Department of Health Education and Promotion, School of Health North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Dordane Asghari
- Measurement And Measurement Field (Psychometric Field), Addiction And Behavioral Sciences Research Center (Researcher), Bojnurd, Iran
| | - Nazanin Gholizadeh
- General Psychology, Addiction and Behavioral Sciences Research Center(Researcher), Bojnurd, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Rohollah Valizadeh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Berghöfer A, Martin L, Hense S, Weinmann S, Roll S. Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model. Qual Life Res 2020; 29:2073-2087. [PMID: 32170584 PMCID: PMC7363717 DOI: 10.1007/s11136-020-02470-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL. METHODS This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation's generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group. RESULTS A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation. CONCLUSION Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care.
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Affiliation(s)
- Anne Berghöfer
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Luise Martin
- Klinik f. Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Hense
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Stefan Weinmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Stephanie Roll
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
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11
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Müller O, Baumann C, Di Patrizio P, Viennet S, Vlamynck G, Collet L, Clerc-Urmès I, Schwan R, Bourion-Bédès S. Patient's early satisfaction with care: a predictor of health-related quality of life change among outpatients with substance dependence. Health Qual Life Outcomes 2020; 18:6. [PMID: 31910879 PMCID: PMC6947996 DOI: 10.1186/s12955-019-1267-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/23/2019] [Indexed: 12/03/2022] Open
Abstract
Background Although research on health-related quality of life (HRQoL) has increased in the addiction field, few studies have focused on the determinants of HRQoL changes. This study aimed to describe dependent patients’ HRQoL changes at a 3-month follow-up and to assess whether satisfaction with care can predict those changes among outpatients starting care for alcohol or opioid dependence. Methods HRQoL was measured with the SF-12 at baseline and 3 months later in a prospective cohort of dependent outpatients. Satisfaction was assessed with the EQS-C early after inclusion. Data on sociodemographics, clinical characteristics and patients’ levels of anxiety and depression were also collected. A multivariable analysis was performed to identify factors associated with HRQoL changes in both the physical and mental component summary scores (PCS and MCS, respectively). Results Of the 172 patients included at baseline, a total of 136 patients assessed their satisfaction with care. The mean PCS and MCS scores were initially low, and HRQoL improvement was significant after 3 months for both the PCS and MCS. Never having been married (β = 5.5; p = 0.001) and a lower baseline PCS score (β = − 0.6; p < 0.0001) were associated with significant PCS improvement, whereas being legally compelled to undergo drug treatment (β = − 5.9; p = 0.02) was associated with less PCS change. Higher early satisfaction with care (β = 0.1; p = 0.02) and a lower baseline MCS score (β = − 0.7; p < 0.0001) were associated with significant MCS improvement. Conclusion The study supported the hypothesis that greater satisfaction with care may predict HRQoL improvement among dependent outpatients. Further studies are needed to understand the factors that affect patients’ early satisfaction to identify areas of improvement and thus improve HRQoL.
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Affiliation(s)
- Ophélie Müller
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Cédric Baumann
- Unit of Methodology, Data Management and Statistics, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France.,EA4360 APEMAC (Health adjustment, measurement and assessment, interdisciplinary approaches) MICS team, University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France
| | - Paolo Di Patrizio
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Sarah Viennet
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Guillaume Vlamynck
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Laura Collet
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Isabelle Clerc-Urmès
- Unit of Methodology, Data Management and Statistics, University Hospital of Nancy, 54500, Vandoeuvre-lès-Nancy, France
| | - Raymund Schwan
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France
| | - Stéphanie Bourion-Bédès
- CSAPA (Health Care Center of Accompaniment and Prevention in Addictology), University Hospital of Nancy, 54000, Nancy, France. .,EA4360 APEMAC (Health adjustment, measurement and assessment, interdisciplinary approaches) MICS team, University of Lorraine, 54500, Vandoeuvre-lès-Nancy, France. .,Service médico-psychologique régional, 1, Rue Seulhotte B.P, 15082 57073, Metz, France.
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12
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Huang H, Shen H, Ning K, Zhang R, Sun W, Li B, Jiang H, Wang W, Du J, Zhao M, Yi Z, Li J, Zhu R, Lu S, Xie S, Wang X, Fu W, Gao C, Hao W. Quality of Life and Its Correlates in Alcohol Use Disorder Patients With and Without Depression in China. Front Psychiatry 2020; 11:627338. [PMID: 33551885 PMCID: PMC7862321 DOI: 10.3389/fpsyt.2020.627338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023] Open
Abstract
Objective: Alcohol use disorder (AUD) is a serious issue worldwide and frequently co-occurs with depression. However, the quality of life (QOL) of AUD patients with and without depression is not well studied in the Chinese Han population. The aim of this study was to investigate QOL and its correlates in AUD patients with and without depression in China. Methods: Five hundred and fifteen psychiatric patients diagnosed with AUD were recruited. All these patients completed the Beck Depression Inventory (BDI) to assess depression, the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) to evaluate QOL and the Alcohol Use Disorders Identification Test (AUDIT) to measure the severity of drinking. Results: Compared with AUD patients without depression, those with depression had a lower QOL in all eight domains of the SF-36 (all P < 0.001), but were more willing to have alcohol-related treatment (P < 0.05). Negative correlations were noted between (i) the BDI total score and all eight domains of the SF-36 (all P < 0.001); and (ii) between the AUDIT total score and six domains of the SF-36 (all P < 0.05). Conclusions: Depression impairs QOL in patients with AUD in China. Early intervention in comorbid depression to improve QOL is needed.
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Affiliation(s)
- Hui Huang
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hongxian Shen
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Kui Ning
- Henan Mental Hospital, Xinxiang, China
| | | | - Wei Sun
- Peking University Sixth Hospital, Beijing, China
| | - Bing Li
- Peking University Sixth Hospital, Beijing, China
| | | | | | - Jiang Du
- Shanghai Mental Health Center, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai, China
| | - Zhihua Yi
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | | | - Wei Fu
- The First Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Chengge Gao
- The First Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Wei Hao
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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13
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Patkar P, Saldanha D, Chaudhury S, Singh I. Quality of life and disability in males with alcohol dependence syndrome. Ind Psychiatry J 2019; 28:262-271. [PMID: 33223721 PMCID: PMC7659994 DOI: 10.4103/ipj.ipj_47_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 05/09/2020] [Indexed: 11/16/2022] Open
Abstract
AIM The aim is to study the quality of life (QoL) and disability in persons with alcohol dependence syndrome (ADS). MATERIALS AND METHODS This cross-sectional, analytical, case-control study in a tertiary hospital in a suburb of Maharashtra included 100 cases of ADS and equal number of age- and sex-matched healthy controls fulfilling the various inclusion and exclusion criteria. RESULTS The study revealed that individuals commonly initiate drinking alcohol between 20 and 30 years and first present to the hospital for seeking medical attention in the age group of 30-40 years after 10-12 years of drinking when they are moderately or severely dependent on alcohol. Alcohol dependence is associated with lower educational levels and lower levels of employment. Many have problems in their marital and intimate relations, making it difficult for them to stay in long-term relationships. As a consequence of their frequent aggressive and violent behaviors, they are more commonly involved in legal matters. Having a positive family history of alcohol dependence and familial psychiatric disorders makes them have a higher chance of developing alcohol dependence. As the number of years of drinking increases, so does the dependency level. CONCLUSION Alcohol dependence is associated with lower QoL and higher levels of disability levels. The severity of alcohol dependence is inversely proportional to the QoL experienced by them and directly proportional to their disabilities.
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Affiliation(s)
- Prajakta Patkar
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
| | - Daniel Saldanha
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
| | - Ichpreet Singh
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
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14
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Lee CH, Lin JC, Liu YH. A study of well-being in drunken driving recidivists. TAIWANESE JOURNAL OF PSYCHIATRY 2019. [DOI: 10.4103/tpsy.tpsy_4_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Kelly PJ, Robinson LD, Baker AL, Deane FP, Osborne B, Hudson S, Hides L. Quality of life of individuals seeking treatment at specialist non-government alcohol and other drug treatment services: A latent class analysis. J Subst Abuse Treat 2018; 94:47-54. [DOI: 10.1016/j.jsat.2018.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
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16
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Gür F, Can Gür G, Okanlı A. The Effect of the Cognitive-behavioral Model-based Psychoeducation and Exercise Intervention on Quality of Life in Alcohol Use Disorder. Arch Psychiatr Nurs 2017; 31:541-548. [PMID: 29179818 DOI: 10.1016/j.apnu.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/12/2017] [Accepted: 07/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to assess the effect of the cognitive behavior model (CBM)-based psychoeducation and exercise intervention on quality of life (QoL) in alcohol use disorder (AUD). DESIGN This study was a non-randomized controlled trial. METHODS CBM-based psychoeducation and exercise intervention was applied to the experimental group four times a week for 6weeks; no intervention was applied to the control group. FINDINGS No difference was seen between the points of pretest QoL of the experimental and control groups (p>0.05). However, according to the posttest, the experimental group's mean score of QoL was higher than the control groups (p<0.05). CONCLUSION It was found that CBM-based psychoeducation and exercise intervention applied to individuals with AUD affected the QoL positively. CLINICAL RELEVANCE CBM-based psychoeducation and exercise intervention can be used by nurses to improve AUD individuals' quality of life.
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Affiliation(s)
- Fatih Gür
- University of Karadeniz Technical, Faculty of Sport Science, Trabzon 61000, Turkey.
| | - Ganime Can Gür
- University of Atatürk, Faculty of Health Science, Department of Psychiatric Nursing, Erzurum 25000, Turkey.
| | - Ayşe Okanlı
- University of Medeniyet, Faculty of Health Science, Department of Psychiatric Nursing, İstanbul 34710, Turkey
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17
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Vederhus JK, Pripp AH, Clausen T. Quality of Life in Patients with Substance Use Disorders Admitted to Detoxification Compared with Those Admitted to Hospitals for Medical Disorders: Follow-Up Results. Subst Abuse 2016; 10:31-7. [PMID: 27226719 PMCID: PMC4874746 DOI: 10.4137/sart.s39192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/17/2016] [Accepted: 04/25/2016] [Indexed: 12/20/2022]
Abstract
Quality of life (QoL) in patients admitted to a general hospital was compared with those admitted to a detoxification unit for the treatment of substance use disorder (SUD). This study combines data from two separate data collections: a cross-sectional study in a general hospital unit (somatic sample, N = 519) and a follow-up study in a detoxification unit (SUD sample, N = 140). A total of 659 patients recruited during 2008-2013 were included in this study. All patients completed a generic QoL questionnaire at inclusion, and the SUD sample also completed it at the six-month follow-up. SUD patients experienced comparably low physical QoL and had significantly lower psychological, social, and existential QoL domain scores when compared with the somatic sample. Mental distress and having a SUD were the major factors explaining variations in QoL, with both influencing QoL negatively. In the SUD sample, QoL improved moderately at the six-month follow-up with less improvement for the domain relationship to a partner. To facilitate the recovery of SUD patients, clinicians must view their patients' situation holistically and invest efforts into the different life domains affected by poor QoL.
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Affiliation(s)
| | - Are Hugo Pripp
- Oslo Centre for Biostatistics and Epidemiology (OCBE), Oslo University Hospital, Oslo, Norway
| | - Thomas Clausen
- Addiction Unit, Sørlandet Hospital HF, Kristiansand, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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18
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Perceived quality of life, 6 months after detoxification: Is abstinence a modifying factor? Qual Life Res 2016; 25:2315-22. [PMID: 26995560 PMCID: PMC4980398 DOI: 10.1007/s11136-016-1272-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/08/2022]
Abstract
Purpose Patients with a substance use disorder (SUD), admitted for detoxification, often suffer from a poor quality of life (QoL). We set out to monitor QoL, together with substance use, in a departure from the usual norm of measuring substance use alone as a treatment outcome. Literature searches revealed scant knowledge of how QoL is influenced. With this in mind, we aimed to investigate whether total abstinence, prior to follow-up, could influence QoL. Methods We studied a prospective cohort of 140 patients admitted for inpatient detoxification treatment at Sørlandet Hospital (Norway), from September 2008 to August 2010. QoL was measured by a generic five-item questionnaire, the QoL-5. The extremes of this scale ranged from the worst possible rating of 0.1 to 0.9, as the best. A norm for the general population was benchmarked at 0.69. Change in QoL was calculated by subtracting baseline QoL from that achieved at the 6-month follow-up interview; linear regression modeling was used to study the influence of individual QoL predictors. Results The mean QoL at baseline was 0.46, 39 % below that of the general reference population. By applying the clinical interpretation of the scale, we found a modest overall mean improvement in QoL at follow-up (0.11 points); the greatest increases were seen for patients with the lowest baseline QoL scores. Abstinence prior to follow-up correlated with improved QoL, while living alone and psychological distress were negative influences. Conclusions For patients with a SUD, clinicians should emphasize that abstinence may help to improve their QoL.
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19
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Guydish J, Passalacqua E, Pagano A, Martínez C, Le T, Chun J, Tajima B, Docto L, Garina D, Delucchi K. An international systematic review of smoking prevalence in addiction treatment. Addiction 2016; 111:220-30. [PMID: 26392127 PMCID: PMC4990064 DOI: 10.1111/add.13099] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/30/2015] [Accepted: 08/06/2015] [Indexed: 11/27/2022]
Abstract
AIMS Smoking prevalence is higher among people enrolled in addiction treatment compared with the general population, and very high rates of smoking are associated with opiate drug use and receipt of opiate replacement therapy (ORT). We assessed whether these findings are observed internationally. METHODS PubMed, PsycINFO and the Alcohol and Alcohol Problems Science Database were searched for papers reporting smoking prevalence among addiction treatment samples, published in English, from 1987 to 2013. Search terms included tobacco use, cessation and substance use disorders using and/or Boolean connectors. For 4549 papers identified, abstracts were reviewed by multiple raters; 239 abstracts met inclusion criteria and these full papers were reviewed for exclusion. Fifty-four studies, collectively comprising 37,364 participants, were included. For each paper we extracted country, author, year, sample size and gender, treatment modality, primary drug treated and smoking prevalence. RESULTS The random-effect pooled estimate of smoking across people in addiction treatment was 84% [confidence interval (CI) = 79, 88%], while the pooled estimate of smoking prevalence across matched population samples was 31% (CI = 29, 33%). The difference in the pooled estimates was 52% (CI = 48%, 57%, P < .0001). Smoking rates were higher in programs treating opiate use compared with alcohol use [odds ratio (OR) = 2.52, CI = 2.00, 3.17], and higher in ORT compared to out-patient programs (OR = 1.42, CI = 1.19, 1.68). CONCLUSIONS Smoking rates among people in addiction treatment are more than double those of people with similar demographic characteristics. Smoking rates are also higher in people being treated for opiate dependence compared with people being treated for alcohol use disorder.
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Affiliation(s)
- Joseph Guydish
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - Emma Passalacqua
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - Anna Pagano
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Prevention and Control Department, Catalan Institute of Oncology-Institut d'Investigació Biomèdica de Bellvitge – IDIBELL, Barcelona, Spain
| | - Thao Le
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - JongSerl Chun
- Department of Social Welfare, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemun-Gu, Seoul, 120-750, South Korea
| | - Barbara Tajima
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - Lindsay Docto
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - Daria Garina
- University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California Street, Suite 265, San Francisco, CA 94118
| | - Kevin Delucchi
- University of California, San Francisco, Department of Psychiatry, University of California San Francisco, San Francisco, CA
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Bourion-Bédès S, Schwan R, Laprevote V, Bédès A, Bonnet JL, Baumann C. Differential item functioning (DIF) of SF-12 and Q-LES-Q-SF items among french substance users. Health Qual Life Outcomes 2015; 13:172. [PMID: 26499191 PMCID: PMC4619284 DOI: 10.1186/s12955-015-0365-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 10/13/2015] [Indexed: 12/24/2022] Open
Abstract
Background Differential Item Functioning (DIF) is investigated to ensure that each item displays a consistent pattern of responses irrespective of the characteristics of the respondents. Assessing DIF helps to understand the nature of instruments, to assess the quality of a measure and to interpret results. This study aimed to examine whether the items of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Short-Form 12 (SF-12) exhibit DIF. Method A total of 124 outpatients diagnosed with substance dependence participated in a cross-sectional, multicenter study. In addition to the Q-LES-Q-SF and SF-12 results, demographic data such as age, sex, type of substance dependence and education level were collected. Rasch analysis was conducted (using RUMM2020 software) to assess DIF of the Q-LES-Q-SF and SF-12 items. Results For SF-12, significant age-related uniform DIF was found in two of the 12 items, and sex-related DIF was found in one of the 12 items. All of the observed DIF effects in SF-12 were found among the mental health items. Three items showed DIF on the Q-LES-Q-SF; however, the impact of DIF item on the delta score calculation for the comparisons of self-reported health status between the groups was minimal in the SF-12 and small in the Q-LES-Q-SF. Conclusion These results indicated that no major measurement bias affects the validity of the self-reported health status assessed using the Q-LES-Q-SF or SF-12. Thus, these questionnaires are largely robust measures of self-reported health status among substance users.
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Affiliation(s)
- Stéphanie Bourion-Bédès
- Service Médico Psychologique Régional, 57 073, Metz, France. .,CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), University Hospital of Nancy, Nancy, France. .,EA4360 APEMAC, University of Lorraine, Nancy, France.
| | - Raymund Schwan
- CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), University Hospital of Nancy, Nancy, France.
| | - Vincent Laprevote
- CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), University Hospital of Nancy, Nancy, France
| | - Alex Bédès
- ANPAA 15- CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), Saint-Flour, Cantal, France.
| | - Jean-Louis Bonnet
- ANPAA 15- CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), Aurillac, Cantal, France
| | - Cédric Baumann
- EA4360 APEMAC, University of Lorraine, Nancy, France. .,ESPRI-BioBase Unit, PARC, University Hospital of Nancy, Nancy, France.
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21
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Rehm J, Manthey J, Struzzo P, Gual A, Wojnar M. Who receives treatment for alcohol use disorders in the European Union? A cross-sectional representative study in primary and specialized health care. Eur Psychiatry 2015; 30:885-93. [PMID: 26647862 DOI: 10.1016/j.eurpsy.2015.07.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Alcohol use disorders (AUDs) are highly prevalent in Europe, but only a minority of those affected receive treatment. It is therefore important to identify factors that predict treatment in order to reframe strategies aimed at improving treatment rates. METHODS Representative cross-sectional study with patients aged 18-64 from primary health care (PC, six European countries, n=8476, data collection 01/13-01/14) and from specialized health care (SC, eight European countries, n=1762, data collection 01/13-03/14). For descriptive purposes, six groups were distinguished, based on type of DSM-IV AUD and treatment setting. Treatment status (yes/no) for any treatment (model 1), and for SC treatment (model 2) were main outcome measures in logistic regression models. RESULTS AUDs were prevalent in PC (12-month prevalence: 11.8%, 95% confidence interval (CI): 11.2-12.5%), with 17.6% receiving current treatment (95%CI: 15.3-19.9%). There were clear differences between the six groups regarding key variables from all five predictor domains. Prediction of any treatment (model 1) or SC treatment (model 2) was successful with high overall accuracy (both models: 95%), sufficient sensitivity (model 1: 79%/model 2: 76%) and high specificity (both models: 98%). The most predictive single variables were daily drinking level, anxiety, severity of mental distress, and number of inpatient nights during the last 6 months. CONCLUSIONS Variables from four domains were highly predictive in identifying treatment for AUD, with SC treatment groups showing very high levels of social disintegration, drinking, comorbidity and functional losses. Earlier intervention and formal treatment for AUD in PC should be implemented to reduce these high levels of adverse outcomes.
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Affiliation(s)
- J Rehm
- Centre for Addiction and Mental Health, 33, Russell Street, Toronto, ON M5S 2S1, Canada; Addiction Policy, Dalla Lana School of Public Health, University of Toronto, 155, College Street, 6th floor, Toronto, ON M5T 3M7, Canada; Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1, King's College Circle, Room 2374, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250, College Street, 8th floor, Toronto, ON M5T 1R8, Canada; Institute of Clinical Psychology and Psychotherapy & Centre of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - J Manthey
- Institute of Clinical Psychology and Psychotherapy & Centre of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
| | - P Struzzo
- Regional Centre for the Training in Primary Care (Ceformed), Via Galvani 1, 34074 Monfalcone, GO, Italy; University of Trieste, Department of Life Sciences, Via Weiss 2, 34128 Trieste, Italy
| | - A Gual
- Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, Carrer Villarroel 170, 08036 Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer Rosselló 149, 08036 Barcelona, Catalonia, Spain; Red de Trastornos Adictivos (RTA-RETICS), Instituto de Salud Carlos III, Villarroel 170, 08036 Barcelona, Catalonia, Spain
| | - M Wojnar
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland; Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
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Saengcharnchai P, Likhitsathian S, Yingwiwattanapong J, Wittayanookulluk A, Uttawichai K, Boonchareon H, Srisurapanont M. Correlates of health-related quality of life in Thai patients with alcohol dependence. J Ethn Subst Abuse 2015; 15:210-20. [PMID: 26422548 DOI: 10.1080/15332640.2015.1022628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study aimed to examine the correlates of health related quality of life in Thai patients with alcohol dependence. The amount of alcohol intake was calculated by timeline followback chart and the health related quality of life was determined by Short Form-36 Health Survey. The means of the Short Form-36 Physical Component and Mental Component Summary were 67.43 (18.74) and 64.45 (20.90), respectively. Stepwise linear regression models showed the number of heavy drinking days was significantly correlated with the Physical Component Summary and Mental Component Summary. Such moderate correlations suggest that drinking and health related quality of life measures might tap different aspects of alcohol outcomes and should be concurrently administered.
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Affiliation(s)
- Pichai Saengcharnchai
- a Department of Psychiatry and Neurology , Phramongkutklao Hospital , Bangkok , Thailand
| | - Surinporn Likhitsathian
- b Department of Psychiatry, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
| | | | | | | | | | - Manit Srisurapanont
- b Department of Psychiatry, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
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François C, Rahhali N, Chalem Y, Sørensen P, Luquiens A, Aubin HJ. The Effects of as-Needed Nalmefene on Patient-Reported Outcomes and Quality of Life in Relation to a Reduction in Alcohol Consumption in Alcohol-Dependent Patients. PLoS One 2015; 10:e0129289. [PMID: 26053024 PMCID: PMC4460126 DOI: 10.1371/journal.pone.0129289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/06/2015] [Indexed: 11/15/2022] Open
Abstract
Background The objective of this article was to investigate the effect of as-needed nalmefene on health-related quality of life (HRQoL) in patients with alcohol dependence, and to relate changes in drinking behavior and status to HRQoL outcomes. Methods This post hoc analysis was conducted on a pooled subgroup of patients with at least a high drinking risk level (men: >60 g/day; women: >40 g/day) who participated in one of two randomized controlled 6-month studies, ESENSE 1 and ESENSE 2. Patients received nalmefene 18 mg or placebo on an as-needed basis, in addition to a motivational and adherence-enhancing intervention (BRENDA). At baseline and after 12 and 24 weeks questionnaires for the Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36), European Quality of life-5 Dimensions (EQ-5D) and the Drinker Inventory of Consequences (DrInC-2R) were completed. Results The pooled population consisted of 667 patients (nalmefene: 335; placebo: 332), with no notable between-group differences in baseline patient demographics/characteristics. At week 24, nalmefene had a superior effect compared to placebo in improving SF-36 mental component summary scores (mean difference [95% CI], p-value: 3.09 [1.29, 4.89]; p=0.0008), SF-36 physical component summary scores (1.23 [0.15, 2.31]; p=0.026), EQ-5D utility index scores (0.03 [0.00, 0.06]; p=0.045), EQ-5D health state scores (3.46 [0.75, 6.17]; p=0.012), and DrInC-2R scores (-3.22 [-6.12, 0.33]; p=0.029). The improvements in SF-36 mental component summary scores at week 24, and the DrInC-2R total score change from baseline to week 24, were significantly correlated to reductions in heavy drinking days and total alcohol consumption at week 24. Conclusions As-needed nalmefene significantly improved almost all patient-reported HRQoL measures included in SF-36 and EQ-5D compared with placebo. These HRQoL gains were significantly correlated to reduced drinking behavior, as determined by reductions in heavy drinking days and total alcohol consumption.
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Affiliation(s)
| | - Nora Rahhali
- H. Lundbeck A/S, Issy les Moulineaux Cedex, France
| | - Ylana Chalem
- H. Lundbeck A/S, Issy les Moulineaux Cedex, France
| | | | - Amandine Luquiens
- Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, INSERM U669, Villejuif Cedex, France
| | - Henri-Jean Aubin
- Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, INSERM U669, Villejuif Cedex, France
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Nogueira JM, Rodríguez-Míguez E. Using the SF-6D to measure the impact of alcohol dependence on health-related quality of life. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2015; 16:347-356. [PMID: 25193526 DOI: 10.1007/s10198-014-0627-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 08/19/2014] [Indexed: 06/03/2023]
Abstract
Alcohol dependence not only reduces life expectancy, but also causes considerable loss of quality of life of the dependents of and persons around those with alcohol dependence. This article presents new evidence on the impact of alcohol dependence on health-related quality of life in Spain. Three samples were recruited: 150 alcoholics and 64 family members of alcoholics, with both samples taken from an alcoholism treatment unit, and 600 persons from the general population. We used the short form 6D, a preference-based generic instrument, applying the utility scores estimated for Spain. It was found that the annual mean loss of quality-adjusted life years associated with alcohol dependence was 0.144 and 0.083 for the alcoholics and their close family members, respectively. This impact becomes more notable after controlling for socio economic variables and was higher than that estimated in similar studies. Possible explanations for these differences are discussed. The results from this work can be applied to economic evaluation studies measuring benefits from policies targeted at reducing the prevalence of alcohol dependence.
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Affiliation(s)
- Jacinto Mosquera Nogueira
- Galician Health Service, Centro de Salud de Bembrive, Ctra. de Bembrive, 259-Bembrive, 36214, Vigo, Spain
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Fuster D, Sanvisens A, Bolao F, Serra I, Rivas I, Tor J, Muga R. Impact of hepatitis C virus infection on the risk of death of alcohol-dependent patients. J Viral Hepat 2015; 22:18-24. [PMID: 25131721 DOI: 10.1111/jvh.12290] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 03/30/2014] [Indexed: 12/20/2022]
Abstract
Hepatitis C virus (HCV) infection is frequent among patients with alcohol use disorders. We aimed to analyse the impact of HCV infection on survival of patients seeking treatment for alcohol use. This was a longitudinal study in a cohort of patients who abused alcohol recruited in two detoxification units. Socio-demographic and alcohol use characteristics, liver function tests for the assessment of alcohol-related liver disease and HCV and HIV infection serologies were obtained at admission. Patients were followed until December 2008; causes of death were ascertained through clinical records and death registry. Cox models were used to analyse predictors of death. A total of 675 patients (79.7% men) were admitted; age at admission was 43.5 years (IQR: 37.9-50.2 years), duration of alcohol abuse was 18 years (IQR: 11-24 years), and median alcohol consumption was 200 g/day (IQR: 120-275 g/day). Distribution of patients according to viral infections was as follows: 75.7% without HCV or HIV infection, 14.7% HCV infection alone and 8.1% HCV/HIV coinfection. Median follow-up was 3.1 years (IQR: 1.5-5.1 years) accounting for 2,345 person-years. At the end of study, 78 patients (11.4%) had died. In the multivariate analysis, age at admission (HR = 1.71, 95%CI: 1.05-2.80), alcohol-related liver disease (HR = 3.55, 95%CI: 1.93-6.53) and HCV/HIV co-infection (HR = 3.86 95%CI: 2.10-7.11) were predictors of death. Younger patients (≤43 years) with HCV infection were more likely to die than those without viral infections (HR = 3.1, 95%CI: 1.3-7.3; P = 0.007). Among patients with alcohol-related liver disease, mortality rate was high, irrespective of viral infections. These data show that HCV infection confers a worse prognosis in patients with alcohol use disorders.
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Affiliation(s)
- D Fuster
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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Levola J, Aalto M, Holopainen A, Cieza A, Pitkänen T. Health-related quality of life in alcohol dependence: a systematic literature review with a specific focus on the role of depression and other psychopathology. Nord J Psychiatry 2014; 68:369-84. [PMID: 24228776 DOI: 10.3109/08039488.2013.852242] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is considered a valid measure of treatment effectiveness in addictions. However, alcohol research has lagged behind other biomedical fields in using HRQOL outcomes as primary or secondary endpoints. Previous work has suggested that psychiatric co-morbidity may mediate the relationship between alcohol dependence and HRQOL. AIM The goal was to summarize the literature on HRQOL and its domains in the context of alcohol dependence. A specific focus was on the impact of depression and other psychopathology on these areas of life. MATERIALS AND METHODS A database search of MEDLINE and PsychINFO was performed within the scope of PARADISE (Psychosocial fActors Relevant to brAin DISorders in Europe); a European Commission funded coordination action. Using pre-defined eligibility criteria, 42 studies were identified. A systematic approach to data collection was employed. RESULTS AND CONCLUSIONS Alcohol dependence was shown to affect overall HRQOL and its domains, including general health, physical and mental health, general and social functioning, activities of daily living, pain and sleep. The evidence demonstrating that alcohol dependence is a primary cause of impairments in overall HRQOL, general health, mental and physical health and social functioning was fairly strong. Treatment interventions helped improve HRQOL and its aforementioned domains. The reduction or cessation of alcohol use facilitated these improvements; however, it was not reported to be predictive of improvement in all instances where improvement was reported. Depression was associated with further decreases in HRQOL. Personality disorders contributed to the severity of social functioning impairment.
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Affiliation(s)
- Jonna Levola
- Jonna Levola, A-clinic Foundation, Research Unit ; Helsinki , Finland , and National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services ; Helsinki , Finland
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Abstract
OBJECTIVES (1) Measure the association between the Functional Comorbidity Index (range, 0-18) and physical function health status (SF-36 Physical Function domain), general physical health status (SF-36 Physical Component Score), and general mental health status (SF-36 Mental Component Score) outcome measures in a cohort of sleep apnea patients. (2) Test if the Functional Comorbidity Index is more strongly associated (a better predictor) than the well-known Charlson Comorbidity Index (range, 0-37) with these SF-36 outcome measures. STUDY DESIGN Cross-sectional study. SETTING University of Washington Sleep Center. SUBJECTS AND METHODS In a cohort of newly diagnosed obstructive sleep apnea patients (N = 233), we obtained scores for the Functional Comorbidity Index, Charlson Comorbidity Index, and SF-36. We calculated Spearman correlations and adjusted coefficients of determination (R2) with multiple linear regression, adjusted for demographic and health covariates. Bootstrapping generated R2 distributions for statistical comparison. RESULTS Functional Comorbidity Index scores (mean ± standard deviation 2.4 ± 1.7) were more widely distributed than Charlson Comorbidity Index scores (0.7 ± 1.4). The Functional Comorbidity Index was significantly correlated with SF-36 Physical Function (-0.53, P < .001), Physical Component Score (-0.44, P < .001), and Mental Component Score (-0.38, P < .001). The Functional Comorbidity Index was a better predictor than the Charlson Comorbidity Index of SF-36 Physical Function (R (2) mean ± standard error 0.27 ± 0.05 vs. 0.17 ± 0.05, P < .001), Physical Component Score (0.23 ± 0.05 vs. 0.17 ± 0.05, P < .001), and Mental Component Score (0.23 ± 0.05 vs. 0.13 ± 0.05, P < .001). CONCLUSION The Functional Comorbidity Index is a more robust predictor of general health status than the Charlson Comorbidity Index in obstructive sleep apnea patients.
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Affiliation(s)
- Corinna G Levine
- Resident Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
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Rivas I, Sanvisens A, Bolao F, Fuster D, Tor J, Pujol R, Torrens M, Rey-Joly C, Muga R. Impact of medical comorbidity and risk of death in 680 patients with alcohol use disorders. Alcohol Clin Exp Res 2013; 37 Suppl 1:E221-7. [PMID: 23320801 DOI: 10.1111/j.1530-0277.2012.01861.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 04/12/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND The association between alcohol use disorders and increased risk of mortality is well known; however, there have been few systematic evaluations of alcohol-related organ damage and its impact on survival in younger alcoholics. Therefore, we assessed medical comorbidity with a clinical index to identify subgroups of alcoholic patients at high risk of premature death. METHODS Hospital-based cohort of alcohol-dependent patients admitted for detoxification between 1999 and 2008 in Barcelona, Spain. At admission, sociodemographic characteristics and a history of alcohol dependence and abuse of illegal drugs were obtained through clinical interviews and questionnaires. Medical comorbidity was assessed with the Cumulative Illness Rating Scale (Substance Abuse) (CIRS-SA). Dates and causes of death were obtained from clinical records and death registers. Survival was analyzed using Kaplan-Meier methods, and Cox regression models were used to analyze the risk factors for premature death. RESULTS Median age of the patients (686 total, 79.7% men) was 43.5 years (interquartile range [IQR], 37.8 to 50.4), average alcohol consumption was 200 g/d (IQR, 120 to 280 g/d), and duration of alcohol use disorder was 18 years (IQR, 11 to 24). Medical comorbidity by CIRS-SA at admission showed that the organs/systems most affected were liver (99%), respiratory (86%), and cardiovascular (58%). After median follow-up of 3.1 years (IQR, 1.5 to 5.1), 78 (11.4%) patients died with a mortality rate of 3.28 × 100 person-years; according to Kaplan-Meier estimates, 50% (95% confidence interval [95% CI], 24 to 69%) of patients with severe medical comorbidity died in the first decade after treatment. In multivariate analysis, severe medical comorbidity (hazard ratio [HR], 5.5; 95% CI, 3.02 to 10.07) and being treated with methadone at admission (HR, 2.60; 95% CI, 1.50 to 4.51) were independent risk factors for premature death. CONCLUSIONS Systematic assessment of alcohol-related organ damage is relevant for the identification and treatment of those at increased risk of death.
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Affiliation(s)
- Inmaculada Rivas
- Municipal Centre for Substance Abuse Treatment (Centro Delta), IMSP Badalona, Badalona, Spain
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Physical and mental quality of life in chronic pancreatitis: a case-control study from the North American Pancreatitis Study 2 cohort. Pancreas 2013; 42:293-300. [PMID: 23357924 PMCID: PMC3618567 DOI: 10.1097/mpa.0b013e31826532e7] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The objective of this study was to define the quality of life (QOL) in patients with chronic pancreatitis (CP). METHODS We studied 443 well-phenotyped CP subjects and 611 control subjects prospectively enrolled from 20 US centers between 2000 and 2006 in the North American Pancreatitis Study 2. Responses to the SF-12 questionnaire were used to calculate the mental (MCS) and physical component summary scores (PCS) with norm-based scoring (normal ≥50). Quality of life in CP subjects was compared with control subjects after controlling for demographic factors, drinking history, smoking, and medical conditions. Quality of life in CP was also compared with known scores for several chronic conditions. RESULTS Both PCS (38 [SD, 11.5] vs 52 [SD, 9.4]) and MCS (44 [SD, 11.5] vs 51 [SD, 9.2]) were significantly lower in CP compared with control subjects (P < 0.001). On multivariable analyses, compared with control subjects, a profound decrease in physical QOL (PCS 12.02 points lower) and a clinically significant decrease in mental QOL (MCS 4.24 points lower) was seen due to CP. Quality of life in CP was similar to (heart, kidney, liver, lung disease) or worse than (nonskin cancers, diabetes mellitus, hypertension, rheumatoid arthritis) other chronic conditions. CONCLUSIONS The impact of CP on QOL appears substantial. The QOL in CP subjects appears to be worse or similar to the QOL of many other chronic conditions.
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Colpaert K, De Maeyer J, Broekaert E, Vanderplasschen W. Impact of addiction severity and psychiatric comorbidity on the quality of life of alcohol-, drug- and dual-dependent persons in residential treatment. Eur Addict Res 2013; 19:173-83. [PMID: 23257413 DOI: 10.1159/000343098] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/29/2012] [Indexed: 01/28/2023]
Abstract
BACKGROUND Substance users' quality of life (QoL) is influenced by several variables, including psychiatric comorbidity and addiction severity. Thus far, the impact of the type of dependence (alcohol, drug or dual dependence) remains unclear. Therefore, the objectives of the study were to evaluate QoL in a clinical sample of alcohol-, drug- and dual-dependent patients and to assess the independent impact of psychiatric comorbidity, addiction severity and type of dependence on QoL. METHODS Face-to-face interviews with 274 patients admitted to residential substance abuse treatment were conducted using the European Addiction Severity Index (EuropASI), the Mini-International Neuropsychiatric Interview and the Assessment of Personality Disorders self-report questionnaire. RESULTS Multivariate analyses showed that anxiety, mood or personality disorder, employment status and the severity rating on the EuropASI domain alcohol use were associated with overall QoL. Gender, anxiety disorder and the severity ratings on the EuropASI domains alcohol use, drug use, physical health and emotional and psychological health were associated with overall perception of health. CONCLUSION Addiction severity and psychiatric comorbidity explained the greatest amount of QoL variance, whereas the type of dependence did not play a central role.
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Affiliation(s)
- Kathy Colpaert
- Department of Orthopedagogics, Ghent University, BE–9000 Ghent, Belgium.
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Abstract
BACKGROUND Quality of life has emerged as an important treatment outcome measure for alcohol dependence whose natural course comprises of remission and relapse. MATERIALS AND METHODS The purpose of this study was to examine the prospective change in Quality of life (QoL) in 56 patients aged 18-45 years of alcohol dependence over a three months' period and compare it with QoL of 150 age- and gender- matched healthy controls using WHOQoL-BREF. Severity of alcohol dependence and drinking parameters were assessed. RESULTS Significant improvement in QoL of patients of alcohol dependence over three months' abstinence. The physical, psychological, social, and environment domains of QoL in alcohol dependence subjects were significantly lower before treatment initiation than the healthy controls. Alcoholic liver disease emerged as a predictor of improvement in psychological and social domains of QoL. CONCLUSION The study confirms poor quality of life in patients of alcohol dependence before intervention. The regular follow-up with the family members in out-patient setting enables the patients achieve complete abstinence, thereby improving their quality of life.
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Affiliation(s)
- Shruti Srivastava
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Manjeet S Bhatia
- Department of Psychiatry, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, India
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Abstract
LEARNING OBJECTIVES After participating in this educational activity, the reader should be better able to identify the instruments that are currently being used to measure quality of life (QoL) in alcohol abuse and dependence; determine the impact of alcohol abuse and dependence on QoL; and evaluate the impact of treating alcohol abuse and dependence on QoL. OBJECTIVE Quality of life, which consists of the physical, mental, and social domains, has been shown to be negatively affected by alcohol abuse and dependence. This review aims to examine QoL in alcohol abuse and dependence by reviewing the instruments used to measure it and by analyzing the impact of alcohol abuse and dependence and of treatment on QoL. METHODS Studies were identified using a database search of PubMed and PsycINFO from the past 40 years (1971-2011) using the following keywords: abuse OR dependence, OR use AND alcohol, AND Quality of Life, QoL, Health-related quality of life, HRQOL. Two authors agreed independently on including 50 studies that met specific selection criteria. RESULTS Although several global measures of QoL have established reliability and validity, many alcohol-specific measures of QoL have not yet been validated. Nevertheless, QoL has been shown to be significantly impaired in those with alcohol abuse and dependence, particularly in the domains of mental health and social functioning, the very areas that show the greatest improvement with abstinence and its maintenance. Moreover, the literature demonstrates the utility of using QoL measures throughout assessment and treatment as a motivational tool and as a marker for treatment efficacy. CONCLUSIONS Measuring and monitoring QoL during assessment and treatment can add important value to patient recovery, for QoL improves with treatment and successful abstinence. Therefore, targeted, disease-specific assessments of QoL are warranted to address the impairments in the physical, mental, and social domains in alcohol abuse and dependence, thereby improving long-term outcomes.
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Marcon SR, Rubira EA, Espinosa MM, Barbosa DA. Quality of life and depressive symptoms among caregivers and drug dependent people. Rev Lat Am Enfermagem 2012; 20:167-74. [PMID: 22481735 DOI: 10.1590/s0104-11692012000100022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Accepted: 01/06/2012] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the quality of life and the presence of depressive symptoms among the caregivers and drug dependent people of the CAPSad. This is a cross-sectional study, with 109 users of four Psychosocial Care Centers for alcohol and other drugs of Mato Grosso and their caregivers, using the instruments: Medical Outcomes Studies 36 (SF-36), Beck Depression Inventory (BDI) and a sociodemographic variables questionnaire. The QoL of the caregivers in the domains functional capacity, physical aspect, pain and vitality were more affected when compared to the users. A strong correlation between QoL and depressive symptoms was found in both groups. The comparisons performed demonstrate a compromise in the quality of life of both, with the group of caregivers most affected, confirming the situation of drug dependence as an important factor in the perception of the caregiver regarding their quality of life.
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Quality of life among Egyptian patients with schizophrenia disorder, impact of psychopathology. MIDDLE EAST CURRENT PSYCHIATRY 2012. [DOI: 10.1097/01.xme.0000415298.98046.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zhang Y, Qu B, Lun SS, Guo Y, Liu J. The 36-item short form health survey: reliability and validity in Chinese medical students. Int J Med Sci 2012; 9:521-6. [PMID: 22991490 PMCID: PMC3444972 DOI: 10.7150/ijms.4503] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 08/19/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The 36-Item Short Form Health Survey (SF-36) is widely validated and popularly used in assessing the subjective quality of life (QOL) of patients and the general public. The aim of the study is to assess the psychometric properties of the 36-Item Short Form Health Survey (SF-36) in medical students in mainland of China. METHODS The reliability and validity of the 36-Item Short Form Health Survey (SF-36) questionnaire were assessed by conducting a cross-sectional study of Chinese medical students in December 2011. All 1358 3(rd) year and 4(th) year medical students from 46 classes at China Medical University were investigated. RESULTS The overall Cronbach's α coefficient of the SF-36 questionnaire was 0.791, while the respective Cronbach's α coefficients for each of the seven dimensions were > 0.70, except where the social function dimension was 0.631. Results showed that the SF-36 questionnaire was reliable and valid. CONCLUSION In general, this study provides evidence that the SF-36 questionnaire is suitable measures for assess the QOL of medical students in China.
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Affiliation(s)
- Yang Zhang
- The Research Centre for Medical Education, China Medical University, 92 North Second Road, Heping District, Shenyang 110001, China
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36
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Senneseth M, Alsaker K, Natvig GK. Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study. J Adv Nurs 2011; 68:402-13. [PMID: 21740459 PMCID: PMC3433795 DOI: 10.1111/j.1365-2648.2011.05752.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Aims This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments.
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Affiliation(s)
- Mette Senneseth
- Department of Public Health and Primary Health Care, University of Bergen, Norway.
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Zhornitsky S, Stip E, Desfossés J, Pampoulova T, Rizkallah E, Rompré PP, Bentaleb LA, Lipp O, Chiasson JP, Gendron A, Potvin S. Evolution of Substance use, Neurological and Psychiatric Symptoms in Schizophrenia and Substance use Disorder Patients: A 12-Week, Pilot, Case-Control Trial with Quetiapine. Front Psychiatry 2011; 2:22. [PMID: 21629845 PMCID: PMC3098726 DOI: 10.3389/fpsyt.2011.00022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 04/18/2011] [Indexed: 12/03/2022] Open
Abstract
Neurological and psychiatric symptoms are consequences of substance abuse in schizophrenia and non-schizophrenia patients. The present case-control study examined changes in substance abuse/dependence, and neurological and psychiatric symptoms in substance abusers with [dual diagnosis (DD) group, n = 26] and without schizophrenia [substance use disorder (SUD) group, n = 24] and in non-abusing schizophrenia patients (SCZ group, n = 23) undergoing 12-week treatment with the atypical antipsychotic, quetiapine. Neurological and psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Extrapyramidal Symptoms Rating Scale, and the Barnes Akathisia Rating Scale. At endpoint, DD and SCZ patients were receiving significantly higher doses of quetiapine (mean = 554 and 478 mg/day, respectively), relative to SUD patients (mean = 150 mg/day). We found that SUD patients showed greater improvement in weekly dollars spent on alcohol and drugs and SUD severity, compared to DD patients. At endpoint, there was no significant difference in dollars spent, but DD patients still had a higher mean SUD severity. Interestingly, DD patients had significantly higher parkinsonism and depression than SCZ patients at baseline and endpoint. On the other hand, we found that SUD patients had significantly more akathisia at baseline, improved more than SCZ patients, and this was related to cannabis abuse/dependence. Finally, SUD patients improved more in Positive and Negative Syndrome Scale positive scores than DD and SCZ patients. Taken together, our results provide evidence for increased vulnerability to the adverse effects of alcohol and drugs in schizophrenia patients. They also suggest that substance abuse/withdrawal may mimic some symptoms of schizophrenia. Future studies will need to determine the role quetiapine played in these improvements.
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Affiliation(s)
- Simon Zhornitsky
- Fernand-Seguin Research Centre, Department of Psychiatry, Faculty of Medicine, Université de Montréal Montréal, QC, Canada
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Dawson DA, Goldstein RB, Moss HB, Li TK, Grant BF. Gender differences in the relationship of internalizing and externalizing psychopathology to alcohol dependence: likelihood, expression and course. Drug Alcohol Depend 2010; 112:9-17. [PMID: 20558014 PMCID: PMC2953598 DOI: 10.1016/j.drugalcdep.2010.04.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 04/27/2010] [Accepted: 04/28/2010] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To determine whether internalizing and externalizing psychopathology were differentially associated with alcohol dependence in men and women. METHODS Four categories of lifetime psychopathology were examined: neither internalizing nor externalizing (NINE), internalizing only (IO), externalizing only (EO) and both internalizing and externalizing (BIE). Multivariate models assessed gender differences in the adjusted associations of these categories with the odds of lifetime alcohol dependence in a representative sample of 43,093 U.S. adults 18 and older and with clinical course and expression in a subsample of 4781 lifetime alcoholics. RESULTS The excess odds of lifetime alcohol dependence associated with IO, EO and BIE were significantly greater for women than men, OR=2.6, 8.8 and 10.7 versus 1.9, 4.0 and 6.5, respectively. Regardless of gender, the ORs were significantly higher for EO than IO and for BIE than EO. Gender differences in the expression and course of alcoholism were most pronounced for the categories of NINE and IO, with men having greater consumption, dependence severity and treatment but less familial alcoholism. Gender variation in the association of psychopathology with the expression and course of alcoholism was most evident in the BIE category, where the associations were stronger for women. Lifetime externalizing psychopathology was associated with an increased likelihood of treatment utilization, especially among women. CONCLUSIONS Findings highlight the need to increase alcoholism screening, prevention and intervention among women with psychopathology, especially externalizing. The greater numbers of internalizing than externalizing alcoholics emphasize the need to treat symptoms of depression and anxiety in alcohol treatment settings.
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Affiliation(s)
- Deborah A. Dawson
- Laboratory of Epidemiology and Biometry, Division of Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892 USA
| | - Risë B. Goldstein
- Laboratory of Epidemiology and Biometry, Division of Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892 USA
| | - Howard B. Moss
- Office of the Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892 USA
| | - Ting-Kai Li
- Duke University School of Medicine, Durham, NC, 27710 USA
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892 USA
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