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Ramirez-Cadiz C, Blaney H, Kubanek N, Díaz LA, Loomba R, Skladany L, Arab JP. Review article: Current indications and selection criteria for early liver transplantation in severe alcohol-associated hepatitis. Aliment Pharmacol Ther 2024; 59:1049-1061. [PMID: 38475893 DOI: 10.1111/apt.17948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/17/2023] [Accepted: 03/03/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Alcohol-associated hepatitis (AH) is a severe inflammatory form of alcohol-associated liver disease (ALD) that carries a high mortality rate. Early liver transplantation for severe AH is increasingly available. However, specific criteria for referral and selection remain a subject of debate. AIMS To provide a narrative review of the natural history, diagnostic criteria and indications for referral for early liver transplantation for severe AH. METHODS We searched PubMed for articles published through August 2023. Key search terms were 'alcoholic hepatitis,' 'alcohol-associated hepatitis,' 'abstinence,' 'alcohol relapse,' and 'liver transplantation.' RESULTS Previously, a six-month period of alcohol abstinence was required before patients with ALD were considered for liver transplantation. However, studies in recent years have demonstrated that, among carefully selected patients, patients who received early transplants have much higher survival rates than patients with similarly severe disease who did not undergo transplants (77% vs. 23%). Despite these successes, early liver transplantation remains controversial, as these patients have typically not undergone treatment for alcohol use disorder, with the ensuing risk of returning to alcohol use. CONCLUSIONS While early liver transplantation for AH has survival benefits, many patients would not have received treatment for alcohol use disorder. An integrated approach to evaluating candidacy for early liver transplantation is needed.
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Affiliation(s)
- Carolina Ramirez-Cadiz
- Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
| | - Hanna Blaney
- Division of Gastroenterology and Hepatology, University of Maryland, College Park, Maryland, USA
| | - Natalia Kubanek
- Division of Hepatology, Gastroenterology and Liver Transplantation, Department of Internal Medicine II, Slovak Medical University Faculty of Medicine, F. D. Roosevelt University Hospital, Banska Bystrica, Slovak Republic
| | - Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rohit Loomba
- Division of Gastroenterology, University of California at San Diego, San Diego, California, USA
| | - Lubomir Skladany
- Division of Hepatology, Gastroenterology and Liver Transplantation, Department of Internal Medicine II, Slovak Medical University Faculty of Medicine, F. D. Roosevelt University Hospital, Banska Bystrica, Slovak Republic
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
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Ayieko P, Kisanga E, Mshana G, Nkosi S, Hansen CH, Parry CDH, Weiss HA, Grosskurth H, Hayes RJ, Morojele NK, Kapiga S. Epidemiology of alcohol use and alcohol use disorders among people living with HIV on antiretroviral therapy in Northwest Tanzania: implications for ART adherence and case management. AIDS Care 2024; 36:652-660. [PMID: 38295268 DOI: 10.1080/09540121.2023.2299324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024]
Abstract
Alcohol use disorders (AUD) among people living with HIV (PLHIV) are associated with poor health outcomes. This cross-sectional study examined current alcohol use and AUD among 300 PLHIV on ART at four HIV care centres in Northwest Tanzania. Participants' data were collected using questionnaires. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT). Logistic regression was used to examine associations between each outcome (current drinking and AUD) and sociodemographic and clinical factors. Association between alcohol use and ART adherence was also studied. The median age of participants was 43 years (IQR 19-71) and 41.3% were male. Twenty-two (7.3%) participants failed to take ART at least once in the last seven days. The prevalence of current drinking was 29.3% (95% CI 24.2-34.8%) and that of AUD was 11.3% (8.2%-15.5%). Males had higher odds of alcohol use (OR 3.03, 95% CI 1.79-5.14) and AUD (3.89, 1.76-8.60). Alcohol use was associated with ART non-adherence (OR = 2.78, 1.10-7.04). There was a trend towards an association between AUD and non-adherence (OR = 2.91, 0.92-9.21). Alcohol use and AUD were common among PLHIV and showed evidence of associations with ART non-adherence. Screening patients for alcohol use and AUD in HIV clinics may increase ART adherence.
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Affiliation(s)
- Philip Ayieko
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Gerry Mshana
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- National Institute for Medical Research, Mwanza, Tanzania
| | - Sebenzile Nkosi
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Psychology, Rhodes University, Makhanda, South Africa
| | - Christian Holm Hansen
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles D H Parry
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Helen A Weiss
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Heiner Grosskurth
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Hayes
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Neo K Morojele
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Medical Research, Mwanza, Tanzania
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Chassin L, Sher KJ. Understanding alcohol use and alcohol use disorders from a developmental psychopathology perspective: Research advances, challenges, and future directions. Dev Psychopathol 2024:1-15. [PMID: 38655739 DOI: 10.1017/s0954579424000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
As part of the special issue of Development and Psychopathology honoring the remarkable contributions of Dr Dante Cicchetti, the current paper attempts to describe the recent contributions that a developmental psychopathology perspective has made in understanding the development of alcohol use and alcohol-related problems over the lifespan. The paper also identifies some of the future challenges and research directions. Because the scope of this task far exceeds the confines of a journal length article this paper does not attempt a comprehensive review. Rather, it builds on an earlier review and commentary that was published in Development and Psychopathology in 2013, with a similar goal.)Building on that work and updating its conclusions and suggestions for future directions, the current paper emphasizes findings from the research areas that were identified for further study in 2013 and the findings that have been published since that time.
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Li H, Xu M, Chen D, Wen W, Luo J. Pirfenidone ameliorates alcohol-induced promotion of breast cancer in mice. Front Oncol 2024; 14:1351839. [PMID: 38590657 PMCID: PMC10999600 DOI: 10.3389/fonc.2024.1351839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/14/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose Alcohol consumption increases the risk of breast cancer and promotes cancer progression. Alcohol exposure could affect both processes of the mammary carcinogenesis, namely, the cell transformation and onset of tumorigenesis as well as cancer aggressiveness including metastasis and drug resistance/recurrence. However, the cellular and molecular mechanisms underlying alcohol tumor promotion remain unclear. There are four members of the mammalian p38 mitogen-activated protein kinase (MAPK) family, namely, p38α, p38β, p38γ and p38δ. We have previously demonstrated alcohol exposure selectively activated p38γ MAPK in breast cancer cells in vitro and in vivo. Pirfenidone (PFD), an antifibrotic compound approved for the treatment of idiopathic pulmonary fibrosis, is also a pharmacological inhibitor of p38γ MAPK. This study aimed to determine whether PFD is useful to inhibit alcohol-induced promotion of breast cancer. Methods Female adolescent (5 weeks) MMTV-Wnt1 mice were exposed to alcohol with a liquid diet containing 6.7% ethanol. Some mice received intraperitoneal (IP) injection of PFD (100 mg/kg) every other day. After that, the effects of alcohol and PFD on mammary tumorigenesis and metastasis were examined. Results Alcohol promoted the progression of mammary tumors in adolescent MMTV-Wnt1 mice. Treatment of PFD blocked tumor growth and alcohol-promoted metastasis. It also significantly inhibited alcohol-induced tumorsphere formation and cancer stem cell (CSC) population. Conclusion PFD inhibited mammary tumor growth and alcohol-promoted metastasis. Since PFD is an FDA-approved drug, the current findings may be helpful to re-purpose its application in treating aggressive breast cancer and alcohol-promoted mammary tumor progression.
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Affiliation(s)
- Hui Li
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Mei Xu
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Danlei Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wen Wen
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Jia Luo
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, United States
- Iowa City VA Health Care System, Iowa City, IA, United States
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van der Boor C, Andersen LS, Massazza A, Tol WA, Taban D, Roberts B, Ssebunnya J, Kinyanda E, May C, Nadkarni A, Fuhr D. Using theory of change to plan for the implementation of a psychological intervention addressing alcohol use disorder and psychological distress in Uganda. Glob Ment Health (Camb) 2024; 11:e6. [PMID: 38283880 PMCID: PMC10808976 DOI: 10.1017/gmh.2023.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings. Three half-day workshops in Uganda engaged 41 stakeholders to develop a ToC map. ToC is a participatory program theory approach aiming to create a visual representation of how and why an intervention leads to specific outcomes. Additionally, five semi-structured interviews were conducted to explore experiences of stakeholders that participated in the ToC workshops. Two necessary pathways influencing the implementation and maintenance of CHANGE were identified: policy impact, and mental health service delivery. Barriers identified included policy gaps, limited recognition of social determinants and the need for integrated follow-up care. Interviewed participants valued ToC's participatory approach and expressed concerns about its adaptability in continuously changing contexts (e.g., humanitarian settings). Our study underscores ToC's value in delineating context-specific outcomes and identifies areas requiring further attention. It emphasizes the importance of early planning and stakeholder engagement for sustainable implementation of psychological interventions in humanitarian settings.
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Affiliation(s)
- Catharina van der Boor
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Lena S. Andersen
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Wietse A. Tol
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Joshua Ssebunnya
- Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda
| | - Eugene Kinyanda
- Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda
| | - Carl May
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Abhijit Nadkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Addictions and Related Research Group, Sangath, Goa, India
| | - Daniela Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
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Petit G, Leclercq S, Quoilin C, Poncin M, Starkel P, Maurage P, Rolland B, Dricot L, De Timary P. Links between psychopathological symptoms and cortical thickness in men with severe alcohol use disorder: A Magnetic Resonance Imaging study. Neuropsychopharmacol Rep 2023; 43:513-520. [PMID: 37013368 PMCID: PMC10739149 DOI: 10.1002/npr2.12331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Anxiety and depression are psychopathological states frequently co-occurring with severe alcohol use disorder (SAUD). These symptoms generally disappear with abstinence but may persist in some patients, increasing the relapse risk. METHODS The cerebral cortex thickness of 94 male patients with SAUD was correlated with symptoms of depression and anxiety, both measured at the end (2-3 weeks) of the detoxification treatment. Cortical measures were obtained using surface-based morphometry implemented with Freesurfer. RESULTS Depressive symptoms were associated with reduced cortical thickness in the superior temporal gyrus of the right hemisphere. Anxiety level was correlated with lower cortical thickness in the rostral middle frontal region, inferior temporal region, and supramarginal, postcentral, superior temporal, and transverse temporal regions of the left hemisphere, as well as with a large cluster in the middle temporal region of the right hemisphere. CONCLUSIONS At the end of the detoxification stage, the intensity of depressive and anxiety symptoms is inversely associated with the cortical thickness of regions involved in emotions-related processes, and the persistence of the symptoms could be explained by these brain deficits.
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Affiliation(s)
- Géraldine Petit
- Psychiatric Emergency Unit, Department of Adult PsychiatryCliniques Universitaires Saint LucBrusselsBelgium
- Institute of Neuroscience, UCLouvainBrusselsBelgium
| | - Sophie Leclercq
- Laboratory of Nutritional PsychiatryInstitute of Neuroscience, UCLouvainBrusselsBelgium
| | | | - Marie Poncin
- Institute of Neuroscience, UCLouvainBrusselsBelgium
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY)UCLouvainLouvain‐la‐NeuveBelgium
| | - Peter Starkel
- Laboratory of Hepato‐GastroenterologyUCLouvainBrusselsBelgium
- Department of Hepato‐GastroenterologyCliniques Universitaires Saint LucBrusselsBelgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY)UCLouvainLouvain‐la‐NeuveBelgium
| | - Benjamin Rolland
- CH Le Vinatier, Service Universitaire d'Addictologie de Lyon (SUAL)BronFrance
| | | | - Philippe De Timary
- Institute of Neuroscience, UCLouvainBrusselsBelgium
- Laboratory of Hepato‐GastroenterologyUCLouvainBrusselsBelgium
- Department of Adult PsychiatryCliniques Universitaires Saint LucBrusselsBelgium
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Levine EA, Sugarman DE, Rockas M, McHugh RK, Jordan C, Greenfield SF. Alcohol Treatment Access and Engagement Among Women in the USA: a Targeted Review of the Literature 2012-2022. Curr Addict Rep 2023; 10:638-648. [PMID: 38505370 PMCID: PMC10948108 DOI: 10.1007/s40429-023-00515-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 03/21/2024]
Abstract
Purpose of Review The purpose of this review is to examine recent literature (2012-2022) on alcohol treatment access and engagement in women in the U.S. and propose future directions for research and clinical practice. Recent Findings A targeted literature review resulted in 27 studies encompassing screening and brief intervention (SBIRT), treatment utilization, treatment engagement, and barriers to treatment. Recent literature demonstrates overall low rates of screening and brief interventions and treatment utilization in the population with women less likely to be screened and utilize alcohol treatment. The magnitude of these gender differences varies with race/ethnicity. Extensive barriers to care include provider knowledge, structural barriers, and attitudinal barriers and these vary with service setting, gender, and race/ethnicity. Summary There is an increasing prevalence of alcohol use and Alcohol Use Disorder (AUD) in women with low rates of screening, brief treatment, treatment, and engagement which have resulted from extensive barriers to care. Possible areas of further inquiry include the impact of race/ethnicity on gender differences, improving provider and system level policies to promote SBIRT and treatment engagement and utilization, further developing digital interventions, and implementation research to investigate factors associated with optimizing effectiveness of gender-responsive and culturally tailored interventions that address the unique needs of women.
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Affiliation(s)
| | | | - Mary Rockas
- McLean Hospital
- Department of Psychiatry, Harvard Medical School
| | | | - Chloe Jordan
- McLean Hospital
- Department of Psychiatry, Harvard Medical School
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Dem U, Letho Z, Dorji C, Nirola DK, Choki S, Dorji T, Chejor P. Aversive Reaction Between Disulfiram and Betel Quid Among Inpatients With Alcohol Use Disorder in Bhutan: A Preliminary Study. Asia Pac J Public Health 2023; 35:532-534. [PMID: 37837338 PMCID: PMC10644688 DOI: 10.1177/10105395231204801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Betel quid (BQ) is commonly used in the Asia-Pacific region. Disulfiram is prescribed for people with alcohol use disorders (PwAUDs) after the completion of detoxification as an alternative to rehabilitation. This prospective observational study reported the aversive reactions and common symptoms of disulfiram and BQ in PwAUDs. Participants included PwAUDs admitted to the psychiatric ward at the Jigme Dorji Wangchuck National Referral Hospital for detoxification, who were on Disulfiram and using BQ at the same time. Aversive reactions between disulfiram and BQ were observed for 100 patients over a year. Twenty participants showed aversive reactions between BQ and disulfiram. Common symptoms included sweating, diarrhea, dizziness, tremors, palpitations, shortness of breath, nausea and vomiting, and headache. Since PwAUDs in Bhutan are inducted on disulfiram after detoxification, and most use BQ simultaneously, this study will help inform health care providers to educate people about the aversive reactions of disulfiram and BQ.
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Affiliation(s)
- Ugyen Dem
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Zimba Letho
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Chencho Dorji
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Damber K. Nirola
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Sonam Choki
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tashi Dorji
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Pelden Chejor
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Western Australia, Australia
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Walsh BE, Dvorak RD, Ebbinghaus A, Gius BK, Levine JA, Cortina W, Schlauch RC. Disaggregating within- and between-person effects of affect on drinking behavior in a clinical sample with alcohol use disorder. J Psychopathol Clin Sci 2023; 132:1051-1059. [PMID: 38010773 PMCID: PMC10683873 DOI: 10.1037/abn0000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE The goal of the current study was to better understand affect-drinking relations among those diagnosed with an alcohol use disorder (AUD), as recent meta-analytic work suggests that daily negative affect may not universally predict subsequent alcohol consumption in those nondependent on alcohol. Specifically, we investigated the between- and within-person effects of positive and negative affects on drinking. METHOD Participants (n = 92) who met AUD diagnostic criteria completed a 90-day daily assessment of drinking behavior and positive and negative affects. RESULTS Time-lagged multilevel modeling revealed that within-person elevations in negative affect predicted increased odds and quantity of drinking later in the day. Relations between positive affect and drinking were nonsignificant. CONCLUSIONS These findings are in contrast to recent meta-analytic findings and highlight the complexity of affect-drinking relations among those diagnosed with AUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Becky K. Gius
- Department of Psychology, University of South Florida
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10
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Van Dessel P, Cummins J, Wiers RW. ABC-training as a new intervention for hazardous alcohol drinking: Two proof-of-principle randomized pilot studies. Addiction 2023; 118:2141-2155. [PMID: 37349262 DOI: 10.1111/add.16271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND AIMS ABC-training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof-of-principle study was to test the effectiveness of web-based ABC-training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers. DESIGN One exploratory and one confirmatory experiment with two between-subject conditions (online ABC- and control-training) and assessments at baseline and 1 week later (after three sessions of training). SETTING Participants recruited on Prolific Academic completed the web-based study. PARTICIPANTS Adults with self-reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years). INTERVENTION AND COMPARATOR ABC-training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control-training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week. MEASUREMENTS Primary outcome was change in automatic and self-reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self-efficacy, craving and motivation (and approach-alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency. FINDINGS Findings of this study are as follows: stronger increase in negative outcome expectancies after ABC- than control-training (Experiment 1: self-report, 95% confidence interval of difference scores (CIdiff ) = [0.04, Inf]; automatic, CIdiff = [0.01, Inf]; Experiment 2: self-report, CIdiff = [0.16, Inf]; automatic, CIdiff = [0.002, Inf]). Stronger reduction in self-reported positive outcome expectancies after ABC- than control-training (Experiment 1: CIdiff = [-Inf, -0.01]; Experiment 2: CIdiff = [-Inf, -0.21]) but mixed findings on automatic positive outcome expectancies (Experiment 1: CIdiff = [-Inf, 0.02]; Experiment 2: CIdiff = [-Inf, -0.001]). CONCLUSIONS ABC-training may change outcome expectancies of alcohol consumption, but testing of clinically relevant effects in other samples is warranted.
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Affiliation(s)
- Pieter Van Dessel
- Learning and Implicit Processes (LIP) Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jamie Cummins
- Learning and Implicit Processes (LIP) Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Laboratory, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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Dharavath RN, Pina-Leblanc C, Tang VM, Sloan ME, Nikolova YS, Pangarov P, Ruocco AC, Shield K, Voineskos D, Blumberger DM, Boileau I, Bozinoff N, Gerretsen P, Vieira E, Melamed OC, Sibille E, Quilty LC, Prevot TD. GABAergic signaling in alcohol use disorder and withdrawal: pathological involvement and therapeutic potential. Front Neural Circuits 2023; 17:1218737. [PMID: 37929054 PMCID: PMC10623140 DOI: 10.3389/fncir.2023.1218737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/04/2023] [Indexed: 11/07/2023] Open
Abstract
Alcohol is one of the most widely used substances. Alcohol use accounts for 5.1% of the global disease burden, contributes substantially to societal and economic costs, and leads to approximately 3 million global deaths yearly. Alcohol use disorder (AUD) includes various drinking behavior patterns that lead to short-term or long-lasting effects on health. Ethanol, the main psychoactive molecule acting in alcoholic beverages, directly impacts the GABAergic system, contributing to GABAergic dysregulations that vary depending on the intensity and duration of alcohol consumption. A small number of interventions have been developed that target the GABAergic system, but there are promising future therapeutic avenues to explore. This review provides an overview of the impact of alcohol on the GABAergic system, the current interventions available for AUD that target the GABAergic system, and the novel interventions being explored that in the future could be included among first-line therapies for the treatment of AUD.
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Affiliation(s)
| | - Celeste Pina-Leblanc
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Victor M. Tang
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Addiction Division, CAMH, Toronto, ON, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Institute of Mental Health Policy Research, CAMH, Toronto, ON, Canada
| | - Matthew E. Sloan
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Addiction Division, CAMH, Toronto, ON, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Institute of Mental Health Policy Research, CAMH, Toronto, ON, Canada
| | - Yuliya S. Nikolova
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter Pangarov
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
| | - Anthony C. Ruocco
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada
| | - Kevin Shield
- Institute of Mental Health Policy Research, CAMH, Toronto, ON, Canada
| | - Daphne Voineskos
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada
| | - Daniel M. Blumberger
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada
| | - Isabelle Boileau
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, CAMH, Toronto, ON, Canada
| | - Nikki Bozinoff
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Philip Gerretsen
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, CAMH, Toronto, ON, Canada
| | - Erica Vieira
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Osnat C. Melamed
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lena C. Quilty
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Thomas D. Prevot
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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12
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Xie W, Emery CR, Liu AY, Ng SM, Choi AWM, Chui CHK. Childhood emotional abuse and alcohol use disorders in a national Nepali women sample: The mediating role of borderline personality traits. Dev Psychopathol 2023:1-9. [PMID: 37680182 DOI: 10.1017/s0954579423001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
While many studies have found an association between childhood emotional abuse and alcohol use disorders (AUD) during adulthood, underlying psychological mechanisms linking the two remain inadequately understood. Drawing on the developmental psychopathology perspective, this study examined the relationship between childhood emotional abuse and AUD during adulthood with a national sample of women in Nepal (N = 1,100, M age = 37.73), focusing on the mediating role of borderline personality traits. Mediation analyses were performed using the Karlson-Holm-Breen (KHB) method and bootstrapping confidence intervals. Results indicated that Nepali women's borderline personality traits significantly mediated the relationship between childhood emotional abuse and AUD. Hence, emotional abuse in childhood increases the risk for AUD during adulthood for Nepali women by increasing the risk of borderline personality traits. Findings underscore the necessity of continued emphasis on developing and implementing early interventions for childhood emotional abuse and therapeutic interventions for borderline personality traits in reducing AUD among vulnerable women in Nepal.
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Affiliation(s)
- Weiyi Xie
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Clifton R Emery
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Amy Yinan Liu
- Graduate School of Child Development and Education, University of Amsterdam, Amsterdam, NH, Netherlands
| | - Siu-Man Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Anna Wai-Man Choi
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Cheryl Hiu-Kwan Chui
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
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13
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Fernández-Regueras M, Carbonell C, Salete-Granado D, García JL, Gragera M, Pérez-Nieto MÁ, Morán-Plata FJ, Mayado A, Torres JL, Corchete LA, Usategui-Martín R, Bueno-Martínez E, Rojas-Pirela M, Sabio G, González-Sarmiento R, Orfao A, Laso FJ, Almeida J, Marcos M. Predominantly Pro-Inflammatory Phenotype with Mixed M1/M2 Polarization of Peripheral Blood Classical Monocytes and Monocyte-Derived Macrophages among Patients with Excessive Ethanol Intake. Antioxidants (Basel) 2023; 12:1708. [PMID: 37760011 PMCID: PMC10525853 DOI: 10.3390/antiox12091708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Excessive alcohol consumption impairs the immune system, induces oxidative stress, and triggers the activation of peripheral blood (PB) monocytes, thereby contributing to alcoholic liver disease (ALD). We analyzed the M1/M2 phenotypes of circulating classical monocytes and macrophage-derived monocytes (MDMs) in excessive alcohol drinkers (EADs). PB samples from 20 EADs and 22 healthy controls were collected for isolation of CD14+ monocytes and short-term culture with LPS/IFNγ, IL4/IL13, or without stimulation. These conditions were also used to polarize MDMs into M1, M2, or M0 phenotypes. Cytokine production was assessed in the blood and culture supernatants. M1/M2-related markers were analyzed using mRNA expression and surface marker detection. Additionally, the miRNA profile of CD14+ monocytes was analyzed. PB samples from EADs exhibited increased levels of pro-inflammatory cytokines. Following short-term culture, unstimulated blood samples from EADs showed higher levels of soluble TNF-α and IL-8, whereas monocytes expressed increased levels of surface TNF-α and elevated mRNA expression of pro-inflammatory cytokines and inducible nitric oxide synthase. MDMs from EADs showed higher levels of TNF-α and CD206 surface markers and increased IL-10 production. LPS/IFNγ induced higher mRNA expression of Nrf2 only in the controls. miRNA analysis revealed a distinctive miRNA profile that is potentially associated with liver carcinogenesis and ALD through inflammation and oxidative stress. This study confirms the predominantly pro-inflammatory profile of PB monocytes among EADs and suggests immune exhaustion features in MDMs.
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Affiliation(s)
- María Fernández-Regueras
- Hospital Universitario de Burgos, 09006 Burgos, Spain
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain
| | - Cristina Carbonell
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Daniel Salete-Granado
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Juan-Luis García
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Translational and Clinical Research Program, Centro de Investigación del Cáncer e Instituto de Biología Molecular y Celular del Cáncer (IBMCC), 37007 Salamanca, Spain
| | - Marcos Gragera
- Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas, 28049 Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares, 28029 Madrid, Spain
| | - María-Ángeles Pérez-Nieto
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Fundación Instituto de Estudios de Ciencias de la Salud de Castilla y León, 42002 Soria, Spain
| | - Francisco-Javier Morán-Plata
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Translational and Clinical Research Program, Centro de Investigación del Cáncer e Instituto de Biología Molecular y Celular del Cáncer (IBMCC), 37007 Salamanca, Spain
| | - Andrea Mayado
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Translational and Clinical Research Program, Centro de Investigación del Cáncer e Instituto de Biología Molecular y Celular del Cáncer (IBMCC), 37007 Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jorge-Luis Torres
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Complejo Asistencial de Zamora, 49022 Zamora, Spain
| | - Luis-Antonio Corchete
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Translational and Clinical Research Program, Centro de Investigación del Cáncer e Instituto de Biología Molecular y Celular del Cáncer (IBMCC), 37007 Salamanca, Spain
| | - Ricardo Usategui-Martín
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Biología Celular, Facultad de Medicina, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Elena Bueno-Martínez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Maura Rojas-Pirela
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Guadalupe Sabio
- Centro Nacional de Investigaciones Cardiovasculares, 28029 Madrid, Spain
| | - Rogelio González-Sarmiento
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Alberto Orfao
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Translational and Clinical Research Program, Centro de Investigación del Cáncer e Instituto de Biología Molecular y Celular del Cáncer (IBMCC), 37007 Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Francisco-Javier Laso
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Julia Almeida
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Translational and Clinical Research Program, Centro de Investigación del Cáncer e Instituto de Biología Molecular y Celular del Cáncer (IBMCC), 37007 Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Miguel Marcos
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
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14
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Azagba S, Ebling T, Hall M. Health claims denial for alcohol intoxication: State laws and structural stigma. Alcohol Clin Exp Res (Hoboken) 2023; 47:1748-1755. [PMID: 38051148 PMCID: PMC10699208 DOI: 10.1111/acer.15153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/13/2023] [Accepted: 07/07/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Some alcohol exclusion laws (AELs) allow health insurers to deny coverage to individuals injured due to being intoxicated. Evidence has shown that such AELs disincentivize health-care providers to screen for alcohol while they deter treatment utilization by people with an alcohol use disorder (AUD). Certain states have changed AELs to enhance the health of people with an AUD, but these changes are not well documented in the extant literature. This study examined the current status and historical trends in AELs across US states. METHODS We conducted a systematic legal analysis in 2023 to examine how state alcohol exclusion laws vary across the United States. These laws allow or prohibit insurers from denying coverage for injuries or deaths related to alcohol use. We classified the states into three categories: (1) States that explicitly permit alcohol exclusions, (2) States that explicitly ban alcohol exclusions, and (3) States that have no clear policy on alcohol exclusions. RESULTS We found that 18 states still have alcohol exclusion laws, down from 37 in 2004. Meanwhile, the number of states that have explicitly banned AELs and prohibited insurers from applying alcohol exclusions (AEs) to their policies has increased from 3 to 15 in the same period. The remaining 17 states have no clear laws on AEs. We also noted that five states that repealed their AELs did not adopt any specific prohibition on AEs, and four states limited their prohibition to policies that cover hospital, medical, or surgical expenses. CONCLUSIONS Our systematic mapping reveals that some states have prohibited AELs in response to their detrimental effects. However, some states maintain these policies, and none has effectively outlawed AEs in the last 10 years, despite their possible role in reinforcing stigma.
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Affiliation(s)
| | - Todd Ebling
- College of Nursing, Pennsylvania State University
| | - Mark Hall
- Health Law and Policy Program, Wake Forest School of Law
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
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15
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Maggioni E, Rossetti MG, Allen NB, Batalla A, Bellani M, Chye Y, Cousijn J, Goudriaan AE, Hester R, Hutchison K, Li CSR, Martin-Santos R, Momenan R, Sinha R, Schmaal L, Solowij N, Suo C, van Holst RJ, Veltman DJ, Yücel M, Thompson PM, Conrod P, Mackey S, Garavan H, Brambilla P, Lorenzetti V. Brain volumes in alcohol use disorder: Do females and males differ? A whole-brain magnetic resonance imaging mega-analysis. Hum Brain Mapp 2023; 44:4652-4666. [PMID: 37436103 PMCID: PMC10400785 DOI: 10.1002/hbm.26404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/03/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Emerging evidence suggests distinct neurobiological correlates of alcohol use disorder (AUD) between sexes, which however remain largely unexplored. This work from ENIGMA Addiction Working Group aimed to characterize the sex differences in gray matter (GM) and white matter (WM) correlates of AUD using a whole-brain, voxel-based, multi-tissue mega-analytic approach, thereby extending our recent surface-based region of interest findings on a nearly matching sample using a complementary methodological approach. T1-weighted magnetic resonance imaging (MRI) data from 653 people with AUD and 326 controls was analyzed using voxel-based morphometry. The effects of group, sex, group-by-sex, and substance use severity in AUD on brain volumes were assessed using General Linear Models. Individuals with AUD relative to controls had lower GM volume in striatal, thalamic, cerebellar, and widespread cortical clusters. Group-by-sex effects were found in cerebellar GM and WM volumes, which were more affected by AUD in females than males. Smaller group-by-sex effects were also found in frontotemporal WM tracts, which were more affected in AUD females, and in temporo-occipital and midcingulate GM volumes, which were more affected in AUD males. AUD females but not males showed a negative association between monthly drinks and precentral GM volume. Our results suggest that AUD is associated with both shared and distinct widespread effects on GM and WM volumes in females and males. This evidence advances our previous region of interest knowledge, supporting the usefulness of adopting an exploratory perspective and the need to include sex as a relevant moderator variable in AUD.
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Affiliation(s)
- Eleonora Maggioni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Maria G Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Albert Batalla
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Melbourne, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Janna Cousijn
- Neuroscience of Addiction Lab, Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, the Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Robert Hester
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Chiang-Shan R Li
- Department of Psychiatry and of Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lianne Schmaal
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Chao Suo
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
- Australian Characterisation Commons at Scale (ACCS) Project, Monash eResearch Centre, Melbourne, Australia
| | - Ruth J van Holst
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Melbourne, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Patricia Conrod
- Department of Psychiatry, Universite de Montreal, CHU Ste Justine Hospital, Montreal, Canada
| | - Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
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Pozzolo Pedro MO, Pozzolo Pedro M, Martins SS, Castaldelli-Maia JM. Alcohol use disorders in patients with bipolar disorder: a systematic review and meta-analysis. Int Rev Psychiatry 2023; 35:450-460. [PMID: 38299650 DOI: 10.1080/09540261.2023.2249548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 02/02/2024]
Abstract
Alcohol consumption has a key role in more than 200 diseases and health injuries, being an important factor for social and public health costs. Studies with clinical populations show an association between alcohol use disorders (AUD) and bipolar disorder. In this meta-analysis we included studies, reports, or summaries identified in Google Scholar, Lilacs, Medline, and MedCaribe that reported original data published up to 31 January 2023. We included cross-sectional and longitudinal observational studies that investigated the prevalence of AUD in patients with bipolar disorder. We calculated the prevalence rates and conducted a meta-analysis using a random effects model. The meta-analysis included 20 unique studies conducted in 12 countries, with a total sample of 32,886 individuals with bipolar disorder, comprising 17,923 women and 13,963 men, all aged 18 years or older. The prevalence of AUD in individuals with bipolar disorder was found to be 29.12%, while the prevalence of Alcohol Dependence (AD) was 15.87% and the prevalence of Alcohol Abuse (AA) was 18.74%. The high prevalence of AUD individuals with bipolar disorder is important because it highlights the need for targeted interventions to prevent and address comorbid conditions, which may improve treatment outcomes, reduce harm, and promote public health.
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Affiliation(s)
| | | | - Silvia S Martins
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
| | - João Maurício Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
- Department of Neuroscience, Medical School, ABC Health University Center, Santo André, Brazil
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17
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Galkin SA, Bokhan NA. [Features of the reward-based decision-making in patients with alcohol use disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:37-43. [PMID: 36843457 DOI: 10.17116/jnevro202312302137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Foreign studies increasingly emphasize the role of reward-based cognitive decision-making and its contribution to alcohol and drug abuse. Unfortunately, such studies are extremely few in Russia. Given the importance of the insufficiency of cognitive functions, primarily the decision-making process based on reward, among the risk factors of addictive pathology, increasing the severity of alcoholism, reducing the effectiveness of its therapy and rehabilitation, research in this direction is extremely relevant. This review summarizes and systematizes current data on the features of the cognitive decision-making process based on reward in patients with alcohol dependence. An analysis of the literature has shown that reward-based decision making is an important component of addictive behavior. Patients with alcohol dependence, as well as people, who abuse alcohol, demonstrate clear impairment of this cognitive function. Thus, the relative value of diagnosing disorders in decision-making in modern psychiatry is beyond doubt. It is recommended to include the above tests in the diagnostic complex of a psychiatrist, along with standard psychometric tools.
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Affiliation(s)
- S A Galkin
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Science, Tomsk, Russia
| | - N A Bokhan
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Science, Tomsk, Russia.,Siberian State Medical University, Tomsk, Russia
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18
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Maalouf E, Hallit S, Salameh P, Hosseini H. Impact of Preexisting Alcohol Use Disorder, Bipolar Disorder, and Schizophrenia on Ischemic Stroke Risk and Severity: A Lebanese Case-Control Study. Healthcare (Basel) 2023; 11. [PMID: 36833072 DOI: 10.3390/healthcare11040538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Stroke remains a major leading cause of morbidity and death globally. For ischemic stroke, the most frequent type of stroke, there are numerous risk models and risk assessments offered. Further research into potential risk factors or triggers is being sought to improve stroke risk models. Schizophrenia, bipolar disorder, and alcohol use disorder are all common causes of serious mental illnesses in the general population. Due to the tangled relationship between stroke and many chronic illnesses, lifestyle factors, and diet that may be present in a patient with a mental disease, the relationship between mental diseases and stroke requires further validation. Consequently, the purpose of this study is to assess the potential influence of bipolar disorder, schizophrenia, and alcohol use disorder on stroke patients as compared to non-stroke participants, after controlling for demographic, physical, and medical conditions. We aimed, as a secondary objective, to evaluate the impact of these pre-existing disorders on stroke severity levels. METHODS This research is a case-control survey study involving 113 Lebanese patients with a clinical diagnosis of ischemic stroke and 451 gender-matched volunteers without clinical signs of stroke as controls recruited from several hospitals in Lebanon (April 2020-April 2021). Based on the participant's consent, data was collected by filling out an anonymous paper-based questionnaire. RESULTS All of the odds ratios (ORs) generated by our regression model were greater than 1, indicating that the factors studied were associated with an increased risk of ischemic stroke. As such having schizophrenia (adjusted OR [aOR]: 6.162, 95% confidence interval [CI]: 1.136-33.423), bipolar disorder (aOR: 4.653, 95% CI: 1.214-17.834), alcohol use disorder (aOR: 3.918, 95% CI: 1.584-9.689), atrial fibrillation (aOR: 2.415, 95% CI: 1.235-4.721), diabetes (aOR: 1.865, 95% CI: 1.117-3.115), heart diseases (aOR: 9.890, 95% CI: 5.099-19.184), and asthma-COPD (aOR: 1.971, 95% CI: 1.190-3.263) were all involved with a high risk of developing an ischemic stroke. Moreover, obesity (aOR: 1.732, 95% CI: 1.049-2.861) and vigorous physical activity (aOR: 4.614, 95% CI: 2.669-7.978) were also linked to an increased risk of stroke. Moreover, our multinomial regression model revealed that the odds of moderate to severe/severe stroke were significantly higher in people with pre-stroke alcohol use disorder (aOR: 1.719, 95% CI: 1.385-2.133), bipolar disorder (aOR: 1.656, 95% CI: 1.281-2.141), and schizophrenia (aOR: 6.884, 95% CI: 3.294-11.492) compared to people who had never had a stroke. CONCLUSION The findings in our study suggest that individuals with schizophrenia, bipolar disorder, and alcohol use disorder may be at a higher risk for ischemic stroke and exhibit more severe symptoms. We believe that the first step toward creating beneficial preventative and treatment interventions is determining individuals with schizophrenia, bipolar disorder, or alcohol use disorder, assessing their risk of ischemic stroke, developing more integrated treatments, and closely monitoring the long-term outcome in the event of an ischemic stroke.
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Fortinguerra F, Pierantozzi A, Trotta F. The use of medications approved for alcohol use disorders in Italy. Front Public Health 2023; 11:1110435. [PMID: 36875354 PMCID: PMC9975714 DOI: 10.3389/fpubh.2023.1110435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/16/2023] [Indexed: 02/17/2023] Open
Abstract
Background Italy has the highest per capita alcohol consumption among European countries. Several pharmacological treatments for alcohol use disorders (AUDs) are currently available in Italy, but no consumption data are available. A first analysis of national drug consumption, comprising the whole Italian population over a long-term period covering the COVID-19 pandemic, was performed. Methods To analyze the consumption of medications indicated for therapy of alcohol dependence, different national data sources were used. Consumption was measured as a defined daily dose (DDD) per 1,000,000 inhabitants per day. Results In 2020, the total consumption of medicines used in the treatment of AUDs amounted to 310.3 DDD per 1 million inhabitants per day (0.018% of the overall drug consumption in Italy) with a decreasing gradient from the north (373.9 DDD) to the south (250.7 DDD). 53.2% of the overall doses were dispensed by public healthcare facilities and 23.5% by community pharmacies, while the remaining 23.3% were purchased privately. The temporal trend of consumption seemed to be stable across the last few years, although an impact of the COVID-19 pandemic was observed. Disulfiram was the most consumed medicine over years. Conclusion All Italian regions offer pharmacological treatments to patients with AUDs, but differences in the number of dispensed doses suggest a different local organization of patient care, which can be partly explained by the different severity of the clinical condition of residing patients. Pharmacotherapy of alcoholism should be deeply investigated to describe the clinical characteristics of treated patients (i.e., comorbidities) and evaluate the appropriateness of prescribed medications.
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Galkin SA, Oshkina TA, Kisel NI. [Features of decision-making in patients with alcohol dependence]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:115-119. [PMID: 37655419 DOI: 10.17116/jnevro2023123081115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To identify electroencephalographic correlates of decision-making features in patients with alcohol dependence. MATERIAL AND METHODS Forty men with alcohol dependence were examined as the main group. Thirty people were examined as a control group. The Cambridge Gambling Task and the Iowa Gambling Task were used to study decision-making functions. Additionally, a background electroencephalogram was recorded with the calculation of absolute spectral power indicators. RESULTS In the main group, the relatively higher indicators of decision-making logic (65 [50; 80]%, p<0.05) were associated with larger values of the spectral power of the theta and alpha rhythm of the electroencephalogram in the central and parietal-occipital leads (R=0.426, p=0.019; R=0.418, p=0.022; R=0.394, p=0.028 and R=0.445, p=0.014; R=0.458, p=0.011; R=0.382, p=0.035, respectively). Difficulties in making decisions based on emotional learning in patients with alcohol dependence were associated with larger values of the spectral power of the beta rhythm of the electroencephalogram in the temporal leads. CONCLUSIONS The study showed that the deficit of decision-making functions in patients with alcohol dependence may be due to an imbalance of the excitation/inhibition mechanisms in the brain.
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Affiliation(s)
- S A Galkin
- Tomsk National Research Medical Center Russian Academy of Science, Tomsk, Russia
| | - T A Oshkina
- Tomsk National Research Medical Center Russian Academy of Science, Tomsk, Russia
| | - N I Kisel
- Tomsk National Research Medical Center Russian Academy of Science, Tomsk, Russia
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21
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Cadoni C, Peana AT. Energy drinks at adolescence: Awareness or unawareness? Front Behav Neurosci 2023; 17:1080963. [PMID: 36891321 PMCID: PMC9986288 DOI: 10.3389/fnbeh.2023.1080963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
Energy drinks (EDs) are beverages similar to soft drinks, characterized by high caffeine concentrations with additional ingredients like taurine and vitamins, marketed for boosting energy, reducing tiredness, increasing concentration, and for their ergogenic effect. The majority of consumers are children, adolescents, and young athletes. Although EDs companies claim about the ergogenic and remineralizing properties of their products, there is a serious lack of evidence at preclinical as well as clinical level to validate their benefits. The regular intake and long-term consequences of these caffeinated drinks are not well documented, especially the possible negative effects in adolescents whose brain is still developing. EDs combined with alcohol are also gaining popularity among adolescents and different publications indicate that this combined consumption might increase the risk to develop an alcohol use disorder, as well as produce serious adverse cardiovascular effects. There is an increasing need to disseminate knowledge on EDs damage on health, so that adolescents can be aware about the potential harmful outcomes of consuming these drinks.
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Affiliation(s)
- Cristina Cadoni
- Department of Biomedical Sciences, Institute of Neuroscience, National Research Council of Italy, Cagliari, Italy
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22
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Nadkarni A, Massazza A, Guda R, Fernandes LT, Garg A, Jolly M, Andersen LS, Bhatia U, Bogdanov S, Roberts B, Tol WA, Velleman R, Moore Q, Fuhr D. Common strategies in empirically supported psychological interventions for alcohol use disorders: A meta-review. Drug Alcohol Rev 2023; 42:94-104. [PMID: 36134481 PMCID: PMC10087716 DOI: 10.1111/dar.13550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/30/2022] [Accepted: 09/03/2022] [Indexed: 01/10/2023]
Abstract
ISSUES Despite the large number of effective psychological interventions for alcohol use disorders (AUD), there is still a lack of clarity concerning the strategies that make these interventions effective. APPROACH The overall goal of this review was to identify, examine and synthesise the information about common strategies from evidence-based psychological interventions for AUDs by conducting a review of systematic reviews, that is, a meta-review. We isolated the relevant primary studies from eligible systematic reviews and extracted information about the interventions from these studies to understand the strategies used. Analysis was restricted to narrative summaries. KEY FINDINGS Thirteen reviews were eligible for inclusion in our meta-review. Of these, eight demonstrated the effectiveness of a range of psychological interventions-behavioural couples therapy, cognitive behaviour therapy combined with motivational interviewing, brief interventions, contingency management, psychotherapy plus brief interventions, Alcoholics Anonymous and 12-step treatment programs, family-therapy or family-involved treatment, and community reinforcement approach. The most commonly used component strategies in effective interventions for AUDs included assessment, personalised feedback, motivational interviewing, goal setting, setting and review of homework, problem solving skills and relapse prevention/management. IMPLICATIONS Evidence about commonly used strategies in evidence-based psychological interventions for AUDs offer the possibility of creating menu-driven interventions that can be tailored to respond to individual client needs and preferences in different contexts.
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Affiliation(s)
- Abhijit Nadkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Addictions Research Group, Sangath, Goa, India
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Rahul Guda
- Addictions Research Group, Sangath, Goa, India
| | | | - Ankur Garg
- Addictions Research Group, Sangath, Goa, India
| | - Mehak Jolly
- Addictions Research Group, Sangath, Goa, India
| | - Lena S Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Sergiy Bogdanov
- Centre for Mental Health and Psychosocial Support, National University of Kyiv-Mohyla Academy, Kyiv, Ukraine
| | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Wietse A Tol
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,HealthRight International, New York, New York, USA.,Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Richard Velleman
- Addictions Research Group, Sangath, Goa, India.,Department of Psychology, University of Bath, Bath, UK
| | - Quincy Moore
- Centre for Mental Health and Psychosocial Support, National University of Kyiv-Mohyla Academy, Kyiv, Ukraine
| | - Daniela Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.,Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.,Health Sciences, University of Bremen, Bremen, Germany
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23
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Li S, Zhang D, Liu J, Su H, Guo L, Wu Q, Du J, Jiang H, Zhong N, Huang C, Chen T, Zhao M. The preliminary efficacy of virtual agent-assisted intelligent rehabilitation treatment (Echo app v2.0) in patients with alcohol use disorders: Study protocol for a randomized controlled trial. Digit Health 2023; 9:20552076231219432. [PMID: 38425746 PMCID: PMC10902404 DOI: 10.1177/20552076231219432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 03/02/2024] Open
Abstract
Background Alcohol use disorder (AUD) is one of the most common substance use disorders. People with AUD are in great need of highly accessible and comprehensive management, involving medicine, exercise, and psychotherapy. However, due to limited resources, providing comprehensive treatment for every patient is challenging. Virtual agent-assisted intelligent rehabilitation treatment can improve the accessibility of comprehensive management. Objectives This randomized controlled trial aims to test whether the virtual agent-assisted intelligent rehabilitation treatment (Echo-app-v2.0) plus treatment as usual (TAU) has greater efficacy than only TAU in AUD. Methods One hundred participants with AUD will be recruited and randomly assigned to either TAU or virtual agent-assisted intelligent rehabilitation treatment plus TAU based on the 1:1 ratio. The virtual agent-assisted intelligent rehabilitation treatment is delivered by the Echo app v2.0 developed by our research team. Participants will be assessed at baseline, week 4 of treatment, one month, and three months after the end of treatment. The primary outcome is the participants' craving for alcohol, measured by Visual Analogue Scale. Other outcomes include the use of alcohol, motivation for treatment, coping style, depression, anxiety, impulsivity, stress, and sleep quality. Discussion The virtual agent, with vivid human image, high privacy, and the ability to interact with users, has the potential to play an important role in the delivery of digital psychotherapy. The development of Echo app v2.0 has the possibility to raise the availability of comprehensive treatment for people with AUD.
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Affiliation(s)
- Shuo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dapeng Zhang
- Department of Psychiatry, Fuyang Third People's Hospital, Fuyang, China
| | - Jingyang Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianying Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuanning Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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Galkin SA, Bokhan NA. [Disorders of cognitive decision-making mechanisms related to reward in alcohol use disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:98-102. [PMID: 37084372 DOI: 10.17116/jnevro202312304198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To assess the relationship of disorders of cognitive decision-making mechanisms related to reward with clinical indicators of alcohol dependence. MATERIAL AND METHODS Forty-five patients with alcohol dependence were studied. A control group consisted of 30 age- and sex-matched healthy individuals. To quantify cognitive functions, the Go/NoGo task, the Balloon test (BART), the Cambridge Game Task (CGT) and the Iowa Game task (IGT) were used. The age of the first alcohol sample, the age of the beginning of systematic alcohol abuse, the average amount of alcohol consumption over the past month, the number of hospitalizations, the age of the first visit to a narcologist and the duration of the last remission were used as clinical indicators. RESULTS The indicators of executive functions are significantly reduced in patients with alcohol dependence compared with the control group. In the Go/NoGo task, patients have more errors, both on the Go signal (p=0.012) and on the NoGo signal (p=0.009). Significant differences in the group of patients with alcohol dependence from the control group were also revealed in CGT: patients had lower values of decision quality (QDM) (p=0.002), higher values of risk acceptance (OBR) (p=0.015), and they also needed more time to make decisions (DT) (p=0.012). It was also found that the age of the onset of systematic alcohol abuse directly correlates with the quality of decision-making in CGT (rs=0.407, p=0.048). CONCLUSION The results emphasize the importance of studying cognitive impairment in patients with alcohol dependence, since the severity of these disorders is associated with the clinical course of the disease.
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Affiliation(s)
- S A Galkin
- Mental Health Research Institute of the Tomsk National Research Medical Center of the Russian Academy of Science, Tomsk, Russia
| | - N A Bokhan
- Mental Health Research Institute of the Tomsk National Research Medical Center of the Russian Academy of Science, Tomsk, Russia
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26
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Castelo Branco FMF, de Vargas D. Alcohol use patterns and associated variables among the Karipuna indigenous people in the extreme Northern Brazilian Amazon. J Ethn Subst Abuse 2023; 22:29-44. [PMID: 33433294 DOI: 10.1080/15332640.2021.1871695] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this study was to identify the prevalence and patterns of alcohol consumption and associated factors in the Karipuna indigenous people. A cross-sectional population-based study was conducted with 230 Karipunan respondents aged 15 or over from 12 villages in the state of Amapá, in the extreme northern Brazilian Amazon. The participants completed the Alcohol Use Disorders Identification Test (AUDIT). The prevalence of alcohol use among the Karipuna was 70%. Of these, 59.6% had low-risk use, 38.3% had hazardous or harmful alcohol use, and 2.2% met criteria for probable alcohol dependence. Overall, 40.5% of the respondents had hazardous or harmful alcohol use; 66.6% were men, and 33.4% were women. In the regression analysis, age, sex, religion, not having an occupation, being a student, low educational attainment, suicidal ideation and having sexual intercourse after alcohol consumption were associated with hazardous or harmful alcohol use. Sex and Catholic religion were risk factors for this alcohol use pattern among the Karipuna. The prevalence of problematic alcohol use among the Karipuna is higher than that observed among the general Brazilian population, and preventive screenings should be widely implemented. Efforts to address and minimize the consequences of harmful and hazardous alcohol use among Brazilian Amazonian indigenous populations could be developed.
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Pautrat M, Le Guen A, Barrault S, Ribadier A, Ballon N, Lebeau JP, Brunault P. Impulsivity as a Risk Factor for Addictive Disorder Severity during the COVID-19 Lockdown: Results from a Mixed Quantitative and Qualitative Study. Int J Environ Res Public Health 2022; 20:705. [PMID: 36613025 PMCID: PMC9819473 DOI: 10.3390/ijerph20010705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Interindividual differences in personality traits, especially impulsivity traits, are robust risk factors for addictive disorders. However, their impact on addictive disorders during the COVID-19 lockdown remains unknown. This study assessed patients being followed for addictive disorders before the lockdown. We aimed to determine whether impulsivity traits (i.e., negative- and positive urgency) were associated with addictive disorders severity during the lockdowns. We also explored the patients' subjective experiences, focusing on high versus low impulsivity. The quantitative study assessed 44 outpatients consulting for addictive disorders, for impulsivity, emotion regulation, anxiety/depression, and their addictive disorder characteristics, using self-administered questionnaires. In the qualitative study, six patients from the quantitative study were assessed using guided interviews. We observed that higher negative and positive urgencies were associated with addictive disorder severity. The subjective experiences of patients during the lockdowns differed according to their emotion-related impulsivity: high versus low. Low impulsive patients used online technologies more effectively to maintain follow-up, with more positive reappraisal. In contrast, highly impulsive patients reverted more frequently to self-medication with substances and/or behaviors, more social isolation, and found coping with negative emotions more challenging. Overall, the patient's ability to cope with stressful events, like the COVID-19 lockdown, depended on their emotion-related impulsivity.
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Affiliation(s)
- Maxime Pautrat
- EA7505 Education Ethique Santé, University of Tours, 37000 Tours, France
- Department of General Practice, Tours Regional University Hospital, 37000 Tours, France
| | - Antoine Le Guen
- EA7505 Education Ethique Santé, University of Tours, 37000 Tours, France
| | - Servane Barrault
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France
- Laboratoire de Psychopathologie et Processus de Santé, Université de Paris, 92100 Boulogne Billancourt, France
- CHRU (Centre Hospitalier Régional Universitaire) de Tours, Service d’Addictologie Universitaire, CSAPA-37, 37000 Tours, France
| | - Aurélien Ribadier
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France
- Laboratoire de Psychopathologie et Processus de Santé, Université de Paris, 92100 Boulogne Billancourt, France
| | - Nicolas Ballon
- UMR 1253, iBrain, Université de Tours, INSERM, 37000 Tours, France
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37000 Tours, France
| | - Jean-Pierre Lebeau
- EA7505 Education Ethique Santé, University of Tours, 37000 Tours, France
- Department of General Practice, Tours Regional University Hospital, 37000 Tours, France
| | - Paul Brunault
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France
- UMR 1253, iBrain, Université de Tours, INSERM, 37000 Tours, France
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37000 Tours, France
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Muacevic A, Adler JR, Mishra P, Akilla R, Luther V. Accidental Acetone Ingestion in Liver Transplant Patient With Alcohol Relapse: A Case Report. Cureus 2022; 14:e32551. [PMID: 36654583 PMCID: PMC9840376 DOI: 10.7759/cureus.32551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Acetone is one of the three main types of ketone bodies that can be found in ketoacidosis, along with acetoacetate, and beta-hydroxybutyrate. Any of these three ketone bodies can be found in the blood after the natural breakdown of fatty acids in diabetes, starvation, or alcoholic ketoacidosis. However, a patient can also develop acetone poisoning from ingestion of common household products such as nail polish removers, paint removers, isopropyl alcohol, or other detergents and cleaners. Ingestion is usually accidental in adults and children and can lead to severe damage to the liver, heart, nervous system, and kidneys. In rare cases, large amounts of ingestion can lead to life-threatening conditions or death. Our case reports a man with a history of alcoholic cirrhosis status post liver transplantation, who unintentionally ingested acetone, mistaking the contents of small bottles for vodka. The patient presented with several syncopal episodes, anion gap metabolic acidosis, transaminitis with hyperbilirubinemia, and pancreatitis.
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Pavarin RM, Fioritti A, Fabbri C, Sanchini S, De Ronchi D. Comparison of Mortality Rates between Italian and Foreign-born Patients with Alcohol Use Disorders. J Psychoactive Drugs 2022; 54:471-481. [PMID: 34963415 DOI: 10.1080/02791072.2021.2014082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In Italy, although the number of foreign-born residents has grown exponentially, there are no data on mortality risk among migrants who have alcohol use disorders (AUDs). We examined the mortality risk and causes of death for natives and non-natives in a cohort of individuals treated for AUDs in Northern Italy in the period from 01/01/1975 to 31/12/2016. We highlight important characteristics of non-natives compared to Italians: 1) a younger age and a higher proportion of females; 2) a better health status; 3) a better social capital 4) a lower risk of death. We found differences in mortality between the various areas of origin, with a higher risk among participants born in Asia and African countries other than Mediterranean. The excess mortality compared to the reference population (SMRs) was at least three times for Italians and two times for migrants. While the non-native patients with AUDs have in general better health than Italians with AUDs, our results highlighted higher percentage of dropouts from treatment and lower access to Mental Health Services, suggesting that barriers to the access and completion of therapeutic programs still exist.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italian Society of Substance Abuse (SITD), Italy
| | - Angelo Fioritti
- Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italy
| | - Chiara Fabbri
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Samantha Sanchini
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Forli, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
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Ayares G, Idalsoaga F, Arnold J, Fuentes-López E, Arab JP, Díaz LA. Public Health Measures and Prevention of Alcohol-Associated Liver Disease. J Clin Exp Hepatol 2022; 12:1480-1491. [PMID: 36340308 PMCID: PMC9630023 DOI: 10.1016/j.jceh.2022.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/25/2022] [Indexed: 12/12/2022] Open
Abstract
Hazardous alcohol consumption causes approximately 4% of deaths globally, constituting one of the leading risk factors for the burden of the disease worldwide. Alcohol has several health consequences, such as alcohol-associated liver disease, hepatocellular carcinoma, nonliver neoplasms, physical injury, cardiac disease, and psychiatric disorders. Alcohol misuse significantly affects workforce productivity, with elevated direct and indirect economic costs. Due to the high impact of alcohol consumption on the population, public health has led to the development of a range of strategies to reduce its harmful effects. Regulatory public health policies (PHP) for alcohol can exist at the global, regional, international, national, or subnational levels. Effective strategies incorporate a multilevel, multicomponent approach, targeting multiple determinants of drinking and alcohol-related harms. The World Health Organization categorizes the PHP into eight categories: national plan to fight the harmful consequences of alcohol, national license and production and selling control, taxes control and pricing policies, limiting drinking age, restrictions on alcohol access, driving-related alcohol policies, control over advertising and promotion, and government monitoring systems. These policies are supported by evidence from different populations, demonstrating that determinants of alcohol use depend on several factors such as socioeconomic level, age, sex, ethnicity, production, availability, marketing, and others. Although most policies have a significant individual effect, a higher number of PHP are associated with a lower burden of disease due to alcohol. The excessive consequences of alcohol constitute a call for action, and clinicians should advocate for developing and implementing a new PHP on alcohol consumption.
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Key Words
- ACLF, Acute-on-Chronic Liver Failure
- ALD, Alcohol-associated Liver Disease
- AUC, Area Under the Curve
- AUD, Alcohol Use Disorder
- AUDIT, Alcohol Use Disorders Identification Test
- AUDIT-C, Alcohol Use Disorders Identification Test Concise
- AVT, Alcohol Volumetric Tax
- BAC, Blood Alcohol Concentration
- DALYs, Disability-adjusted life years
- GDP, Gross domestic product
- PHP, Public Health Policies
- PNPLA3, Patatin-like Phospholipase Domain-containing 3
- USA, United States
- USD, United States Dollars
- WHO, World Health Organization
- alcohol use disorders
- alcohol-associated hepatitis
- cirrhosis
- fatty liver disease
- steatosis
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Affiliation(s)
- Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Departamento de Ciencias de La Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan P. Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A. Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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31
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Jiang W, Chen J, Vidjro OE, Zhang Y, Guo G, Li Z, Qi Y, Dai R, Ma T. Construction and evaluation of an alcohol vapor chamber system. J Biomed Res 2022; 37:115-124. [PMID: 36529969 PMCID: PMC10018410 DOI: 10.7555/jbr.36.20220151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
An increasing number of studies demonstrated that alcohol vapor chamber is an effective way to model physical signs of alcohol use disorders. Although researchers are developing different vapor chambers to study chronic alcohol exposure model worldwide, few studies build and modify their own vapor chambers in China. Here, we designed and established an alcohol vapor chamber system for small animals. We described a paradigm showing how to control and monitor alcohol concentration in whole system. The vapor chamber system with several advantages including accommodating up to ten standard mouse cages. Furthermore, the system was tested by evaluating the blood alcohol concentration and neuron injury in mice. Importantly, the alcohol withdrawal after vapor exposure caused motor coordination impairment, anxiolytic- and depression-like behavior. Finally, the N-methyl-D-aspartate receptor (NMDAR)-mediated glutamatergic transmissions in the medial prefrontal cortex was changed after alcohol vapor exposure-induced behaviors. The frequency and amplitude of spontaneous excitatory postsynaptic currents between control and alcohol groups were not different, suggesting that alcohol exposure-induced behaviors are associated with the change in NMDAR response. Taken together, the new alcohol vapor chamber system was constructed, which would help to research the relationship between the stable alcohol exposure and withdrawal behaviors and to study chronic alcohol exposure-induced disorders in China.
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Affiliation(s)
- Wan Jiang
- Grade 2018, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Jiajia Chen
- Grade 2018, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Olivia Ewi Vidjro
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,Translational Medicine Research Center for Drug Dependence and Withdrawal, Nanjing Medical University, Jiangsu 211166, China
| | - Yingying Zhang
- Grade 2018, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Gengni Guo
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Ziyi Li
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,Translational Medicine Research Center for Drug Dependence and Withdrawal, Nanjing Medical University, Jiangsu 211166, China
| | - Yize Qi
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,Translational Medicine Research Center for Drug Dependence and Withdrawal, Nanjing Medical University, Jiangsu 211166, China
| | - Rouli Dai
- National Institute of Drug Clinical Trial, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210031, China
| | - Tengfei Ma
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,Translational Medicine Research Center for Drug Dependence and Withdrawal, Nanjing Medical University, Jiangsu 211166, China
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32
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Cedrone F, Buomprisco G, Nicola M, La Torre G, Nieto H, Perri R, Montagna V, Greco E, De Sio S. Alcohol Use during COVID-19 Pandemic: A Cross-Sectional Survey among Healthcare and Office Workers in Italy. Int J Environ Res Public Health 2022; 19:ijerph191912587. [PMID: 36231887 PMCID: PMC9566002 DOI: 10.3390/ijerph191912587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND The aim of our study of a sample of Italian healthcare (HCWs) and office workers (OWs) carried out during the pandemic period was to understand alcohol consumption patterns during the COVID-19 pandemic. METHODS A web-based cross-sectional survey based on Google Forms was developed. Harmful alcohol use was assessed through a validated questionnaire (AUDIT-C). Three multivariate logistic regression models were implemented for the overall sample of HCWs and OWs. The presence of harmful alcohol consumption (AUDIT-C score) was considered as a dependent variable. RESULTS A total of 1745 workers answered the survey. A lower risk of harmful drinking behavior among men overall and in both working groups was found (aOR 0.42, CI 95% 0.33-0.53), but also for both HCWs (aOR 0.62, CI 95% 0.46-0.84) and OWs (aOR 0.17, CI 95% 0.11-0.27). Comparing OWs and HCWs, we found a higher risk of harmful drinking in the first group (aOR 1.62, CI 95% 1.20-2.18). CONCLUSIONS The results of the survey indicate that unhealthy behaviors were elevated during the pandemic. It is urgent to implement company policies managed by an occupational doctor to raise workers' awareness of alcohol-related dangers and provide educational tools that have the task of preventing the damage caused by alcohol.
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Affiliation(s)
- Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65122 Pescara, Italy
| | - Giuseppe Buomprisco
- R.U. of Occupational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Mucci Nicola
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Hector Nieto
- Occupational Medicine School, University of Business and Social Sciences, Buenos Aires C1061 ABA, Argentina
| | - Roberto Perri
- R.U. of Occupational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Vincenzo Montagna
- Section of Hygiene, Department of Biomedical Science and Public Health, School of Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Emilio Greco
- Faculty of Innovative Technologies for Digital Communication, Link Campus University, Via del Casale di San Pio V 44, 00165 Roma, Italy
| | - Simone De Sio
- R.U. of Occupational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
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33
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Yamashita A, Yoshioka SI. Subjective recovery accounts of Japanese female patients suffering from alcohol use disorder. A phenomenological study. Perspect Psychiatr Care 2022; 58:2820-2827. [PMID: 35726722 DOI: 10.1111/ppc.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to examine the subjective recovery accounts of Japanese female patients with alcohol use disorder (AUD) and the factors that affect their recovery. DESIGN AND METHODS This qualitative study used a phenomenological design. A focus group with 10 Japanese participants was conducted. FINDINGS Five theme clusters emerged: drinking to forget unpleasant feelings, fighting compulsive cravings with craving, unhealed wounds from past traumatic experiences, encounters with role models in self-help groups, and changing one's mindset to a proactive pursuit of happiness. PRACTICE IMPLICATIONS To support the recovery of women with AUD, psychiatric nurses should help them improve their family relationships, find recovery models, and proactively provide them with trauma-informed care.
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Affiliation(s)
- Ayako Yamashita
- School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shin-Ichi Yoshioka
- School of Health Science, Faculty of Medicine, Tottori University, Yonago, Japan
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34
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Guiraud J, Addolorato G, Antonelli M, Aubin HJ, de Bejczy A, Benyamina A, Cacciaglia R, Caputo F, Dematteis M, Ferrulli A, Goudriaan AE, Gual A, Lesch OM, Maremmani I, Mirijello A, Nutt DJ, Paille F, Perney P, Poulnais R, Raffaillac Q, Rehm J, Rolland B, Rotondo C, Scherrer B, Simon N, Skala K, Söderpalm B, Somaini L, Sommer WH, Spanagel R, Vassallo GA, Walter H, van den Brink W. Sodium oxybate for the maintenance of abstinence in alcohol-dependent patients: An international, multicenter, randomized, double-blind, placebo-controlled trial. J Psychopharmacol 2022; 36:1136-1145. [PMID: 35796481 PMCID: PMC9548946 DOI: 10.1177/02698811221104063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sodium oxybate (SMO) has been shown to be effective in the maintenance of abstinence (MoA) in alcohol-dependent patients in a series of small randomized controlled trials (RCTs). These results needed to be confirmed by a large trial investigating the treatment effect and its sustainability after medication discontinuation. AIMS To confirm the SMO effect on (sustained) MoA in detoxified alcohol-dependent patients. METHODS Large double-blind, randomized, placebo-controlled trial in detoxified adult alcohol-dependent outpatients (80% men) from 11 sites in four European countries. Patients were randomized to 6 months SMO (3.3-3.9 g/day) or placebo followed by a 6-month medication-free period. Primary outcome was the cumulative abstinence duration (CAD) during the 6-month treatment period defined as the number of days with no alcohol use. Secondary outcomes included CAD during the 12-month study period. RESULTS Of the 314 alcohol-dependent patients randomized, 154 received SMO and 160 received placebo. Based on the pre-specified fixed-effect two-way analysis of variance including the treatment-by-site interaction, SMO showed efficacy in CAD during the 6-month treatment period: mean difference +43.1 days, 95% confidence interval (17.6-68.5; p = 0.001). Since significant heterogeneity of effect across sites and unequal sample sizes among sites (n = 3-66) were identified, a site-level random meta-analysis was performed with results supporting the pre-specified analysis: mean difference +32.4 days, p = 0.014. The SMO effect was sustained during the medication-free follow-up period. SMO was well-tolerated. CONCLUSIONS Results of this large RCT in alcohol-dependent patients demonstrated a significant and clinically relevant sustained effect of SMO on CAD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04648423.
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Affiliation(s)
- Julien Guiraud
- Department of Psychiatry, Amsterdam
Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The
Netherlands,D&A Pharma, Paris, France,Julien Guiraud, D&A Pharma, 7 rue
d’Aguesseau, Paris 75008, France. Emails:
;
| | - Giovanni Addolorato
- Alcohol Use Disorder and Alcohol
Related Disease Unit, Department of Internal Medicine and Gastroenterology,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Internal Medicine Unit,
Columbus-Gemelli Hospital, Department of Internal Medicine and Gastroenterology,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mariangela Antonelli
- Internal Medicine Unit,
Columbus-Gemelli Hospital, Department of Internal Medicine and Gastroenterology,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Henri-Jean Aubin
- French Institute of Health and Medical
Research (Inserm), Centre de Recherche en Epidémiologie et Santé des Populations
(CESP), Universite Paris-Saclay, Villejuif, France,Addiction Research and Treatment
Center, Paul Brousse Hospital, Paris-Sud University, Villejuif, France
| | - Andrea de Bejczy
- Section of Psychiatry and
Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy,
University of Gothenburg, Goteborg, Sweden
| | - Amine Benyamina
- Addiction Research and Treatment
Center, Paul Brousse Hospital, Paris-Sud University, Villejuif, France
| | | | - Fabio Caputo
- Department of Internal Medicine, SS.
Annunziata Hospital, Cento (Ferrara), University of Ferrara, Italy,Centre for the Study and Treatment of
Alcohol-Related Diseases, Department of Translational Medicine, University of
Ferrara, Ferrara, Italy
| | - Maurice Dematteis
- Department of Addiction Medicine,
Grenoble-Alpes University Hospital, and Faculty of Medicine, Grenoble Alpes
University, France
| | - Anna Ferrulli
- Department of Endocrinology,
Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy,Department of Biomedical Sciences for
Health, University of Milan, Milan, Italy
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam
University Medical Centers, University of Amsterdam, Amsterdam, The
Netherlands,Arkin, Department of Research and
Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The
Netherlands
| | - Antoni Gual
- Psychiatry Department, Neurosciences
Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Otto-Michael Lesch
- University Clinic of Psychiatry and
Psychotherapy, Department of Social Psychiatry, Medical University of Vienna,
Austria
| | - Icro Maremmani
- Santa Chiara University Hospital,
University of Pisa, Italy
| | - Antonio Mirijello
- Department of Medical Sciences, IRCCS
Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo (FG),
Italy
| | - David J Nutt
- Centre for Neuropsychopharmacology,
Imperial College London, United Kingdom
| | - François Paille
- Department of Addiction Treatment,
University Hospital, Vandoeuvre-lès-Nancy, France
| | | | | | | | - Jürgen Rehm
- Institute for Mental Health Policy
Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Dalla Lana
School of Public Health, University of Toronto, Toronto, Ontario, Canada,Clinical Psychology &
Psychotherapy Technical University Dresden, Dresden, Germany,Department of International Health
Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow
State Medical University, Moscow, Russia
| | - Benjamin Rolland
- SUAL, HCL, CH Le Vinatier; Univ Lyon;
UCBL; INSERM U1028; CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon
(CRNL), Bron, France
| | - Claudia Rotondo
- Centro di Riferimento Alcologico
della Regione Lazio (CRARL), Dipartimento di Salute Mentale, Roma, Italy
| | - Bruno Scherrer
- Bruno Scherrer Conseil, Saint Arnoult
en Yvelines, France
| | - Nicolas Simon
- Aix Marseille Univ, APHM, INSERM,
IRD, SESSTIM, Hop Sainte Marguerite, Department of Clinical Pharmacology, CAP-TV,
Marseille, France
| | - Katrin Skala
- Department of Child and Adolescent
Psychiatry, Medical University of Vienna, Austria
| | | | - Lorenzo Somaini
- Addiction Treatment Center, Local
Health Unit, ASL Biella, Italy
| | - Wolfgang H Sommer
- Medical Faculty, Institute of
Psychopharmacology, Central Institute of Mental Health, University of Heidelberg,
Mannheim, Germany,Institute of Psychopharmacology,
Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Rainer Spanagel
- Institute of Psychopharmacology,
Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | | | | | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Centers, University of Amsterdam, Amsterdam, The
Netherlands
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35
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Wakabayashi M, Sugiyama Y, Takada M, Kinjo A, Iso H, Tabuchi T. Loneliness and Increased Hazardous Alcohol Use: Data from a Nationwide Internet Survey with 1-Year Follow-Up. Int J Environ Res Public Health 2022; 19:ijerph191912086. [PMID: 36231395 PMCID: PMC9566210 DOI: 10.3390/ijerph191912086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 06/01/2023]
Abstract
We aimed to examine the association between loneliness and developing alcohol dependence or hazardous alcohol use. A cohort study was conducted utilizing data from a nationwide internet survey in 2021 and 2022 in Japan. A total of 15,854 follow-up participants (55% men, with a mean age of 52.8 years) were divided based on AUDIT scores: nondrinkers (AUDIT: 0), low-risk drinkers (AUDIT: 1-7), medium-risk drinkers (AUD: 8-14), high-risk drinkers (AUDIT: 15-19), and probable alcohol dependence (AUDIT: 20-40). The University of California, Los Angeles Loneliness Scale (Version 3), a short-form three-item scale, was used to assess loneliness (high loneliness score of ≥6). The prevalence of high loneliness was higher in nondrinkers than that in low- and medium-risk drinkers, i.e., 22%, 18%, and 17%, respectively, as well as in high-risk drinkers (32%) and those with probable alcohol dependence (43%) compared to non-high-risk drinkers (19%). After adjusting for various factors (sociodemographic, social isolation, psychological distress, and smoking), non-high-risk drinkers (AUDIT: 0-14) with high loneliness were more likely to become high-or-over-risk drinkers (AUDIT: 15-40) than those without high loneliness, with adjusted risk ratios of 1.45 (95% confidence interval: 1.08-1.96) through multivariable binary logistic regression. Among non-high-risk drinkers, people with high loneliness scores at baseline were associated with increased high-risk drinking patterns with probable alcohol dependence.
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Affiliation(s)
- Mami Wakabayashi
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo 162-8655, Japan
| | - Yoshifumi Sugiyama
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Midori Takada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka 536-8588, Japan
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo 162-8655, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan
- The Tokyo Foundation for Policy Research, Tokyo 106-6234, Japan
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36
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Ayares G, Idalsoaga F, Díaz LA, Arnold J, Arab JP. Current Medical Treatment for Alcohol-Associated Liver Disease. J Clin Exp Hepatol 2022; 12:1333-1348. [PMID: 36157148 PMCID: PMC9499849 DOI: 10.1016/j.jceh.2022.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/06/2022] [Indexed: 12/12/2022] Open
Abstract
Alcohol-associated liver disease is one of the main causes of chronic liver disease. It comprises a clinical-histologic spectrum of presentations, from steatosis, steatohepatitis, to different degrees of fibrosis, including cirrhosis and severe necroinflammatory disease, called alcohol-associated hepatitis. In this focused update, we aim to present specific therapeutic interventions and strategies for the management of alcohol-associated liver disease. Current evidence for management in all spectra of manifestations is derived from general chronic liver disease recommendations, but with a higher emphasis on abstinence and nutritional support. Abstinence should comprise the treatment of alcohol use disorder as well as withdrawal syndrome. Nutritional assessment should also consider the presence of sarcopenia and its clinical manifestation, frailty. The degree of compensation of the disease should be evaluated, and complications, actively sought. The most severe acute form of this disease is alcohol-associated hepatitis, which has high mortality and morbidity. Current treatment is based on corticosteroids that act by reducing immune activation and blocking cytotoxicity and inflammation pathways. Other aspects of treatment include preventing and treating hepatorenal syndrome as well as preventing infections although there is no clear evidence as to the benefit of probiotics and antibiotics in prophylaxis. Novel therapies for alcohol-associated hepatitis include metadoxine, interleukin-22 analogs, and interleukin-1-beta antagonists. Finally, granulocyte colony-stimulating factor, microbiota transplantation, and gut-liver axis modulation have shown promising results. We also discuss palliative care in advanced alcohol-associated liver disease.
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Key Words
- AC, Amoxicillin/clavulanate
- ACLF, Acute-on-Chronic Liver Failure
- ADLs, Activities of Daily Living
- AH, Alcohol-Associated Hepatitis
- AKI-HRS, Acute Kidney Injury - Hepatorenal Syndrome
- ALD
- ALD, Alcohol-Associated Liver Disease
- ASH, Alcoholic Steatohepatitis
- AUD, Alcohol Use Disorder
- AWS, Alcohol Withdrawal Syndrome
- BCAAs, Branched-Chain Amino Acids
- CDC, Center for Disease Control
- CI, Confidence Interval
- COVID-19, Coronavirus Disease 2019
- CT, Computerized Tomography
- GABA, gamma-aminobutyric acid agonist
- HBV, Hepatitis B Virus
- HCC, Hepatocellular Carcinoma
- HCV, Hepatitis C Virus
- HE, Hepatic Encephalopathy
- HIV, Human Immunodeficiency Virus
- HR, Hazard Ratio
- IBW, Ideal Body Weight
- ICA, International Club of Ascites
- IL-1β, Interleukin-1β
- IL-22, Interleukin-22
- KPS, Karnofsky Performance Status
- LB, Liver Biopsy
- LPS, Lipopolysaccharide
- LSM, Liver Stiffness Measurement
- LT, Liver Transplantation
- MDF, Maddrey’s Discriminant Function
- MELD, Model of End-Stage Liver Disease
- MRI, Magnetic Resonance Imaging
- MUST, Malnutrition Universal Screening Tool
- NIAAA, National Institute on Alcohol Abuse and Alcoholism
- NRS-2002, Nutritional Risk Screening-2002
- OR, Odds Ratio
- PAMPs, Pathogen-Activated Molecular Patterns
- PMI, Psoas Muscle Index
- PTX, Pentoxifylline
- RAI, Relative Adrenal Insufficiency
- RCT, Randomized Clinical Trials
- RFH-NPT, Royal Free Hospital-Nutritional Prioritizing Tool
- ROS, Reactive Oxygen Species
- RR, Relative Risk
- SIRS, Systemic Inflammatory Response Syndrome
- TNF, Tumor Necrosis Factor
- WKS, Wernicke-Korsakoff Syndrome
- alcohol
- alcohol use disorders
- alcohol-associated hepatitis
- cirrhosis
- fatty liver disease
- steatosis
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Affiliation(s)
- Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A. Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan P. Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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37
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Singh R, Goyal E, Chaudhury S, Puria A, Kumar S, Kumar A. Psychiatric morbidity in family members of alcohol dependence patients. Ind Psychiatry J 2022; 31:306-312. [PMID: 36419709 PMCID: PMC9678177 DOI: 10.4103/ipj.ipj_179_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/25/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There is a paucity of Indian studies assessing psychiatric morbidity among family members of subjects with alcohol use disorder. AIM To study psychiatric morbidity in wives/life partners and children of alcohol-dependent patients. MATERIALS AND METHODS Fifty consecutive index patients diagnosed to be alcohol dependent according to the International Classification of Diseases-10 classification of mental and behavioral disorders diagnostic criterion for research reporting to psychiatry department were taken. The study was conducted on family members of alcohol-dependent patients who were enrolled in the study as subjects. These included both their children and spouses and they were evaluated for any psychopathology using M. I. N. I. AND M. I. N. I.-KID scales. RESULTS Out of 50 spouses and 67 children enrolled in the study group. Sixty-eight percent had psychiatric morbidity in spouses which include 34% had major depressive episodes. Spouses living in the nuclear family and illiterate had more psychiatric morbidity. Total psychiatric morbidity in children above 18 years was 56.25%, maximum being in alcohol and substance dependence. Total psychiatric morbidity in children between 6 years and 18 years was 31.37%, maximum being in generalized anxiety disorder (11.76%). CONCLUSION Spouses of subjects with alcohol dependence have a high prevalence of psychiatric morbidity. Spouses living in the nuclear family had a more major depressive episode and generalized anxiety disorder. Psychiatric morbidity was more in illiterate spouses. Psychiatric morbidity was also high in children. Female children between 6 years and 18 years had more generalized anxiety disorder than males.
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Affiliation(s)
- Rahul Singh
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | - Ekram Goyal
- Department of Psychiatry, DR.B.R.Ambedkar State Institute of Medical Sciences, Mohali, Punjab, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Alka Puria
- Department of Biochemistry, DMCH, Darbhanga, Bihar, India
| | - Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Ajay Kumar
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
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Gilmore W, Symons M, Liang W, Graham K, Kypri K, Miller P, Chikritzhs T. Association between Bar Closing Time, Alcohol Use Disorders and Blood Alcohol Concentration: A Cross-Sectional Observational Study of Nightlife-Goers in Perth, Australia. Int J Environ Res Public Health 2022; 19. [PMID: 35742275 DOI: 10.3390/ijerph19127026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023]
Abstract
Introduction and aims: Associations between bar trading hours, a government lever for controlling alcohol availability, nightlife-goer intoxication levels and their likelihood of alcohol use disorder (AUD) have not been explored. We investigated whether: (i) participant AUD was associated with blood alcohol concentration (BAC); and, (ii) any association between AUD and BAC was moderated by participant preferred bar (i.e., venue spent most time at) closing time. Design and methods: A cross-sectional observational study using a sample of nightlife-goers who went out drinking in Perth, Western Australia, on weekends in 2015-16. Participants who reported alcohol use that night and spent most time in a bar (n = 667) completed street intercept surveys including AUDIT-C (n = 459) and provided a breath sample to estimate BAC (n = 651). We used gender-specific multinomial logistic regression models to explore associations between participant AUDIT-C score (1−4, lower risk; 5−7, hazardous; 8−12, active AUD), preferred bar type (standard vs. late closing time based on absence or presence of an extended trading permit) and BAC (male: 0−0.049, 0.05−0.099, ≥0.1 g/100 mL; female: 0−0.049, 0.05−0.079, ≥0.08 g/100 mL). Results: Males with active AUD (RR = 3.31; 95% CI 1.30−8.42; p = 0.01) and females with hazardous/active AUD (RR = 9.75; 95% CI 2.78−34.21; p < 0.001) were both more likely to have high-range BAC than their counterparts typically drinking at lower risk. We also found preferred bar type moderated the association between AUDIT-C score and BAC for some males but no females. Males with active AUD and high-range BAC were less likely to prefer late closing bars than males usually drinking at lower risk and high-range BAC (RR = 0.12; 95% CI 0.02−0.96; p = 0.046). Discussion and conclusions: Our study provides evidence of positive associations between AUD and acute intoxication among nightlife-goers and on the moderating effect of bar closing times among males.
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Rehm J, Shield KD, Bunova A, Ferreira‐Borges C, Franklin A, Gornyi B, Rovira P, Neufeld M. Prevalence of alcohol use disorders in primary health-care facilities in Russia in 2019. Addiction 2022; 117:1640-1646. [PMID: 35072306 PMCID: PMC9305418 DOI: 10.1111/add.15816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
AIMS To estimate prevalence of alcohol use disorders (AUD) and alcohol dependence (AD) for Russia in 2019, based on clients in primary health-care facilities. DESIGN Cross-sectional assessment of AUD and AD. Prevalence estimates were cross-validated using a treatment multiplier methodology. SETTING A total of 21 primary health-care facilities, including dispanserization units (population health preventive care settings). PARTICIPANTS A total of 2022 participants (986 women and 1036 men) 18 years of age and older. MEASUREMENTS Composite International Diagnostic Interview. FINDINGS The prevalence of AD and AUD was 7.0% [95% confidence interval (CI) = 5.9-8.1%] and 12.2% (95% CI = 10.8-13.6%), respectively. Marked sex differences were observed for the prevalence of AD (women: 2.8%; 95% CI = 1.7-3.8%; men: 12.2%; 95% CI = 10.3-14.1%) and AUD (women: 6.1%; 95% CI = 4.6-7.7%; men: 19.5%; 95% CI = 17.2-21.8%). Age patterns of AD and AUD prevalence were sex-specific. Among women, the prevalence of AUD and AD was highest in the youngest age group and decreased with age. Among men, the prevalence of AUD and AD was highest among men aged 45-59 years. Sensitivity analyses indicated that the prevalence of AD as estimated using a treatment multiplier (6.5%; 95% CI = 5.0-8.9%) was similar to the estimates of the main analysis. CONCLUSIONS Even though alcohol use has declined since 2003 in Russia, the prevalence of alcohol use disorders and alcohol dependence remains high at approximately 12 and 7%, respectively.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada,Dalla Lana School of Public Health and Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Department of Psychiatry, Faculty of MedicineUniversity of TorontoTorontoOntarioCanada,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany,Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthTorontoOntarioCanada,Faculty of Medicine, Institute of Medical ScienceUniversity of TorontoTorontoOntarioCanada,Program on Substance Abuse and World Health Organization (WHO) CC, Public Health Agency of CataloniaBarcelonaSpain,I. M. Sechenov First Moscow State Medical University (Sechenov University)MoscowRussia
| | - Kevin D. Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada,Dalla Lana School of Public Health and Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian FederationMoscowRussia
| | - Carina Ferreira‐Borges
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable DiseasesMoscowRussia
| | - Ari Franklin
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian FederationMoscowRussia
| | - Pol Rovira
- Program on Substance Abuse and World Health Organization (WHO) CC, Public Health Agency of CataloniaBarcelonaSpain
| | - Maria Neufeld
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada,Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany,World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable DiseasesMoscowRussia
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Joseph J, Varghese A, Vijay VR, Grover S, Sharma S, Dhandapani M, Khakha DC, Arya S, Mahendia N, Varkey BP, Kishore K. The prevalence of alcohol use disorders using alcohol use disorders identification test (AUDIT) in the Indian setting: - a systematic review and meta-analysis. J Ethn Subst Abuse 2022; 23:2-20. [PMID: 35404781 DOI: 10.1080/15332640.2022.2056105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is a wide discrepancy in the epidemiology of alcohol use disorders (AUDs) due to diverse scales and survey approaches. We estimated the prevalence of AUDs by comparing the pooled prevalence based on the alcohol use disorders identification test (AUDIT) Vs. non-AUDIT (all scales other than AUDIT). This review searched the community-based prevalence of AUDs in PubMed, Web of Science, PsycINFO, Scopus, Ovid, and Google Scholar. Articles published during the years from 2000 to 2020 were included. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated, and the publication bias was evaluated. Twenty-one studies conducted in different states of India included 73997 community-based respondents, which estimated the overall prevalence of AUDs as 12.5% (95% CI: 9 to 17.3%). The pooled prevalence based on AUDIT was 12.4% (AUDIT ≥8; 95% CI: 8.8 to 17.1%) in which the magnitude of hazardous and harmful alcohol use (8.6%; 95% CI: 5.7 to 12.8%; AUDIT 8-19) was significantly higher than dependent alcohol use (2.3%; 95% CI: 1.1 to 4.8%; AUDIT ≥ 20). The pooled prevalence using the non-AUDIT tool was 14.2(95%; CI: 6-30%). Our findings further reveal that about one in twelve of the population of India have AUDs, and there is a gross variation in the patterns of alcohol use across the country. The high prevalence of AUDs suggests developing a national policy to benefit alcohol use, justifying regional variations.Supplemental data for this article is available online at https://doi.org/10.1080/15332640.2022.2056105 .
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Affiliation(s)
- Jaison Joseph
- Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Abin Varghese
- All India Institute of Medical Sciences, Nagpur, India
| | - V R Vijay
- AIl India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Sandeep Grover
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Suresh Sharma
- All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Manju Dhandapani
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Deepika C Khakha
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sidharth Arya
- Institute of Mental Health, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Neeraj Mahendia
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Biji P Varkey
- Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Kamal Kishore
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Wittgens C, Fischer MM, Buspavanich P, Theobald S, Schweizer K, Trautmann S. Mental health in people with minority sexual orientations: A meta-analysis of population-based studies. Acta Psychiatr Scand 2022; 145:357-372. [PMID: 35090051 DOI: 10.1111/acps.13405] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 12/23/2022]
Abstract
AIMS To conduct a meta-analysis of population-based studies to quantify the association between sexual minority status (lesbian women, gay men, and bisexual people) and the risk of common mental disorders (depressive disorders, alcohol use disorders (AUD), anxiety disorders, and suicidality). METHOD PubMed, PsycInfo, Web of Science, the Cochrane Library Database, the Applied Social Sciences Index and Abstracts, and ProQuest were searched for relevant studies published between 2000 and May 2020. The PRISMA guidelines were followed for selection processes. Twenty-six studies met the inclusion criteria which included a total of 519,414 heterosexuals, 10,178 lesbian/gay people and 14,410 bisexual people. RESULTS Lesbian/gay people (ORs between 1.97, 95% [CI = 1.76, 2.19] and 2.89, 95% [CI = 2.41,3.38]) and bisexual people (ORs between 2.70; 95% [CI = 2.21,3.18], and 4.81; 95% [CI = 3.63, 5.99]) had a higher risk for mental disorders than heterosexuals for all investigated diagnostic categories. The risk for depression (OR = 2.70; 95% [CI = 2.21, 3.18]) and suicidality (OR = 4.81; 95% [CI = 3.63, 5.99]) was higher in bisexual compared with lesbian/gay people. Exploratory meta-regressions revealed no evidence for a decrease in mental health differences between people with minority sexual orientations and heterosexuals in more recent years of data assessment, except for AUD. CONCLUSIONS These findings clearly suggest disparities in mental health between people with minority sexual orientations and heterosexual people. There is a lack of data regarding a wider spectrum of sexual orientations and mental disorders and studies in non-Western countries.
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Affiliation(s)
- Charlotte Wittgens
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Mirjam M Fischer
- Institute of Sociology and Social Psychology (ISS), Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Pichit Buspavanich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Theobald
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Katinka Schweizer
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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Lai D, Johnson EC, Colbert S, Pandey G, Chan G, Bauer L, Francis MW, Hesselbrock V, Kamarajan C, Kramer J, Kuang W, Kuo S, Kuperman S, Liu Y, McCutcheon V, Pang Z, Plawecki MH, Schuckit M, Tischfield J, Wetherill L, Zang Y, Edenberg HJ, Porjesz B, Agrawal A, Foroud T. Evaluating risk for alcohol use disorder: Polygenic risk scores and family history. Alcohol Clin Exp Res 2022; 46:374-383. [PMID: 35267208 PMCID: PMC8928056 DOI: 10.1111/acer.14772] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Early identification of individuals at high risk for alcohol use disorder (AUD) coupled with prompt interventions could reduce the incidence of AUD. In this study, we investigated whether Polygenic Risk Scores (PRS) can be used to evaluate the risk for AUD and AUD severity (as measured by the number of DSM-5 AUD diagnostic criteria met) and compared their performance with a measure of family history of AUD. METHODS We studied individuals of European ancestry from the Collaborative Study on the Genetics of Alcoholism (COGA). DSM-5 diagnostic criteria were available for 7203 individuals, of whom 3451 met criteria for DSM-IV alcohol dependence or DSM-5 AUD and 1616 were alcohol-exposed controls aged ≥21 years with no history of AUD or drug dependence. Further, 4842 individuals had a positive first-degree family history of AUD (FH+), 2722 had an unknown family history (FH?), and 336 had a negative family history (FH-). PRS were derived from a meta-analysis of a genome-wide association study of AUD from the Million Veteran Program and scores from the problem subscale of the Alcohol Use Disorders Identification Test in the UK Biobank. We used mixed models to test the association between PRS and risk for AUD and AUD severity. RESULTS AUD cases had higher PRS than controls with PRS increasing as the number of DSM-5 diagnostic criteria increased (p-values ≤ 1.85E-05 ) in the full COGA sample, the FH+ subsample, and the FH? subsample. Individuals in the top decile of PRS had odds ratios (OR) for developing AUD of 1.96 (95% CI: 1.54 to 2.51, p-value = 7.57E-08 ) and 1.86 (95% CI: 1.35 to 2.56, p-value = 1.32E-04 ) in the full sample and the FH+ subsample, respectively. These values are comparable to previously reported ORs for a first-degree family history (1.91 to 2.38) estimated from national surveys. PRS were also significantly associated with the DSM-5 AUD diagnostic criterion count in the full sample, the FH+ subsample, and the FH? subsample (p-values ≤6.7E-11 ). PRS remained significantly associated with AUD and AUD severity after accounting for a family history of AUD (p-values ≤6.8E-10 ). CONCLUSIONS Both PRS and family history were associated with AUD and AUD severity, indicating that these risk measures assess distinct aspects of liability to AUD traits.
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Affiliation(s)
- Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Sarah Colbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Lance Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - Meredith W. Francis
- The Brown School of Social Work, Washington University School of Medicine, St. Louis, MO
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - John Kramer
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Sally Kuo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Vivia McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Zhiping Pang
- Department of Neuroscience and Cell Biology, Child Health Institute of New Jersey, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Martin H. Plawecki
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Marc Schuckit
- Department of Psychiatry, University of California, San Diego Medical School, San Diego, CA
| | - Jay Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Yong Zang
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Howard J. Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
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Constant A, Sanz M, Moirand R. Predictors of Short-Term Alcohol Drinking in Patients with Alcohol Use Disorders during the Third Wave of the COVID-19 Pandemic: Prospective Study in Three Addiction Outpatient Centers in France. Int J Environ Res Public Health 2022; 19:1948. [PMID: 35206137 DOI: 10.3390/ijerph19041948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/27/2022] [Accepted: 01/30/2022] [Indexed: 12/12/2022]
Abstract
The present study investigates the extent to which the COVID-19 crisis disturbed different life domains of patients with alcohol use disorder (AUD) and assessed the associations between these disturbances and the risk of short-term alcohol drinking. All patients aged >18 years receiving outpatient care at three addiction treatment facilities from 15 April to 30 May 2021 were eligible for inclusion in the study. A trained resident assessed the extent to which the COVID-19 crisis affected their professional activity, social life, access to healthcare, and drinking problems, together with craving, drinking behavior, psychological distress, physical/mental health, and sociodemographic and clinical data. The same investigator assessed alcohol drinking 1 month after their visit. Nearly half of the patients felt that the COVID-19 crisis had a serious impact on their drinking problems, despite minor disruptions in access to healthcare. These disturbances significantly influenced short-term alcohol drinking in univariate analysis, together with psychological distress, craving, and drinking problems. Only craving predicted alcohol drinking in multivariate analyses, suggesting that psychological and drinking problems, as well as COVID-19 disturbances, increased the risk of alcohol drinking by increasing craving. Craving should be systematically investigated in patients with AUD to establish adapted social support systems during pandemics.
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Mallet V, Parlati L, Martinino A, Scarano Pereira JP, Jimenez CN, Sakka M, Bouam S, Retbi A, Krasteva D, Meritet JF, Schwarzinger M, Thabut D, Rufat P, Bonnefont-Rousselot D, Sogni P, Pol S, Tsochatzis E; Demosthenes research group. Burden of liver disease progression in hospitalized patients with type 2 diabetes mellitus. J Hepatol 2022; 76:265-74. [PMID: 34606913 DOI: 10.1016/j.jhep.2021.09.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND & AIMS There are uncertainties regarding the burden of liver disease in patients with type 2 diabetes (T2D). Thus, we aimed to quantify the burden of liver disease, identify risk factors, and estimate attributable risks in patients with T2D. METHODS We measured adjusted hazard ratios of liver disease progression to hepatocellular carcinoma and/or decompensated cirrhosis in a 2010-2020 retrospective, bicentric, longitudinal, cohort of 52,066 hospitalized patients with T2D. RESULTS Mean age was 64±14 years and 58% were men. Alcohol use disorders accounted for 57% of liver-related complications and were associated with all liver-related risk factors. Non-metabolic liver-related risk factors accounted for 37% of the liver burden. T2D control was not associated with liver disease progression. The incidence (95% CI) of liver-related complications and of competing mortality were 3.9 (3.5-4.3) and 27.8 (26.7-28.9) per 1,000 person-years at risk, respectively. The cumulative incidence of liver disease progression exceeded the cumulative incidence of competing mortality only in the presence of well-identified risk factors of liver disease progression, including alcohol use. The incidence of hepatocellular carcinoma was 0.3 (95% CI 0.1-0.5) per 1,000 person-years in patients with obesity and it increased with age. The adjusted hazard ratios of liver disease progression were 55.7 (40.5-76.6), 3.5 (2.3-5.2), 8.9 (6.9-11.5), and 1.5 (1.1-2.1), for alcohol-related liver disease, alcohol use disorders without alcohol-related liver disease, non-metabolic liver-related risk factors, and obesity, respectively. The attributable fractions of alcohol use disorders, non-metabolic liver-related risk factors, and obesity to the liver burden were 55%, 14%, and 7%, respectively. CONCLUSIONS In this analysis of data from 2 hospital-based cohorts of patients with T2D, alcohol use disorders, rather than obesity, contributed to most of the liver burden. These results suggest that patients with T2D should be advised to drink minimal amounts of alcohol. LAY SUMMARY There is uncertainty on the burden of liver-related complications in patients with type 2 diabetes. We studied the risks of liver cancer and complications of liver disease in over 50,000 patients with type 2 diabetes. We found that alcohol was the main factor associated with complications of liver disease. This finding has major implications on the alcohol advice given to patients with type 2 diabetes.
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Tan HT, Lui YS, Peh LH, Winslow RM, Guo S. Examining the Attitudes of Non-Psychiatric Practicing Healthcare Workers Towards Patients With Alcohol Problems in General Hospital Setting. Subst Abuse 2022; 16:11782218211065755. [PMID: 35035219 PMCID: PMC8753239 DOI: 10.1177/11782218211065755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 11/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Problematic alcohol-use affect the physical and mental well-being of hospitalised individuals and may receive screening and brief-intervention during treatment. Non-psychiatric doctors and nurses might respond inadequately due to negative attitudes and beliefs. This study aimed to examine these attitudes of non-psychiatric workers in the medical and surgical wards. METHODS A total of 457 doctors and 1643 nurses were recruited from the medical, surgical and orthopaedic disciplines over a period of 4 months. Three questionnaires were administered: demographics, Alcohol & Alcohol-Problems Perceptions Questionnaire (AAPPQ) and Staff Perception of Alcohol Treatment Resources. RESULTS About 128 doctors and 785 nurses responded. Around 75.5% doctors and 51.9% nurses endorsed role-legitimacy in the AAPPQ. Both the doctor (86.7%) and nurse (77.6%) groups agreed on the importance to initiate intervention for patients with problematic alcohol-use in daily work. Both groups were sceptical and negative towards these patients endorsing low-level role-adequacy (41.2%), role-support (36.9%), motivation (36.5%), task-specific self-esteem (25.1) as well as work satisfaction (20.5%). CONCLUSION/DISCUSSION Doctors and nurses demonstrated low levels of therapeutic commitments towards patients with problematic alcohol-use thereby necessitating the introduction of in-house programmes to educate, empower and emphasise the importance of therapeutic contact with patients for alcohol intervention. SCIENTIFIC SIGNIFICANCE The prompt identification and treatment of patients with alcohol problems are contingent on the workers' attitudes towards them. This study's results should spark a nation-wide interest to improve the training and recognition of such patients and providing adequate educational resources.
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Affiliation(s)
- Ho Teck Tan
- Department of Psychological Medicine,
National University Hospital, Singapore
| | - Yit Shiang Lui
- Department of Psychological Medicine,
National University Health System, Singapore
| | - Lai Huat Peh
- Department of Psychological Medicine,
Changi General Hospital, Singapore
| | | | - Song Guo
- National Addictions Management Service,
Institute of Mental Health, Singapore
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Peltier MR, Roberts W, Verplaetse TL, Zakiniaeiz Y, Burke C, Moore KE, McKee SA. Sex Differences across Retrospective Transitions in Posttraumatic Stress and Substance Use Disorders. J Dual Diagn 2022; 18:11-20. [PMID: 34965199 PMCID: PMC9086923 DOI: 10.1080/15504263.2021.2016027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: Concurrent substance use disorder (SUD) and posttraumatic stress disorder (PTSD) occur at high rates and are typically associated with poor treatment outcomes in both sexes. However, women have a propensity to cope with increased negative affect via substance use in comparison to men; thus, it is important to elucidate the sex-specific bidirectional relationships between SUD and PTSD to improve our understanding of concurrent SUD/PTSD in men and women. Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-Wave 3; n = 36,309), the present study evaluated the impact of sex on the relationship between past-year SUDs (new, remitted, ongoing), including alcohol and drug use, and retrospective transitions in new vs. absent and ongoing vs. remitted diagnoses of PTSD. Additionally, the impact of sex was explored in models examining past year PTSD (new, remitted, ongoing) and retrospective transitions in new vs. absent and ongoing vs. remitted diagnosis of SUDs. Diagnostic transitions were based on retrospective reporting. Results: Results indicated that new, remitted, and ongoing SUDs increase the likelihood of new PTSD diagnoses (OR range = 2.53-8.11; p < 0.05). Among individuals with ongoing drug use disorders (DUD), there were greater odds of ongoing PTSD (OR = 2.10, p < 0.01). When examining the relationship reciprocally, new, remitted, and ongoing PTSD increased the likelihood of new SUDs (OR range = 2.50-8.22; p < 0.05), and ongoing PTSD increased the likelihood of ongoing SUD and DUD (OR = 1.40, 1.70, respectively; p < 0.05). Sex-specific analyses revealed that the relationship between PTSD and SUDs varies between sexes, particularly among women. For instance, women with new PTSD had higher odds of SUDs, and women with ongoing PTSD were almost 2.5 times more likely to have an ongoing DUD. Women with a new PTSD diagnosis were more likely to be diagnosed with a new SUD (OR = 3.27) and an ongoing DUD (OR = 3.08). Conclusions: Results indicate a bidirectional relationship between PTSD and SUD that is in many instances larger in women. Thus, illustrating potential sex-specific differences in underlying mechanisms implicated in SUD/PTSD, warranting additional research.
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Affiliation(s)
- MacKenzie R Peltier
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Terril L Verplaetse
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Yasmin Zakiniaeiz
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Catherine Burke
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kelly E Moore
- Department of Psychology, Eastern Tennessee State University, Johnson City, Tennessee, USA
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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Nadkarni A, Tu A, Garg A, Gupta D, Gupta S, Bhatia U, Tiwari N, Heath A, Wen K, Fernandes G, Velleman R. Alcohol use among adolescents in India: a systematic review. Glob Ment Health (Camb) 2022; 9:1-25. [PMID: 36618747 DOI: 10.1017/gmh.2021.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Alcohol use is typically established during adolescence and initiation of use at a young age poses risks for short- and long-term health and social outcomes. However, there is limited understanding of the onset, progression and impact of alcohol use among adolescents in India. The aim of this review is to synthesise the evidence about prevalence, patterns and correlates of alcohol use and alcohol use disorders in adolescents from India. METHODS Systematic review was conducted using relevant online databases, grey literature and unpublished data/outcomes from subject experts. Inclusion and exclusion criteria were developed and applied to screening rounds. Titles and abstracts were screened by two independent reviewers for eligibility, and then full texts were assessed for inclusion. Narrative synthesis of the eligible studies was conducted. RESULTS Fifty-five peer-reviewed papers and one report were eligible for inclusion in this review. Prevalence of ever or lifetime alcohol consumption ranged from 3.9% to 69.8%; and prevalence of alcohol consumption at least once in the past year ranged from 10.6% to 32.9%. The mean age for initiation of drinking ranged from 14.4 to 18.3 years. Some correlates associated with alcohol consumption included being male, older age, academic difficulties, parental use of alcohol or tobacco, non-contact sexual abuse and perpetuation of violence. CONCLUSION The evidence base for alcohol use among adolescents in India needs a deeper exploration. Despite gaps in the evidence base, this synthesis provides a reasonable understanding of alcohol use among adolescents in India and can provide direction to policymakers.
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Gilmore W, Symons M, Liang W, Graham K, Kypri K, Miller P, Chikritzhs T. Association between Nightlife Goers' Likelihood of an Alcohol Use Disorder and Their Preferred Bar's Closing Time: A Cross-Sectional Observational Study in Perth, Australia. Int J Environ Res Public Health 2021; 18:13040. [PMID: 34948660 DOI: 10.3390/ijerph182413040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
Introduction and aims: Associations between longer-term alcohol-related conditions and licensed outlet trading hours are not well understood. We investigated the association between nightlife-goers’ likelihood of an alcohol use disorder (AUD) and their preference for bars with special permits to remain open ‘late’ (i.e., spent more time there compared to any other venue) until 2 a.m. or 3 a.m. (Friday; Saturday) or midnight (Sunday) compared to bars with ‘standard’ closing times of midnight (Friday; Saturday) or 10 p.m. (Sunday). Design and methods: A cross-sectional observational study was conducted in four major nightlife areas of Perth, Australia, in 2015–2016. We conducted weekend street intercept surveys outside bars between 8 p.m. and 3 a.m. and screened participants who reported alcohol use prior to the survey and spent more time in a bar than any other venue type (n = 667) regarding their past year drinking pattern using AUDIT-C (n = 459). We used gender-specific logistic regression models to estimate associations between AUDIT-C categories (1–4, low risk; 5–7, hazardous; 8–12, active AUD) and preference for bars with different closing times (late vs. standard). Results: A large proportion of participants were hazardous drinkers or had active AUD (83% males; 65% females), and over half preferred a late to a standard closing bar. We found evidence of a positive association between preference for late closing bars and hazardous drinking females (OR = 3.48; 95% CI 1.47–8.23; p = 0.01), but not for females with active AUD, male hazardous drinkers, nor males with active AUD. Discussion and conclusions: Our study adds new evidence on associations between likelihood of AUD among nightlife-goers and trading hours. With increasing international relaxation of trading hours, evidence that late closing bars may be preferred by hazardous drinking females will be of concern to policymakers wanting to curb alcohol-related harms in the community.
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Parkes T, Carver H, Masterton W, Booth H, Ball L, Murdoch H, Falzon D, Pauly BM, Matheson C. Exploring the Potential of Implementing Managed Alcohol Programmes to Reduce Risk of COVID-19 Infection and Transmission, and Wider Harms, for People Experiencing Alcohol Dependency and Homelessness in Scotland. Int J Environ Res Public Health 2021; 18:12523. [PMID: 34886249 DOI: 10.3390/ijerph182312523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023]
Abstract
People who experience homelessness and alcohol dependency are more vulnerable than the general population to risks/harms relating to COVID-19. This mixed methods study explored stakeholder perspectives concerning the impact of COVID-19 and the potential utility of introducing managed alcohol programmes (MAPs) in Scotland as part of a wider health/social care response for this group. Data sources included: 12 case record reviews; 40 semi-structured qualitative interviews; and meeting notes from a practitioner-researcher group exploring implementation of MAPs within a third sector/not-for-profit organisation. A series of paintings were curated as a novel part of the research process to support knowledge translation. The case note review highlighted the complexity of health problems experienced, in addition to alcohol dependency, including polysubstance use, challenges related to alcohol access/use during lockdown, and complying with stay-at-home rules. Qualitative analysis generated five subthemes under the theme of ‘MAPs as a response to COVID-19′: changes to alcohol supply/use including polysubstance use; COVID-19-related changes to substance use/homelessness services; negative changes to services for people with alcohol problems; the potential for MAPs in the context of COVID-19; and fears and concerns about providing MAPs as a COVID-19 response. We conclude that MAPs have the potential to reduce a range of harms for this group, including COVID-19-related harms.
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Johansson M, Berman AH, Sinadinovic K, Lindner P, Hermansson U, Andréasson S. Effects of Internet-Based Cognitive Behavioral Therapy for Harmful Alcohol Use and Alcohol Dependence as Self-help or With Therapist Guidance: Three-Armed Randomized Trial. J Med Internet Res 2021; 23:e29666. [PMID: 34821563 PMCID: PMC8663526 DOI: 10.2196/29666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/23/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Alcohol use is a major contributor to health loss. Many persons with harmful use or alcohol dependence do not obtain treatment because of limited availability or stigma. They may use internet-based interventions as an alternative way of obtaining support. Internet-based interventions have previously been shown to be effective in reducing alcohol consumption in studies that included hazardous use; however, few studies have been conducted with a specific focus on harmful use or alcohol dependence. The importance of therapist guidance in internet-based cognitive behavioral therapy (ICBT) programs is still unclear. Objective This trial aims to investigate the effects of a web-based alcohol program with or without therapist guidance among anonymous adult help-seekers. Methods A three-armed randomized controlled trial was conducted to compare therapist-guided ICBT and self-help ICBT with an information-only control condition. Swedish-speaking adult internet users with alcohol dependence (3 or more International Classification of Diseases, Tenth Revision criteria) or harmful alcohol use (alcohol use disorder identification test>15) were included in the study. Participants in the therapist-guided ICBT and self-help ICBT groups had 12-week access to a program consisting of 5 main modules, as well as a drinking calendar with automatic feedback. Guidance was given by experienced therapists trained in motivational interviewing. The primary outcome measure was weekly alcohol consumption in standard drinks (12 g of ethanol). Secondary outcomes were alcohol-related problems measured using the total alcohol use disorder identification test-score, diagnostic criteria for alcohol dependence and alcohol use disorder, depression, anxiety, health, readiness to change, and access to other treatments or support. Follow-up was conducted 3 (posttreatment) and 6 months after recruitment. Results During the recruitment period, from March 2015 to March 2017, 1169 participants were included. Participants had a mean age of 45 (SD 13) years, and 56.72% (663/1169) were women. At the 3-month follow-up, the therapist-guided ICBT and control groups differed significantly in weekly alcohol consumption (−3.84, 95% Cl −6.53 to −1.16; t417=2.81; P=.005; Cohen d=0.27). No significant differences were found in weekly alcohol consumption between the self-help ICBT group and the therapist-guided ICBT at 3 months, between the self-help ICBT and the control group at 3 months, or between any of the groups at the 6-month follow-up. A limitation of the study was the large number of participants who were completely lost to follow-up (477/1169, 40.8%). Conclusions In this study, a therapist-guided ICBT program was not found to be more effective than the same program in a self-help ICBT version for reducing alcohol consumption or other alcohol-related outcomes. In the short run, therapist-guided ICBT was more effective than information. Only some internet help-seekers may need a multisession program and therapist guidance to change their drinking when they use internet-based interventions. Trial Registration ClinicalTrials.gov NCT02377726; https://clinicaltrials.gov/ct2/show/NCT02377726
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Affiliation(s)
- Magnus Johansson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Anne H Berman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kristina Sinadinovic
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Philip Lindner
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Ulric Hermansson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Sven Andréasson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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