1,172 results
Search Results
2. Management of end-stage alcohol-related liver disease and severe acute alcohol-related hepatitis: position paper of the Italian Society on Alcohol (SIA).
- Author
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Testino, Gianni, Vignoli, Teo, Patussi, Valentino, Scafato, Emanuele, and Caputo, Fabio
- Abstract
Worldwide, the prevalence of alcohol use disorder (AUD) is 20–30% in men and 10–15% in women, and cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). Thus, the management of ESALD and SAAH in patients affected by AUD may be an essential part of the clinical skills for hepatologists. For these reasons, the national board of the Italian Society on Alcohol have reviewed the most recent data on the management of ESALD, SAAH and LT for ALD in patients with AUD, formulating a position paper with related recommendations regarding four issues of specific clinical interest in this field: (a) the management of hepatic encephalopathy in patients with AUD, and LT in patients with ESALD; (b) the management of SAAH; (c) the management of AUD in patients with ESALD and SAAH; (d) special populations: polydrug addicts. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
3. Emergency Department Management of Patients With Alcohol Intoxication, Alcohol Withdrawal, and Alcohol Use Disorder: A White Paper Prepared for the American Academy of Emergency Medicine.
- Author
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Strayer, Reuben J., Friedman, Benjamin W., Haroz, Rachel, Ketcham, Eric, Klein, Lauren, LaPietra, Alexis M., Motov, Sergey, Repanshek, Zachary, Taylor, Scott, Weiner, Scott G., and Nelson, Lewis S.
- Subjects
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ALCOHOLISM , *ALCOHOLIC intoxication , *EMERGENCY management , *EMERGENCY medicine , *HOSPITAL emergency services - Published
- 2023
- Full Text
- View/download PDF
4. Alcohol use disorder in the COVID-19 era: Position paper of the Italian Society on Alcohol (SIA).
- Author
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Testino, Gianni, Vignoli, Teo, Patussi, Valentino, Allosio, Pierluigi, Amendola, Maria Francesca, Aricò, Sarino, Baselice, Aniello, Balbinot, Patrizia, Campanile, Vito, Fanucchi, Tiziana, Macciò, Livia, Meneguzzi, Cristina, Mioni, Davide, Parisi, Michele, Renzetti, Doda, Rossin, Raffaella, Gandin, Claudia, Bottaro, Luigi Carlo, Caio, Giacomo, and Lungaro, Lisa
- Subjects
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ALCOHOLISM , *COVID-19 , *THERAPEUTICS , *CAREGIVERS , *COVID-19 pandemic - Abstract
Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples); (d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
5. Management of end-stage alcohol-related liver disease and severe acute alcohol-related hepatitis: position paper of the Italian Society on Alcohol (SIA)
- Author
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Emanuele Scafato, Valentino Patussi, Sia board, Teo Vignoli, Gianni Testino, and Fabio Caputo
- Subjects
Pediatrics ,medicine.medical_specialty ,Cirrhosis ,media_common.quotation_subject ,medicine.medical_treatment ,Alcohol use disorder ,Liver transplantation ,NO ,End Stage Liver Disease ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Liver Cirrhosis, Alcoholic ,mental disorders ,Medicine ,Humans ,Stage (cooking) ,Hepatic encephalopathy ,Societies, Medical ,media_common ,Hepatitis ,Hepatology ,business.industry ,Alcohol Abstinence ,Hepatitis, Alcoholic ,Addiction ,Gastroenterology ,medicine.disease ,Alcoholism ,Alcohol use disorder, End stage alcohol-related liver disease, Liver transplantation, Severe acute alcohol-related hepatitis ,Italy ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,End stage alcohol-related liver disease ,Severe acute alcohol-related hepatitis - Abstract
Worldwide, the prevalence of alcohol use disorder (AUD) is 20-30% in men and 10-15% in women, and cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). Thus, the management of ESALD and SAAH in patients affected by AUD may be an essential part of the clinical skills for hepatologists. For these reasons, the national board of the Italian Society on Alcohol have reviewed the most recent data on the management of ESALD, SAAH and LT for ALD in patients with AUD, formulating a position paper with related recommendations regarding four issues of specific clinical interest in this field: (a) the management of hepatic encephalopathy in patients with AUD, and LT in patients with ESALD; (b) the management of SAAH; (c) the management of AUD in patients with ESALD and SAAH; (d) special populations: polydrug addicts.
- Published
- 2020
6. PTSD, panic disorder and alcohol use disorder as a triple threat for violence among male jail detainees
- Author
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Barrett, Alexa J., Taylor, Stephanie L., Kopak, Albert M., and Hoffmann, Norman G.
- Published
- 2021
- Full Text
- View/download PDF
7. How to achieve greater comparability-suggested ways to improve the determination of treatment gap and treatment lag
- Author
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Schaub, Michael Patrick
- Published
- 2021
- Full Text
- View/download PDF
8. Consensus paper of the WFSBP task force on biological markers: Biological markers for alcoholism.
- Author
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Hashimoto, Eri, Riederer, Peter Franz, Hesselbrock, Victor M., Hesselbrock, Michie N., Mann, Karl, Ukai, Wataru, Sohma, Hitoshi, Thibaut, Florence, Schuckit, Marc A., and Saito, Toshikazu
- Subjects
- *
BIOMARKERS , *ALCOHOLISM , *PEOPLE with alcoholism , *GENETIC polymorphism research , *GENETIC disorders - Abstract
Objectives. This article presents an overview of the current literature on biological markers for alcoholism, including markers associated with the pharmacological effects of alcohol and markers related to the clinical course and treatment of alcohol-related problems. Many of these studies are well known, while other studies cited are new and still being evaluated. Methods. In this paper we first describe known biomarkers of alcohol-related disorders, review their features and the problems involved in their use. We then consider future developments on biomarkers and their possible impact on the field. Results. More recent findings cited include the work on type 7 adenylcyclase (AC) polymorphism and its lower expression levels in female alcoholics. Neuroimaging studies involving biomarkers have also reported brain volume reductions of gray and white matter, including amygdala and subcortical regions in alcoholic patients, while a high association between the copy number variations (CNVs) in 6q14.1/5q13.2 and alcohol dependence has more recently been identified in genetic studies. Conclusions. In addition to their possible importance for diagnosis, biomarkers may have utility for predicting prognosis, progression of the disorder, the development of new treatments, and monitoring treatment effects. Although such findings should be verified in independent studies, the search for new biomarkers is continuing. Several potential candidate biomarkers have been found recently in blood, imaging, and genetic studies with encouraging results. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
9. Increased propensity for violence among female jail detainees with PTSD, panic disorder and alcohol use disorder
- Author
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Taylor, Stephanie L., Barrett, Alexa J., Kopak, Albert M., and Hoffmann, Norman G.
- Published
- 2021
- Full Text
- View/download PDF
10. Characteristics of people who have received treatment for late-onset problem drinking and alcohol use disorder: A systematic review and narrative synthesis.
- Author
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McInerney, Kevin, Best, David, and Cross, Ainslea
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ALCOHOLISM ,PEOPLE with alcoholism ,MENTAL illness ,MENTAL health ,GENDER differences (Psychology) - Abstract
Aims: The current review investigated the psychosocial characteristics of late-onset problem drinkers, an under-researched area of alcohol harm that accounts for one-third of older problem drinkers. Method: Following the PRISMA model, the protocol and search strategy included a scoping search and main search of nine databases. A total of 1,595 papers were identified; after screening, 26 papers were considered eligible and were included in the review. The review used an investigative framework comprising three categories: standardising age of onset; gender differences; and psychosocial and mental health characteristics. The review also investigated how meaning and purpose in life, and treatment have been reported in relation to this cohort. Findings/Conclusions: The combined onset ages of the reviews' 26 papers (mean age = 52.69 years) and the participants' self-reported age at onset (mean age = 56.79 years), suggest that late-onset alcohol use disorder (AUD)/problem drinking is likely to emerge at the age of 55 years and older. Moreover, there is a high prevalence of co-morbid mental health disorders among elderly, late-onset drinkers. Retirement was reported as the most prevalent psychosocial risk factor for late-onset problematic drinking; other late-life events included bereavement, loneliness and social isolation, and boredom. In the context of gender, women are at greater risk of developing late-onset problem drinking than men. Furthermore, late-onset problem drinkers, particularly women, are more treatment compliant than their early-onset counterparts, highlighting the case for bespoke treatments/interventions for late-onset problem drinkers. Finally, the role that meaning and purpose in life plays in late-onset problem drinking has been under-reported and requires further investigation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
11. Alcohol problems in a remand Scottish prisoner population
- Author
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Graham, Lesley, Heller‐Murphy, Stephen, Aitken, Lucy, and McAuley, Andrew
- Published
- 2012
- Full Text
- View/download PDF
12. Classical blood biomarkers identify patients with higher risk for relapse 6 months after alcohol withdrawal treatment
- Author
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Florian Raabe, Kristina Adorjan, Elias Wagner, Oliver Pogarell, Judith Weiser, Gabriele Koller, Eva Hoch, Sarah Brechtel, and David Popovic
- Subjects
medicine.medical_specialty ,Longitudinal study ,Sociodemographic Factors ,media_common.quotation_subject ,030508 substance abuse ,Alcohol ,Alcohol use disorder ,Risk Assessment ,Blood biomarkers ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Recurrence ,Internal medicine ,medicine ,Withdrawal treatment ,Humans ,Pharmacology (medical) ,Aspartate Aminotransferases ,Longitudinal Studies ,Alanine aminotransferase ,Mean corpuscular volume ,Biological Psychiatry ,media_common ,Outcome ,Original Paper ,medicine.diagnostic_test ,business.industry ,Alcohol dependence ,Risk for relapse ,Alanine Transaminase ,General Medicine ,Abstinence ,medicine.disease ,Psychiatry and Mental health ,Alcoholism ,chemistry ,0305 other medical science ,business ,030217 neurology & neurosurgery ,Biomarkers - Abstract
This naturalistic study among patients with alcohol dependence examined whether routine blood biomarkers could help to identify patients with high risk for relapse after withdrawal treatment. In a longitudinal study with 6-month follow-up among 133 patients with alcohol dependence who received inpatient alcohol withdrawal treatment, we investigated the usefulness of routine blood biomarkers and clinical and sociodemographic factors for potential outcome prediction and risk stratification. Baseline routine blood biomarkers (gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT/GPT], aspartate aminotransferase [AST/GOT], mean cell volume of erythrocytes [MCV]), and clinical and sociodemographic characteristics were recorded at admission. Standardized 6 months’ follow-up assessed outcome variables continuous abstinence, days of continuous abstinence, daily alcohol consumption and current abstinence. The combined threshold criterion of an AST:ALT ratio > 1.00 and MCV > 90.0 fl helped to identify high-risk patients. They had lower abstinence rates (P = 0.001), higher rates of daily alcohol consumption (P P = 0.027) compared with low-risk patients who did not meet the threshold criterion. Regression analysis confirmed our hypothesis that the combination criterion is an individual baseline variable that significantly predicted parts of the respective outcome variances. Routinely assessed indirect alcohol biomarkers help to identify patients with high risk for relapse after alcohol withdrawal treatment. Clinical decision algorithms to identify patients with high risk for relapse after alcohol withdrawal treatment could include classical blood biomarkers in addition to clinical and sociodemographic items.
- Published
- 2020
13. Evaluating for Differences by Race/Ethnicity in the Association Between Income and Gambling Disorder
- Author
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Geoffrey L. Rosenthal, Christina Scheele, J. Kathleen Tracy, Andrea Monaghan, Fiyinfolu Adetunji, and Brendan Day
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Adult ,Male ,Race ,Sociology and Political Science ,Adolescent ,Substance-Related Disorders ,media_common.quotation_subject ,Ethnic group ,030508 substance abuse ,Alcohol abuse ,Alcohol use disorder ,Gambling disorder ,Odds ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,medicine ,Ethnicity ,Prevalence ,Humans ,Prospective Studies ,General Psychology ,media_common ,Aged ,Original Paper ,Addiction ,Racial Groups ,Smoking ,Middle Aged ,medicine.disease ,United States ,030227 psychiatry ,Substance abuse ,Logistic Models ,Socioeconomic Factors ,Gambling ,Income ,Marital status ,Household income ,Female ,Risk factor ,0305 other medical science ,Psychology ,Demography - Abstract
Multiple studies show an increased prevalence of gambling disorder among African Americans compared to whites. However, few studies take an analytic approach to understanding differences in risk factors by race/ethnicity. Income is inversely associated with gambling disorder; we hypothesized that this association would vary by race/ethnicity. The main objective was to evaluate whether the association between income and gambling disorder varies by race/ethnicity. With data from the baseline visit of a prospective cohort study, Prevention and Etiology of Gambling Addiction Study in the United States, we used multivariable logistic regression analysis to determine whether the association between income and gambling disorder varies by race/ethnicity. 1164 participants were included in the final analyses. Measures included: demographics (age, sex, race/ethnicity, education, employment, annual household income), veteran status, marital status, homelessness, smoking, substance abuse, alcohol abuse, marijuana use, and lifetime gambling disorder diagnosis as derived from Alcohol Use Disorder and Associated Disabilities Interview Schedule. There was no evidence of effect modification by race/ethnicity in the association between income and gambling disorder (global p value = 0.17). Income was associated with increased odds of gambling disorder, but only for those with low income (
- Published
- 2020
14. Restoring an adequate dietary fiber intake by inulin supplementation: a pilot study showing an impact on gut microbiota and sociability in alcohol use disorder patients
- Author
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Camille Amadieu, Valentin Coste, Audrey M. Neyrinck, Victoria Thijssen, Quentin Leyrolle, Laure B. Bindels, Hubert Piessevaux, Peter Stärkel, Philippe de Timary, Nathalie M. Delzenne, Sophie Leclercq, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, and UCL - (SLuc) Service de psychiatrie adulte
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Adult ,Dietary Fiber ,Male ,Microbiology (medical) ,psychological symptoms ,Adolescent ,Pilot Projects ,RC799-869 ,alcohol use disorder ,Microbiology ,Social Skills ,Feces ,Young Adult ,Double-Blind Method ,Humans ,Aged ,Bacteria ,inulin ,gut-brain axis ,Gastroenterology ,Middle Aged ,Diseases of the digestive system. Gastroenterology ,Gastrointestinal Microbiome ,Gastrointestinal Tract ,Alcoholism ,sociability ,Infectious Diseases ,Female ,prebiotics ,Research Article ,Research Paper - Abstract
Alcohol use disorder (AUD) is a chronic relapsing disease associated with malnutrition, metabolic disturbances, and gut microbiota alterations that are correlated with the severity of psychological symptoms. This study aims at supplementing AUD patients with prebiotic fiber during alcohol withdrawal, in order to modulate the gut microbiota composition and to evaluate its effect on gastrointestinal tolerance, metabolism, and patient’s behavior. A randomized, double-blind, placebo-controlled study included 50 AUD patients assigned to inulin versus maltodextrin daily supplementation for 17 days. Biological measurements (fecal microbial 16S rDNA sequencing, serum biology), dietary intake, validated psychological questionnaires, and gastrointestinal tolerance assessment were performed before and after the intervention. Inulin significantly decreased the richness and evenness and induced changes of 8 genera (q
- Published
- 2022
15. The role of temperament in alcohol use among college students
- Author
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Stephanie S. J. Morris, Rachel B. Tenenbaum, Julio A. Yanes, Rosario Pintos Lobo, Kathleen E. Feeney, and Erica D. Musser
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medicine.medical_specialty ,Research paper ,media_common.quotation_subject ,Binge drinking ,Alcohol ,Alcohol use disorder ,Binge Drinking ,chemistry.chemical_compound ,Social pathology. Social and public welfare. Criminology ,Intervention (counseling) ,medicine ,Negative affect ,Psychology ,Young adult ,Temperament ,Alcohol Use ,HV1-9960 ,media_common ,Public health ,medicine.disease ,BF1-990 ,Psychiatry and Mental health ,Positive affect ,chemistry ,Effortful control ,Alcohol use disorder (AUD) ,Analysis of variance ,Orienting sensitivity ,Clinical psychology - Abstract
Highlights • Examining the mechanisms underlying alcohol use in college students. • Interplay among temperament domains and alcohol use. • Positive affect (PA) linked with engagement in hazardous alcohol use. • Effortful control (EC) associated with reduced engagement in alcohol use broadly. • PA and EC temperament domains linked to alcohol use in college students., Alcohol use and alcohol use disorder (AUD) among young adults are important public health concerns. The high prevalence and negative effects of alcohol use suggests that there is a need for improved understanding of the mechanisms underlying alcohol use. The current study utilizes the model of adult temperament proposed by Evans and Rothbart (2007) as the framework with which to examine the interplay among temperament domains and alcohol use. Specifically, we examined individual and interactive associations among self-report ratings of positive affect, negative affect, effortful control, orienting sensitivity and alcohol use patterns, among a large sample of college students. ANOVA and linear regression analyses indicated that positive affect was associated with engagement in hazardous alcohol use and binge drinking. Furthermore, effortful control was associated with reduced engagement in overall alcohol use. These results corroborate and extend previous work which suggests that positive affect and effortful control temperament domains are linked to alcohol use patterns in college-age young adults. These findings may serve as an important step for informed decision-making about prevention and intervention efforts related to problematic alcohol use in young adults.
- Published
- 2021
16. Risk Factors Associated With Nonfatal Opioid Overdose Leading to Intensive Care Unit Admission: A Cross-sectional Study
- Author
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William C. Becker, Hiba Ahsan, Hong Yu, Weisong Liu, Avijit Mitra, David A. Smelson, Jack Tsai, Robert D. Kerns, and Wenjun Li
- Subjects
medicine.medical_specialty ,Cross-sectional study ,social and behavioral determinants of health ,Health Informatics ,Alcohol use disorder ,intensive care unit ,law.invention ,Health Information Management ,law ,Health care ,medicine ,risk factors ,natural language processing ,Original Paper ,business.industry ,opioids ,Opioid overdose ,Odds ratio ,medicine.disease ,Intensive care unit ,electronic health records ,Relative risk ,Emergency medicine ,overdose ,Risk assessment ,business - Abstract
Background Opioid overdose (OD) and related deaths have significantly increased in the United States over the last 2 decades. Existing studies have mostly focused on demographic and clinical risk factors in noncritical care settings. Social and behavioral determinants of health (SBDH) are infrequently coded in the electronic health record (EHR) and usually buried in unstructured EHR notes, reflecting possible gaps in clinical care and observational research. Therefore, SBDH often receive less attention despite being important risk factors for OD. Natural language processing (NLP) can alleviate this problem. Objective The objectives of this study were two-fold: First, we examined the usefulness of NLP for SBDH extraction from unstructured EHR text, and second, for intensive care unit (ICU) admissions, we investigated risk factors including SBDH for nonfatal OD. Methods We performed a cross-sectional analysis of admission data from the EHR of patients in the ICU of Beth Israel Deaconess Medical Center between 2001 and 2012. We used patient admission data and International Classification of Diseases, Ninth Revision (ICD-9) diagnoses to extract demographics, nonfatal OD, SBDH, and other clinical variables. In addition to obtaining SBDH information from the ICD codes, an NLP model was developed to extract 6 SBDH variables from EHR notes, namely, housing insecurity, unemployment, social isolation, alcohol use, smoking, and illicit drug use. We adopted a sequential forward selection process to select relevant clinical variables. Multivariable logistic regression analysis was used to evaluate the associations with nonfatal OD, and relative risks were quantified as covariate-adjusted odds ratios (aOR). Results The strongest association with nonfatal OD was found to be drug use disorder (aOR 8.17, 95% CI 5.44-12.27), followed by bipolar disorder (aOR 2.69, 95% CI 1.68-4.29). Among others, major depressive disorder (aOR 2.57, 95% CI 1.12-5.88), being on a Medicaid health insurance program (aOR 2.26, 95% CI 1.43-3.58), history of illicit drug use (aOR 2.09, 95% CI 1.15-3.79), and current use of illicit drugs (aOR 2.06, 95% CI 1.20-3.55) were strongly associated with increased risk of nonfatal OD. Conversely, Blacks (aOR 0.51, 95% CI 0.28-0.94), older age groups (40-64 years: aOR 0.65, 95% CI 0.44-0.96; >64 years: aOR 0.16, 95% CI 0.08-0.34) and those with tobacco use disorder (aOR 0.53, 95% CI 0.32-0.89) or alcohol use disorder (aOR 0.64, 95% CI 0.42-1.00) had decreased risk of nonfatal OD. Moreover, 99.82% of all SBDH information was identified by the NLP model, in contrast to only 0.18% identified by the ICD codes. Conclusions This is the first study to analyze the risk factors for nonfatal OD in an ICU setting using NLP-extracted SBDH from EHR notes. We found several risk factors associated with nonfatal OD including SBDH. SBDH are richly described in EHR notes, supporting the importance of integrating NLP-derived SBDH into OD risk assessment. More studies in ICU settings can help health care systems better understand and respond to the opioid epidemic.
- Published
- 2021
17. Gender Differences in Alcohol Use: a Nationwide Study in a Multiethnic Population.
- Author
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Goh, Chong Min Janrius, Asharani, P. V., Abdin, Edimansyah, Shahwan, Shazana, Zhang, Yunjue, Sambasivam, Rajeswari, Vaingankar, Janhavi Ajit, Ma, Stefan, Chong, Siow Ann, and Subramaniam, Mythily
- Subjects
GENDER differences (Psychology) ,ALCOHOLISM ,ALCOHOL drinking ,OBSESSIVE-compulsive disorder ,GENDER inequality - Abstract
The increase in alcohol consumption, and the greater consequences of chronic alcohol use among females, as well as the convergence of the gender gap warrants investigation. This paper aims to uncover gender differences in individuals with alcohol use disorder (AUD) in Singapore. The SMHS 2016 was a population-based, cross-sectional, epidemiological study. Recruitment spanned from August 2016 to March 2018, where 6126 respondents were recruited. Similarly to global estimates, lifetime prevalence and 12-month prevalence for AUD were higher in males than females. However, females had a higher prevalence of obsessive–compulsive disorder (OCD) co-morbidity than males. Women also had an earlier onset and age of recovery of AUD than men. Alarmingly, male (94.14%) and female (100%) respondents reported low help-seeking for their AUD. Gender differences in individuals with AUD were identified in Singapore population. Future research should direct its effort to identify barriers to help-seeking for individuals with alcohol use disorder. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
18. Nicotine increases alcohol self-administration in male rats via a mu-opioid mechanism within the mesolimbic pathway
- Author
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Marvin Pätz, Anita C. Hansson, Eric Augier, Li Xu, Sanne Toivainen, Anton Nordeman, Gaëlle Augier, Markus Heilig, Lovisa Holm, and Esi Domi
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0301 basic medicine ,Male ,Receptors, Opioid, mu ,Alcohol ,Alcohol use disorder ,Mesolimbic pathway ,Pharmacology and Toxicology ,Nucleus accumbens ,Pharmacology ,Naltrexone ,Nucleus Accumbens ,Nicotine ,03 medical and health sciences ,chemistry.chemical_compound ,κ receptors ,0302 clinical medicine ,medicine ,Animals ,μ ,alcohol ,Receptors, Opioid, kappa ,comorbidity ,nicotine ,kappa receptors ,mu ,Ventral Tegmental Area ,medicine.disease ,Farmakologi och toxikologi ,Research Papers ,Rats ,Ventral tegmental area ,Analgesics, Opioid ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,Opioid ,030217 neurology & neurosurgery ,medicine.drug ,Research Paper - Abstract
Background and Purpose: Alcohol and nicotine use disorders are commonly comorbid. Both alcohol and nicotine can activate opioid systems in reward-related brain regions, leading to adaptive changes in opioid signalling upon chronic exposure. The potential role of these adaptations for comorbidity is presently unknown. Here, we examined the contribution of mu and kappa-opioid receptors to nicotine-induced escalation of alcohol self-administration in rats. Experimental Approach: Chronic nicotine was tested on alcohol self-administration and motivation to obtain alcohol. We then tested the effect of the kappa antagonist CERC-501 and the preferential mu receptor antagonist naltrexone on basal and nicotine-escalated alcohol self-administration. To probe mu or kappa receptor adaptations, receptor binding and G-protein coupling assays were performed in reward-related brain regions. Finally, dopaminergic activity in response to alcohol was examined, using phosphorylation of DARPP-32 in nucleus accumbens as a biomarker. Key Results: Nicotine robustly induced escalation of alcohol self-administration and motivation to obtain alcohol. This was blocked by naltrexone but not by CERC-501. Escalation of alcohol self-administration was associated with decreased DAMGO-stimulated mu receptor signalling in the ventral tegmental area (VTA) and decreased pDARPP-32 in the nucleus accumbens shell in response to alcohol. Conclusions and Implications: Collectively, these results suggest that nicotine contributes to escalate alcohol self-administration through a dysregulation of mu receptor activity in the VTA. These data imply that targeting mu rather than kappa receptors may be the preferred pharmacotherapeutic approach for the treatment of alcohol use disorder when nicotine use contributes to alcohol consumption. Funding Agencies|Deutsche Forschungsgemeinschaft (DFG), German Research FoundationGerman Research Foundation (DFG) [402170461 - TRR 265]; Bundesministerium fur Bildung und Forschung (BMBF) SysMedSUDs - FKZFederal Ministry of Education & Research (BMBF) [01ZX1909]; Swedish Research CouncilSwedish Research Council [2013-07434]
- Published
- 2020
19. Evaluating the Therapeutic Efficacy of Attentional Bias Modulation in the Treatment of Alcohol Use Disorder.
- Author
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Breddy, Taylor
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ALCOHOL-induced disorders ,ATTENTIONAL bias ,TREATMENT effectiveness ,EVIDENCE-based medicine ,STROOP effect - Abstract
Alcohol Use Disorders (AUDs) are prevalent, relapsing conditions that have considerable health-related, interpersonal, and economic consequences for the individual and society. There is a growing body of evidence demonstrating that individuals with AUD have biased attentional processing. Specifically, those with AUD tend to display increased attention towards alcohol-related cues compared to neutral cues, which is associated with increased craving and decreased time to relapse (Cox et al., 2002; Schoenmakers et al., 2010). This paper covers an overview and critique of measures used to examine this attentional bias, including the Modified Stroop and Visual Probe tasks (Ehrman et al., 2002; Ryan, 2002). Importantly, this paper explores how the Alcohol Attentional Bias (AAB) can be modified through Attentional Bias Modulation (ABM) approaches. Articles highlighting the clinical utility of ABM are summarized and analyzed, and methodological issues of previous studies evaluating ABM are presented. Overall, preliminary studies have highlighted the potential therapeutic efficacy of ABM, specifically if used in multiple sessions, incorporated into current evidence-based treatments, and administered as a home-based, online program (Schoenmakers et al., 2010). However, due to the methodological limitations of many studies, randomized controlled trials with larger, more diverse samples are necessary before firm conclusions regarding the clinical utility of ABM can be substantiated. Notably, this review emphasizes the importance of developing empirically supported treatments for those with AUD to improve clinical outcomes and enhance the recovery process. [ABSTRACT FROM AUTHOR]
- Published
- 2023
20. Associations Between Physiological Signals Captured Using Wearable Sensors and Self-reported Outcomes Among Adults in Alcohol Use Disorder Recovery: Development and Usability Study
- Author
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Ramesh Kumar Sah, Michael G. McDonell, Hassan Ghasemzadeh, Sara Parent, Patricia Pendry, Michael J. Cleveland, and Parastoo Alinia
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medicine.medical_specialty ,media_common.quotation_subject ,alcohol consumption ,Psychological intervention ,Medicine (miscellaneous) ,Wearable computer ,emotion ,Health Informatics ,Alcohol use disorder ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Heart rate variability ,stress markers ,030304 developmental biology ,media_common ,0303 health sciences ,Original Paper ,mobile phone ,Descriptive statistics ,business.industry ,Addiction ,heart rate variability ,alcohol relapse prevention ,medicine.disease ,electrodermal activity ,Computer Science Applications ,Structured interview ,Ambulatory ,business ,030217 neurology & neurosurgery - Abstract
Background Previous research has highlighted the role of stress in substance misuse and addiction, particularly for relapse risk. Mobile health interventions that incorporate real-time monitoring of physiological markers of stress offer promise for delivering tailored interventions to individuals during high-risk states of heightened stress to prevent alcohol relapse. Before such interventions can be developed, measurements of these processes in ambulatory, real-world settings are needed. Objective This research is a proof-of-concept study to establish the feasibility of using a wearable sensor device to continuously monitor stress in an ambulatory setting. Toward that end, we first aimed to examine the quality of 2 continuously monitored physiological signals—electrodermal activity (EDA) and heart rate variability (HRV)—and show that the data follow standard quality measures according to the literature. Next, we examined the associations between the statistical features extracted from the EDA and HRV signals and self-reported outcomes. Methods Participants (N=11; female: n=10) were asked to wear an Empatica E4 wearable sensor for continuous unobtrusive physiological signal collection for up to 14 days. During the same time frame, participants responded to a daily diary study using ecological momentary assessment of self-reported stress, emotions, alcohol-related cravings, pain, and discomfort via a web-based survey, which was conducted 4 times daily. Participants also participated in structured interviews throughout the study to assess daily alcohol use and to validate self-reported and physiological stress markers. In the analysis, we first used existing artifact detection methods and physiological signal processing approaches to assess the quality of the physiological data. Next, we examined the descriptive statistics for self-reported outcomes. Finally, we investigated the associations between the features of physiological signals and self-reported outcomes. Results We determined that 87.86% (1,032,265/1,174,898) of the EDA signals were clean. A comparison of the frequency of skin conductance responses per minute with previous research confirmed that the physiological signals collected in the ambulatory setting were successful. The results also indicated that the statistical features of the EDA and HRV measures were significantly correlated with the self-reported outcomes, including the number of stressful events marked on the sensor device, positive and negative emotions, and experienced pain and discomfort. Conclusions The results demonstrated that the physiological data collected via an Empatica E4 wearable sensor device were consistent with previous literature in terms of the quality of the data and that features of these physiological signals were significantly associated with several self-reported outcomes among a sample of adults diagnosed with alcohol use disorder. These results suggest that ambulatory assessment of stress is feasible and can be used to develop tailored mobile health interventions to enhance sustained recovery from alcohol use disorder.
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- 2021
21. E-cigarette use and beliefs among adult smokers with substance use disorders
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Babak Tofighi, Scott E. Sherman, Joshua D. Lee, Daniel Schatz, Omar El-Shahawy, and Donna Shelley
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medicine.medical_specialty ,Research paper ,medicine.medical_treatment ,030508 substance abuse ,Alcohol use disorder ,Smoking cessation ,Logistic regression ,Odds ,03 medical and health sciences ,Combustible cigarettes ,0302 clinical medicine ,Social pathology. Social and public welfare. Criminology ,medicine ,Psychology ,Psychiatry ,HV1-9960 ,Harm reduction ,Descriptive statistics ,business.industry ,Opioid use disorder ,medicine.disease ,030227 psychiatry ,BF1-990 ,Psychiatry and Mental health ,Electronic cigarettes ,Substance use ,0305 other medical science ,business - Abstract
Highlights • We estimated prevalence of e-cigarette dual use among smokers with substance use disorders. • Dual e-cigarette users were more likely to have tried to quit in the past year. • Overall, participants preferred to use e-cigarettes in comparison to nicotine patches/gum. • E-cigarettes seem appealing to patients with substance use disorders. • E-cigarette use may be effective for harm reduction among patients in addiction treatment., Background We explored characteristics and beliefs associated with e-cigarette use patterns among cigarette smokers requiring inpatient detoxification for opioid and/or alcohol use disorder(s). Methods Adult cigarette smokers (≥18 years), admitted to inpatient detoxification for alcohol and/or opioid use disorder(s) in a safety-net tertiary referral center in New York City were surveyed in 2015 (n = 158). Descriptive statistics (proportions) were used to assess for demographic, clinical diagnosis, cigarette smoking patterns (exclusive and dual use of e-cigarettes). Chi-square, t-test statistics, and logistic regression models were used. Results Among our sample of combustible cigarette users, 13.9% (n = 22) reported dual use with electronic cigarettes. Dual use did not differ by demographic or clinical variables. Compared to exclusive smokers, dual users were more likely to have tried to quit in the past year (Adjusted Odds ratio = 8.59; CI: 2.58, 28.35; p
- Published
- 2021
22. Traumatic Stress-Enhanced Alcohol Drinking: Sex Differences and Animal Model Perspectives
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Finn, Deborah A., Clark, Crystal D., and Ryabinin, Andrey E.
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- 2024
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23. Using Machine Learning to Classify Individuals With Alcohol Use Disorder Based on Treatment Seeking Status
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William G. Kennedy, Mary R. Lee, Jennifer J. Barb, Aaron Hammer, Lorenzo Leggio, Vignesh Sankar, and Philip G. McQueen
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Treatment utilization ,Decision tree ,Alcohol abuse ,Alcohol use disorder ,Machine learning ,computer.software_genre ,Logistic regression ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,Informed consent ,0502 economics and business ,medicine ,030212 general & internal medicine ,0101 mathematics ,050207 economics ,lcsh:R5-920 ,050208 finance ,Substance dependence ,business.industry ,Decision tree learning ,010102 general mathematics ,Alcohol dependence ,05 social sciences ,Neuropsychology ,General Medicine ,medicine.disease ,Institutional review board ,3. Good health ,Substance abuse ,Alternating decision tree ,Artificial intelligence ,Psychology ,business ,lcsh:Medicine (General) ,computer ,Alcohol Use Disorder ,Research Paper - Abstract
Objective: The authors used a decision tree classifier to reduce neuropsychological, behavioral and laboratory measures to a subset of measures that best predicted whether an individual with alcohol use disorder (AUD) seeks treatment. Method: Clinical measures (N = 178) from 778 individuals with AUD were used to construct an alternating decision tree (ADT) with 10 measures that best classified individuals as treatment or not treatment-seeking for AUD. ADT's were validated by two methods: using cross-validation and an independent dataset (N = 236). For comparison, two other machine learning techniques were used as well as two linear models. Results: The 10 measures in the ADT classifier were drinking behavior, depression and drinking-related psychological problems, as well as substance dependence. With cross-validation, the ADT classified 86% of individuals correctly. The ADT classified 78% of the independent dataset correctly. Only the simple logistic model was similar in accuracy; however, this model needed more than twice as many measures as ADT to classify at comparable accuracy. Interpretation: While there has been emphasis on understanding differences between those with AUD and controls, it is also important to understand, within those with AUD, the features associated with clinically important outcomes. Since the majority of individuals with AUD do not receive treatment, it is important to understand the clinical features associated with treatment utilization; the ADT reported here correctly classified the majority of individuals with AUD with 10 clinically relevant measures, misclassifying
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- 2019
24. Examining co-patterns of depression and alcohol misuse in emerging adults following university graduation
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Roisin M. O'Connor, Jona R. Frohlich, Matthew T. Keough, and Karli K. Rapinda
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Alcohol misuse ,medicine.medical_specialty ,Research paper ,lcsh:Social pathology. Social and public welfare. Criminology ,lcsh:BF1-990 ,030508 substance abuse ,Alcohol ,Alcohol use disorder ,lcsh:HV1-9960 ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,High-risk individuals ,medicine ,Emerging adults ,Psychiatry ,Depressive symptoms ,Depression (differential diagnoses) ,Heavy drinking ,Depression ,Parallel process ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,lcsh:Psychology ,chemistry ,0305 other medical science ,Psychology ,Graduation - Abstract
Depression and alcohol use disorders are highly comorbid. Typically, alcohol use peaks in emerging adulthood (e.g., during university), and many people also develop depression at this time. Self-medication theory predicts that depressed emerging adults drink to reduce negative emotions. While research shows that depression predicts alcohol use and related problems in undergraduates, far less is known about the continuity of this association after university. Most emerging adults “mature out” of heavy drinking; however, some do not and go on to develop an alcohol use disorder. Depressed emerging adults may continue to drink heavily to cope with the stressful (e.g., remaining unemployed) transition out of university. Accordingly, using parallel process latent class growth modelling, we aimed to distinguish high- from low-risk groups of individuals based on joint patterns of depression and alcohol misuse following university graduation. Participants (N = 123) completed self-reports at three-month intervals for the year post-graduation. Results supported four classes: class 1: low stable depression and low decreasing alcohol misuse (n = 52), class 2: moderate stable depression and moderate stable alcohol misuse (n = 35), class 3: high stable depression and low stable alcohol misuse (n = 29), and class 4: high stable depression and high stable alcohol misuse (n = 8). Our findings show that the co-development of depression and alcohol misuse after university is not uniform. Most emerging adults in our sample continued to struggle with significant depressive symptoms after university, though only two classes continued to drink at moderate (class 2) and high (class 4) risk levels., Highlights • Co-patterns of depression and alcohol misuse were examined in emerging adults. • Four distinct classes were supported. • Co-patterns of depression and alcohol misuse were not uniform. • Some continue to struggle with alcohol misuse and depression after graduation.
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- 2018
25. Usability and Acceptability of a Mobile App for the Self-Management of Alcohol Misuse Among Veterans (Step Away): Pilot Cohort Study
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Carol A. Malte, John S. Baer, Aline Lott, Patrick L. Dulin, John C. Fortney, Anissa N. Danner, and Eric J. Hawkins
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Adult ,Male ,medicine.medical_specialty ,020205 medical informatics ,Adolescent ,Alcohol abuse ,Health Informatics ,Pilot Projects ,02 engineering and technology ,Alcohol use disorder ,smartphone ,law.invention ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,access ,Randomized controlled trial ,Quality of life ,law ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,030212 general & internal medicine ,veterans ,mobile apps ,Original Paper ,lcsh:T58.5-58.64 ,business.industry ,lcsh:Information technology ,System usability scale ,lcsh:Public aspects of medicine ,Self-Management ,Mobile apps ,Usability ,lcsh:RA1-1270 ,Middle Aged ,medicine.disease ,Mobile Applications ,alcohol misuse ,Alcoholism ,Physical therapy ,Quality of Life ,Female ,business ,Cohort study - Abstract
Background Alcohol misuse is common among Operation Enduring Freedom and Operation Iraqi Freedom veterans, yet barriers limit treatment participation. Mobile apps hold promise as means to deliver alcohol interventions to veterans who prefer to remain anonymous, have little time for conventional treatments, or live too far away to attend treatment in person. Objective This pilot study evaluated the usability and acceptability of Step Away, a mobile app designed to reduce alcohol-related risks, and explored pre-post changes on alcohol use, psychological distress, and quality of life. Methods This single-arm pilot study recruited Operation Enduring Freedom and Operation Iraqi Freedom veterans aged 18 to 55 years who exceeded National Institute on Alcohol Abuse and Alcoholism drinking guidelines and owned an iPhone. Enrolled veterans (N=55) completed baseline and 1-, 3-, and 6-month assessments. The System Usability Scale (scaled 1-100, ≥70 indicating acceptable usability) assessed the effectiveness, efficiency, and satisfaction dimensions of usability, while a single item (scaled 1-9) measured the attractiveness of 10 screenshots. Learnability was assessed by app use during week 1. App engagement (proportion of participants using Step Away, episodes of use, and minutes per episode per week) over 6 months measured acceptability. Secondary outcomes included pre-post change on heavy drinking days (men: ≥5 drinks per day; women: ≥4 drinks per day) and Short Inventory of Problems–Revised, Kessler-10, and brief World Health Organization Quality of Life Questionnaire scores. Results Among the 55 veterans enrolled in the study, the mean age was 37.4 (SD 7.6), 16% (9/55) were women, 82% (45/55) were White, and 82% (45/55) had an alcohol use disorder. Step Away was used by 96% (53/55) of participants in week 1, 55% (30/55) in week 4, and 36% (20/55) in week 24. Step Away use averaged 55.1 minutes (SD 57.6) in week 1 and Conclusions Operation Enduring Freedom and Operation Iraqi Freedom veterans found the usability of Step Away to be acceptable and engaged in the app over the 6-month study. Reductions were seen in heavy drinking days, alcohol-related problems, and Kessler-10 scores. A larger randomized trial is warranted to confirm our findings.
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- 2021
26. Virtual Reality Cognitive Training Among Individuals With Alcohol Use Disorder Undergoing Residential Treatment: Pilot Randomized Controlled Trial
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Pedro Gamito, Marcelo Matias, Alberto Deus, Rodrigo Brito, Jorge Oliveira, Elsa Cunha, and Paulo Lopes
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Adult ,Male ,medicine.medical_specialty ,Activities of daily living ,Psychological intervention ,030508 substance abuse ,Health Informatics ,Pilot Projects ,Alcohol use disorder ,alcohol use disorder ,lcsh:Computer applications to medicine. Medical informatics ,law.invention ,cognitive training ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Physical medicine and rehabilitation ,Randomized controlled trial ,law ,Activities of Daily Living ,medicine ,Humans ,Aged ,Original Paper ,lcsh:Public aspects of medicine ,Cognitive flexibility ,Virtual Reality ,Cognition ,lcsh:RA1-1270 ,Middle Aged ,medicine.disease ,Executive functions ,Cognitive training ,Alcoholism ,lcsh:R858-859.7 ,Female ,0305 other medical science ,Psychology ,Cognition Disorders ,030217 neurology & neurosurgery - Abstract
Background Alcohol use disorder (AUD) has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting of cognitive training. The advent of computer-based interventions may leverage these improvements, but randomized controlled trials (RCTs) of digital interactive-based interventions are still scarce. Objective The aim of this study is to explore whether a cognitive training approach using VR exercises based on activities of daily living is feasible for improving the cognitive function of patients with AUD undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs. Methods This study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre- and postassessments, including measurement of global cognition, executive functions, attention, visual memory, and cognitive flexibility. Results In order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled for in the statistical analysis for each individual outcome. Results indicate intervention effects on attention in two out of five outcomes and on cognitive flexibility in two out of six outcomes, with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies. Conclusions Overall, the data suggest that VR-based cognitive training results in specific contributions to improving attention ability and cognitive flexibility of patients recovering from AUD. Trial Registration ClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345
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- 2021
27. Factors associated with quality of life trajectories among inpatients treated for alcohol use disorders: A prospective cohort study
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Trond Nordfjærn and Helle Wessel Andersson
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medicine.medical_specialty ,Research paper ,Mental distress ,lcsh:Social pathology. Social and public welfare. Criminology ,media_common.quotation_subject ,lcsh:BF1-990 ,Alcohol use disorder ,lcsh:HV1-9960 ,Patient satisfaction ,Overall quality of life ,Quality of life ,Medicine ,Prospective cohort study ,media_common ,business.industry ,Abstinence ,medicine.disease ,Residential treatment ,Substance abuse ,Psychiatry and Mental health ,lcsh:Psychology ,Physical therapy ,business ,Cohort study - Abstract
Highlights • Substantial growth in quality of life during the course of treatment. • Co-occurrence between mental distress and lower quality of life. • Higher patient satisfaction associated with higher quality of life trajectories. • Substance use at follow-up was not associated with quality of life., Aims The main study purpose was to investigate patient- and treatment-related factors associated with overall quality of life (OQOL) trajectories during and after inpatient alcohol use disorder (AUD) treatment. Design A large-scale prospective multicenter cohort study of patients with different substance use disorder (SUD) types who were consecutively admitted for inpatient SUD treatment. Data were obtained at treatment entry (T1), discharge (T2), three months after discharge (T3), and one year after discharge (T4). The inclusion criterion was that the patient be dependent solely on alcohol. OQOL data were collected at all four time points. Independent variables included demographics, mental distress, psychiatric disorders, substance use, treatment history, and patient satisfaction. Results Among the 611 patients available, 236 met the AUD inclusion criterion and completed T1 assessments. A linear mixed model showed substantial co-occurrence between higher mental distress and lower OQOL. Higher patient satisfaction with inpatient treatment (T2) was associated with higher trajectories of OQOL, whereas abstinence (T3) was not. There was a substantial increase in OQOL from T1 to T2, which then remained stable during the last two assessment time points. Conclusions Routine OQOL screening at treatment entry, and targeting mental distress both during and after inpatient treatment, may be associated with improved OQOL among individuals with AUD. Further research should investigate inpatient treatment factors that contribute to OQOL improvement and those that moderate the relationship between patient satisfaction and OQOL.
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- 2020
28. Patterns and temporal change of psychopathological symptoms among inpatients with alcohol use disorder undergoing a twelve-step based treatment
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Zsolt Horváth, Zsolt Fazekas, Judit Farkas, Zsolt Demetrovics, Róbert Urbán, Mariann Tremkó, Mark D. Griffiths, Zsolt Petke, and András Tóth
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medicine.medical_specialty ,Research paper ,lcsh:Social pathology. Social and public welfare. Criminology ,Drinking motives ,Psychopathological symptoms ,lcsh:BF1-990 ,030508 substance abuse ,Medicine (miscellaneous) ,Alcohol use disorder ,macromolecular substances ,lcsh:HV1-9960 ,03 medical and health sciences ,Twelve-step based treatment ,0302 clinical medicine ,Minnesota model ,Internal medicine ,medicine ,Temporal change ,High severity ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,Multinomial logistic regression ,Alcohol Use Disorder (AUD) ,business.industry ,Attendance ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Increased risk ,lcsh:Psychology ,Alcohol comorbidity ,0305 other medical science ,business ,Psychopathology - Abstract
Highlights • Psychopathological symptom profiles and trajectories were examined among AUD inpatients. • Three quantitatively different subgroups were identified in terms of psychopathological symptoms. • Classes were discriminated by different psychopathological symptom change trajectories. • Subgroups with more severe psychopathological symptoms used alcohol in a more harmful way. • Drinking of the more severely affected classes were more motivated by coping and conformity motives., Background Patients diagnosed with Alcohol Use Disorder (AUD) present an increased risk for experiencing severe internalizing and externalizing symptoms. Involvement in twelve-step based treatment programs, such as the Minnesota Model (MM), can contribute to improvement of an individual’s psychopathological symptom profile. The present study’s main objective was to examine profiles and change trajectories of psychopathological symptoms of AUD subgroups during an eight-week long period of MM treatment attendance. Method Inpatients with AUD (N = 303) who attended MM treatment programs participated in the present study. Latent Class Growth Analysis (LCGA) was used to evaluate the psychopathological symptom change trajectories assessed by using the Brief Symptom Inventory (BSI). Multiple comparisons and multinomial logistic regression were performed to validate the subgroups. Results Three subgroups were identified: low severity (48.5%), moderate severity (35.2%), and high severity (16.2%) symptomatic subgroups. The moderate severity class demonstrated the largest effect in terms of symptoms decrease. Higher severity classes showed significantly higher rates of harmful alcohol drinking and drinking motives. Conclusions The present study identified three severity-based subgroups which indicate that psychopathology sits on a spectrum of severity among AUD patients. The findings highlight the associations between AUD and internalizing symptoms, negative reinforcement drinking motives, and the symptomatic improvement that can occur among those participating in MM treatment programs.
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- 2020
29. The potential of 5‐methoxy‐N,N‐dimethyltryptamine in the treatment of alcohol use disorder: A first look at therapeutic mechanisms of action.
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Tap, Stephan C.
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ALCOHOLISM , *LSD (Drug) , *CONTROL (Psychology) , *EXECUTIVE function , *ADAPTABILITY (Personality) - Abstract
Alcohol use disorder (AUD) remains one of the most prevalent psychiatric disorders worldwide with high economic costs. Current treatment options show modest efficacy and relapse rates are high. Furthermore, there are increases in the treatment gap and few new medications have been approved in the past 20 years. Recently, psychedelic‐assisted therapy with psilocybin and lysergic acid diethylamide has garnered significant attention in the treatment of AUD. Yet, they require significant amounts of therapist input due to prolonged subjective effects (~4–12 h) leading to high costs and impeding implementation. Accordingly, there is an increasing interest in the rapid and short‐acting psychedelic 5‐methoxy‐N,N‐dimethyltryptamine (5‐MeO‐DMT). This paper offers a first look at potential therapeutic mechanisms for AUD by reviewing the current literature on 5‐MeO‐DMT. Primarily, 5‐MeO‐DMT is able to induce mystical experiences and ego‐dissolution together with increases in psychological flexibility and mindfulness. This could decrease AUD symptoms through the alleviation of psychiatric mood‐related comorbidities consistent with the negative reinforcement and self‐medication paradigms. In addition, preliminary evidence indicates that 5‐MeO‐DMT modulates neural oscillations that might subserve ego‐dissolution (increases in gamma), psychological flexibility and mindfulness (increases in theta), and the reorganization of executive control networks (increases in coherence across frequencies) that could improve emotion regulation and inhibition. Finally, animal studies show that 5‐MeO‐DMT is characterized by neuroplasticity, anti‐inflammation, 5‐HT2A receptor agonism, and downregulation of metabotropic glutamate receptor 5 with clinical implications for AUD and psychiatric mood‐related comorbidities. The paper concludes with several recommendations for future research to establish the purported therapeutic mechanisms of action. [ABSTRACT FROM AUTHOR]
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- 2024
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30. Changes in mental health and drug use among men who have sex with men using daily and event-driven pre-exposure prophylaxis: Results from a prospective demonstration project in Amsterdam, the Netherlands
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Anders Boyd, M.F. Schim van der Loeff, Arjan Hogewoning, Elske Hoornenborg, Udi Davidovich, S.J.A. Meuzelaar, M S van Rooijen, Maria Prins, H J C de Vries, R.C.A. Achterbergh, Liza Coyer, Sociale Psychologie (Psychologie, FMG), Psychology Other Research (FMG), Graduate School, AII - Infectious diseases, Medical Microbiology and Infection Prevention, APH - Global Health, APH - Methodology, Infectious diseases, and Dermatology
- Subjects
medicine.medical_specialty ,Alcohol use disorder ,Substance use ,01 natural sciences ,Men who have sex with men ,03 medical and health sciences ,Pre-exposure prophylaxis ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Health care ,medicine ,030212 general & internal medicine ,0101 mathematics ,Psychiatry ,Homosexuality male ,lcsh:R5-920 ,Alcohol Use Disorders Identification Test ,business.industry ,Risk behavior ,Transgender persons ,010102 general mathematics ,HIV ,General Medicine ,Syndemics ,medicine.disease ,Mental health ,Anxiety ,medicine.symptom ,lcsh:Medicine (General) ,business ,Research Paper - Abstract
BackgroundGay, bisexual and other men who have sex with men (GBMSM) are at increased risk of mental health disorders and drug use. In GBMSM taking pre-exposure prophylaxis (PrEP) for HIV, the proportion engaging in risk behaviors could increase due to decreased perception in HIV risk. In turn, this could leave them further susceptible to mental health disorders.MethodsThe AMsterdam PrEP study (AMPrEP) is a demonstration project offering a choice of daily PrEP or event-driven PrEP regimen at the STI clinic of the Public Health Service of Amsterdam. Eligible participants were HIV-negative GBMSM and transgender people at risk of HIV, aged ≥18 years. We assessed anxiety and depressive mood disorders (Mental Health Inventory 5), sexual compulsivity (Sexual Compulsivity Scale), alcohol use disorder (Alcohol Use Disorder Identification Test), and drug use disorder (Drug Use Disorder Identification Test) using yearly self-administered assessments (August 2015–September 2018). The proportion of mental health problems were analyzed and changes over time and between regimen were assessed using a logistic regression model. Variables associated with the development or recovery of disorders were assessed using a multistate Markov model.OutcomesOf 376 enrolled, we analyzed 341 participants with data at baseline and at least one follow-up visit. During a median follow-up of 2.5 years (IQR=2.3–2.7), the proportion assessed with sexual compulsivity decreased from 23% at baseline to 10% at the last visit (pp = 0.004). No changes occurred in proportion assessed with anxiety/depressive mood disorders (20% at baseline, 18% at last visit, p = 0.358) or alcohol use disorder (28% at baseline, 22% at the last visit, p = 0.106). During follow-up, participants reported significant less use of alcohol (pppInterpretationMental health disorders are prevalent among those initiating PrEP. We did not find increases in mental health disorders during PrEP use, but rather a decrease in sexual compulsivity and drug use disorders. The initial prevalence of mental health disorders in our study point at the continuous need to address mental health disorders within PrEP programs.FundingZonMw, H-TEAM, Internal GGD research funds, Aidsfonds, Stichting AmsterdamDiner Foundation, Gilead Sciences, Janssen Pharmaceutica, M A C AIDS Fund, and ViiV Healthcare.
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- 2020
31. Using Web-Based Social Media to Recruit Heavy-Drinking Young Adults for Sleep Intervention: Prospective Observational Study
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Stephanie S. O'Malley, Momoko Ishii, Brian Pittman, Kelly S. DeMartini, David S Robledo, Garrett I. Ash, Nancy S. Redeker, and Lisa M. Fucito
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Gerontology ,Adult ,Male ,Sleep Wake Disorders ,Volunteers ,020205 medical informatics ,Adolescent ,Alcohol Drinking ,social media ,Psychological intervention ,030508 substance abuse ,Health Informatics ,02 engineering and technology ,Alcohol use disorder ,lcsh:Computer applications to medicine. Medical informatics ,03 medical and health sciences ,Young Adult ,Intervention (counseling) ,Surveys and Questionnaires ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,substance abuse ,Humans ,Social media ,Prospective Studies ,Young adult ,sleep ,Response rate (survey) ,Original Paper ,mobile phone ,business.industry ,lcsh:Public aspects of medicine ,lcsh:RA1-1270 ,medicine.disease ,Substance abuse ,Alcoholism ,lcsh:R858-859.7 ,Observational study ,Female ,0305 other medical science ,business - Abstract
Background Novel alcohol prevention strategies are needed for heavy-drinking young adults. Sleep problems are common among young adults who drink heavily and are a risk factor for developing an alcohol use disorder (AUD). Young adults, interested in the connection between sleep and alcohol, are open to getting help with their sleep. Therefore, sleep interventions may offer an innovative solution. This study evaluates social media advertising for reaching young adults and recruiting them for a new alcohol prevention program focused on sleep. Objective This study aims to evaluate the effectiveness and cost of using Facebook, Instagram, and Snapchat advertising to reach young adults who drink heavily for a sleep intervention; characterize responders’ sleep, alcohol use, and related concerns and interests; and identify the most appealing advertising content. Methods In study 1, advertisements targeting young adults with sleep concerns, heavy alcohol use, or interest in participating in a sleep program ran over 3 months. Advertisements directed volunteers to a brief web-based survey to determine initial sleep program eligibility and characterize the concerns or interests that attracted them to click the advertisement. In study 2, three advertisements ran simultaneously for 2 days to enable us to compare the effectiveness of specific advertising themes. Results In study 1, advertisements generated 13,638 clicks, 909 surveys, and 27 enrolled volunteers in 3 months across the social media platforms. Fees averaged US $0.27 per click, US $3.99 per completed survey, US $11.43 per volunteer meeting initial screening eligibility, and US $106.59 per study enrollee. On average, those who completed the web-based survey were 21.1 (SD 2.3) years of age, and 69.4% (631/909) were female. Most reported sleep concerns (725/909, 79.8%) and an interest in the connection between sleep and alcohol use (547/909, 60.2%), but few had drinking concerns (49/909, 5.4%). About one-third (317/909, 34.9%) were identified as being at risk for developing an AUD based on a validated alcohol screener. Among this subsample, 8.5% (27/317) met the final criteria and were enrolled in the trial. Some volunteers also referred additional volunteers by word of mouth. In study 2, advertisements targeting sleep yielded a higher response rate than advertisements targeting alcohol use (0.91% vs 0.56% click rate, respectively; P Conclusions Social media advertisements designed to target young adults with sleep concerns reached those who also drank alcohol heavily, despite few being concerned about their drinking. Moreover, advertisements focused on sleep were more effective than those focused on drinking. Compared with previous studies, cost-effectiveness was moderate for engagement (impressions to clicks), excellent for conversion (clicks to survey completion), and reasonable for enrollment. These data demonstrate the utility of social media advertising focused on sleep to reach young adults who drink heavily and recruit them for intervention.
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- 2020
32. The Kaiser Permanente Northern California Adult Alcohol Registry, an Electronic Health Records-Based Registry of Patients With Alcohol Problems: Development and Implementation
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Vanessa A. Palzes, Derek D. Satre, Murtuza Ghadiali, Constance Weisner, Stacy Sterling, Matthew E. Hirschtritt, Andrea H. Kline-Simon, and Felicia W. Chi
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medicine.medical_specialty ,Population ,Computer applications to medicine. Medical informatics ,R858-859.7 ,030508 substance abuse ,Alcohol abuse ,Health Informatics ,Alcohol use disorder ,registry ,alcohol use disorder ,unhealthy alcohol use ,secondary data ,03 medical and health sciences ,recovery ,0302 clinical medicine ,Health Information Management ,Health care ,medicine ,030212 general & internal medicine ,education ,education.field_of_study ,Original Paper ,business.industry ,alcohol ,Public health ,medicine.disease ,Mental health ,Addiction medicine ,electronic health records ,Family medicine ,Cohort ,0305 other medical science ,business - Abstract
Background Electronic health record (EHR)–based disease registries have aided health care professionals and researchers in increasing their understanding of chronic illnesses, including identifying patients with (or at risk of developing) conditions and tracking treatment progress and recovery. Despite excessive alcohol use being a major contributor to the global burden of disease and disability, no registries of alcohol problems exist. EHR-based data in Kaiser Permanente Northern California (KPNC), an integrated health system that conducts systematic alcohol screening, which provides specialty addiction medicine treatment internally and has a membership of over 4 million members that are highly representative of the US population with access to care, provide a unique opportunity to develop such a registry. Objective Our objectives were to describe the development and implementation of a protocol for assembling the KPNC Adult Alcohol Registry, which may be useful to other researchers and health systems, and to characterize the registry cohort descriptively, including underlying health conditions. Methods Inclusion criteria were adult members with unhealthy alcohol use (using National Institute on Alcohol Abuse and Alcoholism guidelines), an alcohol use disorder (AUD) diagnosis, or an alcohol-related health problem between June 1, 2013, and May 31, 2019. We extracted patients’ longitudinal, multidimensional EHR data from 1 year before their date of eligibility through May 31, 2019, and conducted descriptive analyses. Results We identified 723,604 adult patients who met the registry inclusion criteria at any time during the study period: 631,780 with unhealthy alcohol use, 143,690 with an AUD diagnosis, and 18,985 with an alcohol-related health problem. We identified 65,064 patients who met two or more criteria. Of the 4,973,195 adult patients with at least one encounter with the health system during the study period, the prevalence of unhealthy alcohol use was 13% (631,780/4,973,195), the prevalence of AUD diagnoses was 3% (143,690/4,973,195), and the prevalence of alcohol-related health problems was 0.4% (18,985/4,973,195). The registry cohort was 60% male (n=432,847) and 41% non-White (n=295,998) and had a median age of 41 years (IQR=27). About 48% (n=346,408) had a chronic medical condition, 18% (n=130,031) had a mental health condition, and 4% (n=30,429) had a drug use disorder diagnosis. Conclusions We demonstrated that EHR-based data collected during clinical care within an integrated health system could be leveraged to develop a registry of patients with alcohol problems that is flexible and can be easily updated. The registry’s comprehensive patient-level data over multiyear periods provides a strong foundation for robust research addressing critical public health questions related to the full course and spectrum of alcohol problems, including recovery, which would complement other methods used in alcohol research (eg, population-based surveys, clinical trials).
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- 2020
33. Risk of repetition and subsequent self-harm following presentation to hospital with suicidal ideation: A longitudinal registry study
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Eve Griffin, Katerina Kavalidou, Brendan Bonner, Denise O'Hagan, and Paul Corcoran
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medicine.medical_specialty ,lcsh:R5-920 ,Research paper ,Recidivism ,business.industry ,Public health ,010102 general mathematics ,Poison control ,General Medicine ,Alcohol use disorder ,medicine.disease ,01 natural sciences ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,medicine ,030212 general & internal medicine ,0101 mathematics ,medicine.symptom ,business ,Psychiatry ,lcsh:Medicine (General) ,Suicidal ideation - Abstract
Background Few studies have focused on those who present to hospital with suicidal thoughts (suicidal ideation). The aim of this study was to establish the risk of repeat presentation to hospital following suicidal ideation and to identify factors which were associated with further ideation or subsequent self-harm. Methods Data were obtained from the Northern Ireland Registry of Self-harm. Risk of repeat presentation following hospital-presenting ideation was analysed using Kaplan Meier analyses, specifically cox proportional hazard models. Findings During the period April 2014 to March 2019, a total of 14,695 presentations to hospital due to suicidal ideation were made in Northern Ireland. The cumulative incidence of repeat presentation to hospital was 40·5% within five years, with an 18·3% risk of subsequent self-harm. Previous ideation had the strongest association with repeat presentation. There was evidence of recidivism considering further ideation, with an increased risk according to number of previous presentations. In contrast, risk of subsequent self-harm was highest after the first or second presentation. Male gender and alcohol were associated with further ideation, while females and young people were more likely to re-present with self-harm. Interpretation The findings indicate that individuals who present to hospital with suicidal ideation are at risk of repeat presentation and future self-harm, however clinical guidelines do not specifically address hospital-presenting ideation. The transition from ideation to suicidal behaviour is important to consider and research could inform effective screening and early intervention measures. Role of Funding The Northern Ireland Registry of Self-harm is funded by the Public Health Agency, Northern Ireland.
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- 2020
34. Intestinal permeability, microbial translocation, changes in duodenal and fecal microbiota, and their associations with alcoholic liver disease progression in humans
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Philippe de Timary, Isabelle Leclercq, Sophie Leclercq, Yves Horsmans, Luca Maccioni, Derrick E. Fouts, Peter Stärkel, Boris Pirlot, Bei Gao, Bernd Schnabl, UCL - SSS/IONS/NEUR - Clinical Neuroscience, and UCL - (SLuc) Service de psychiatrie adulte
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0301 basic medicine ,Male ,Alcoholic liver disease ,Physiology ,Alcohol ,Alcohol use disorder ,chemistry.chemical_compound ,Liver disease ,Feces ,ck-18 ,0302 clinical medicine ,RNA, Ribosomal, 16S ,Intestinal Mucosa ,alcohol abstinence ,alcohol ,Gastroenterology ,dysbiosis ,Middle Aged ,Alcoholism ,Infectious Diseases ,Liver ,030211 gastroenterology & hepatology ,Female ,liver disease ,Research Article ,Research Paper ,Microbiology (medical) ,Adult ,CK-18 ,microbial translocation ,Duodenum ,Biology ,alcohol use disorder ,Microbiology ,Capillary Permeability ,03 medical and health sciences ,Animal data ,medicine ,microbiota ,Humans ,lcsh:RC799-869 ,Liver Diseases, Alcoholic ,Intestinal permeability ,Bacteria ,gut barrier ,medicine.disease ,Gastrointestinal Microbiome ,030104 developmental biology ,chemistry ,lcsh:Diseases of the digestive system. Gastroenterology ,Dysbiosis ,Alcohol Abstinence - Abstract
Background Animal data suggest a role of the gut-liver axis in progression of alcoholic liver disease (ALD), but human data are scarce especially for early disease stages. Methods We included patients with alcohol use disorder (AUD) who follow a rehabilitation program and matched healthy controls. We determined intestinal epithelial and vascular permeability (IP) (using urinary excretion of 51Cr-EDTA, fecal albumin content, and immunohistochemistry in distal duodenal biopsies), epithelial damage (histology, serum iFABP, and intestinal gene expression), and microbial translocation (Gram – and Gram + serum markers by ELISA). Duodenal mucosa-associated microbiota and fecal microbiota were analyzed by 16 S rRNA sequencing. ALD was staged by Fibroscan® (liver stiffness, controlled attenuation parameter) in combination with serum AST, ALT, and CK18-M65. Results Only a subset of AUD patients had increased 51Cr-EDTA and fecal albumin together with disrupted tight junctions and vasculature expression of plasmalemma Vesicle-Associated Protein-1. The so-defined increased intestinal permeability was not related to changes of the duodenal microbiota or alterations of the intestinal epithelium but associated with compositional changes of the fecal microbiota. Leaky gut alone did not explain increased microbial translocation in AUD patients. By contrast, duodenal dysbiosis with a dominance shift toward specific potential pathogenic bacteria genera (Streptococcus, Shuttleworthia, Rothia), increased IP and elevated markers of microbial translocation characterized AUD patients with progressive ALD (steato-hepatitis, steato-fibrosis). Conclusion Progressive ALD already at early disease stages is associated with duodenal mucosa-associated dysbiosis and elevated microbial translocation. Surprisingly, such modifications were not linked with increased IP. Rather, increased IP appears related to fecal microbiota dysbiosis.
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- 2020
35. The role of perceived loneliness in youth addictive behaviors: Cross-national survey study
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Hye-Jin Paek, Anu Sirola, Markus Kaakinen, Atte Oksanen, Iina Savolainen, Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences, Tampere University, and Institute of Criminology and Legal Policy
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problem behavior ,Youth ,Sosiologia - Sociology ,050109 social psychology ,Alcohol use disorder ,ADOLESCENT ,ALCOHOL-USE ,0302 clinical medicine ,Muut yhteiskuntatieteet - Other social sciences ,030212 general & internal medicine ,Social isolation ,10. No inequality ,SCALE ,media_common ,youth ,05 social sciences ,PROBLEMATIC INTERNET USE ,1. No poverty ,Loneliness ,Psychiatry and Mental health ,SOCIAL-ISOLATION ,5141 Sociology ,medicine.symptom ,Psychology ,Clinical psychology ,media_common.quotation_subject ,Social issues ,03 medical and health sciences ,DRINKING ,Intervention (counseling) ,loneliness ,medicine ,0501 psychology and cognitive sciences ,Excessive alcohol consumption ,Problem behavior ,Original Paper ,Internet ,IDENTIFICATION ,Addiction ,Psykologia - Psychology ,CONSUMPTION ,medicine.disease ,Mental health ,Social relation ,gambling ,OAKS GAMBLING SCREEN ,excessive alcohol consumption ,Gambling ,internet ,AUDIT-C - Abstract
Background In the ever-growing and technologically advancing world, an increasing amount of social interaction takes place through the Web. With this change, loneliness is becoming an unprecedented societal issue, making youth more susceptible to various physical and mental health problems. This societal change also influences the dynamics of addiction. Objective Employing the cognitive discrepancy loneliness model, this study aimed to provide a social psychological perspective on youth addictions. Methods A comprehensive survey was used to collect data from American (N=1212; mean 20.05, SD 3.19; 608/1212, 50.17% women), South Korean (N=1192; mean 20.61, SD 3.24; 601/1192, 50.42% women), and Finnish (N=1200; mean 21.29, SD 2.85; 600/1200, 50.00% women) youths aged 15 to 25 years. Perceived loneliness was assessed with the 3-item Loneliness Scale. A total of 3 addictive behaviors were measured, including excessive alcohol use, compulsive internet use, and problem gambling. A total of 2 separate models using linear regression analyses were estimated for each country to examine the association between perceived loneliness and addiction. Results Loneliness was significantly related to only compulsive internet use among the youth in all 3 countries (P Conclusions The findings reveal existing differences between youths who spend excessive amounts of time online and those who engage in other types of addictive behaviors. Experiencing loneliness is consistently linked to compulsive internet use across countries, although different underlying factors may explain other forms of addiction. These findings provide a deeper understanding in the mechanisms of youth addiction and can help improve prevention and intervention work, especially in terms of compulsive internet use.
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- 2020
36. Real-Time Mobile Monitoring of Drinking Episodes in Young Adult Heavy Drinkers: Development and Comparative Survey Study
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Daniel J. Fridberg, James Faria, Dingcai Cao, and Andrea C. King
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young adults ,Adult ,Male ,Intrusiveness ,medicine.medical_specialty ,Alcohol Drinking ,030508 substance abuse ,Binge drinking ,Health Informatics ,Alcohol use disorder ,Information technology ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Environmental health ,Surveys and Questionnaires ,Epidemiology ,Medicine ,Humans ,Young adult ,Adverse effect ,Retrospective Studies ,Original Paper ,business.industry ,ecological momentary assessment ,Survey research ,medicine.disease ,T58.5-58.64 ,Mobile Applications ,binge drinking ,3. Good health ,Feasibility Studies ,Female ,Smartphone ,Public aspects of medicine ,RA1-1270 ,0305 other medical science ,business ,030217 neurology & neurosurgery - Abstract
Background Binge drinking, defined as consuming five or more standard alcoholic drinks for men (four for women) within a 2-hour period, is common among young adults and is associated with significant alcohol-related morbidity and mortality. To date, most research on this problem in young adults has relied upon retrospective questionnaires or costly laboratory-based procedures. Smartphone-based ecological momentary assessment (EMA) may address these limitations by allowing researchers to measure alcohol use and related consequences in real time and in drinkers’ natural environments. To date, however, relatively less research has systematically examined the utility of this approach in a sample of young adults targeting real-world heavy drinking episodes specifically. Objective This study aimed to evaluate the feasibility, acceptability, and safety of a smartphone-based EMA method targeting binge drinking and related outcomes in heavy drinking young adults during real-world drinking occasions. Methods Young adult binge drinkers in the smartphone group (N=83; mean 25.4 (SD 2.6) years; 58% (48/83) male; bingeing on 23.2% (6.5/28) days in the past month) completed baseline measures of alcohol use and drinking-related consequences, followed by up to two smartphone-based EMA sessions of typical drinking behavior and related outcomes in their natural environments. They also completed next-day and two-week follow-up surveys further assessing alcohol use and related consequences during the EMA sessions and two weeks after study participation, respectively. A separate demographic- and drinking-matched safety comparison group (N=25) completed the baseline and two-week follow-up surveys but did not complete EMA of real-world drinking behavior. Results Most participants (71%, 59/83) in the smartphone group engaged in binge drinking during at least one 3-hour EMA session, consuming 7.3 (SD 3.0) standard alcoholic drinks. They completed 87.2% (507/581) system-initiated EMA prompts during the real-world drinking episode, supporting the feasibility of this approach. The procedure was acceptable, as evidenced by high participant ratings for overall satisfaction with the EMA software and study procedures and low ratings for intrusiveness of the mobile surveys. Regarding safety, participants endorsed few drinking-related consequences during or after the real-world drinking episode, with no adverse or serious adverse events reported. There were no differences between the groups in terms of changes in drinking behavior or consequences from baseline to two-week follow-up. Conclusions This study provided preliminary support for the feasibility, acceptability, and safety of a smartphone-based EMA of real-time alcohol use and related outcomes in young adult heavy drinkers. The results suggest that young adults can use smartphones to safely monitor drinking even during very heavy drinking episodes. Smartphone-based EMA has strong potential to inform future research on the epidemiology of and intervention for alcohol use disorder by providing researchers with an efficient and inexpensive way to capture large amounts of data on real-world drinking behavior and consequences.
- Published
- 2019
37. Central markers of neuroinflammation in alcohol use disorder: A meta‐analysis of neuroimaging, cerebral spinal fluid, and postmortem studies.
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Adams, Claire, Perry, Nina, Conigrave, James, Hurzeler, Tristan, Stevens, Julia, Yacou Dunbar, Kristiane P., Sweeney, Alicia, Lee, Kylie, Sutherland, Greg, Haber, Paul, and Morley, Kirsten C.
- Subjects
CEREBROSPINAL fluid examination ,COMPLICATIONS of alcoholism ,HIPPOCAMPUS physiology ,BIOMARKERS ,CYTOKINES ,PROTEINS ,ONLINE information services ,META-analysis ,CONFIDENCE intervals ,AUTOPSY ,SYSTEMATIC reviews ,RADIOISOTOPES ,NEUROINFLAMMATION ,COMPARATIVE studies ,POSITRON emission tomography ,DESCRIPTIVE statistics ,CHEMOKINES ,MEDLINE ,NEURORADIOLOGY - Abstract
Introduction and aims: There is emerging evidence that heavy long‐term alcohol consumption may alter the neuroimmune profile. We conducted a meta‐analysis of the association between alcohol use disorder (AUD) and the extent of neuroinflammation using cerebrospinal (CSF), PET (Positron Emission Tomography), and postmortem studies. Design and methods: A comprehensive search of electronic databases was conducted using the Preferred Reporting Items for Systematic Review and Meta‐Analysis Protocols (PRISMA‐P) for AUD‐related terms in combination with neuroinflammatory markers and cytokine‐ and chemokine‐related terms for CSF, PET, and postmortem studies. Participants had to meet established criteria for AUD and/or heavy alcohol consumption with dependence features and be compared with healthy controls. Papers retrieved were assessed for inclusion criteria and a critical appraisal was completed using the Newcastle‐Ottawa Scale. A meta‐analysis was conducted on postmortem and PET studies. Results: Eleven papers met the inclusion criteria with CSF, PET, and postmortem studies included in the final analysis. Postmortem studies demonstrate significant heterogeneity (푄 (14) = 62.02, 푝 < 0.001), with the alcohol group showing higher levels of neuroimmune markers than controls (푑 = 1.50 [95% CI 0.56, 2.45]). PET studies demonstrated a lower [11C] PBR28 total volume of distribution (VT) for translocator protein in the hippocampus (g = −1.95 [95% CI −2.72, −1.18], p < 0.001) of the alcohol group compared to controls. Conclusion: There is emerging evidence across multiple diagnostic modalities that alcohol impacts neuroimmune signaling in the human brain. [ABSTRACT FROM AUTHOR]
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- 2023
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38. A Mobile Phone App Featuring Cue Exposure Therapy As Aftercare for Alcohol Use Disorders:An Investigator-Blinded Randomized Controlled Trial
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Mellentin, Angelina Isabella, Nielsen, Bent, Nielsen, Anette Søgaard, Yu, Fei, Mejldal, Anna, Nielsen, Dorthe Grüner, and Stenager, Elsebeth
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Adult ,Male ,medicine.medical_specialty ,020205 medical informatics ,Cue exposure ,cognitive behavior therapy ,Aftercare ,Implosive Therapy ,Health Informatics ,Alcohol ,Craving ,Information technology ,02 engineering and technology ,Alcohol use disorder ,alcohol use disorder ,Ambulatory Care Facilities ,Mean difference ,law.invention ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Randomized controlled trial ,law ,mental disorders ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,In real life ,030212 general & internal medicine ,mobile phone app ,Original Paper ,Cognitive Behavioral Therapy ,business.industry ,T58.5-58.64 ,medicine.disease ,Mobile Applications ,Alcoholism ,chemistry ,cue exposure therapy ,Mobile phone ,randomized controlled trial ,Physical therapy ,Female ,Public aspects of medicine ,RA1-1270 ,medicine.symptom ,business ,aftercare - Abstract
Background Cue exposure therapy (CET) is a psychological approach developed to prepare individuals with alcohol use disorder (AUD) for confronting alcohol and associated stimuli in real life. CET has shown promise when treating AUD in group sessions, but it is unknown whether progressing from group sessions to using a mobile phone app is an effective delivery pathway. Objective The objectives of this study were to investigate (1) whether CET as aftercare would increase the effectiveness of primary treatment with cognitive behavior therapy, and (2) whether CET delivered through a mobile phone app would be similarly effective to CET via group sessions. Methods A total of 164 individuals with AUD were randomized to one of three groups: CET as group aftercare (CET group), CET as fully automated mobile phone app aftercare (CET app), or aftercare as usual. Study outcomes were assessed face-to-face at preaftercare, postaftercare, and again at 6 months after aftercare treatment. Generalized mixed models were used to compare the trajectories of the groups over time on drinking, cravings, and use of urge-specific coping skills (USCS). Results In all, 153 of 164 individuals (93%) completed assessments both at posttreatment and 6-month follow-up assessments. No differences in the trajectories of predicted means were found between the experimental groups (CET group and app) compared with aftercare as usual on drinking and craving outcomes over time. Both CET group (predicted mean difference 5.99, SE 2.59, z=2.31, P=.02) and the CET app (predicted mean difference 4.90, SE 2.26, z=2.31, P=.02) showed increased use of USCS compared to aftercare as usual at posttreatment, but this effect was reduced at the 6-month follow-up. No differences were detected between the two experimental CET groups on any outcomes. Conclusions CET with USCS delivered as aftercare either via group sessions or a mobile phone app did not increase the effectiveness of primary treatment. This suggests that CET with USCS may not be an effective psychological approach for the aftercare of individuals treated for AUD. Trial Registration ClinicalTrials.gov NCT02298751; https://clinicaltrials.gov/ct2/show/NCT02298751
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- 2019
39. Saying yes or no to physical activity – A comparative cohort analysis of patients seeking treatment for Alcohol Use Disorder
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Anette Søgaard Nielsen, Kirsten Kaya Roessler, and Randi Bilberg
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medicine.medical_specialty ,lcsh:Social pathology. Social and public welfare. Criminology ,Research paper ,AUD ,lcsh:BF1-990 ,Physical activity ,Treatment as usual ,Physical exercise ,Alcohol use disorder ,Alcohol treatment ,law.invention ,Drinking pattern ,lcsh:HV1-9960 ,Randomized controlled trial ,law ,medicine ,Psychiatry ,business.industry ,medicine.disease ,Psychiatry and Mental health ,lcsh:Psychology ,Non-participants ,business ,Alcohol ,Cohort study - Abstract
Introduction Engaging individuals, suffering from alcohol use disorder (AUD), in a physical activity can be a challenge, and often it is a limitation of the quality of studies on the topic. The aim of the present study is to investigate differences between participants and non-participants in a randomized controlled trial on the effect of physical exercise as add-on to treatment as usual (TAU) to treatment for alcohol use disorder, thereby identifying potential factors that may predict lack of willingness or ability to consider increasing the level of physical activity. Method The Healthy Lifestyle Study was a randomized controlled trial with three arms, of which two included adding physical activities to treatment for AUD as usual. All patients from an outpatient alcohol treatment clinic were invited to participate in the study. 172 accepted participation, and 384 patients either did not show up for information about the study or declined to participate. All patients in the treatment clinic were assessed by means of European Addiction Severity Index (EuropASI). Results The only predictor of participation in the study was the drinking pattern. Patients, who had been drinking every day for the last 6 months were less likely to participate in the study (OR 0.7 CI 0.4–0.9). Neither somatic nor psychiatric health seemed to impact whether or not the patients participated in the study. Conclusion Non-participants did not differ from participants in this study except in their drinking pattern., Highlights • No psychological or social differences between participants and non-participants • Non-participants drink alcohol on a daily base. • Non-participants are affected by something else than health and social problems.
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- 2019
40. Psychological treatment of PTSD with comorbid substance use disorder (SUD): expert recommendations of the European Society for Traumatic Stress Studies (ESTSS).
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Roberts, Neil P., Lotzin, Annett, and Schäfer, Ingo
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PSYCHOTHERAPY ,POST-traumatic stress disorder ,ALCOHOLISM ,EMOTIONAL trauma ,SUBSTANCE abuse ,COMORBIDITY ,RANDOMIZED controlled trials - Abstract
Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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41. Alcohol Misuse post Metabolic and Bariatric Surgery: A Systematic Review of Longer-term Studies with Focus on new Onset Alcohol use Disorder and Differences Between Surgery Types
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Kenkre, Julia S., Gesell, Sutapa, Keller, Annalise, Milani, Raffaella M., Scholtz, Samantha, and Barley, Elizabeth A.
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- 2024
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42. Emotion regulation in substance use disorders: a systematic review and meta‐analysis.
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Stellern, Jordan, Xiao, Ke Bin, Grennell, Erin, Sanches, Marcos, Gowin, Joshua L., and Sloan, Matthew E.
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SUBSTANCE abuse diagnosis ,SUBSTANCE abuse & psychology ,ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,NARCOTICS ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,ALCOHOLISM ,SYSTEMATIC reviews ,CROSS-sectional method ,METHAMPHETAMINE ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,EMOTION regulation ,MEDLINE ,DATA analysis software ,PSYCHOLOGICAL resilience ,COMPULSIVE behavior - Abstract
Background and aims: The ability to regulate emotions effectively has been associated with resilience to psychopathology. Individuals with substance use disorders (SUDs) have been shown to have higher levels of negative emotionality, with some evidence suggesting impairment in emotion regulation compared with individuals without SUDs. However, no previous attempt has been made to systematically review the literature to assess the magnitude of this difference. We aimed to assess the association between SUD diagnosis and emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ) through a systematic review and meta‐analysis of existing findings. Methods: The systematic review was conducted using PubMed, PsycINFO and Embase. We examined cross‐sectional studies that compared a SUD group with a control group and measured emotion regulation using the DERS or the ERQ. The primary analysis focused on papers using the DERS, as this was the predominant instrument in the literature. Results: Twenty‐two studies met our primary analysis criteria, representing 1936 individuals with a SUD and 1567 controls. Individuals with SUDs relative to controls had significantly greater DERS scores, with a mean difference of 21.44 [95% confidence interval (CI) = 16.49–26.40, P < 0.001] and Hedges' g = 1.05 (95% CI = 0.86–1.24, P < 0.001). The difference was robust, remaining significant after removing outliers and studies with high risk of bias. Individuals with SUDs demonstrated poorer emotion regulation on each subscale of the DERS, with the largest deficits in the Strategies and Impulse subscales. The ERQ analysis revealed greater use of expressive suppression in those with SUDs relative to controls (Hedges' g = 0.76, 95% CI = 0.25–1.28, P = 0.004). Conclusions: People with substance use disorders appear to have greater difficulties in emotion regulation than people without substance use disorders. [ABSTRACT FROM AUTHOR]
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- 2023
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43. Alcohol use and alcohol use disorders in sub‐Saharan Africa: A systematic review and meta‐analysis.
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Belete, Habte, Yimer, Tesfa Mekonen, Dawson, Danielle, Espinosa, Dorothy C., Ambaw, Fentie, Connor, Jason P., Chan, Gary, Hides, Leanne, and Leung, Janni
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- *
SUBSTANCE abuse risk factors , *SUBSTANCE abuse , *MEDICAL information storage & retrieval systems , *RISK assessment , *RESEARCH funding , *META-analysis , *DISEASE prevalence , *HEALTH insurance exchanges , *DESCRIPTIVE statistics , *SYSTEMATIC reviews , *MEDLINE , *TEENAGERS' conduct of life , *ALCOHOLISM , *ALCOHOL drinking , *ONLINE information services , *CONFIDENCE intervals , *PSYCHOLOGY information storage & retrieval systems , *LONGEVITY ,DEVELOPED countries - Abstract
Background and aims: Population‐level alcohol use data are available from high‐income countries, but limited research has been conducted in sub‐Saharan Africa. This systematic review and meta‐analysis aimed to summarize population‐level alcohol use in sub‐Saharan Africa. Method: Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'substance‐related disorders' and 'prevalence' and 'sub‐Saharan Africa'. We included general population studies on alcohol use (including any use, high‐risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub‐Saharan African adolescents (10–17) and adults (18+) were extracted. Analyses included life‐time and past 12‐ and 6‐month alcohol use. Results: We included 141 papers. Among adolescents, the life‐time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3–37.1%], 36.2% (CI = 18.4–56.1%) in the past year and 11.3% (CI = 4.5–20.4%) in the past 6 months. Among adolescents, 12‐month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0–27.8%) and 4.1% (CI = 1.4–7.9%), respectively. Among adults, the life‐time prevalence of alcohol use was 34.9% (CI = 17.7–54.1%), 27.1% (CI = 5.0–56.4%) in the past year and 32.2% (CI = 19.8–46.0%) in the past 6 months. Among adults, the 12‐month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0–30.4%) and 4.3% (CI = 0.8–9.8%), respectively. The highest weighted life‐time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6‐month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents. Conclusion: Alcohol use patterns vary across countries and subregions within sub‐Saharan Africa, and comprehensive population‐level data on alcohol use remain scarce in numerous sub‐Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]
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- 2024
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44. Harm Reduction as 'Continuum Care' in Alcohol Abuse Disorder
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Alessandro Rossi, Pier Paolo Pani, Mauro Cibin, Icro Maremmani, and Giuseppe Turchetti
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medicine.medical_specialty ,Alcohol Drinking ,Substance-Related Disorders ,Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,alcohol dependence ,Alcohol abuse ,lcsh:Medicine ,Alcohol use disorder ,opioid receptors ,economic costs ,Harm Reduction ,Behavior Therapy ,Risk Factors ,Intervention (counseling) ,medicine ,Humans ,detoxification ,Psychiatry ,media_common ,harm reduction strategy ,Harm reduction ,Motivation ,Primary Health Care ,alcoholism ,Addiction ,Alcohol dependence ,comprehensive treatment ,public health ,lcsh:R ,Public Health, Environmental and Occupational Health ,compliance with treatment ,Concept Paper ,Abstinence ,Continuity of Patient Care ,medicine.disease ,anti-craving medications ,reduction in alcohol consumption ,stigma ,Behavior, Addictive ,Psychology ,Psychosocial ,Alcohol-Related Disorders - Abstract
Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.
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- 2015
45. Alcohol use disorder conceptualizations and diagnoses reflect their sociopolitical context.
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Boness, Cassandra L., Votaw, Victoria R., Francis, Meredith W., Watts, Ashley L., Sperry, Sarah H., Kleva, Christopher S., Nellis, Linda, McDowell, Yoanna, Douaihy, Antoine B., Sher, Kenneth J., and Witkiewitz, Katie
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ALCOHOL-induced disorders ,SOCIAL norms ,PRACTICAL politics ,SOCIAL skills ,CLASSIFICATION of mental disorders - Abstract
The present paper highlights how alcohol use disorder (AUD) conceptualizations and resulting diagnostic criteria have evolved over time in correspondence with interconnected sociopolitical influences in the United States. We highlight four illustrative examples of how DSM-defined alcoholism, abuse/dependence, and AUD have been influenced by sociopolitical factors. In doing so, we emphasize the importance of recognizing and understanding such sociopolitical factors in the application of AUD diagnoses. Last, we offer a roadmap to direct the process of future efforts toward the improved diagnosis of AUD, with an emphasis on pursuing falsifiability, acknowledging researchers' assumptions about human behavior, and collaborating across subfields. Such efforts that center the numerous mechanisms and functions of behavior, rather than signs or symptoms, have the potential to minimize sociopolitical influences in the development of diagnostic criteria and maximize the treatment utility of diagnoses. [ABSTRACT FROM AUTHOR]
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- 2023
- Full Text
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46. Hangover resistance in a Canadian University student population
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Kruisselbrink, L Darren, Bervoets, Adriana C, de Klerk, Suzanne, van de Loo, Aurora J A E, Verster, Joris C, Sub BasicPharmacology&Psychopharmacology, dIRAS RA-1, Afd Pharmacology, LS IRAS Tox Algemeen, Sub BasicPharmacology&Psychopharmacology, dIRAS RA-1, Afd Pharmacology, and LS IRAS Tox Algemeen
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Gerontology ,lcsh:Social pathology. Social and public welfare. Criminology ,Research paper ,lcsh:BF1-990 ,Population ,030508 substance abuse ,Alcohol use disorder ,lcsh:HV1-9960 ,03 medical and health sciences ,Time frame ,Hangover resistance ,Alcohol hangover ,0502 economics and business ,medicine ,Prevalence ,Risk factor ,education ,BAC ,Student population ,education.field_of_study ,Drinking episode ,05 social sciences ,medicine.disease ,Psychiatry and Mental health ,lcsh:Psychology ,050211 marketing ,Hangover ,0305 other medical science ,Psychology ,Alcohol ,Behavioral Sciences ,Demography - Abstract
Background Resistance to alcohol hangover may be a risk factor for alcohol use disorder. Previous research to establish the prevalence of hangover resistance in a drinking population has either not used comparable intoxication levels or has considered hangover resistance over a limited time frame. The purpose of this study was to examine the prevalence of lifetime hangover negative (LHN) drinkers across comparable eBAC values ranging from 0 to 500 mg/dl. Methods Students at an eastern Canadian university were surveyed about their heaviest drinking episode in the past month and indicated whether they had ever experienced a hangover in their lifetime (LHN) and, if they had, the hangover severity they experienced the next day. eBACs were calculated and the percentage of LHN drinkers was computed at each 10 mg/dl eBAC increment from 0 to 500 mg/dl. Results Most LHN drinkers (58% female, 71% male) had an eBAC on their heaviest drinking occasion below 80 mg/dl. Above eBACs of 80 mg/dl, 5.8% of female and 5.1% of male drinkers were lifetime hangover negative. Conclusions The results suggest that only a small percentage of heavy drinkers lay claim to being lifetime hangover negative., Highlights • The estimated BAC of more than half of male and female lifetime hangover negative drinkers was below 80 mg%. • Approximately 5% of drinkers registering estimated BAC’s beyond 80 mg% claim to be lifetime hangover negative. • Biological and psychological hypotheses are proposed to explain why heavy drinkers may be lifetime hangover negative.
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- 2017
47. Smartphone Alcohol Use Disorder Recovery Apps: Cross-sectional Survey of Behavioral Intention to Use.
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Menon, Rijuta, Meyer, Julien, Nippak, Pria, and Begum, Housne
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SMARTPHONES ,ALCOHOLISM ,SOCIAL influence ,MOBILE health ,DISEASE management - Abstract
Background: Alcohol use disorder (AUD) carries a huge health and economic cost to society. Effective interventions exist but numerous challenges limit their adoption, especially in a pandemic context. AUD recovery apps (AUDRA) have emerged as a potential complement to in-person interventions. They are easy to access and show promising results in terms of efficacy. However, they rely on individual adoption decisions and remain underused. Objective: The aim of this survey study is to explore the beliefs that determine the intention to use AUDRA. Methods: We conducted a cross-sectional survey study of people with AUD. We used the Unified Theory of Acceptance and Use of Technology, which predicts use and behavioral intention to use based on performance expectancy, effort expectancy, social influence, and facilitating conditions. Participants were recruited directly from 2 sources; first, respondents at addiction treatment facilities in Ontario, Canada, were contacted in person, and they filled a paper form; second, members from AUD recovery support groups on social media were contacted and invited to fill an internet-based survey. The survey was conducted between October 2019 and June 2020. Results: The final sample comprised 159 participants (124 involved in the web-based survey and 35 in the paper-based survey) self-identifying somewhat or very much with AUD. Most participants (n=136, 85.5%) were aware of AUDRA and those participants scored higher on performance expectancy, effort expectancy, and social influence. Overall, the model explains 35.4% of the variance in the behavioral intention to use AUDRA and 11.1% of the variance in use. Social influence (P=.31), especially for women (P=.23), and effort expectancy (P=.25) were key antecedents of behavioral intention. Facilitating conditions were not significant overall but were moderated by age (P=.23), suggesting that it matters for older participants. Performance expectancy did not predict behavioral intention, which is unlike many other technologies but confirms other findings associated with mobile health (mHealth). Open-ended questions suggest that privacy concerns may significantly influence the use of AUDRA. Conclusions: This study suggests that unlike many other technologies, the adoption of AUDRA is not mainly determined by utilitarian factors such as performance expectancy. Rather, effort expectancy and social influence play a key role in determining the intention to use AUDRA. [ABSTRACT FROM AUTHOR]
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- 2022
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48. The affective temperaments as a prognostic factor in the course of alcohol addiction - a key to enhance diagnoses and therapy?
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Podlecka, Marlena, Nowakowska-Domagała, Katarzyna, Czarnecki, Jan, and Mokros, Łukasz
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ALCOHOLISM , *DRUG addiction , *SUICIDAL behavior , *PROGNOSIS , *TEMPERAMENT - Abstract
The paper outlines the role of affective temperaments, as defined by Akiskal, in the development and maintenance of alcohol use disorders with a particular focus on the clinical course of addiction. Among affective temperaments, a cyclothymic temperament seems to play a key role in the development and maintenance of alcohol use disorders, and have the greatest influence on the clinical course of addiction. A high cyclothymic score is associated with inter alia an earlier onset of drinking and alcohol dependence, a negative course of alcohol dependence, relapse and alcohol craving. The structure of affective temperaments is also a predictor of suicidal behavior and drug addiction in the alcohol addict population. Interest has been growing regarding the role of affective temperament in the development and course of alcohol dependence; however, further research in this area is needed. An understanding of the temperamental determinants of alcohol dependence in the affective dimension may significantly support diagnostic and therapeutic procedures. Affective temperament profile may be suggestive of alcohol use disorders and may be a primary prognostic factor of craving and relapse, potential suicide, treatment motivation and the co-occurrence of drug dependence among patients with alcohol use disorder. [ABSTRACT FROM AUTHOR]
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- 2024
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49. Alcohol use disorder among Whites and Hispanics on and off the U.S./Mexico border in California.
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Caetano, Raul, Vaeth, Patrice A. C., Gruenewald, Paul J., Ponicki, William R., and Kaplan, Zoe
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INCOME , *DATA analysis , *STATISTICAL significance , *RESEARCH funding , *HISPANIC Americans , *SEX distribution , *MULTIPLE regression analysis , *WHITE people , *CLASSIFICATION of mental disorders , *AGE distribution , *CHI-squared test , *MULTIVARIATE analysis , *DISEASE prevalence , *DESCRIPTIVE statistics , *ALCOHOL-induced disorders , *BIRTHPLACES , *RELIGION , *STATISTICS , *ALCOHOL drinking , *DATA analysis software , *EMPLOYMENT , *EDUCATIONAL attainment - Abstract
This paper examines whether U.S./Mexico border residence in California is related to the prevalence of DSM-5 alcohol use disorder (AUD) among Whites and Hispanics. Household survey data were obtained from 1,209 adults (59.7% female) 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample, with data collected on the phone or online. Results show that AUD rates were not different between border and non-border location and between Whites and Hispanics. AUD was negatively associated with higher income ($20,000 to $60,000: AOR=.38; 95%CI=.17–.86; p<.01—more than $60,000: AOR=.27; 95%CI:.09–.81; p<.01) and poor risk perception (AOR=.86; 95%CI=.78–.94; p<.01). AUD was positively associated with continued volume of drinking (AOR = 1.05; 95%CI = 1.01–1.09; p<.01), drinking in Mexico (AOR = 4.28; 95%CI = 1.61–11.36; p<.01), marijuana use (AOR = 4.11; 95%CI = 1.73–9.77; p<.01), and impulsivity (AOR = 1.55; 95%CI = 1.23–1.94). Efforts to prevent AUD in the population in California, and especially among those who live close to the border with Mexico, should take into consideration factors such as impulsivity, marijuana use, border crossing to drink in Mexico, all of which increased risk of AUD. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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50. The public stigma of problem gambling: Its nature and relative intensity compared to other health conditions
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Nerilee Hing, Elaine Nuske, Alex M. T. Russell, and Sally M. Gainsbury
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Adult ,Male ,Societal stigma ,Sociology and Political Science ,Social stigma ,Health Status ,Public stigma ,Population ,Social Stigma ,030508 substance abuse ,Stigma (botany) ,public stigma ,Alcohol use disorder ,Gambling disorder ,medicine.disease_cause ,treatment-seeking ,Problem gambling ,03 medical and health sciences ,0302 clinical medicine ,problem gambling ,societal stigma ,medicine ,Humans ,education ,Psychology(all) ,General Psychology ,education.field_of_study ,Stereotyping ,Original Paper ,Social distance ,Chemical imbalance ,gambling disorder ,Australia ,170106 - Health, Clinical and Counselling Psychology [FoR] ,Treatment-seeking ,Middle Aged ,medicine.disease ,Mental health ,030227 psychiatry ,Distress ,Gambling ,Female ,0305 other medical science ,Psychology ,Social psychology ,Attitude to Health ,mental health - Abstract
Problem gambling attracts considerable public stigma, with deleterious effects on mental health and use of healthcare services amongst those affected. However, no research has examined the extent of stigma towards problem gambling within the general population. This study aimed to examine the stigma-related dimensions of problem gambling as perceived by the general public compared to other health conditions, and determine whether the publicly perceived dimensions of problem gambling predict its stigmatisation. A sample of 2000 Australian adults was surveyed, weighted to be representative of the state population by gender, age and location. Based on vignettes, the online survey measured perceived origin, peril, concealability, course and disruptiveness of problem gambling and four other health conditions, and desired social distance from each. Problem gambling was perceived as caused mainly by stressful life circumstances, and highly disruptive, recoverable and noticeable, but not particularly perilous. Respondents stigmatised problem gambling more than sub-clinical distress and recreational gambling, but less than alcohol use disorder and schizophrenia. Predictors of stronger stigma towards problem gambling were perceptions it is caused by bad character, is perilous, non-recoverable, disruptive and noticeable, but not due to stressful life circumstances, genetic/inherited problem, or chemical imbalance in the brain. This new foundational knowledge can advance understanding and reduction of problem gambling stigma through countering inaccurate perceptions that problem gambling is caused by bad character, that people with gambling problems are likely to be violent to other people, and that people cannot recover from problem gambling. Financial support for this research was provided by the Victorian Research Gambling Foundation. The funding body had no role in the creation of the study design; in the collection, analysis and interpretation of data; in the writing of articles; and in the decision to submit this article for publication.
- Published
- 2016
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