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Aims: To investigate the onset and outcome of alcohol dependence in subjects with childhood attention deficit/hyperactivity disorder (ADHD) in a Turkish sample. Methods: Among patients being treated for alcohol dependence, 15 had a history of childhood ADHD (ADHD (+)) and 45 did not (ADHD (-)). ADHD history was assessed according to DSM-IV criteria by a child and adolescent psychiatrist who interviewed the subjects and their close relatives. Severity of dependence was measured by the Michigan Alcoholism Screening Test. Subjects were followed up for 1 year for the assessment of relapse. Results: The age of onset for alcohol drinking, alcohol abuse and alcohol dependence were significantly lower in the ADHD (+) group than in the ADHD (-) group. Comorbid substance use was more prevalent in the ADHD (+) group. The study found no significant difference in the severity of alcohol dependence between ADHD (+) and ADHD (-) groups. During follow-up, 80% of the ADHD (+) subjects relapsed, compared with 55.6% in the ADHD (-) group. Relapse occurred on average 2.74 months earlier in the ADHD (+) group than in the ADHD (-) group. Conclusions: As found in other countries, alcohol dependence in Turkish subjects with childhood ADHD starts early and is relatively resistant to treatment. Early diagnosis and treatment of ADHD might help prevent alcohol- and substance-related disorders.

The present study was designed to test the hypothesis that preference for stronger sweet solutions may be associated with the genetic risk for alcoholism. Thirty-two male patients with alcohol dependence admitted for alcoholism in-patient treatment and 25 non-alcoholic control subjects were used in the study. Hedonic response to sweets was evaluated using the sweet preference t est. Family history of alcoholism was evaluated using a Russian version of the Michigan Alcoholism Screening Test modified for the assessment of the alcohol-related behaviour of the subject's biological father. Similar to our previous findings, alcoholics were far more likely to prefer the highest offered sucrose concentration (0.83 M), compared to non-alcoholic controls. Such preference was de termined by two factors: positive family history of alcoholism and alcoholic status. Statistically, these factors contributed to the lik elihood of preferring sweet solutions independently. Therefore, the effects of these factors may enhance each other. These findings suppor t the hypothesis that preference for a stronger sweet solution is associated with a paternal history of alcohol dependence and may re flect a genetic predisposition to alcoholism.

This longitudinal study aimed at comparing aggregate measures of heavy or problem drinking and their variations across time among the same subjects. We examined middle-aged men participating in a health survey over a 5-year interval. Of the 133 consecutive men in the whole age group interviewed as 40-year-olds in 1989, 114 were reached and re-interviewed in 1994. Alcohol consumption was measured by self-report, Malmo-modified Michigan Alcoholism Screening Test (Mm-MAST), and serum carbohydrate-deficient transferrin (CDT). Self-reported alcohol consumption decreased with years (142 vs 105 g/week, P = 0.01), as did CDT (16.9 vs 14.4 U/l, P = 0.02), but there was no change in the Mm-MAST results. There was no significant difference in the number of heavy drinkers (either Mm-MAST score > or = 3, or by self-reported alcohol consumption > or = 280 g/week, or by CDT > or = 20 U/l) at 40 and 45 years of age (37 and 47% respectively). At the individual level, alcohol consumption both increased and decreased with age. At 45 years of age 5/114 (4%) of the men reported that they had increased their alcohol consumption by more than 80 g/week and 25/114 (22%) said that they had reduced their drinking by the same amount. The remaining 84 (74%) reported drinking the same amount as 5 years earlier (+/- 80 g/week). This indicates that alcohol drinking habits are not stable in middle age. Most heavy drinkers in both age groups were detected by Mm-MAST and this proportion increased with age while the proportion of positive self-reports and CDTs decreased. Thus, the social consequences, measured here by the Mm-MAST, may be more readily experienced with years even at smaller consumption levels.

Male medical inpatients rated alcoholic on the Michigan Alcoholism Screening Test in 1982 were compared with non-alcoholic controls admitted to medical wards in the same year. By 1990 the alcoholic subjects had moderated their drinking, although peak consumption at follow-up was twice that of controls. A similar number of health and social disabilities occurred during the follow-up period among alcoholics and controls. Untraced and dead alcoholics had scored highly on MAST and the Severity of Alcohol Dependence Questionnaire in 1982.

Eight hundred and eighteen (400 males and 418 females), randomly selected inhabitants of an economically depressed rural village in the south of Tenerife, have been analysed with respect to their daily alcoholic intake and its relationship to sex, age, marital status, educational and economical level, job, tobacco use and the CAGE and brief MAST tests. Five hundred and four (68.9%) consumed alcoholic beverages, while 254 (31.1%) were teetotal; 12.1% of the subjects aged more than 15 years (23.85% of the males and 1.4% of the females) consumed 'risk' amounts of alcoholic beverages (more than 80 g/day and 40 g/day respectively). Mean ethanol consumption was 37.9 +/- 2.1 g/day for the male sex and 3.9 +/- 0.6 g/day for the female. Maximum mean ethanol consumption (60.9 g/day) was observed among the males aged 55-64 years. The distribution of the population according to the amount of ethanol consumed fits into Lederman's curve, most of the individuals being consumers of small amounts of ethanol. Male sex, middle age, married status, unskilled job, low educational level, and tobacco use were all related to a higher ethanol consumption. CAGE and brief MAST tests detected only 40.5% and 47% respectively of the subjects with 'risk' levels of alcohol consumption.

A new biological alcohol marker, the ratio between the acetaldehyde-induced haemoglobin fraction HbA1ach and the glycated haemoglobin fraction HbA1c (HbA1ach/HbA1c), was studied in association with data obtained in a questionnaire, the Malmö modified Michigan alcoholism screening test (Mm-MAST), completed by 270 consecutive middle-aged men participating in a voluntary health screening. None of them had earlier alcoholic health or alcohol-dependent social problems. The nine-question Mm-MAST correlated positively with the ratio of HbA1ach/HbA1c (r = 0.272, P less than 0.001). In the three drinker groups defined according to the questionnaire, HbA1ach/HbA1c values were significantly higher among heavy drinkers (mean = 40, S.E.M. = 1) than among teetotallers (mean = 32, S.E.M. = 2, P less than 0.01) or social drinkers (mean = 35, S.E.M. = 1, P less than 0.01). In the groups formed according to the respondents' own alcohol anamnesis there was no significant difference between the marker values, but the Mm-MAST score was significantly higher in both social (P less than 0.001) and heavy drinkers' (P less than 0.001) groups as compared with teetotallers. This shows that the questionnaire detected heavy drinkers better than the self-given anamnesis. The correlation of HbA1ach/HbA1c and the questionnaire means that the biological marker studied represents a new possibility to identify heavy drinkers before alcoholic health problems or social consequences have appeared.

A discriminant function based on a number of biochemical and haematological tests from an extended multiple biochemical analysis and full blood count, together with weight, smoking status and systolic blood pressure is developed. The function was far more effective at detecting high alcohol use (greater than 40 g ethanol per day) than serum gamma-glutamyl transpeptidase (GGT) or the Short Michigan Alcoholism Screening Test (SMAST) in a community sample of adult males. When classifying high alcohol consumption by GGT only, several division criteria were considered, the most effective being at 40 i.u./l. In terms of identifying high alcohol consumers, rather than alcoholics, the SMAST was no better than GGT, and both had unacceptably low sensitivity (49%, 51%) and poor performance on other measures, thus limiting their use as community screening tools. The discriminant function, however, had an estimated community sensitivity of 78%, was similarly high on other performance measures, and would perform satisfactorily as a community screening tool, particularly in situations where there was a tendency for individuals to under-report their alcohol consumption.

The major focus of research on alcohol is not on the majority who drink without problems, but on the small minority who have extreme problems. Difficulty in conceiving, measuring, and analyzing non-problem thinking lies in the exclusively problem-drinking orientation of most drinking measures. Drawing on conventionally used scales (e.g. Short Michigan Alcoholism Screening Test) and other established concepts in the alcohol literature (e.g. craving, hangover), a set of 24 items was selected to classify all persons in a sample from Tecumseh, Michigan, as to their alcohol-related behaviors ( N = 1266). A Sensible-Problem Drinking Classification (SPDC) was developed with five categories: very sensible, sensible, borderline, problem, and impaired A variety of known alcohol and psychosocial variables were related monotonically across these categories in expected directions. Ethanol ounces per week was only modestly related to SPDC groups: R2 = 0.09 for women, R1 = 0.21 for men. The positive relationship of problem and non-problem SPDC groups to high and low blood pressure was P = 0.07, while ethanol (oz/week) was uncorrelated to blood pressure (mm Hg) in this subsample ( N = 453). The development of SPDC requires additional items measuring self and group regulatory alcohol behavior. However, this initial analysis of no-problem subgroups has direct import for public health regulation of alcohol use by providing a model of a sensible view of alcohol use.

The paper describes a study of 58 consecutive male soldiers under 30 years old admitted to an alcohol treatment unit in London, and 51 age- and gender-matched controls to compare the efficacy of isoelectric focusing, a non-quantitative measure of carbohydrate deficient transferrin (CDT), with other markers of alcohol misuse. The Severity of Alcohol Dependence Questionnaire, the Michigan Alcohol Screening Test and the CAGE questions were all more sensitive in detecting alcohol misusers than the laboratory markers measured. At standard cut-off levels, the laboratory markers yielded low sensitivities even in those subjects who admitted to drinking over 80 g alcohol daily for at least 3 weeks immediately prior to the study. CDT was the most sensitive (31%), followed by mean cell volume (14%) and gamma glutamyl transferase (11%). The questionnaires and laboratory markers had good specificities.

Ten previously published and two new MMPI-derived scales were compared with the short-form of the Michigan Alcohol Screening Test (SMAST-13) in terms of sensitivity and specificity at detecting alcohol disorder in a study of 100 alcohol out-patients, 100 mental health out-patients, and 100 college students. The SMAST-13 and the new MMPI-derived alcoholism scales performed best at detecting alcohol disorder on multiple criteria including the standard contingency table, relative efficiency, and receiver operator characteristic analyses. These conclusions. were found to be robust in separate analyses for males and females.

The relationship between blood catalase activity and alcohol consumption was investigated in a group of Caucasian volunteers (N = 191). Subjects individually attended a 1-hr session, during which they were asked to complete the Michigan Alcoholism Screening Test (MAST) and MacAndrew Scale (MAC), supply information on alcohol consumption (averaged over the most recent and typical 30-day periods: Recent and Typical Q-values) and other drug use by answering the Concordia Alcohol Screening Questionnaire (CASQ), and provide a 100-microliter blood sample from the fingertip. Results showed a significant positive relationship between typical Q-Value and catalase activity (r = 0.43, P less than 0.001), which improved after eliminating multiple drug users from the analysis (r = 0.65, P less than 0.001). Multiple regression analyses showed that catalase activity combined with being male, using cocaine or crack, scoring highly on the MAC scale and having alcohol-related problems (MAST), explained a significant portion of the variance in Typical Q-Value. These results support the notion that catalase activity is a strong positive determinant of alcohol intake and support the hypothesis that the enzyme catalase plays a role in regulating voluntary ethanol consumption.

We studied 120 injured male patients of working age who were heavy drinkers or alcoholics, obtaining seven points or more in the Michigan Alcoholism Screening Test (MAST). They were randomly allocated either to an intervention group (IG) or to a control group (CG). In addition to the MAST interview, the consumption of alcohol during the previous week prior to hospital admission was calculated and laboratory measures (serum GGT, ASAT and ALAT) were obtained. Counselling of the patients in the IG was carried out by a trained assistant nurse and a physician. Forty-nine patients in IG and 40 patients in , CG were re-examined after 6 months. In the IG 45% and in the CG 20% of the patients were improved (Chi square test, P