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Background: Cue exposure therapy is used to treat alcohol dependence. However, its effectiveness is controversial due to the limitations of the clinical treatment setting. Virtual reality technology may improve the therapeutic effect. The aim of this study is to explore whether virtual reality-based cue exposure therapy can reduce the psychological craving and physiological responses of patients with alcohol dependence. Methods: Forty-four male alcohol-dependent patients were recruited and divided into the study group (n = 23) and the control group (n = 21) according to a random number table. The control group received only conventional clinical treatment for alcohol dependence. The study group received conventional clinical treatment with the addition of VR cue exposure (treatment). The primary outcome was to assess psychological craving and physiological responses to cues of patients before and after treatment. Results: After virtual reality-based cue exposure therapy, the changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those in the control group (P < 0.05), while the changes in skin conductance and respiration between the study group and the control group were not significantly different (P > 0.05). The changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those before treatment (P < 0.05), while the changes in skin conductance and respiration were not significantly different from those before treatment (P > 0.05). The changes in VAS, heart rate, skin conductance and respiration before and after cue exposure in the control group were not significantly different from those before treatment (P > 0.05). Conclusion: Virtual reality-based cue exposure therapy can reduce the psychological craving and part of the physiological responses of alcohol-dependent patients during cue exposure in the short term and may be helpful in the treatment of alcohol dependence. Trial registration: The study protocol was registered at the China Clinical Trial Registry on 26/02/2021 (www.chictr.org.cn; ChiCTR ID: ChiCTR2100043680). [ABSTRACT FROM AUTHOR]

Previous diffusion tensor imaging (DTI) studies have demonstrated widespread white matter microstructure damage in individuals with alcoholism. However, very little is known about the alterations in the topological architecture of white matter structural networks in alcohol dependence (AD). This study included 67 AD patients and 69 controls. The graph theoretical analysis method was applied to examine the topological organization of the white matter structural networks, and network-based statistics (NBS) were employed to detect structural connectivity alterations. Compared to controls, AD patients exhibited abnormal global network properties characterized by increased small-worldness, normalized clustering coefficient, clustering coefficient, and shortest path length; and decreased global efficiency and local efficiency. Further analyses revealed decreased nodal efficiency and degree centrality in AD patients mainly located in the default mode network (DMN), including the precuneus, anterior cingulate and paracingulate gyrus, median cingulate and paracingulate gyrus, posterior cingulate gyrus, and medial part of the superior frontal gyrus. Furthermore, based on NBS approaches, patients displayed weaker subnetwork connectivity mainly located in the region of the DMN. Additionally, altered network metrics were correlated with intelligence quotient (IQ) scores and global assessment function (GAF) scores. Our results may reveal the disruption of whole-brain white matter structural networks in AD individuals, which may contribute to our comprehension of the underlying pathophysiological mechanisms of alcohol addiction at the level of white matter structural networks. • Alcohol-dependent patients exhibited abnormal global network properties. • Alcohol-dependent patients displayed altered network organization, especially in the DMN. • Altered network metrics were correlated with IQ scores and GAF scores in alcohol-dependent patients. [ABSTRACT FROM AUTHOR]

Introduction: Findings from general population studies are lacking in regard to the co-occurrence of alcohol and nicotine dependence in relation to later mortality. The aim of this study was to analyze potential interactions of risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and time until the first cigarette is smoked in the morning after awakening in the prediction of mortality. Methods: This study analyzed a random sample of the general population in Northern Germany, which comprised adults aged 18–64 years. Risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and the time until the first cigarette in the morning after awakening were assessed for the period of 1996–1997 by applying the Munich-Composite International Diagnostic Interview. Data about all-cause mortality were gathered for the period of 2017–2018 and analyzed using Cox proportional hazards models. Results: Risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and the time until the first cigarette in the morning were associated with each other and predicted the time to death. Among participants with a former alcohol dependence, 29.59% had a current nicotine dependence. Participants who had ever been dependent on alcohol at some point in their life before and currently smoked their first cigarette in the morning within 30 min or less after awakening had a hazard ratio of 5.28 (95% confidence interval: 3.33–8.38) for early death compared to low-risk alcohol consumers who had never smoked. Conclusion: Risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and the time until the first cigarette in the morning may have a cumulative impact on time to death. The findings suggest that it could be beneficial to provide support for quitting both risky alcohol drinking and tobacco smoking among nondependent individuals in addition to supporting remission from dependence. [ABSTRACT FROM AUTHOR]

Aims: Given the high dropout rates from initial treatment for alcoholism among patients with alcohol dependence, it is highly essential to prevent alcohol‐dependent patients from early dropout. This study aims to investigate whether a multidisciplinary approach can help achieve continuous hospital visits for this patient population for initial treatment. Methods: This is a retrospective cohort study based on the medical records of all sequential alcohol‐dependent outpatients who visited Sodegaura Satsukidai Hospital for alcoholism at least once between October 2017 and March 2019. The primary outcome was the difference in the rates of patients who achieved 6 and 12 months of continuous hospital visits following the first visit with and without the multidisciplinary approach. Results: Of all the participants (n = 67), the female‐to‐male ratios for patients supported with and without the multidisciplinary approach were 6:30 and 5:26, respectively. It was found that the rate of alcoholic patients treated with the multidisciplinary approach (n = 33, 91.7%), who had continuous hospital visits, was significantly higher than that of those without (n = 12, 38.7%) (χ2 = 21.2, p < 0.0001) during the first 6 months of treatment. Similarly, the rate of alcoholic patients treated with the multidisciplinary approach (n = 29, 90.6%) having continuous visits was significantly higher than that of those who did not receive such support (n = 8, 25.8%) (χ2 = 27.3, p < 0.0001) during the first 12 months. Conclusion: A multidisciplinary approach can be used to reduce dropout from initial treatment among outpatients with alcohol dependence. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of alcohol use disorder in adult residents in Ningxia and related factors, and to provide scientific evidence for intervention. Methods: In this cross-sectional study, multi-stage sampling was administrated. According to the diagnostic criterion of the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-Ⅳ), face-to-face interview in household was carried out using Composite Intermational Diagnostic Interview in Ningxia Hui Autonomous Region. The prevalence of alcohol use disorder and the related factors were analyzed. Results: In 4 085 residents who completed the survey, the 12-month prevalence of alcohol use disorder was 1.2%, and the life-time prevalence rate was 3.5%. The twelve-month prevalence rates of alcohol abuse and alcohol dependence were 1.1% and 0.6%, respectively, and the life-time prevalence rates of them were 2.8% and 1.2%, respectively. Comparing with control population, male (OR=10. 84, 95% CI: 2.88-40.87), age groups of 18 to 29 years old (OR=3.67, 95%CI: 1.27-10. 59), 30 to 39 years old (OR=5. 12, 95%CI: 1. 98-13. 24), and 40 to 49 years old (OR=3. 82, 95% CI: 1.45-10.06), secondary school (OR=3. 07, 95%CI: 1.22-7.75), high school or above (OR=3.13, 95% CI: 1.21-8. 12), smoking (OR=3. 00, 95% CI: 1.34-6.70) and body pain (OR=1. 88, 95% CI: 1.05-3.36) were risk factors of alcohol use disorder. Conclusions: The prevalence of alcohol use disorder in different populations distribute dissimilarly in Ningxia. Males, middle-aged and young people, smokers, and those with physical pain should be key objects of intervention for alcohol use disorders. [ABSTRACT FROM AUTHOR]

ObjectiveThis study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence.MethodsA total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People’s Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed.ResultsFamily intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group.ConclusionFamily intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.

ObjectiveTo analyze the association between alcohol dependence and overweight and obesity among high school students.MethodsThis study adopted stratified cluster sampling method. Four high schools （one vocational high school included） were selected as the research sites. We used self-designed questionnaires to investigate the drinking behavior of high school students. This study used propensity score matching method to control confounding factors （e.g gender， school type， etc.）. Then we compared the differences in drinking behavior between obese/overweight group and normal weight group after matching， and used a multivariate logistic regression model to analyze the relationship between drinking behavior and overweight and obesity.ResultsA total of 811 high school students participated in the survey. 60 people were excluded due to mild and moderate weight loss， and 751 people were normal or obese/overweight. After 1：1 propensity score matching， there were 217 people each in obese/overweight group and normal group. The characteristics of gender， school type， grade and family economic level of the two groups were balanced after matching. The difference was statistically significant （P

Abstract Background Alcohol dependence (AD) results in several medical problems including vitamin D deficiency and thyroid dysfunction. However, the relationship between these two complications remains unclear. The aim of the present study was to explore the relationship between serum vitamin D and thyroid hormone profiles in male patients with AD. Methods A total of 117 male patients with AD were enrolled. Vitamin D deficiency was defined as serum concentrations of the main circulating vitamin D, 25-hydroxy vitamin D [25(OH)D], below 50 nmol/L. The AD patients were divided into two groups accordingly: 46 patients with normal vitamin D levels (normal group) and 71 patients with vitamin D deficiency (deficiency group). The levels of thyroid hormone profiles including total triiodothyronine 3 (TT3), total thyroxine 4 (TT4), thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) between the two groups were compared. Correlation between the serum levels of 25(OH)D and thyroid hormone profiles was evaluated using simple correlation (Pearson’s correlation) and multivariable analysis using linear regression models. Results The prevalence of vitamin D deficiency in male patients with AD is 60.7% (71/117; 95% confidence interval: 51.6–69.1%). Moreover, the serum levels of TT3 (t = -2.682, p = 0.009), TT4 (t = -2.033, p = 0.044), fT3 (t = -2.986, p = 0.003), and fT4 (t = -2.558, p = 0.012) in deficiency group were significantly higher than those in normal group. Post hoc power analyses showed that the power for fT3 was sufficient (power > 0.80). Furthermore, univariate analysis showed that the serum vitamin D levels were negatively correlated with the TT3 (r = -0.189, p = 0.044), fT3 (r = -0.350, p

Background: Alcohol abuse is one of the most common psychiatric disorders observed worldwide. Aims and Objectives: The study aimed to assess cognitive impairment in alcohol-dependent patients, its correlation with neuroimaging, and compare the findings with non-alcoholics. Materials and Methods: We have included 30 alcoholics and 30 control participants. Tools such as semi-structured pro forma, alcohol use disorder identification test score, the severity of alcohol dependence questionnaire (SADQ), and PGI memory scale (PGIMS) were used for the assessment. The measurements of the third and fourth ventricle width, interhemispheric fissure width, cerebellar transverse width, the inner diameter of the skull, anterior horn distance, and midbrain diameter were taken from a magnetic resonance imaging (MRI) brain. Results: There was a significant difference in remote memory, mental balance, attention and concentration, delayed recall, immediate recall, visual retention, third and fourth ventricle width, interhemispheric fissure width, and cerebral transverse length between alcoholics and non-alcoholics. Further, a correlation analysis of the PGIMS total score with MRI measurements and alcohol intake showed a significant negative correlation of PGIMS total score with third ventricle width, duration of alcohol consumption, period of alcohol dependence, the quantity of alcohol per day, and SADQ score. However, a significantly positive correlation was observed between PGIMS total score and cerebellar transverse length. Conclusion: Alcohol-dependent patients had poor cognitive functions compared to non-alcoholics. They also had significant cerebral and cerebellar atrophy and were characterized by dilation of the third and fourth ventricles. The increase in the duration of alcohol consumption, period of alcohol dependence, and quantity of alcohol intake caused cognitive impairment independently.

Introduction: Alcohol dependence is an increasing and pervasive problem. Alcohol Withdrawal Syndrome (AWS) is a cluster of symptoms that occur in alcohol-dependent individuals after cessation or reduction of alcohol consumption. However, studies on the clinicoepidemiological profile of patients with AWS and treatment patterns in India are scarce. Aim: To assess the treatment patterns during hospitalisation and after discharge in Indian patients with AWS. Materials and Methods: A retrospective observational study was conducted using data from 1000 patients with AWS who were admitted to nine addiction centres across India. Data from medical charts from the previous five years were collected over six months, from January to June 2022. The study included patients of either sex, aged ≥18 years at the time of data collection, who had been hospitalised for AWS symptoms and had ≥3 months of documented follow-ups. The primary endpoints of the study were the most commonly used medications and their dose titrations in the treatment of AWS, as well as the duration of treatment in the hospital and post-discharge. Key secondary endpoints included the socio-demographic profile of patients, common comorbidities, common signs and symptoms, the association between prescription patterns of Benzodiazepines (BZDs) and liver enzyme levels, and the average duration of hospital stay. Continuous variables were summarised as mean and Standard Deviation (SD), while categorical variables were summarised as frequency and percentages. Levels of serum Aspartate Aminotransferase (AST), Alanine Transaminase (ALT), γ-Glutamyl Transferase (GGT), and bilirubin were recorded from the source data, if available, and the association with the use of chlordiazepoxide and lorazepam was analysed using the Chi-square test. Results: The mean±SD age of the 1000 enrolled patients was 41.4±9.6 years, with the majority (n=997; 99.7%) being males. BZDs were the mainstay pharmacotherapy, with lorazepam (n=686; 68.6%) and chlordiazepoxide (n=482; 48.2%) being the two most commonly prescribed BZDs during hospitalisation. During post-discharge treatment, 57.0% (n/N=74/130) of patients received lorazepam, while 52.0% (n/N=67/130) received chlordiazepoxide. Frequently used drug regimens during hospitalisation included fixed doses of chlordiazepoxide {25 mg twice a day (BID:143/482; 29.7%), 20 mg thrice a day (TID:103/482; 21.4%), or 25mg TID (87/482; 18.0%)}, or lorazepam {2 mg TID (188/686; 27.4%), 2 mg BID (183/686; 26.7%), or 2 mg once a day (OD;175/686; 25.5%)}. Commonly observed signs and symptoms included tremors (n=567; 56.7%), irritability (n=539; 53.9%), and agitation (n=500; 50.0%). Depression (n=182; 18.2%) and anxiety (n=136; 13.6%) were the most commonly reported co-morbidities. Among the patients, only 13.4% (86/641) had an AST/ALT ratio >2, and 12.9% (44/340) had AST and GGT levels >2× Upper Limit of Normal (ULN). There was no significant difference in these patients between those receiving and not receiving chlordiazepoxide (p>0.05). The mean±SD duration of hospitalisation was 23.1±18.97 days, while the mean±SD duration of treatment during hospitalisation and post-discharge was 22.3±16.36 days and 71.6±52.3 days, respectively. Conclusion: The two most commonly prescribed drugs during hospitalisation and post-discharge were the BZDs, lorazepam and chlordiazepoxide. Fixed-dose regimens of chlordiazepoxide at 25 mg BID or TID, or 20 mg TID, and lorazepam at 2 mg TID, BID, or OD were frequently used during hospitalisation.

Understanding factors that contribute to the escalation of alcohol consumption is key to understanding how an individual transitions from non/social drinking to AUD and to providing better treatment. In this review, we discuss how the way ethanol is consumed as well as individual and environmental factors contribute to the escalation of ethanol consumption from intermittent low levels to consistently high levels. Moreover, we discuss how these factors are modelled in animals. It is clear a vast array of complex, interacting factors influence changes in alcohol consumption. Some of these factors act early in the acquisition of ethanol consumption and initial escalation, while others contribute to escalation of ethanol consumption at a later stage and are involved in the development of alcohol dependence. There is considerable need for more studies examining escalation associated with the formation of dependence and other hallmark features of AUD, especially studies examining mechanisms, as it is of considerable relevance to understanding and treating AUD.

To identify neuroimaging biomarkers of alcohol dependence (AD) from structural magnetic resonance imaging, it may be useful to develop classification models that are explicitly generalizable to unseen sites and populations. This problem was explored in a mega-analysis of previously published datasets from 2,034 AD and comparison participants spanning 27 sites curated by the ENIGMA Addiction Working Group. Data were grouped into a training set used for internal validation including 1,652 participants (692 AD, 24 sites), and a test set used for external validation with 382 participants (146 AD, 3 sites). An exploratory data analysis was first conducted, followed by an evolutionary search based feature selection to site generalizable and high performing subsets of brain measurements. Exploratory data analysis revealed that inclusion of case- and control-only sites led to the inadvertent learning of site-effects. Cross validation methods that do not properly account for site can drastically overestimate results. Evolutionary-based feature selection leveraging leave-one-site-out cross-validation, to combat unintentional learning, identified cortical thickness in the left superior frontal gyrus and right lateral orbitofrontal cortex, cortical surface area in the right transverse temporal gyrus, and left putamen volume as final features. Ridge regression restricted to these features yielded a test-set area under the receiver operating characteristic curve of 0.768. These findings evaluate strategies for handling multi-site data with varied underlying class distributions and identify potential biomarkers for individuals with current AD.

Alcohol dependence is associated with aberrant decision-making processes, particularly in the presence of alcohol-related environmental cues. For instance, alcohol cues can trigger alcohol seeking, consumption, and even relapse behavior. Recently, works have suggested that alcohol dependence may induce more general alterations in cued processes that support adaptive behavior, including enhanced cue control of volitional behavior unrelated to alcohol use. Here we examine this hypothesis by combining prior exposure to chronic intermittent ethanol and repeated withdrawal (CIE) procedures with a Pavlovian-to-instrumental transfer (PIT) task in mice. The PIT task entails training a Pavlovian association, separately training an instrumental contingency, and a final test during which the Pavlovian cue and instrumental action are combined for the first time. We first tested two variants of the PIT procedure in ethanol-naïve mice, differing in part in the duration of Pavlovian conditioned cues (short or long). We found in the PIT test that the short cue procedure produced negative transfer, whereas the long cue procedure produced positive transfer. We then used the long cue variant to examine PIT behavior in mice previously exposed to either CIE or air vapor. We found that prior CIE exposure strengthened PIT behavior, with enhanced instrumental responding during presentation of the food-associated cue. We further found that this enhancement in CIE mice persisted even after devaluation of the food outcome. Our findings suggest that ethanol dependence can enhance the influence of reward-predictive cues on ongoing behavior. Greater non-alcohol cue control of behavior may reflect the effect of chronic ethanol exposure on neural circuitry critical for cue-guided behavior in general.

Objective·To investigate if male alcohol-dependent patients have attention bias to alcohol-related pictures, show the behavioral and eye movement characteristics of attention bias, and explore the correlation between attention bias and sleep, anxiety, depression, impulsion and other psychological factors.Methods·Twenty-nine subjects in the case group (alcohol-dependent patients who were hospitalized in Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, from August 2021 to February 2022) and 29 healthy subjects in the healthy control group participated in the study. The experimental design was a mixed experimental design of three-factor hybrid. The cue types were alcohol-related and emotion pictures. The probe was on the same side or on the opposite side of the alcohol or emotional picture. The characteristics of subjects' attentional bias to alcohol cues were investigated by using the classical dot detection paradigm and eye movement monitoring technique. Groups were inter-group variables, and clue types and relative locations of probe points were intra-group variables. The behavioral and eye movement data were collected while the study subjects viewed pairs of alcohol-related and neutral pictures, or pairs of emotional and neutral pictures in a dot-probe paradigm. Dependent variables included behavioral indicators and eye movement indicators. Pittsburgh Sleep Quality Index (PSQI), 7-tiem Generalized Anxiety Disorder Scale (GAD-7), Patien Health Questionnaire (PHQ-9), and Barratt Impulsiveness Scale (BIS-11) scales were used to assess psychosomatic conditions such as sleep, anxiety, depression, and impulsivity, respectively. Behavioral and eye movement characteristics of attention bias in the alcohol-dependent group were analyzed. In addition, the correlation with behavioral and eye movement characteristics of attention bias and scale scores was analyzed.Results·The behavioral results showed that the reaction time of the alcohol-dependent group was significantly longer than that of the healthy control group (P=0.006). The eye movement results showed that when the type of cue was alcohol-related picture, the alcohol-dependent group had slower attention detection (P=0.031) and longer attention maintenance (P=0.005) on alcohol-related cues. Moreover, the pupil size during the viewing of alcohol-related cues (P=0.001) and emotional cues (P=0.008) were significantly smaller than those of the healthy control group. It was also found that, there was a negative correlation between the correct rate of the alcohol-dependent group and the BIS-11 scale score (r=-0.437, P=0.032), and a positive correlation between reaction time and GAD-7 score (r=0.407, P=0.033). The time of the first visual fixation entry was positively correlated with GAD-7 score (r=0.414, P=0.045), and the PSQI score was positively correlated with PHQ-9 score (r=0.422, P=0.041) in the case group.Conclusion·Alcohol-dependent patients have attention bias towards alcohol-related cues according to the behavioral and eye movement result. Compared with the traditional behavioral regression of attention bias based on correct rate and reaction time results, eye movement provides more direct and multi indicator evidence for the evaluation of attention bias in alcohol-dependent patients.

Introduction. Executive functions are multidimensional cognitive processes that provide organization and regulation of behavior. Impairments in executive functions are considered to be a risk factor for addiction, including alcohol dependence. However, it is not clear which domains of executive functions are the most vulnerable and how their changes relate to progression to addiction. Methods. A total of 244 individuals with different alcohol consumption experiences (78 with safe alcohol consumption and 166 with diagnosed alcohol dependence) participated in this study. Executive functions were investigated with the Go/No-Go task, the Simon Test, the Wisconsin Card Sorting Test, and the Corsi Block-Tapping Test, implemented in a computerized version on the Cognitive Symphony platform (Russia). In participants with alcohol dependence, data on dependence duration, remission duration, and treatment courses were also considered. Results of the study showed that participants with alcohol dependence had significantly lower outcomes of executive cognition performance than those who practiced safe alcohol consumption. In particular, alcohol-dependent participants performed worse in cognitive control task (p = 0.0001), attention task (p = 0.026), and cognitive flexibility task (p = 0.006 and p = 0.040). Working memory was also found to be vulnerable, with all alcohol-dependents who performed with lower working memory span compared to participants with safe alcohol consumption (p = 0.044). Subsequent regression analysis showed that cognitive control errors and cognitive flexibility errors in individuals with alcohol dependence were associated with years of alcohol abuse (p < 0.01). In addition, the higher rate of progression to alcohol dependence, the more vulnerable was working memory (p = 0.002559). Discussion. The study showed that executive cognition vulnerability in people with alcohol dependence was associated with alcohol abuse duration and dependence progression rate. The study results may contribute to intervention programs that target executive cognitive functions in alcohol addicts and those at high risk for alcohol dependence.

Introduction. Disulfiram is one of three medications approved by the Federal Drug Administration (FDA) to treat alcohol dependence. Patients tend to abstain from alcohol to avoid the unpleasant effects of alcohol toxicity. There may be some side effects, the most common of which are drowsiness, unusual tiredness, headache, metallic taste in mouth, skin rashes, decreased libido. Disulfiram induced psychosis is a psychiatric side effect that occurs very rarely. Case report. We report the case of a 33-year-old patient with nearly 15 years history of psychiatric personality disorder and alcohol dependence. Approximately 4 days of alcohol abstinence, as an inpatient he was administered disulfiram. After two weeks, the patient began to feel some side effects. He was admitted to hospital and was diagnosed with disulfiram induced psychosis. Discussion. The effect of disulfiram on alcohol metabolism was noticed in the 1940s. It should be used only by motivated patients who must be fully informed about the alcohol-disulfiram reaction. Disulfiram should only be started after about 10 days of sobriety, and the recommended dosage is 500 mg/day. The drug should be used with caution in people with a history of heart disease, diabetes mellitus, hypothyroidism, cerebral damage, nephritis, liver cirrhosis, epilepsy. Caution is recommended for patients who use benzodiazepines, some antibiotics, anticoagulants, tricyclic antidepressants. There may be some adverse effects, more serious ones include changes in vision, numbness, pain or weakness in the limbs, liver cell damage, peripheral neuropathy, seizures – but these are considered to be very rare. Psychiatric side effects may include mood changes, psychotic reactions, memory impairment. Reliable data is lacking, but cases of disulfiram induced psychosis are considered to be rare. Patients taking disulfiram should be monitored carefully.

Abstract Alcohol Use Disorder (AUD) is a highly prevalent condition worldwide that produces a wide range of pathophysiological consequences, with a critical impact on health and social issues. Alcohol influences gene expression through epigenetic changes mainly through DNA methylation. In this sense, levels of 5-methylcytosine (5-mC), namely Global DNA methylation (GMe), which can be influenced by environmental and hormonal effects, represent a putative biological mechanism underlying alcohol effects. Our aim was to investigate the influence of AUD diagnosis and alcohol patterns (i.e., years of addiction, use in the last 30 days, and alcohol severity) on GMe levels. The sample consisted of 256 men diagnosed with AUD and 361 men without AUD. DNA samples from peripheral blood were used to assess GMe levels, measured through the levels of 5-mC using high-performance liquid chromatography. Results from multiple linear regression analysis indicated that the presence of AUD was associated with lower GMe levels (beta=-0.155, p=0.011). Other alcohol-related outcomes were not associated with DNA methylation. Our findings are consistent with the hypothesis that the impact of chronic and heavy alcohol use in GMe could be a potential mechanism mediating the multiple organ damages related to AUD.

The epidemic of alcohol abuse affects millions of people worldwide. Relevant evidence supports the notion that the gut microbiota (GM) plays a crucial role in central nervous system (CNS) function, and its composition undergoes changes following alcohol consumption. Therefore, the purpose of this study was to investigate the effect of reconstructing the gut microbiota by fecal microbiota transplantation (FMT) on alcohol dependence. Here, we established an alcohol dependence model with C57BL/6J mice and proved that FMT treatment improved anxiety-like behavior and alcohol-seeking behavior in alcohol-dependent mice. Additionally, we found that the expression of the intestinal intercellular tight junction structure proteins ZO-1 and occludin was significantly increased after FMT. FMT repaired intestinal permeability in alcohol-dependent mice and decreased the levels of lipopolysaccharide (LPS) and proinflammatory factors. Moreover, the serotonin (5-hydroxytryptamine, 5-HT) content was significantly increased in alcohol-dependent mouse intestinal and brain tissues after receiving the fecal microbiome from healthy mice. 16S rRNA sequencing demonstrated that FMT markedly reshaped the composition of the gut microbiota and elicited changes in the intestinal barrier and 5-HT levels. Collectively, our results revealed that FMT has a palliative effect on alcohol dependence and explored the underlying mechanisms, which provides new strategies for the treatment of alcohol dependence.

The prefrontal cortex is a crucial regulator of alcohol drinking, and dependence, and other behavioral phenotypes associated with AUD. Comprehensive identification of cell-type specific transcriptomic changes in alcohol dependence will improve our understanding of mechanisms underlying the excessive alcohol use associated with alcohol dependence and will refine targets for therapeutic development. We performed single nucleus RNA sequencing (snRNA-seq) and Visium spatial gene expression profiling on the medial prefrontal cortex (mPFC) obtained from C57BL/6 J mice exposed to the two-bottle choice-chronic intermittent ethanol (CIE) vapor exposure (2BC-CIE, defined as dependent group) paradigm which models phenotypes of alcohol dependence including escalation of alcohol drinking. Gene co-expression network analysis and differential expression analysis identified highly dysregulated co-expression networks in multiple cell types. Dysregulated modules and their hub genes suggest novel understudied targets for studying molecular mechanisms contributing to the alcohol dependence state. A subtype of inhibitory neurons was the most alcohol-sensitive cell type and contained a downregulated gene co-expression module; the hub gene for this module is Cpa6, a gene previously identified by GWAS to be associated with excessive alcohol consumption. We identified an astrocytic Gpc5 module significantly upregulated in the alcohol-dependent group. To our knowledge, there are no studies linking Cpa6 and Gpc5 to the alcohol-dependent phenotype. We also identified neuroinflammation related gene expression changes in multiple cell types, specifically enriched in microglia, further implicating neuroinflammation in the escalation of alcohol drinking. Here, we present a comprehensive atlas of cell-type specific alcohol dependence mediated gene expression changes in the mPFC and identify novel cell type-specific targets implicated in alcohol dependence.

ABSTRACTAlcohol dependence (AD) is a worldwide epidemic of psychiatric disorders. Gut microbiota dysbiosis may be involved in the development of AD. Recently, the number of studies on the relationship between gut microbiota and alcohol is increasing. However, most previous studies were focused on rodent models and gut microbiota, and the data about the alteration of the gut fungi in AD patients were scarce. Convincing evidence of the gut microbiota’s role in the development of AD is lacking. Here, we investigated the characteristics of gut microbiota (bacterial) and mycobiota (fungal) dysbioses in AD patients and assessed the role of the gut microbiome on the behaviors of rats by fecal microbiota transfer, trying to illuminate the possible microbiota mechanism in AD development. We found that AD patients developed gut microbiota dysbiosis, displayed by the fact that the bacterial genus of Ruminococcaceae significantly decreased and that of Lachnospiraceae increased and the fungal genus of Saccharomyces and Kurtzmaniella obviously increased and that of Candida decreased. Alcohol consumption disturbs the gut equilibrium between bacteria and fungi. The fungal-to-bacterial species ratio was significantly decreased, and the bacterial-fungal trans-kingdom interactions were reduced. By transplanting the gut microbiota from AD patients to rats, we confirmed that the microbiota from AD patients induced the behavioral alterations associated with alcohol dependence in rats, including increased anxiety- and depression-like behaviors, reduced exploratory and recognition memory, and higher alcohol preference. Meanwhile, the microbiota from the AD patient donor upregulated the expression levels of cholecystokinin receptors in the frontal lobe, hippocampus, and cortex in rats, which might be involved in the development of alcohol dependence. Our results demonstrate that AD patients developed gut bacterial and fungal microbiota dysbioses and the gut microbiota may be involved in the development of alcohol addiction by regulating the endogenous cholecystokinin and related receptors’ expression. Our data open new avenues for adjuvant treating AD patients via administrating the intestinal microbiota.IMPORTANCEIntestinal microbiome dysbiosis is associated with psychiatric disease through the “microbiota-gut-brain” axis. Here, we revealed that there was obvious intestinal microbiome (including bacterial and fungal) dysbiosis in alcohol-dependent patients. Alcohol consumption seriously disturbs the gut equilibrium between bacteria and fungi, reduces the interactions among bacterial-fungal trans-kingdom, and increases intestinal permeability. Gut microbiota should be considered as a whole to study the development of alcohol dependence. The gut microbiome of alcohol-dependent patients increased the anxiety- and depression-like behavior in rats. The gut microbiota dysbiosis may promote the development of alcohol dependence by regulating the endogenous cholecystokinin (CCK) and related receptors. Hence, regulating the balance of gut microbiota and the endogenous CCK may be a potential strategy for reducing the risk of relapse in alcohol addiction patients.

A wealth of functional magnetic resonance imaging monetary incentive delay task (MIDT) research has shown alcohol dependency is associated with a hypoactive striatal response during gain anticipation (gain > neutral) and loss anticipation (loss > neutral). Electroencephalography (EEG) holds clinical advantages over fMRI (high temporal resolution, low cost, portable) however its use to study reward processing in alcohol dependence is limited. We aimed to carry out the first EEG MIDT (eMIDT) study in alcohol dependence. 21 abstinent alcohol dependent individuals and 26 controls performed an MIDT while neural activity was recorded using 64-channel EEG. Trial averaged event-related potentials (ERPs) and single-trial machine learning discriminant analyses were applied to EEG data. Clinical variables related to severity of dependence were collected and relationships with ERP data explored. Alcohol dependent individuals, compared with healthy controls, had blunted cue-P3 amplitudes for gain and loss anticipation (interaction: p = 0.019); and elevated contingent negative variation amplitudes for all conditions (gain, loss, neutral)(main effect: p < 0.001) which was associated with increased alcohol consumption (p = 0.002). The machine learning analyses demonstrated alcohol dependent individuals had reduced ability to discriminate between loss and neutral cues between 328 – 350 ms (p = 0.040), 354 – 367 ms (p = 0.047) and 525 – 572 ms (p = 0.022). The eMIDT approach is demonstrated to be a low-cost, sensitive measure of dysfunctional anticipatory reward processing in alcohol dependence, which we propose is ideal for big data approaches to prognostic psychiatry and translation into clinical practice.

Background: Prolonged and excessive use of alcohol can affect the sexual function. The occurrence of sexual dysfunction has adverse psychological and interpersonal consequences. Aim: To assess the occurrence and correlates of sexual dysfunction in individuals suffering from alcohol dependence. Materials and Methods: Seventy male subjects hospitalized in a tertiary care hospital for treatment of alcohol dependence syndrome with simple withdrawal symptoms were included in the study with their informed consent. Their sexual function was evaluated utilizing a 14-item changes in sexual functioning questionnaire. Results: According to the findings of the current study, sexual dysfunction is quite prevalent in alcohol-dependent people (75.7%). Erectile dysfunction was the most common disorder, followed by diminished sexual desire and early ejaculation. Conclusion: Alcohol-dependence patients have a high prevalence of sexual dysfunctions. In routine clinical practice, this may be overlooked. Clinicians must be made aware of the frequent occurrence of sexual disorders in alcohol dependence patients. [ABSTRACT FROM AUTHOR]

Alcoholism does not limit on a certain group of the population but it is a problem of every social layer and age group. General practitioners have a key role in finding, diagnosing and tracking the people with alcohol dependence. The target of the preparing scientific research is ascertainment of the level of the alcohol consumption with a combined screening method, and also the frequency of the physical and mental damages because of it; and also development of a model for tracking and dispensary of the found dependent and risky people in the general practice. For the pilot investigation with 100 patient in Razgrad city a survey was developed, laboratory tests took place and hepatic ultrasound was performed. In the analysis of the results, the level of risky and alcohol dependent patients is very high – 42%, and a part of them are with newfound complications caused by the chronic alcohol disease. It is necessary during the prophylactic check-ups to be looked for manifests of abuse with alcohol and availability of the alcohol disease. That will allow early diagnosis and treatment of the ill and dependent people, and also protection from physical, mental and social defeats. [ABSTRACT FROM AUTHOR]

Alcohol dependence (AD) is a debilitating disease associated with high relapse rates even after long periods of abstinence. Thus, elucidating neurobiological substrates of relapse risk is fundamental for the development of novel targeted interventions that could promote long‐lasting abstinence. In the present study, we analysed resting‐state functional magnetic resonance imaging (rsfMRI) data from a sample of recently detoxified patients with AD (n = 93) who were followed up for 12 months after rsfMRI assessment. Specifically, we employed graph theoretic analyses to compare functional brain network topology and functional connectivity between future relapsers (REL, n = 59), future abstainers (ABS, n = 28) and age‐ and gender‐matched controls (CON, n = 83). Our results suggest increased whole‐brain network segregation, decreased global network integration and overall blunted connectivity strength in REL compared with CON. Conversely, we found evidence for a comparable network architecture in ABS relative to CON. At the nodal level, REL exhibited decreased integration and decoupling between multiple brain systems compared with CON, encompassing regions associated with higher‐order executive functions, sensory and reward processing. Among patients with AD, increased coupling between nodes implicated in reward valuation and salience attribution constitutes a particular risk factor for future relapse. Importantly, aberrant network organization in REL was consistently associated with shorter abstinence duration during follow‐up, portending to a putative neural signature of relapse risk in AD. Future research should further evaluate the potential diagnostic value of the identified changes in network topology and functional connectivity for relapse prediction at the individual subject level. [ABSTRACT FROM AUTHOR]

Baclofen has been shown to reduce alcohol consumption in some individuals with alcohol use disorder. This preliminary study aimed to evaluate i) the effect of baclofen versus placebo on hypothalamic-pituitary-adrenocortical activity (HPA axis), as measured by cortisol, and ii) the relationship between clinical outcomes such as alcohol consumption on a randomized controlled trial of baclofen (BAC) versus placebo (PL) (Kirsten C. Morley et al., 2018; K. C. Morley, Leung, Baillie, & Haber, 2013). We hypothesized that baclofen will reduce HPA-axis activity following a mild stressor in patients with alcohol dependence. Plasma cortisol levels were taken from N = 25 alcohol-dependent patients at two time points, approximately 60 (pre-MRI scan: PreCortisol) and 180 min (post MRI scan: PostCortisol) following administration of PL, BAC 10 mg, or BAC 25 mg. Participants were followed up for the remaining 10 weeks as part of the trial for clinical outcome (percentage days abstinent). Mixed models revealed a significant main effect of medication on cortisol levels (F = 3.88, p = 0.037), no significant effect of time (F = 0.04, p = 0.84), and a significant time × medication interaction (F = 3.54, p = 0.049). Linear regression (F = 6.98, p = 0.01, R 2 = 0.66) revealed that abstinence at follow-up, weighted by gender, was predicted by blunted cortisol response (β = −0.48 p = 0.023), in addition to medication (β = 0.73 p = 0.003). In conclusion, our preliminary data suggest that baclofen moderates HPA-axis activity, as measured by blood cortisol, and that these alterations may play a role in long-term treatment response. • Baclofen has been shown to reduce alcohol consumption in alcohol-dependent patients. • We evaluated the effect of baclofen on HPA axis activity. • Baclofen relative to placebo acutely moderates HPA axis activity following a mild stressor. • Alterations to HPA axis activity may play a role in long-term outcome. [ABSTRACT FROM AUTHOR]

Craving for alcohol is an important diagnostic criterion in alcohol use disorder (AUD) and an established predictor of future relapse. The 5-item Penn Alcohol Craving Scale (PACS) is one of the most widely used questionnaires to quantify craving and has been translated into different languages. It is assumed that the PACS constitutes one factor, although theoretical considerations suggest an additional second factor. We conducted stability and factor analyses (principal component and confirmatory factor analyses) of the German PACS (PACS-G) in samples of patients with AUD from the following three German study sites: Erlangen, N  = 188 (mean age: 47.1 years, 43.5% female); Mannheim, N  = 440 (45.5 years, 28.6% female); Hannover, N  = 107 (48.1 years, 48.6% female). In our samples, the 2-factor solution of the PACS-G version is more stable than the internationally assumed 1-factor solution. The resulting two PACS-G subscores 'difficulty to resist' (items 4 and 5) and 'thoughts about alcohol' (items 1, 2, and 3) have an internal consistency (Cronbach's alpha) of 0.80 ≤ α ≤ 0.90, m  = 0.86 and 0.86 ≤ α ≤ 0.91, m  = 0.89 with an overlap of R2 = 62%. We found good convergent validity assessed via the Craving Automatized Scale-Alcohol and the Obsessive-Compulsive Drinking Scale, but also correlations with depression and anxiety assessed via the Beck's Depression and Anxiety Inventories. This study is the first to provide evidence for a 2-factor solution ('difficulty to resist' and 'thoughts about alcohol') underlying the PACS-G version. [ABSTRACT FROM AUTHOR]

Alcoholism and chronic stress lead to impaired cognitive functions, which are regulated, in particular, by neurosteroid hormones. Exogenous administration of progesterone is one of the ways to influence the brain system of hormonal and neurotransmitter regulation. The effect of intranasal administration of low doses of progesterone on endogenous neurosteroid modulation of working and spatial memory in male rats with alcohol dependence and aggressive behavior was investigated. Alcohol dependence in male rats was modeled by voluntary intake of bread soaked in ethanol solution at a dose of 1.2 g/kg for 30 days. Aggressiveness was determined using the sensory contact method and the "partition" test. To study memory processes in rats, neuroethological methods of testing working (recognition of new objects) and spatial (orientation in the Barnes maze) memory were used. Progesterone was administered intranasally at a dose of 80 μg per rat for 10 days. Progesterone, testosterone, and cortisol levels were measured in the frontal neocortex (FC), hippocampus, and serum using enzyme-linked immunosorbent assay kits. The stimulatory effect of alcoholization on spatial memory and impairment of working memory in male rats with aggressive behavior was found. Zoosocial conflict on the background of prolonged alcohol consumption leads to impaired object recognition and spatial orientation against the background of neurosteroid imbalance: a decrease in progesterone and testosterone content in the FC, hippocampus, serum, and an increase in cortisol levels in these structures. Intranasal administration of progesterone to rats with alcohol dependence and aggressive behavior offsets the negative effects of confrontational relationships on working memory processes, restores the acquired experience to the baseline (however, the processes of object differentiation remain weakened); leads to improved spatial memory. The favorable effects of progesterone on memory are accompanied by a decrease in the imbalance of hormonal influences in brain structures with the restoration of progesterone and testosterone concentrations in the FC, hippocampus and serum against the background of weakening of stress-induced glucocorticoid activity. Therefore, intranasal administration of low doses of progesterone improves working and spatial memory in male rats with alcohol dependence and aggressive behavior due to the tendency to restore the balance of hormones (progesterone, testosterone, cortisol) in the brain structures responsible for memory. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol dependence is a chronic condition impacting millions of individuals worldwide. Safe and effective medicines to reduce relapse can be prescribed by general practitioners but are underutilised in the general Australian population. Prescription rates of these medicines to Aboriginal and Torres Strait Islander (First Nations) Australians in primary care are unknown. We assess these medicines in Aboriginal Community Controlled Health Services and identify factors associated with prescription. Methods: Baseline data (spanning 12 months) were used from a cluster randomised trial involving 22 Aboriginal Community Controlled Health Services. We describe the proportion of First Nations patients aged 15+ who were prescribed a relapse prevention medicine: naltrexone, acamprosate or disulfiram. We explore associations between receiving a prescription, a patient AUDIT‐C score and demographics (gender, age, service remoteness) using logistic regression. Results: During the 12‐month period, 52,678 patients attended the 22 services. Prescriptions were issued for 118 (0.2%) patients (acamprosate n = 62; naltrexone n = 58; disulfiram n = 2; combinations n = 4). Of the total patients, 1.6% were ‘likely dependent’ (AUDIT‐C ≥ 9), of whom only 3.4% received prescriptions for these medicines. In contrast, 60.2% of those who received a prescription had no AUDIT‐C score. In multivariate analysis, receiving a script (OR = 3.29, 95% CI 2.25–4.77) was predicted by AUDIT‐C screening, male gender (OR = 2.24, 95% CI 1.55–3.29), middle age (35–54 years; OR = 14.41, 95% CI 5.99–47.31) and urban service (OR = 2.87, 95% CI 1.61–5.60). Discussion and Conclusions: Work is needed to increase the prescription of relapse prevention medicines when dependence is detected. Potential barriers to prescription and appropriate ways to overcome these need to be identified. [ABSTRACT FROM AUTHOR]

Aim. The aim of the research was to present the Polish adaptation and validation of the Short Inventory of Problems (SIP-2L) by Miller et al. (1995). The SIP-2L is a popular self-report measure used to assess the negative consequences of alcohol use in 5 domains with negative consequences: physical, interpersonal, intrapersonal, social and impulse control. The adapted version of SIP assesses lifetime consequences of using alcohol. Material and method. A total of 256 participants diagnosed with alcohol dependence (71 women and 185 men) completed an assessment battery that included SIP-2L and Polish versions of AUDIT, MAST and KOEP-R, which is a modified Polish adaptation of CEAQ -- Comprehensive Effects of Alcohol Questionnaire. Results. Confirmatory factor analysis demonstrated the hypothesized 5-factor model produced the best fit. Reliability of the entire method (Cronbach's α = 0.868) and for all factors was satisfactory, as was convergent validity. Conclusions. The results support that the Polish version of the SIP-2L has good psychometric properties and can successfully assess the consequences of drinking among patients diagnosed with alcohol dependence. [ABSTRACT FROM AUTHOR]

I develop an externalist perspective and analysis of the relatedness of loneliness and (harmful) alcohol use and the concept of loneliness. I depart from twenty qualitative interviews with people undergoing inpatient treatment for alcohol dependence. Both, loneliness and its relatedness to alocohol dependence turn out to be complex relational and interactional phenomena whose occurrence and dynamics depend on the social and situational conditions under which they arise. Despite huge variations in interviewees' experiences of loneliness, they share a common phenomenological and analytical structure. Loneliness arises when instances of social interaction fail to arrive at mutual understanding within a certain social context. Loneliness is neither reducible to individual experiences nor to distinctive characteristics of a person. Rather, it presents an evaluative and interactional phenomenon, a person's awareness of his/her failure to establish mutual understanding with others in social interaction. The relatedness of alcohol dependence and loneliness is neither conceptual nor causal nor explainable by facts about the individuals concerned, but depends on the kind of loneliness involved and the function habitual ways of drinking alcohol have in a person's everyday life and social environment. [ABSTRACT FROM AUTHOR]

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Alcohol-dependent patients face a risk of relapse after detoxification and alcohol dependence relapse is affected by many factors in different countries. The study aims to analyze some of the factors associated to the relapse in alcohol-dependent inpatients in northern Vietnam. Methods: A prospective study that monitored alcohol-dependent inpatient in northern Vietnam for six months. Results: Patients with education from high school and higher had a relapse rate of 0.65 times as compared to patients with education below high school (IRR=0.65; 95% CI: 0.43-0.99). Patients with four or more times of alcohol withdrawal had a relapse rate of 1.76 times compared with patients with less than four times of alcohol withdrawal (IRR=1.76; 95% CI: 1.09-2.84). Patients with severe and very severe depressive disorders on the Hamilton depression rating scale at one month after being discharge from hospital had a relapse rate of 4.27 times that of non-depressed patients. (IRR=4.27; 95% CI: 1.08-16.97). Conclusion: Alcohol-dependent patients had many previous alcohol withdrawal times, the cooccurrence of depressive disorder increased alcohol dependence relapse and relapse soon after recovering from alcohol dependence. In particular, higher education was a protective factor against relapse. These factors were depended on economic, medical, cultural and social characteristics in different countries. [ABSTRACT FROM AUTHOR]

Introduction and objective: Kernberg’s model of personality organisation allows to explain the sources of pathomechanisms underlying mental disorders, personality disorders in particular. Ruminations are automatic, constantly recurring thoughts that constitute a predisposition to a specific interpretation of the world and oneself. They are associated with two mechanisms – adaptive (reflection) and maladaptive (rumination). The aim of the study was to investigate the relationship between personality organisation and the general tendency to rumination, rumination on anger and sadness, and reflectivity among alcohol addicts. Materials and methods: 91 alcohol-dependent persons aged 20–77 years (mean, M = 43.57; standard deviation, SD = 12.92), including 26 women and 65 men, participated in the study. The Inventory of Personality Organization (IPO) by John F. Clarkin, Pamela A. Foelsch and Otto F. Kernberg (Polish adaptation by Agnieszka Izdebska and Beata Pastwa-Wojciechowska), The Rumination-Reflection Questionnaire (RRQ-short) by Janet A. Carter (Polish adaptation by Stanisław Radoń), Sadness and Anger Rumination Inventory (SARI) by Maya Peled and Marlene Moretti (Polish adaptation by Małgorzata Anna Basińska) and a sociodemographic questionnaire were used. Results: A significant positive correlation was found between the tendency to rumination and anger and sadness rumination and all dimensions of personality organisation. A higher level of identity diffusion predicted a higher tendency to rumination and sadness rumination. A higher level of identity diffusion and aggression predicted a higher tendency to anger rumination. Moreover, marital status, comorbid mental disorders and age at problematic alcohol use onset were significantly correlated with the analysed variables. Conclusions: A positive relationship between ruminations and all dimensions of personality organisation was confirmed. Greater identity diffusion was a predictor of the tendency to ruminate in its analysed ranges in the study group of alcoholdependent individuals. [ABSTRACT FROM AUTHOR]

Introduction and aim: The clinical approach to the diagnosis of mental disorders focuses on identifying mechanisms that predispose to pathology. Temperament, which is determined by biological factors, mediates, among others, the need for stimulation, which may manifest in risky behaviours, including problematic alcohol use. The aim of the study was to verify the relationships between temperamental properties and dimensions of personality organisation in alcohol-dependent individuals. Materials and methods: The study involved 91 alcohol-dependent individuals (26 women and 65 men). We used the PTS Temperament Questionnaire to measure the strength of excitation, the strength of inhibition and the mobility of nervous processes; the Inventory of Personality Organization (IPO) to assess the dimensions of personality organisation: primitive defences, identity diffusion, reality testing, aggression and moral values; as well as a demographic questionnaire. Results: Significant relationships were found between the strength of inhibition and mobility of nervous processes with all dimensions of personality organisation: primitive defences, identity diffusion and the ability to test reality, as well as aggression and moral values. The strongest relationship was demonstrated between the strength of inhibition and aggression. A weak, negative correlation was also noted between the strength of excitation and identity diffusion. Exploratory analyses further showed that the stronger the temperament type (higher strength of excitation and inhibition), the smaller the impairment of personality organisation in the group of alcohol-dependent individuals. The most severe disorders of personality organisation were shown by alcohol-dependent individuals with a weak temperament. Conclusions: Both correlational and exploratory analyses have shown that biologically determined temperamental traits are related to the abnormally developed personality organisation in alcohol-dependent individuals. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Excessive alcohol consumption is associated with a wide range of cognitive deficits observed in varying degrees among users. The aim of the research was to compare performance across different domains of cognition in a clinical group of people with alcohol dependence and a control group of people without a dependence. METHODS: The research population consisted of 53 male patients with alcohol dependence treated at the Specialized Psychiatric Institute Predná Hora. For each participant from the clinical group, a participant of the same age and level of educational attainment was selected from the nonclinical population. The NEUROPSY battery tests were used to assess cognitive performance. Significance of differences between clinical and control groups was analyzed using the Mann-Whitney U test and indicators of effect size. Sensitivity and specificity of the scales were determined using ROC analyses. RESULTS: Research findings indicate a lower level of cognitive ability in people with alcohol dependence. The greatest differences were found in the areas of executive function, attention, and memory. The Symbol Encoding Test, Trail Making, and the Verbal Learning Test showed the highest discriminative ability for performance between groups. Differences in phonemic fluency were not found. CONCLUSIONS: These research findings provide a relatively comprehensive picture of the cognitive performance of people with alcohol dependence. They indicate a lower level of cognitive ability in people with alcohol dependence across all areas measured, except phonemic fluency. [ABSTRACT FROM AUTHOR]

China is a large country with substantial urban-rural disparity. With the increasing concerns related to the rapid growth of the older adult population and problems related to smoking and alcohol consumption, this study aims to examine the potential urban-rural disparity associated with nicotine or alcohol dependence among Chinese older adults. We used three waves of the Chinese Longitudinal Healthy Longevity Survey and included older adults who were 65 years old or above (CLHLS; n = 18,207). The Heckman two-step selection procedure was applied to reduce potential selection bias. The first and the second steps of the Heckman two-step selection procedure all included multivariable logistic regressions. In the final study sample, approximately 8.1% and 4.0% of older adults reported nicotine and alcohol dependence, respectively. In the first step of the Heckman selection procedure, urban residents were less likely to become current smokers and alcohol users than rural residents (all p <.05). However, urban-rural disparity was not associated with either nicotine or alcohol dependence (all p >.05). We did not observe the urban-rural disparity in nicotine and alcohol dependence among Chinese older adults. Chinese policymakers should continue to strengthen national policy to combat smoking and alcohol consumption, especially older adults. [ABSTRACT FROM AUTHOR]

Individuals with alcohol dependence often experience cognitive dysfunction after detoxification, which can persist even after sustained abstinence. Transcranial direct current stimulation (tDCS) has shown promise in improving cognitive functioning in these patients. The main objective of this research was to assess the impact of ten sessions of transcranial direct-current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (DLPFC) on the neuropsychological functioning of hospitalized individuals with alcohol dependence who have undergone detoxification. This single-center, parallel, and single-blind randomized controlled trial assessed the effects of ten sessions of add-on tDCS treatment on neuropsychological functions. 44 recently detoxified alcohol-dependent inpatients were randomly assigned to either treatment as usual (TAU) plus ten sessions of active tDCS over left DLPFC, or TAU plus ten sessions of sham tDCS and assessed the effect of tDCS sessions and time on neuropsychological functions. Neuropsychological functions were evaluated in inpatients undergoing treatment for alcohol dependence at T1 (9.95 + 2.42 days abstinence) and T2 (19 ± 1.48 days abstinence), and while time had a significant impact on mean scores of various neuropsychological tests, neither active tDCS treatment nor its interaction with time displayed a significant effect on neuropsychological functioning, as revealed by two-way ANOVAs with repeated measurements. In detoxified inpatients with alcohol dependence, tDCS treatment was not found to have a significant impact on neuropsychological functioning when compared to sham treatment, whereas abstinence from alcohol for approximately three weeks resulted in significant improvements in various cognitive domains including mental speed, verbal learning & memory, visual memory, verbal fluency, and response inhibition. [ABSTRACT FROM AUTHOR]

Background: Alcohol abuse is one of the most common psychiatric disorders observed worldwide. Aims and Objectives: The study aimed to assess cognitive impairment in alcohol-dependent patients, its correlation with neuroimaging, and compare the findings with non-alcoholics. Materials and Methods: We have included 30 alcoholics and 30 control participants. Tools such as semi-structured pro forma, alcohol use disorder identification test score, the severity of alcohol dependence questionnaire (SADQ), and PGI memory scale (PGIMS) were used for the assessment. The measurements of the third and fourth ventricle width, interhemispheric fissure width, cerebellar transverse width, the inner diameter of the skull, anterior horn distance, and midbrain diameter were taken from a magnetic resonance imaging (MRI) brain. Results: There was a significant difference in remote memory, mental balance, attention and concentration, delayed recall, immediate recall, visual retention, third and fourth ventricle width, interhemispheric fissure width, and cerebral transverse length between alcoholics and non-alcoholics. Further, a correlation analysis of the PGIMS total score with MRI measurements and alcohol intake showed a significant negative correlation of PGIMS total score with third ventricle width, duration of alcohol consumption, period of alcohol dependence, the quantity of alcohol per day, and SADQ score. However, a significantly positive correlation was observed between PGIMS total score and cerebellar transverse length. Conclusion: Alcohol-dependent patients had poor cognitive functions compared to non-alcoholics. They also had significant cerebral and cerebellar atrophy and were characterized by dilation of the third and fourth ventricles. The increase in the duration of alcohol consumption, period of alcohol dependence, and quantity of alcohol intake caused cognitive impairment independently. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the associations between impairments in reward-based cognitive decision-making mechanisms and clinical indicators of alcohol dependence. Materials and methods. A total of 54 patients with alcohol dependence were examined. The control group consisted of 30 healthy individuals, comparable in gender and age to the study group. Cognitive functions were assessed quantitatively using the Go/No-Go task, the Balloon Art Test (BART), the Cambridge Game Task (CGT), and the Iowa Game Task (IGT). Clinical data were: the age of first trying alcohol, the age of onset of systematic alcohol abuse, the average amount of alcohol consumption over the last month, the number of hospitalizations, the age of the first visit to a narcologist, and the duration of the last remission. Results. Indicators of executive functions were statistically significantly decreased in patients with alcohol dependence as compared with the control group: in the Go/No-Go task, patients made more errors both on the Go signal (p = 0. 012) and on the No-Go signal (p = 0. 009); significant differences between the alcohol dependence group and the control group were also seen on the CGT: patients had lower quality of decision-making (QDM) (p = 0.002), higher risk-taking (OBR) (p = 0. 015), and had longer deliberation times(DT) (p = 0. 012). Age at onset of habitual alcohol abuse showed a positive correlation with decision-making quality in the CGT (rs = 0. 407, p = 0.048). Conclusions. These findings highlight the importance of studying cognitive impairment in patients with alcohol dependence, as the severity of these impairments is associated with the clinical course of the disease. [ABSTRACT FROM AUTHOR]

Preclinical studies have identified glucagon-like peptide-1 receptor (GLP-1R) agonists, and the antismoking agents varenicline and bupropion as tentative agents for treatment of alcohol use disorder (AUD). Combining different medications is a recent approach that has gained attention regarding heterogenous and difficult-to-treat diseases, like AUD. Successfully, this approach has been tested for the combination of varenicline and bupropion as it prevents relapse to alcohol drinking in rats. However, studies assessing the effects of the combination of semaglutide, an FDA-approved GLP-1R agonist for diabetes type II, and varenicline or bupropion to reduce alcohol intake in male and female rats remains to be conducted. Another approach to influence treatment outcome is to combine a medication with feeding interventions like high fat diet (HFD). While HFD reduces alcohol intake, the ability of the combination of HFD and semaglutide to alter alcohol drinking is unknown and thus the subject for a pilot study. Therefore, three intermittent alcohol drinking experiments were conducted to elucidate the effectiveness of these treatment combinations. We show that semaglutide, bupropion or HFD reduces alcohol intake in male as well as female rats. While various studies reveal beneficial effects of combinatorial pharmacotherapies for the treatment of AUD, we herein do not report any additive effects on alcohol intake by adding either varenicline or bupropion to semaglutide treatment. Neither does HFD exposure alter the ability of semaglutide to reduce alcohol intake. Although no additive effects by the combinatorial treatments are found, these findings collectively provide insight into possible monotherapeutical treatments for AUD. [ABSTRACT FROM AUTHOR]

Background and Aims: The Scottish Government introduced minimum unit pricing (MUP) for alcohol on 1 May 2018. This means retailers in Scotland cannot sell alcohol to consumers for less than £0.50 per unit (1 UK unit = 8 g ethanol). The Government intended the policy to increase the price of cheap alcohol, cut alcohol consumption overall and particularly among those drinking at hazardous or harmful levels, and ultimately reduce alcohol‐related harm. This paper aims to summarise and assess the evidence to date evaluating the impact of MUP on alcohol consumption and related behaviours in Scotland. Argument: Evidence from analyses of population‐level sales data suggest, all else being equal, MUP reduced the volume of alcohol sold in Scotland by ~ 3.0% to 3.5%, with the largest reductions affecting cider and spirits sales. Analyses of two time series datasets on household‐level alcohol purchasing and individual‐level alcohol consumption suggest reductions in purchasing and consumption among those drinking at hazardous and harmful levels, but offer conflicting results for those drinking at the most harmful levels. These subgroup analyses are methodologically robust, but the underlying datasets have important limitations as they rely on non‐random sampling strategies. Further studies identified no clear evidence of reduced alcohol consumption among those with alcohol dependence or those presenting to emergency departments and sexual health clinics, some evidence of increased financial strain among people with dependence and no evidence of wider negative outcomes arising from changes in alcohol consumption behaviours. Conclusions: Minimum unit pricing for alcohol in Scotland has led to reduced consumption, including among heavier drinkers. However, there is uncertainty regarding its impact on those at greatest risk and some limited evidence of negative outcomes, specifically financial strain, among people with alcohol dependence. [ABSTRACT FROM AUTHOR]

Emerging evidence suggests distinct neurobiological correlates of alcohol use disorder (AUD) between sexes, which however remain largely unexplored. This work from ENIGMA Addiction Working Group aimed to characterize the sex differences in gray matter (GM) and white matter (WM) correlates of AUD using a whole‐brain, voxel‐based, multi‐tissue mega‐analytic approach, thereby extending our recent surface‐based region of interest findings on a nearly matching sample using a complementary methodological approach. T1‐weighted magnetic resonance imaging (MRI) data from 653 people with AUD and 326 controls was analyzed using voxel‐based morphometry. The effects of group, sex, group‐by‐sex, and substance use severity in AUD on brain volumes were assessed using General Linear Models. Individuals with AUD relative to controls had lower GM volume in striatal, thalamic, cerebellar, and widespread cortical clusters. Group‐by‐sex effects were found in cerebellar GM and WM volumes, which were more affected by AUD in females than males. Smaller group‐by‐sex effects were also found in frontotemporal WM tracts, which were more affected in AUD females, and in temporo‐occipital and midcingulate GM volumes, which were more affected in AUD males. AUD females but not males showed a negative association between monthly drinks and precentral GM volume. Our results suggest that AUD is associated with both shared and distinct widespread effects on GM and WM volumes in females and males. This evidence advances our previous region of interest knowledge, supporting the usefulness of adopting an exploratory perspective and the need to include sex as a relevant moderator variable in AUD. [ABSTRACT FROM AUTHOR]

Background: Use and abuse of alcohol is well known. Its abuse, predominantly its dependence, can cause medical, psychological, and social issues. Excessive alcohol intake over time is linked to cognitive problems, including memory loss. Excessive alcohol use has been linked to significant cognitive deficits that can last even after the person stops drinking. Executive functioning impairments are most likely to impact rehabilitation outcomes in people with cognitive impairment. Aim: To study the cognitive impairments in alcohol dependence and comparing with healthy individuals. Methods: An observational, analytical case--control study was done on 30 alcohol-dependent patients after stabilization and 25 healthy individuals from July 2019 to July 2021 in a tertiary care center in Pune; all subjects after diagnosis were assessed with Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Barratt Impulsiveness Scale, Stroop Test, and the Wisconsin card sorting test (WCST). Results: The mean score on MMSE of the case group was 28.60 and the controls--29.72. The mean score on FAB of the case group was 16.45 and the controls--17.4. The mean score on BIS of the case group was 16.45 and in control 17.4. Stroop Effect score of the case group was 187.16 seconds and in control it was 146.92 seconds, all being statically significant in comparison. On the WCST, all the findings were statistically significant. Conclusion: Long-term alcohol consumption affects executive functions considerably. The current study showed significant cognitive deficits in individuals with alcohol dependence mainly in executive functions, working memory, and high impulsiveness. [ABSTRACT FROM AUTHOR]

The article discusses a systematic review conducted by researchers including Tomáš Skorkovský and published in an unspecified journal. The study aims to present and compare data from studies evaluating the success rates of medium-term inpatient treatment for alcohol-dependent patients in the Czech Republic. The review reveals that the success rates varydue to factors such as selection bias, differences in defining abstinence,.

Background: Effective pharmacologic treatments for comorbid alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are lacking. Kappa (κ) opioid receptor antagonists may address this unmet need. Buprenorphine is a κ‐opioid antagonist and a partial agonist of mu (μ) opioid receptors. Whereas naltrexone blocks all μ‐mediated effects combining it with buprenorphine yields a pharmacologic net effect of opioid receptor antagonism. Because no κ‐opioid receptor antagonist it available for clinical use, we tested this combination in a proof‐of‐concept study. Methods: Consenting participants were enrolled in a Phase II, multisite, double‐blind, randomized, placebo‐controlled trial evaluating the effectiveness of sublingual (SL) buprenorphine combined with extended‐release (XR) injectable naltrexone for the treatment of comorbid AUD and PTSD. Eligible participants (n = 75) were randomized (1:1:1) to receive either buprenorphine 2 mg/day plus naltrexone‐XR (n = 35), buprenorphine 8 mg/day plus naltrexone‐XR (n = 6) or SL plus injectable placebo (n = 34) for 12 weeks. The buprenorphine 8 mg/day plus naltrexone‐XR arm was dropped early in the trial due to the negative impact of COVID‐19 on enrollment. A binary primary outcome of response at week 8 was defined as a decrease from baseline of ≥10 points on the past week Clinician‐Administered PTSD Scale (CAPS‐5) and a reduction of ≥1 of past month alcohol risk level, as defined by the World Health Organization (WHO) and measured by the Timeline Follow‐Back. Results: Based on the results of a futility analysis, enrollment was stopped prior to reaching the initial goal of 90 participants. At the week eight primary timepoint, there were no statistically significant differences between buprenorphine plus naltrexone‐XR and placebo group for the primary composite outcome (OR = 0.63; p‐value = 0.52), or the subcomponents of the PTSD outcome (OR = 0.76; p‐value = 0.69) and AUD outcome (OR = 0.17; p‐value = 0.08). The placebo arm had a significantly higher proportion of participants with ≥1 WHO risk level reduction than the buprenorphine plus naltrexone‐XR arm (OR = 0.18, p value = 0.02). Conclusions: This is the first study to evaluate the potential of κ‐opioid receptor antagonism for the treatment of comorbid AUD and PTSD. The combination of buprenorphine and naltrexone‐XR showed no significant improvement over placebo for the composite, PTSD, or alcohol measures. [ABSTRACT FROM AUTHOR]