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Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited. We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption. We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models. One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education. We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study that has evaluated correlates of interest in herbal supplements for alcohol use among MSM. As researchers implement novel alcohol treatment studies, they should focus on recruitment efforts among MSM with a motivation to reduce their alcohol use patterns.

Background: Bipolar disorder is a psychiatric disorder characterized by mood swings between manic and depressed states that causes psychosocial problems. Cognitive function deteriorates with each recurrence, making it important to maintain remission through continued treatment. Bipolar disorder often co-occurs with alcohol dependence, which is known to lead to decreased treatment adherence and increased suicide risk. However, the real-world clinical determinants of alcohol dependence in outpatients with bipolar disorder in Japan remain unclear. Methods: We conducted an observational study targeting 2392 patients with bipolar disorder using data from the MUSUBI study, a joint project of the Japanese Association of Neuro-Psychiatric Clinics and the Japanese Society of Clinical Neuropsychopharmacology. After determining the prevalence of alcohol dependence and the sociodemographic characteristics of patients with bipolar disorder, multivariate analysis was performed to identify risk factors for alcohol comorbidity. Results: The prevalence of alcohol dependence among outpatients with bipolar disorder in this study was 5.7%. The prevalence was 7.6% for males and 3.1% for females. The results of the binomial logistic regression analysis revealed that bipolar I disorder, manic state, comorbidities with other psychiatric disorders, male sex, and suicidal ideation were significantly associated with alcohol dependence. Stratified analysis by gender showed that alcohol dependence was more strongly associated with the presence of suicidal ideation in women than in men. Limitation: First, because this was an observational study with a cross-sectional design, causal relationships between factors cannot be determined. In addition, this study included outpatients in Japan but lacked information on inpatients. Therefore, it was considered necessary to conduct the study on a larger population in order to generate more robust evidence. Conclusions: We found that outpatients with bipolar disorder, especially men, had higher rates of alcohol dependence overall than the general population in Japan. In addition, the relationship between alcohol dependence and suicidal ideation was stronger in women than in men with bipolar disorder. There was a strong association between manic states and alcohol dependence in outpatients with bipolar disorder. These results are useful to clinicians because they reinforce real-world clinical evidence for the treatment of bipolar disorder and co-occurring alcohol dependence. [ABSTRACT FROM AUTHOR]

Alcohol dependence, influenced by physical activity (PA) and sedentary behavior, lacks clear causal clarity. This study aims to clarify causal relationships by estimating these effects using bidirectional two-sample Mendelian randomization (MR). A bidirectional multivariable two-sample MR framework was employed to assess the causal effects of PA and sedentary behavior on alcohol dependence. Summarized genetic association data were analyzed for four PA-related activity patterns—moderate to vigorous physical activity (MVPA), vigorous physical activity (VPA), accelerometer-based physical activity with average acceleration (AccAve), and accelerometer-based physical activity with accelerations greater than 425 milli-gravities (Acc425)—and three sedentary behavior patterns—sedentary, TV watching, and computer use. The study was expanded to include the examination of the relationship between sedentary behavior or PA and general drinking behavior, quantified as drinks per week (DPW). We obtained summarized data on genetic associations with four PA related activity patterns (MVPA, VPA, AccAve and Acc425) and three sedentary behavior related behavior patterns (sedentary, TV watching and computer use). MR analysis found AccAve inversely associated with alcohol dependence risk (OR: 0.87; 95% CI: 0.80–0.95; p < 0.001), MVPA positively associated (OR: 2.86; 95%CI: 1.45–5.66; p = 0.002). For sedentary behavior and alcohol dependence, only TV watching was positively associated with the risk of alcohol dependence (OR: 1.43; 95%CI: 1.09–1.88; p = 0.009). No causal links found for other physical or sedentary activities. Reverse analysis and sensitivity tests showed consistent findings without pleiotropy or heterogeneity. Multivariate MR analyses indicated that while MVPA, AccAve and TV watching are independently associated with alcohol dependence, DPW did not show a significant causal relationship. Our results suggest that AccAve is considered a protective factor against alcohol dependence, while MVPA and TV watching are considered risk factors for alcohol dependence. Conversely, alcohol dependence serves as a protective factor against TV watching. Only TV watching and alcohol dependence might mutually have a significant causal effect on each other. • Expanded analysis of genetic data links activity patterns to drinking behaviors. • AccAve reduces alcohol dependence risk; MVPA and TV watching increases it. • Lifestyle changes could reduce alcohol dependence risk. [ABSTRACT FROM AUTHOR]

The mechanism of comorbidity between alcohol dependence and depressive disorders are not well understood. This study investigated differences in the brain function of alcohol-dependent patients with and without depression by performing functional connectivity analysis using resting-state functional magnetic resonance imaging. A total of 29 alcohol-dependent patients with depression, 31 alcohol-dependent patients without depression and 31 healthy control subjects were included in this study. The resting-state functional connectivity between the amygdala and the whole brain was compared among the three groups. Additionally, we examined the correlation between functional connectivity values in significantly different brain regions and levels of alcohol dependence and depression. The resting-state functional connectivity between the left amygdala and the right caudate nucleus was decreased in alcohol-dependent patients. Additionally, the resting-state functional connectivity of the right amygdala with the right caudate nucleus, right transverse temporal gyrus, right temporal pole: superior temporal gyrus were also decreased. In alcohol-dependent patients with depression, not only was functional connectivity between the above brain regions significantly decreased, but so was functional connectivity between the right amygdala and the left middle temporal gyrus. Also, there was no significant correlation between the resting-state functional connectivity values in statistically significant brain regions and the levels of alcohol dependence and depression. The impairment of the functional connectivity of the amygdala with caudate nucleus and partial temporal lobe may be involved in the neural mechanism of alcohol dependence comorbidity depressive disorders. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol craving, characterized by a strong desire or compulsion to consume alcohol, is a prominent symptom of substance dependence syndrome. Research indicates that alcohol craving is a significant factor leading to the termination of abstinence. The mechanisms underlying the activation of alcohol craving remain not fully understood. The urge to reach for alcohol may be stimulated by emotions, memories, thoughts, or bodily sensations, as well as external factors. It has been postulated that individuals with high levels of interoceptive sensibility tend to exhibit a high degree of alexithymia and emotion dysregulation in the context of alcohol craving. Deficits in identifying and verbalizing emotions, along with an operational thinking style, facilitate alcohol consumption by impeding accurate insight into one's mental state, thereby hindering the comprehension of bodily states, emotions, and the regulation of self. Method: This study involved 160 inmates incarcerated in a prison in Poland, awaiting participation in therapy for individuals with substance dependence following psychiatric diagnosis. Four questionnaires were used in the study: multidimensional Assessment of Interoceptive Sensibility (MAIA) for interoceptive sensibility, Toronto Alexithymia Scale (TAS-20) for alexithymia, Difficulties in Emotion Regulation Scale (DERS) for emotional dysregulation, and the Penn Alcohol Craving Scale (PACS) for alcohol craving assessment. Results: The results of the study are as follows: the study findings indicated that alexithymia and emotional dysregulation significantly mediates the relationship between interoceptive sensibility and alcohol craving. The indirect effect for both factors was found to be significant, similar to the indirect effect observed for alexithymia as an mediator. However, in the case of emotional dysregulation, no significant indirect effect was observed. Conclusion: Our study provides insights into the potential contribution of interoceptive sensibility to the heightened risk of alcohol dependence. Specifically, impaired interoceptive sensibility may be associated with the development of alexithymia and emotional dysregulation, potentially rendering individuals more susceptible to alcohol craving. Interoceptive sensibility could serve as a prerequisite for the cultivation of positive emotional processing skills. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption in India has increased significantly in recent decades, with changing social norms and increased availability contributing to rising rates of alcohol dependence. This study aimed to assess the impact of socio-demographic factors on alcohol dependence among patients at a tertiary care hospital in Hyderabad, India. Materials and Methods: This cross-sectional study included 30 consecutive male patients with alcohol-related disorders at a tertiary care hospital in Hyderabad. Participants were screened using the CAGE questionnaire and diagnosed using DSM-IV-TR criteria. Detailed socio-demographic data was collected, including age, education, employment, income, family type, and reasons for alcohol initiation and consultation. Data was analyzed using descriptive statistics, chi-square tests, and Pearson's correlation. Results: The majority of patients (76.67%) were aged 30-49 years. Alcohol initiation predominantly occurred before age 20, but daily drinking and dependence peaked in the 21-40 age group. Illiteracy was high (46.67%) among patients. Most patients (86.67%) were employed, primarily in unskilled or semi-skilled jobs. Peer pressure was the dominant reason for alcohol initiation (86.67% of cases). Over half (53.3%) of patients presented following a suicide attempt. All patients were from rural backgrounds, with 90% living in nuclear families. Conclusion: This study highlights the complex interplay of socio-demographic factors in alcohol dependence among male patients in Hyderabad. Findings suggest the need for targeted interventions, including early prevention programs, workplace initiatives, peer-based approaches, integrated mental health care, and strategies tailored for rural communities. Future research should include larger, multi-center studies and explore gender differences to develop more comprehensive prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder (BD) and alcohol use disorder (AUD) often co‐occur, with BD + AUD characterized by higher levels of impulsivity relative to either disorder alone. Emotional facets of impulsivity (e.g., "urgency," measured by the UPPS‐P), however, remain underexplored in this population and could have distinct associations with clinical correlates. Methods: This cross‐sectional study used a two‐by‐two (BDxAD) factorial design, including groups with BD + AD (n = 28), BD (n = 29), AD (n = 28), and healthy controls (HC) (n = 27), to identify between‐group differences among the five subscales of the UPPS‐P. Associations of UPPS‐P subscales with Barratt Impulsiveness Scale (BIS) total scores and clinical variables of interest were also examined. Results: BD + AD had the highest scores for every UPPS‐P subscale but Sensation Seeking, with the Positive and Negative Urgency subscales having the largest main effects for both BD and AD. BIS‐11 total scores were most correlated with the urgency subscales of the UPPS‐P. Negative Urgency was found to be uniquely relevant to clinical measures in the BD + AD group. Rapid cycling was associated with both urgency subscales and BIS‐11 scores, and the Alcohol Dependence Scale was most correlated with the Premeditation subscale. Limitations: Cross sectional design and predominantly white sample. Conclusions: Unlike the BIS‐11, UPPS‐P is able to distinguish emotional from nonemotional facets of impulsivity, something especially relevant to people with co‐occurring BD + AD, where fluid emotionality is a key part of symptom presentation. For this reason, the UPPS‐P should be utilized in future studies and clinical settings measuring trait impulsivity in this population. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionChronic alcohol disorder hospital admissions are increasing in England and present a huge cost to England’s health and social care costs. Hospital-based alcohol care teams (ACTs) aim to better meet these patients’ complex needs through assessment and targeted referral. This has the potential to work effectively within England’s newly established integrated care system.The aim of this project was to identify in what ways ACTs can be effective in improving care pathways for complex care in a whole-system health and social care setting. We conducted semi-structured, tailored interviews with practitioners, managers and commissioners, across three hospital and community settings in one large urban region in England, comparing ACT working with non-ACT working.Effective pathways were enabled by the presence of an ACT, multi-agency community initiatives, assertive alcohol outreach and frequent-attender team meetings. Identified barriers were lack of systemic funding and commissioning, poor communication between agencies, lack of information-sharing and insufficient staff training.Community outreach and in-reach between hospitals and community services enable effective care pathways when ACTs provide the point of contact. A well-resourced ACT with clear operational remit can create links between diverse agencies and enables improved wraparound care for alcohol dependent patients. [ABSTRACT FROM AUTHOR]

Background: Codependence is a form of relationship addiction, described as a "disease of lost selfhood." Codependence among primary caregivers adversely impacts treatment outcomes in Alcohol Dependence Syndrome (ADS) patients. Personality traits of the caregiver may also influence codependency and its severity. However, in routine clinical practice, codependence among primary caregivers of alcoholic patients is not assessed and addressed. This study aimed to identify codependence among caregivers of ADS patients and determine its association with personality traits in various subgroups. Materials and Methods: A cross-sectional study was conducted in a private mental health establishment in urban Karnataka, India, among 125 adult primary caregivers of ADS patients who were spending at least 4 h daily with the patient for more than a year. Spann-Fischer codependence scale and Big Five personality inventory were used to assess codependence and personality domains, respectively. Codependence scores were correlated with Big Five personality scores and examined in various subgroups. Results: Among 125 study participants, 103 (82.4%) were female and 81 (64.8%) were spouse of ADS patients. Moderate and high codependency was found in 86 (68.8%) and 38 (30.4%) participants, respectively. Codependence was found to be significantly higher among females (64.5 ± 7.7) than males (57.6 ± 10.9), (t = −2.8, df = 25.6, P = 0.000), independent of the type of relationship with the patient. There was a significant positive correlation with neuroticism personality trait. Sociocultural and economic conditions of the caregiver also contributed to codependence. Conclusions: The study identified the presence of moderate-to-severe codependence, especially among female caregivers of ADS patients. This emphasizes the need for a protocol to assess codependency and personality traits among caregivers of ADS patients to improve treatment outcomes in urban Indian settings. [ABSTRACT FROM AUTHOR]

Background: Alcohol intake has long been associated with an increase in disease and mortality. Recent investigations have made a significant contribution to our comprehension of the connection between drinking and particular ailments and have demonstrated that the relationship between alcohol use and its consequences on health is complicated and multifaceted. Aims and Objectives: This study aims to evaluate cognition ability in alcoholics with a prolonged history of alcohol intake. Blinded Montreal Cognitive Assessment (MoCA) was used to analyze cognition ability. Materials and Methods: It is a comparative study between two study groups. The study includes 30 healthy alcoholic males (experimental group) attending the psychiatric hospital outpatient department and 30 healthy appropriate nonalcoholics (control group) within the age group of 18--45 years of age. The total sample size is n = 60. Results: The age of individuals did not show any statistically significant correlation with alcohol consumption (P = 0.7). In our results, alcohol consumption has a significant impact on cognition. Mean blind MoCA score is found to be 12.5 in alcoholics and 18.9 in non-alcoholics (P < 0.001). Conclusion: The proportion of heavy, moderate, and light drinkers was found to be 37%, 40%, and 23%, respectively. Blind MoCA score was found to be higher in the non-alcoholic (control) group compared to the alcoholic (experimental) group. [ABSTRACT FROM AUTHOR]

Background and aims Methods Results Conclusions The Substance Abuse and Mental Health Services Administration's annual National Survey on Drug Use and Health (NSDUH) is a commonly used source for estimating trends in alcohol use disorders (AUD) in the United States. From 2015 to 2019 the annual prevalence of people diagnosed with either Diagnostic and Statistical Manual 4th edition (DSM‐IV) alcohol abuse or dependence ranged from 5.3 to 5.9%. More recent estimates, using the DSM 5th edition (DSM‐5) AUD diagnostic formulation, have been higher, with AUD base rates ranging from 10.1 to 10.7% from 2020 to 2022. This study aimed to compare the past 12‐month base rates of AUD in the United States general population when using the DSM‐5 versus DSM‐IV AUD (i.e. abuse or dependence) and assess the AUD severity of individuals captured with each diagnostic formulation using DSM‐5 AUD symptom counts.We examined descriptive trends in the rate of past‐year NSDUH AUD diagnoses from 2015 to 2022. We contrasted them with trends in drinking behavior: the percentage of individuals who had ever reported drinking and the number of drinking days and binge drinking days for those who drink. We also analyzed the concordance between DSM‐IV and DSM‐5 AUD diagnoses in the 2020 NSDUH, which concurrently assessed AUD with both diagnostic formulations.The transition to DSM‐5 AUD formulation coincided with a drastic increase in AUD prevalence rates that occurred without increases in drinking behavior. In 2020 NSDUH data, the estimated past‐year DSM‐5 AUD prevalence rate was 10.1% compared with a 5.4% rate of past‐year DSM‐IV abuse or dependence. The DSM‐5 AUD formulation captured more mild‐severity individuals than the DSM‐IV formulation.Higher recent base rates of alcohol use disorders (AUD) in the National Survey on Drug Use and Health are likely, at least partially, explained by measurement changes in AUD; specifically, the shift from DSM‐IV abuse or dependence to DSM‐5 AUD. The DSM‐5 formulation appears substantially more inclusive than the DSM‐IV formulation, leading to a larger number of mild severity individuals being captured. [ABSTRACT FROM AUTHOR]

Alcohol consumption is an important risk factor for illness, disability, and mortality. Alcohol withdrawal symptoms have a significant health concern for individuals with alcohol dependence. This study aims to investigate the prevalence of withdrawal symptoms and liver function test abnormalities in this population and also to identify the factors associated with the severity of withdrawal symptoms. This cross-sectional study was conducted at a tertiary care facility involving 100 patients seeking treatment for alcohol dependence. Data collection included structured interviews and assessments using standardized scales and biochemical tests. Descriptive statistics, t-tests, and chi-square tests were employed to analyse the data. Individuals exhibiting mild/moderate alcohol withdrawal symptoms in this study displayed several distinctive features. They were more likely to have attained at least a high school education, their average alcohol consumption was notably lower, Importantly, their blood parameters, including RBC count, platelet count, total bilirubin levels, and liver enzyme levels (AST and ALT), generally exhibited fewer deviations from normal ranges. Family history of alcohol dependence and nicotine dependence was common among the participants. This research highlights the need for a holistic approach to address alcohol dependence, taking into consideration sociodemographic factors, clinical markers, and the diverse nature of this condition. The findings provide important insights for healthcare professionals to identify individuals at higher risk and guide treatment decisions. [ABSTRACT FROM AUTHOR]

Addressing the limited access to treatments for alcohol dependence, we developed ALM-002, a therapeutic application to be "prescribed" for non-abstinence-oriented treatment in internal medicine settings. Our objective was to preliminarily assess the efficacy and safety of ALM-002. In a multicenter, open-label randomized controlled trial, participants aged ≥20 with alcohol dependence and daily alcohol consumption exceeding 60 g for men and 40 g for women, without severe complications, were randomly assigned to either the intervention group using ALM-002 or the treatment-as-usual control group. Participant in both groups received individual face-to-face sessions by physicians at weeks 0, 4, 8, and 12. The primary endpoint was the change in heavy drinking days (HDDs) from week 0 to week 12. A mixed model for repeated measures was employed. We enrolled 43 participants: 22 in the intervention group and 21 in the control group. A significant reduction in HDDs every 4 weeks from week 0 to week 12 was observed, with a between-group difference of −6.99 days (95% CI: −12.4 to −1.6 days, standardized mean difference: −0.80). These results indicate the potential of ALM-002 as a viable treatment for alcohol dependence. Further studies are needed to evaluate the clinical potential of ALM-002. [ABSTRACT FROM AUTHOR]

Road crime is one of the most prevalent types of crime, which is why more and more frequent offenders and repeat offenders enter prison convicted of serious crimes. The present study aimed to determine the clinical and sociodemographic profile of road offenders, trying to establish differences and relationships with other types of crime and with community drivers. The study involved 513 drivers, classified into four groups: inmates with crimes against road safety (CTRO); inmates with crimes against road safety and with another type of criminal history (CTRO&OO); prisoners convicted of other criminal offences (COO); community drivers with no criminal record (DWCR). All were given a battery of instruments that assessed personality traits, sensation-seeking, psychiatric symptomatology, alcohol dependence, aspects related to driving and sociodemographic data. The results reveal similar profiles, between the CTRO&OO groups and the COO, in personality, search for emotions and psychopathological symptoms and important differences between the groups of road offenders (CTRO AND CTRO&OO) and of these with the DWCR. The classification and regression tree identified as relevant predictors, the number of fines and traffic accidents, alcohol dependence and obsessive-compulsive symptoms. These data can be useful for the prevention and rehabilitation of offenders against road safety. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol use is common in patients with chronic hepatitis C virus (HCV) infection. We examined the impact of alcohol use on direct‐acting antiviral (DAA) therapy outcome and the clinical course of liver disease and 2‐year survival for patients receiving HCV DAA therapy. Methods: Adults (n = 2624) recruited from 26 Australian hospital liver clinics during 2016–2021 were followed up for 2 years. Risky alcohol use was defined by a combination of self‐report (≥40 g/day of ethanol), physician‐reported history of problematic alcohol use, and anti‐craving medication prescription via population‐based database linkage. We examined factors associated with advanced liver fibrosis and survival using multivariable logistic and Cox regression. Results: Among 1634 patients (62.3%) with risky alcohol use, 24.6% reported consuming ≥40 g/day of alcohol, 98.3% physician‐reported problematic alcohol use; only 4.1% were dispensed naltrexone/acamprosate. One hundred and forty‐three patients with cirrhosis reported ≥40 g/day of alcohol, 6 (4.3%) were prescribed naltrexone/acamprosate. Risky alcohol use was associated with advanced fibrosis (adjusted‐odds ratio 1.69, 95% confidence interval 1.32–2.17) and patients were over‐represented for cirrhosis (45.1% vs. 25.6% in no‐risky alcohol use [p < 0.001]) and hepatocellular carcinoma (5.7% vs. 2.5% [p < 0.001]). Sustained viral response (p = 0.319) and 2‐year survival (adjusted‐hazard ratio 1.98, 95% confidence interval 0.84–4.63) after DAA therapy were not associated with risky alcohol use. Discussion and Conclusions: Risky alcohol use in HCV patients was prevalent, but did not reduce HCV cure. Treatment for alcohol dependence was low. Risky alcohol use may be under‐recognised in liver clinics. Better integration of addiction medicine into liver services and increased resourcing and addiction medicine training opportunities for hepatologists may help address this. [ABSTRACT FROM AUTHOR]

Background: Alcohol dependence develops because of repeated alcohol intake. Alcohol damages the cardiac autonomic nerve fibers leading to autonomic imbalance, resulting in reduced heart rate variability (HRV). HRV refers to the complex beat-to-beat variation in the heart rate, produced by the interplay of sympathetic and parasympathetic neural activity at the Sino-atrial node. Our body works effectively in parasympathetic activity dominance. The time domain indices of HRV are specific markers of parasympathetic activity. A decrease in the time domain parameters indicates reduced parasympathetic activity in the heart, indicating cardiac autonomic dysfunction with vagal neuropathy. Aims and Objectives: The objectives of the study are as follows: (1) To assess the HRV in alcohol-dependent individuals using time domain indices. (2) To compare the HRV between alcoholic-dependent individuals and non-alcoholic subjects. Materials and Methods: A total of 110 individuals in the age group of 20-55 years were recruited for our study. Among them, 55 were alcohol-dependent individuals selected based on the diagnostic and statistical manual-IV, international classification of diseases-10 criteria, and 55 age and gender-matched volunteers were selected as healthy non-alcoholic controls. Short-term HRV was recorded in a supine posture, and the results were interpreted. Statistical analysis was done using the software SPSS version 21.0. Results: Our results showed a significant reduction in the time-domain parameters of HRV -- SDNN, RMSSD, NN50, and pNN50 in the alcohol-dependent individuals compared to the controls, suggesting reduced parasympathetic activity in the heart indicating cardiac autonomic neuropathy. Conclusion: Alcohol affects the cardiac autonomic status leading to sudden death due to arrhythmias. HRV can be used as a non-invasive test to assess cardiac autonomic dysfunction and its biofeedback can help alcohol-dependent individuals to adopt healthy lifestyle measures. [ABSTRACT FROM AUTHOR]

Alcohol use disorders (AUD) are commonly occurring, heritable and polygenic disorders with etiological origins in the brain and the environment. To outline the causes and consequences of alcohol-related milestones, including AUD, and their related psychiatric comorbidities, the Collaborative Study on the Genetics of Alcoholism (COGA) was launched in 1989 with a gene-brain-behavior framework. COGA is a family based, diverse (~25% self-identified African American, ~52% female) sample, including data on 17,878 individuals, ages 7-97 years, in 2246 families of which a proportion are densely affected for AUD. All participants responded to questionnaires (e.g., personality) and the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) which gathers information on psychiatric diagnoses, conditions and related behaviors (e.g., parental monitoring). In addition, 9871 individuals have brain function data from electroencephalogram (EEG) recordings while 12,009 individuals have been genotyped on genome-wide association study (GWAS) arrays. A series of functional genomics studies examine the specific cellular and molecular mechanisms underlying AUD. This overview provides the framework for the development of COGA as a scientific resource in the past three decades, with individual reviews providing in-depth descriptions of data on and discoveries from behavioral and clinical, brain function, genetic and functional genomics data. The value of COGA also resides in its data sharing policies, its efforts to communicate scientific findings to the broader community via a project website and its potential to nurture early career investigators and to generate independent research that has broadened the impact of gene-brain-behavior research into AUD.

Background: Acute gamma-aminobutyric acid (GABAergic) effects of alcohol consumption are well-known, whereas prior research has yielded inconsistent findings regarding on adaptations of the GABAergic neurotransmitter system to chronic alcohol use. Previous studies indicate either elevated or reduced GABA levels in cortical regions such as the anterior cingulate cortex (ACC) in persons with alcohol use disorder (AUD). We tested the hypothesis that active alcohol consumption compared to abstinence contributes to GABA levels as observed in prior research on chronic alcohol use. Methods: We investigated GABA levels in the ACC of 31 healthy controls (low risk, LR), 38 high risk individuals providing an active drinking pattern (high risk, HR) and 27 recently detoxified alcohol-dependent (AD) subjects via proton magnetic resonance spectroscopy (1H-MRS). Results: GABA levels in the ACC were significantly lower in HR compared with AD, but did neither differ between LR and AD nor between LR and HR. Also, we observed a quadratic effect indicating a distribution of GABA levels in the ACC as follows: LR > HR < AD. GABA levels were not associated with abstinence duration in AD. Conclusions: This study suggests that the GABAergic neurotransmitter system is blunted in AUD. More precisely GABA levels in the ACC seem to be higher in recently detoxified AD patients than in individuals at high risk which might suggest that GABA levels may increase after abstinence. No correlation was found between GABA levels and abstinence duration. Longitudinal studies are required to investigate alterations in the GABAergic system throughout the development and maintenance of AUD. Clinical Trial Registration: No: NCT02094196. Registered 20 March 2014, https://clinicaltrials.gov/study/NCT02094196. [ABSTRACT FROM AUTHOR]

Background. Alcohol slows down the work of the brain and central nervous system, leads to deterioration of memory and concentration, cognitive disorders, and the formation of organic mental disorders. Due to the retirement of elderly people, some of them resort to taking alcohol as an adaptogen to alleviate various social, mental and psychological disorders, which can lead to the emergence of new or exacerbation of existing somatic disorders, the formation of alcoholism, as well as organic mental disorders. Aim. To investigate the risk factors (RF) for the formation of secondary organic mental disorders (SOMD) in elderly people with alcohol dependence (AD), formed in middle and old age. Patients and methods. The study included only male patients for the purity of the study aged 60 to 74 years (average age 67.5±7.2), who were divided into 2 groups depending on the age of occurrence of AD: group 1 – 21 people (36.2%), AD occurred at the age of 51.6±1.2 years, and the symptoms of SOMD at 61.8±2.1 years; group 2 – 37 people (63.8%), AD occurred at the age of 64.5±2.5 years, and SOMD at 71.3±2.8 years. The following methods were used: questionnaire – using the developed "Anamnestic chart", clinical (anamnesis collection), statistical (parametric and nonparametric). Results. The main factors of the formation of SOMD in people with formed AD in middle and old age are combinations of various RF, as well as a monofactor in the form of chronic alcohol abuse, the proportion of which varies depending on the age of AD formation. Conclusion. When AD is formed in old age, combinations of RF have a greater influence on the development of SOMD. And in the formation of AD in middle age, both alcohol, as an exogenous mono-damaging factor, and a combination of RF contribute to the formation of SOMD. Hereditary burden of alcoholism affects the progrediency of alcoholism, but does not play a role in the rate of formation of SOMD. The formation of alcoholism in middle age is combined with a relatively slow rate of formation of SOMD and a smaller number of associated somatic pathology, and when formed in old age – with a relatively fast rate of development of SOMD and a large number of associated somatic pathology.

BackgroundAlcohol dependence and related health problems have attracted greater than ever attention in recent years. Alcohol dependence not only affected personal behavior control ability， but also brought adverse effect to families and society.ObjectiveTo analyze the relationship between cognitive function and personality traits among male alcohol-dependent patients with aggressive behavior， in order to provide references for improving the cognitive function of male alcohol-dependent patients with aggressive behavior.MethodsMale patients with alcohol dependence attending Hunan Brain Hospital from March 2020 to March 2022 and fulfilling the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria were enrolled. According to the score of Modified Overt Aggression Scale （MOAS）， participants were classified into aggressive behavior group and non-aggressive behavior group at 1∶1 ratio， each with 80 cases. The enrolled subjects were then evaluated using Revised Eysenck Personality Questionnaire Short Scale for Chinese （EPQ-RSC） and Repeatable Battery for the Assessment of Neuropsychological Status （RBANS）. Pearson correlation analysis was utilized to examine the correlation between EPQ-RSC and RBANS scores among alcohol-dependent patients with aggressive behavior.ResultsScores on each subscale in RBANS were all lower in aggressive behavior group than those in non-aggressive behavior group （t=2.176， 2.580， 2.076， 2.308， 2.193， P

Background: Studies examining the outcome of the camp approach in the treatment of alcohol dependence are limited in India. Aim: The aim of the study was to compare the outcomes of the community-based camp (CBC) approach and the hospital-based camp (HBC) approach in the treatment of persons with alcohol dependence. Methods: The study used a non-randomized controlled study design (quasi-experimental research design before and after with a control group). In total, 60 respondents were selected through the census method (30 in the study group and 30 in the control group). Thirty respondents from the CBC formed the experimental group, and another 30 from the HBC formed the control group. The CBC was held for 7 days, and the HBC was held for 10 days. The tools used are the Alcohol Use Disorders Identification Test and the World Health Organization quality of life (QoL)-BREF. Statistical Analysis: Independent t-test and effect size analysis were used. Kasturba Hospital Institute Ethics Committee, Manipal, had given the ethical clearance. Results: The majority (73%) of the respondents in the CBC and 57% of the HBC participants maintained complete abstinence during the post-test. The relapse rate was lower in the CBC (27%) than in the HBC (43%). CBC is effective at increasing the number of follow-ups and decreasing alcohol intake during relapse. The effect of the camp intervention on increasing the number of follow-ups was medium (d = 0.36). The CBC had a small effect on enhancing the QoL of treated individuals with alcohol dependence syndrome during the post-test (d = 0.27). Conclusion: The CBC approach is more effective than the hospital one at increasing follow-up and QoL and reducing the relapse rate.

Background: Despite alcohol use being a risk factor for numerous health-related conditions and alcohol use disorder (AUD) recognized as a disease, there was limited research in India until 2010. This narrative review aims to evaluate AUD-related research in India from 2010 to July 2023. Methods: A PubMed search used key terms for AUD in India after 2010. Indian and international journals with regional significance that publish alcohol-related research were searched by each author individually. These were then collated, and duplicates were removed. In addition, we also conducted a gray literature search on focused areas related to AUD. Results: The alcohol-related research in India after 2010 focused on diverse areas associated with alcohol use. Some areas of research have received more attention than others. Two major epidemiological surveys conducted in the past decade reveal that around 5% have a problematic alcohol use pattern. Factors associated with alcohol use, like genetic, neurobiological, psychological, and sociocultural, were studied. The studies focused on the clinical profile of AUD, including their correlates, such as craving, withdrawal, alcohol-related harm, and comorbid psychiatric and medical illnesses. During this period, minimal research was conducted to understand AUD’s laboratory biomarkers, course, and prognosis. While there was a focus on generating evidence for different psychological interventions for alcohol dependence in management-related research, pharmacological studies centered on anticraving agents like baclofen. Research on noninvasive brain stimulation, such as rTMS, has shown preliminary usefulness in treating alcohol dependence. Very little research has been conducted regarding alcohol policy. Conclusion: In the past decade, Indian research on alcohol has focused on diverse areas. Epidemiological and psychological management-related research received maximum attention. Considering the magnitude of the alcohol-related burden, it is essential to prioritize research to other less studied areas like pharmacological management of alcohol dependence and alcohol policy.

Genetic features of alcohol dependence have been extensively investigated in recent years. A large body of studies has underlined the important role of genetic variants not only in metabolic pathways but also in the neurobiology of alcohol dependence, mediated by the neuronal circuits regulating reward and craving. Serotonin transporter (5-HTT), encoded by the SLC6A4 gene (Solute carrier family 6-neurotransmitter transporter-member 4), is targeted by antidepressant drugs such as selective serotonin reuptake inhibitors (SSRIs) and plays a pivotal role in serotoninergic transmission; it has been associated with psychiatric diseases and alcohol dependence. Transcriptional regulation and expression of 5-HTT depend not only on epigenetic modifications, among which DNA methylation (CpG and non-CpG) is primarily involved, but also on sequence variations occurring in intron/exon regions and in untranslated regions in 5′ and 3′, being the first sequences important for the splicing machinery and the last for the binding of transcription factors and micro RNAs. This work intends to shed light on the role of sequence variations known to affect the expression or function of 5-HTT in alcohol-dependent individuals. We found a statistically significant difference in the allelic (p = 0.0083) and genotypic (p = 0.0151) frequencies of the tri-allelic polymorphism, with higher function alleles and genotypes more represented in the control population. Furthermore, we identified three haplotypes more frequent in subjects with AUD (p < 0.0001) and one more frequent in the control population (p < 0.0001). The results obtained for the tri-allelic polymorphism in alcohol dependence confirm what is already present in part of the literature. The role of haplotypes requires further studies to be clarified. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol dependence is a global issue with many negative consequences, including alcohol-related brain damage (ARBD). Assessment of the sociodemographic and cognitive characteristics of individuals with confirmed or suspected ARBD presenting to alcohol services warrants further investigation. Methods: This study retrospectively examined rates of cognitive impairment using Montreal Cognitive Assessment (MoCA) data from 300 adults who visited three alcohol support services. We demonstrate that 55.3% of the sample had significant levels of cognitive impairment. Females' cognitive performance was disproportionately negatively affected by historical alcohol use relative to males. Results: The analysis identified four categories of participants, and the majority had a long history (+10 years) of alcohol use and were still actively drinking. Those taking part in active treatment for ARBD or practising abstinence demonstrated lower levels of cognitive impairment. Additionally, prior access to specialised ARBD care was associated with higher MoCA scores. Discussion: This research has identified a range of key service engagement, sociodemographic and cognitive characteristics that could be used to optimise support for those with alcohol dependence, whilst also highlighting some critical questions to be addressed in future research. [ABSTRACT FROM AUTHOR]

Background: Alcohol-related issues are widespread worldwide and are fairly substantial. Numerous studies have identified and clarified the effects and prevalence of alcohol use across different contexts. However, when it comes to the prevalence of alcohol in psychiatry and its impact on treatment outcomes compared to other patient groups, studies are relatively scarce, and results often vary, sometimes with different outcomes. This study focuses on investigating the effectiveness of psychological treatment in psychiatric clinics for outpatients, considering those with and without hazardous alcohol use under naturalistic conditions. Methods: Patients were recruited between 2012 and 2016 from psychiatric clinics in Sormland, Sweden, as part of the regular services. Patients completed symptom assessment instruments regarding depression, anxiety, quality-of-life, and alcohol consumption at the beginning of their psychological treatment, upon completion, and during a follow-up 1 year after completion. Completion of questionnaires was ongoing for some patients until 2021. A total of 324 patients were included in the study, distributed among 59 participating therapists. Results: Among all patients in the study, 30.2% showed hazardous alcohol use at the start of their psychological treatment, with a higher proportion being men. There was a significant reduction in the proportion of patients with hazardous use and a notable decrease in the mean audit score upon completion of psychological treatment. At follow-up, there was no significant change compared to completion. There were 31.2% of the patients who achieved recovery or improvement in the audit score upon completion of treatment. Patients with hazardous alcohol use consistently scored higher mean values on the symptom assessment instruments and lower on the quality-oflife instrument at the beginning. More individuals with hazardous alcohol use typically achieved better results across all outcome instruments at both at completion and follow-up. Conclusion: Patients with hazardous alcohol use demonstrate significant improvements in their alcohol consumption through standard psychological treatment in psychiatry, despite the treatment not specifically focusing on alcohol consumption. The progress/improvement appears to be largely maintained at follow-up. Moreover, patients with hazardous alcohol use tend to show greater progress across all outcome instruments. No significant gender differences were detected in this context. [ABSTRACT FROM AUTHOR]

Background Alcohol dependence and related health problems have attracted greater than ever attention in recent years. Alcohol dependence not only affected personal behavior control ability, but also brought adverse effect to families and society. Objective To analyze the relationship between cognitive function and personality traits among male alcohol-dependent patients with aggressive behavior, in order to provide references for improving the cognitive function of male alcohol-dependent patients with aggressive behavior. Methods Male patients with alcohol dependence attending Hunan Brain Hospital from March 2020 to March 2022 and fulfilling the International Classification of Diseases, tenth edition (ICD-10) diagnostic criteria were enrolled. According to the score of Modified Overt Aggression Scale (MOAS), participants were classified into aggressive behavior group and non-aggressive behavior group at 1∶1 ratio, each with 80 cases. The enrolled subjects were then evaluated using Revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Pearson correlation analysis was utilized to examine the correlation between EPQ-RSC and RBANS scores among alcohol-dependent patients with aggressive behavior. Results Scores on each subscale in RBANS were all lower in aggressive behavior group than those in non-aggressive behavior group (t=2. 176, 2. 580, 2. 076, 2. 308, 2. 193, P<0. 05), and scores on each dimension in EPQ-RSC in aggressive behavior group were higher than those in non-aggressive behavior group (t=4. 497, 5. 242, 6. 459, P<0. 01). Pearson correlation analysis denoted that the scores of introversion/extroversion, neuroticism and psychoticism in EPQ-RSC were positively correlated with the scores of immediate memory, visuospatial/constructional ability, language, attention and delayed memory in RBANS among alcohol-dependent patients with aggressive behavior (r=0. 294~0. 482, 0. 362~0. 511, 0. 265~0. 475, P<0. 05). Conclusion The cognitive function may have a certain correlation with personality traits in alcohol-dependent patients with aggressive behavior. [ABSTRACT FROM AUTHOR]

We aimed to assess the prevalence of hazardous drinking and potential alcohol dependence among Japanese primary care patients, and their readiness to change and awareness of others' concerns. From July to August 2023, we conducted a multi-site cross-sectional study as a screening survey for participants in a cluster randomized controlled trial. The trial included outpatients aged 20–74 from primary care clinics. Using the Alcohol Use Disorders Identification Test (AUDIT) alongside a self-administered questionnaire, we evaluated the prevalence of hazardous drinking and suspected alcohol dependence, patients' readiness to change, and their awareness of others' concerns. Among the 1388 participants from 18 clinics, 22% (95% confidence interval (CI): 20% to 24%) were identified as engaging in hazardous drinking or suspected of being alcohol dependent. As the AUDIT scores increased, so did their readiness to change. However, only 22% (95%CI: 16% to 28%) of those with scores ranging from 8 to 14 reported that others, including physicians, had expressed concerns about their drinking during the past year. For those with scores of 15 or higher, the figure was 74%. This study underscores the need for universal or high-risk alcohol screening and brief intervention in Japanese primary care settings. Trial registry UMIN-CTR (https://www.umin.ac.jp/ctr/) (UMIN000051388). [ABSTRACT FROM AUTHOR]

Background: Caregiving to a patient with substance-abuse is quite stressful and places an additional burden to the caregiver which in turn have a huge impact on their quality of life. To overcome this burden and improve their quality of life, caregivers adopt some coping strategies. Aim: To study the burden of care, coping strategies and quality of life among spouses of alcohol-dependence patients. Methodology: In this case control study, 100 spouses of diagnosed alcohol-dependence patients were taken as cases and the same number of age and sex-matched spouses of normal healthy individuals were taken as controls. AUDIT - C scale was applied to diagnose alcohol dependence in patients. M.I.N.I scale used on spouses, to rule out any chronic psychiatric illness. Burden Interview Schedule (BIS), EUROHIS-QOL scale, and Brief COPE Scale were used to find the burden on spouses, their quality of life, and coping strategies used by them. Results: In this study, the mean burden of care score (BIS) was significantly higher in cases (35.11 ± 4.97) as compared to that in controls (16.56 ± 9.98). Mean scores for BIS subdomains were also significantly higher in cases as compared to that in controls. There was no significant difference in the EUROHIS-QOL ratings between the cases and controls. Mean BRIEF COPE scale scores were significantly lower in cases (77.39 ± 18.10) as compared to that in controls (82.89 ± 16.43). The only difference between the two groups that was statistically significant was the avoidant coping score. Conclusion: The findings of this study showed that spouses of alcohol-dependent patients experience a high burden of care in all subdomains. Adaptive coping strategies were mainly taken by spouses of alcohol dependence patients, to cope with the situation. The quality of life of spouses of alcohol-dependent patients was not affected. [ABSTRACT FROM AUTHOR]

Background Underweight is a significant symptom in alcohol-dependent patients, yet few studies have examined underweight in Chinese male patients. The current study aimed to identify the prevalence, sociodemographic, and clinical correlates of underweight in Chinese male patients with alcohol dependency. Methods In this cross-sectional study, 405 male inpatients with alcohol dependence and 383 healthy male controls were recruited. Participants' demographic and clinical data, including anthropometric data, were collected. We first conducted univariate analysis to identify seven variables with significant differences between groups: smoking behavior, hospitalization, alcohol consumption, cerebral infarction, hypertension, Hamilton Depression Scale (HAMD) score, and Scale for Assessment of Negative Symptom (SANS) score. Then, binary logistic regression was used to assess their relationship with underweight, with a significance level of.05. Results The prevalence of underweight was significantly higher in the study population than in the control group (2.99% vs. 2.87%; P  < .001). Patients with underweight had significantly higher rates of smoking behavior and cerebral infarction, as well as higher scores of SANS and HAMD than non-underweight patients. The non-underweight patients had higher daily alcohol consumption and times of hospitalization. Furthermore, logistic regression analysis showed that smoking behavior [odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.03–7.80, P  = .043)], cerebral infarction (OR = 5.20, 95% CI = 1.13–23.85, P  = .036), SANS score (OR = 1.22, 95% CI = 1.16–1.28, P  < .001), and HAMD score (OR = 1.06, 95% CI = 1.02–1.11, P  = .005) were associated with underweight. Conclusions More than 20% of male alcohol-dependent patients in a Chinese sample were underweight. Some demographic and clinical variables independent correlates for underweight in alcohol-dependent patients. We need to focus on alcohol-dependent patients with smoking, cerebral infarction, depression, and more prominent negative symptoms. [ABSTRACT FROM AUTHOR]

Introduction: We assessed the prevalence of prescribing of certain medications for alcohol dependence and the extent of any inequalities in receiving prescriptions for individuals with such a diagnosis. Further, we compared the effectiveness of two of the most prescribed medications (acamprosate and disulfiram) for alcohol dependence and assessed whether there is inequality in prescribing either of them. Methods: We used a nationwide dataset on prescriptions and hospitalisations in Scotland, UK (N = 19,748). We calculated the percentage of patients receiving alcohol dependence prescriptions after discharge, both overall and by socio‐economic groups. Binary logistic regressions were used to assess the odds of receiving any alcohol‐dependence prescription and the comparative odds of receiving acamprosate or disulfiram. Comparative effectiveness in avoiding future alcohol‐related hospitalisations (N = 11,239) was assessed using Cox modelling with statistical adjustment for potential confounding. Results: Upto 7% of hospitalised individuals for alcohol use disorder received prescriptions for alcohol dependence after being discharged. Least deprived socio‐economic groups had relatively more individuals receiving prescriptions. Inequalities in prescribing for alcohol dependence existed, especially across sex and comorbidities: males had 12% (odds ratio [OR] 0.88, 95% confidence interval [CI] 0.81–0.96) and those with a history of mental health hospitalisations had 10% (OR 0.90, 95% CI 0.82–0.98) lower odds of receiving prescriptions after an alcohol‐related hospitalisation. Prescribing disulfiram was superior to prescribing acamprosate in preventing alcohol‐related hospitalisations (hazard ratio ranged between 0.60 and 0.81 across analyses). Disulfiram was relatively less likely prescribed to those from more deprived areas. Discussion and Conclusions: Inequalities in prescribing for alcohol dependence exists in Scotland with lower prescribing to men and disulfiram prescribed more to those from least deprived areas. [ABSTRACT FROM AUTHOR]

The instability of remission in alcohol dependence (AD) creates a need to search for criteria for predicting its duration. The aim of study was to determine the hormones, oxidized proteins, and lipids in patients with AD, and the possible relations between these parameters and the duration of remission. Blood samples were obtained from 49 male patients with AD after alcohol detoxification (Total group). Two groups of patients were formed: with unstable therapeutic remission up to 6 months (UTR-group); with stable therapeutic remission which lasted 12 months or longer (STR-group). The control group comprised men without AD. The levels of carbonylated proteins (CP), lipid peroxidation (TBA-RS) were determined in the blood plasma. The levels of cortisol, testosterone total, thyroid-stimulating hormone (TSH), triiodothyronine free (fT3), and thyroxine free (fT4) in the blood serum were measured. The Total group of patients showed an increase in CP, TBA-RS, Cortisol, cortisol/testosterone ratio, and a decrease in TSH, fT3, and fT3/fT4 levels. A set of parameters (T, fT3, fT4, cortisol/testosterone ratio) associated with unstable remission was identified. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol addiction is associated with many negative outcomes that influence the quality of life. However, the factors that contribute to these effects remain a subject of research interest. Aim: The present study compares the quality of life of alcoholics and non-alcoholics and explores the role of age of onset and years of alcohol abuse as predictors of quality of life. Materials and methods: T he s tudy w as c onducted among 120 adults aged >18 years in Sofia, Bulgaria. The experimental group consists of 45 male and 15 female with alcohol addiction. The representatives of the control group are balanced by gender and age with the experimental group. The WHOQOL-Bref was used for the purposes of measurement of Quality of life. The data was analysed via independent t-test and Linear Regression Analysis. Results: The results reveal that people with alcohol dependence have significantly worse results on all domains of quality of life in comparison to the representatives of the control group. The regression analysis of the data of the participants from the experimental group shows that the earlier the onset of alcohol abuse is the worse is the quality of life. Additional regression analyses illustrate that the longer alcohol abuse is the worse is the quality of life. Conclusion: Although these data are indicative of the reduced quality of life of alcohol dependent people in the studied Bulgarian cohort, further research is needed to confirm or challenge the results. Knowledge about the quality of life of alcohol dependent people and the factors that influence it can contribute to optimizing the prevention, treatment and rehabilitation of alcohol dependence. [ABSTRACT FROM AUTHOR]

Several studies are published, that investigated dopamine receptor 2 (DRD2) gene TaqIA polymorphism as a risk factor for alcohol dependence (AD) with positive and negative associations. To derive a more precise estimation of the relationship, a meta-analysis of case–control studies that examined the association between DRD2 gene Taq1A polymorphism and alcohol dependence was performed. Eligible articles were identified through a search of databases including PubMed, Science Direct, Springer link, and Google Scholar. The association between the DRD2 TaqIA polymorphism and AD susceptibility was conducted using odds ratios (ORs) and 95% confidence intervals (95% CIs) as association measures. A total of 69 studies with 9125 cases and 9123 healthy controls were included in the current meta-analysis. Results of the present analysis showed significant association between DRD2 TaqIA polymorphism and AD risk using five genetic modes (allele contrast model—OR 1.22, 95% CI 1.13–1.32, p < 0.0001; homozygote model—OR 1.35, 95%CI 1.18–1.55; p ≤ 0.0001; dominant model—OR 1.29; 95% CI 1.20–1.39; p < 0.0001; recessive model—OR 1.21; 95% CI 1.08–1.36; p = 0.0006). There was no significant association found in subgroup analysis, TaqIA polymorphism was not significantly associated with AD risk in the Asian population under all genetic models, but in the Caucasian population, TaqIA polymorphism was significantly associated with AD risk. Overall, results support the hypothesis that DRD2 Taq1A polymorphism plays a role in alcohol dependence. [ABSTRACT FROM AUTHOR]

This corrigendum addresses an error in the assumptions made during the extrapolation of data from the German pension insurance in an article titled "Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage." The corrected figures show that 72.6% of individuals with alcohol dependence had a diagnosis documented, and 10% of individuals used addiction-specific care services. The correction also provides additional information about the German pension insurance and the funding of rehabilitation treatments. The study estimates that there were 614 individuals receiving addiction rehabilitation in Bremen, with 72.6% having a corresponding diagnosis and 10.7% receiving addiction-specific care measures. The estimated number of individuals with alcohol dependence in Bremen in 2017 was 15,792, with 73% receiving a corresponding diagnosis and 11% using addiction-specific care measures. The article acknowledges limitations and provides detailed extrapolations in Supplementary Tables and Figures. [Extracted from the article]

Background: In Germany, most individuals with alcohol dependence are recognized by the health care system and about 16% per year receive addiction-specific care. This paper aimed to analyze the prevalence and treatment utilization rate of people with alcohol dependence by type of addiction-specific care in the federal state of Bremen using routine and survey data. Methods: The number of individuals with alcohol dependence was estimated using data from the 2018 Epidemiological Survey of Substance Abuse (ESA). Furthermore, linked routine data of two statutory health insurances (SHIs), the German pension insurance (GPI), and the communal hospital group Gesundheit Nord - Bremen Hospital Group (GeNo), from 2016/2017, were analyzed. Based on SHI data, the administrative prevalence of various alcohol-related diagnoses according to the International Classification of Diseases (ICD-10), in various treatment settings, was extrapolated to the total population of Bremen. Based on all routine data sources, treatment and care services for individuals with alcohol dependence were also extrapolated to Bremen's total population. Care services included outpatient addiction care visits and addiction-specific treatments, [i.e., qualified withdrawal treatment (QWT), outpatient pharmacotherapy as relapse prevention, and rehabilitation treatment]. Results: Of the survey-estimated 15,792 individuals with alcohol dependence in Bremen, 72.6% (n = 11,467) had a diagnosis documented with an ICD-10 code for alcohol dependence (F10.2) or withdrawal symptoms (F10.3-F10.4). One in ten individuals with alcohol dependence (n = 1,689) used one or more addiction-specific care services during the observation period. Specifically, 4.3% (n = 675) received outpatient addiction care, 4.7% (n = 736) initiated QWT, 0.8% (n = 133) received pharmacotherapy, and 3.9% (n = 614) underwent rehabilitation treatment. The share of seeking addiction-specific treatment after diagnosis was highest among younger and male patients. Conclusion: Although more than half of the individuals with alcohol dependence are documented in the health system, utilization rates of addiction-specific treatments are low. These low utilization rates suggest that there are existing barriers to transferring patients with alcohol dependence into addiction-specific care. Strengthening primary medical care provision in dealing with alcohol-related disorders and improving networking within the addiction support system appear to be particularly appropriate. [ABSTRACT FROM AUTHOR]

Alcohol dependence remains a significant public health challenge, affecting millions globally and contributing to substantial morbidity and mortality. It is associated with multiple health, social and economic consequences. Taking into consideration the important burden of alcohol dependence, this review aims to provide a comprehensive assessment of the risk factors associated with the development of alcohol dependence. Various risk factors are analysed including age, gender, socioeconomic status, predictive factors from childhood, adolescence and young adulthood and comorbid psychiatric disorders. Understanding the multifaceted nature of alcohol dependence and the complexity of various risk factors' interactions is essential for developing targeted prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Despite alcohol use being a risk factor for numerous health-related conditions and alcohol use disorder (AUD) recognized as a disease, there was limited research in India until 2010. This narrative review aims to evaluate AUD-related research in India from 2010 to July 2023. Methods: A PubMed search used key terms for AUD in India after 2010. Indian and international journals with regional significance that publish alcohol-related research were searched by each author individually. These were then collated, and duplicates were removed. In addition, we also conducted a gray literature search on focused areas related to AUD. Results: The alcohol-related research in India after 2010 focused on diverse areas associated with alcohol use. Some areas of research have received more attention than others. Two major epidemiological surveys conducted in the past decade reveal that around 5% have a problematic alcohol use pattern. Factors associated with alcohol use, like genetic, neurobiological, psychological, and sociocultural, were studied. The studies focused on the clinical profile of AUD, including their correlates, such as craving, withdrawal, alcohol-related harm, and comorbid psychiatric and medical illnesses. During this period, minimal research was conducted to understand AUD's laboratory biomarkers, course, and prognosis. While there was a focus on generating evidence for different psychological interventions for alcohol dependence in management-related research, pharmacological studies centered on anticraving agents like baclofen. Research on noninvasive brain stimulation, such as rTMS, has shown preliminary usefulness in treating alcohol dependence. Very little research has been conducted regarding alcohol policy. Conclusion: In the past decade, Indian research on alcohol has focused on diverse areas. Epidemiological and psychological management-related research received maximum attention. Considering the magnitude of the alcohol-related burden, it is essential to prioritize research to other less studied areas like pharmacological management of alcohol dependence and alcohol policy. [ABSTRACT FROM AUTHOR]

Background: Processing speed is a task-independent construct underpinning more complex goal-related abilities. Processing speed is impaired in alcohol dependence (AD) and is linked to relapse, as are the functions it underpins. Reliable measurement of processing speed may allow tracking of AD recovery trajectories and identify patients requiring additional support. Aims: To assess changes in reaction time (RT) from baseline (at the start of a detoxification programme) across early abstinence. Methods: Vibrotactile RT was assessed in early recovery between days 3 and 7 of treatment in 66 individuals with AD (25 females; aged 19–74, 44.60 ± 10.60 years) and against 35 controls tested on one occasion (19 females; 41.00 ± 13.60), using two multivariate multiple regressions. A mixed multivariate analysis of covariance (MANCOVA) of available AD data (n = 45) assessed change in RT between timepoints and between treatment settings (outpatient vs inpatient). Results: The group (AD vs control) significantly predicted choice RT at baseline and follow-up but did not significantly predict simple RT or RT variability, which is inconsistent with previous findings. At follow-up, mental fatigue was also predicted by the group, and MANCOVA indicated that this had worsened in inpatients but improved in outpatients. Conclusions: Recovery of RT measures so early in the treatment journey was not in line with previous research which indicates persisting deficits. The interaction between setting and timepoint indicates that despite being typically less medically complex, outpatients require ongoing support and monitoring during their recovery. [ABSTRACT FROM AUTHOR]

Background: The association of impaired dopaminergic neurotransmission with the development and maintenance of alcohol use disorder is well known. More specifically, reduced dopamine D2/3 receptors in the striatum of subjects with alcohol dependence (AD) compared to healthy controls have been found in previous studies. Furthermore, alterations of gamma‐aminobutyric acid (GABA) and glutamate (Glu) levels in the anterior cingulate cortex (ACC) of AD subjects have been documented in several studies. However, the interaction between cortical Glu levels and striatal dopamine D2/3 receptors has not been investigated in AD thus far. Methods: This study investigated dopamine D2/3 receptor availability via 18F‐fallypride positron emission tomography (PET) and GABA as well as Glu levels via magnetic resonance spectroscopy (MRS) in 19 detoxified AD subjects, 18 healthy controls (low risk, LR) controls and 19 individuals at high risk (HR) for developing AD, carefully matched for sex, age and smoking status. Results: We found a significant negative correlation between GABA levels in the ACC and dopamine D2/3 receptor availability in the associative striatum of LR but not in AD or HR individuals. Contrary to our expectations, we did not observe a correlation between Glu concentrations in the ACC and striatal D2/3 receptor availability. Conclusions: The results may reflect potential regulatory cortical mechanisms on mesolimbic dopamine receptors and their disruption in AD and individuals at high risk, mirroring complex neurotransmitter interactions associated with the pathogenesis of addiction. This is the first study combining 18F‐fallypride PET and MRS in AD subjects and individuals at high risk. [ABSTRACT FROM AUTHOR]

Objective: A severe and long-term alcohol use can have adverse effects on lower limb function. Over time, some individuals may develop gait ataxia, which refers to the impairment of controlled lower body movements that are important for walking and maintaining proper gait. Gait ataxia is well-documented in patients who have been diagnosed with alcohol-related Wernicke–Korsakoff syndrome (WKS); however, less is known on how common ataxia is among patients with alcohol use disorder (AUD) without WKS. To date, no study has systematically reviewed the evidence focusing on patients suffering only from AUD. Our aim was to perform a qualitative synthesis of the existing literature examining behavioral signs of gait ataxia among abstinent patients with AUD. Method: Two facets were created encompassing keywords for "alcohol use disorder" and "measures of gait ataxia." Databases, including EMBASE, APA PsycInfo, Medline, and Cochrane Library, were searched for studies, and a quality assessment was performed. Results: Ten studies were identified (37 ≥ ns ≤ 247), which were all rated as being of moderate (N = 7) to good quality (N = 3). The age range was 31.4–53.4 years (weighted mean age: 53.6 years), and 78.3% of the participants were male. Eight studies found that patients with AUD and without WKS exhibited behavioral signs of gait ataxia. Conclusions: Although there is evidence of gait ataxia among patients with AUD, heterogeneous results and methodological shortcomings such as lack of screening for neurocognitive deficits deem these findings preliminary and highlight the need for more research in the future. Public Health Significance Statement: The lack of knowledge on whether gait ataxia is present among patients with alcohol use disorder can delay an early diagnosis and impede on the treatment of the motor dysfunction. This systematic review provides important insights to the nature of gait ataxia among patients with alcohol use disorder. [ABSTRACT FROM AUTHOR]

BackgroundBipolar disorder is a psychiatric disorder characterized by mood swings between manic and depressed states that causes psychosocial problems. Cognitive function deteriorates with each recurrence, making it important to maintain remission through continued treatment. Bipolar disorder often co-occurs with alcohol dependence, which is known to lead to decreased treatment adherence and increased suicide risk. However, the real-world clinical determinants of alcohol dependence in outpatients with bipolar disorder in Japan remain unclear.MethodsWe conducted an observational study targeting 2392 patients with bipolar disorder using data from the MUSUBI study, a joint project of the Japanese Association of Neuro-Psychiatric Clinics and the Japanese Society of Clinical Neuropsychopharmacology. After determining the prevalence of alcohol dependence and the sociodemographic characteristics of patients with bipolar disorder, multivariate analysis was performed to identify risk factors for alcohol comorbidity.ResultsThe prevalence of alcohol dependence among outpatients with bipolar disorder in this study was 5.7%. The prevalence was 7.6% for males and 3.1% for females. The results of the binomial logistic regression analysis revealed that bipolar I disorder, manic state, comorbidities with other psychiatric disorders, male sex, and suicidal ideation were significantly associated with alcohol dependence. Stratified analysis by gender showed that alcohol dependence was more strongly associated with the presence of suicidal ideation in women than in men.LimitationFirst, because this was an observational study with a cross-sectional design, causal relationships between factors cannot be determined. In addition, this study included outpatients in Japan but lacked information on inpatients. Therefore, it was considered necessary to conduct the study on a larger population in order to generate more robust evidence.ConclusionsWe found that outpatients with bipolar disorder, especially men, had higher rates of alcohol dependence overall than the general population in Japan. In addition, the relationship between alcohol dependence and suicidal ideation was stronger in women than in men with bipolar disorder. There was a strong association between manic states and alcohol dependence in outpatients with bipolar disorder. These results are useful to clinicians because they reinforce real-world clinical evidence for the treatment of bipolar disorder and co-occurring alcohol dependence.

IntroductionAlcohol craving, characterized by a strong desire or compulsion to consume alcohol, is a prominent symptom of substance dependence syndrome. Research indicates that alcohol craving is a significant factor leading to the termination of abstinence. The mechanisms underlying the activation of alcohol craving remain not fully understood. The urge to reach for alcohol may be stimulated by emotions, memories, thoughts, or bodily sensations, as well as external factors. It has been postulated that individuals with high levels of interoceptive sensibility tend to exhibit a high degree of alexithymia and emotion dysregulation in the context of alcohol craving. Deficits in identifying and verbalizing emotions, along with an operational thinking style, facilitate alcohol consumption by impeding accurate insight into one’s mental state, thereby hindering the comprehension of bodily states, emotions, and the regulation of self.MethodThis study involved 160 inmates incarcerated in a prison in Poland, awaiting participation in therapy for individuals with substance dependence following psychiatric diagnosis. Four questionnaires were used in the study: multidimensional Assessment of Interoceptive Sensibility (MAIA) for interoceptive sensibility, Toronto Alexithymia Scale (TAS-20) for alexithymia, Difficulties in Emotion Regulation Scale (DERS) for emotional dysregulation, and the Penn Alcohol Craving Scale (PACS) for alcohol craving assessment.ResultsThe results of the study are as follows: the study findings indicated that alexithymia and emotional dysregulation significantly mediates the relationship between interoceptive sensibility and alcohol craving. The indirect effect for both factors was found to be significant, similar to the indirect effect observed for alexithymia as an mediator. However, in the case of emotional dysregulation, no significant indirect effect was observed.ConclusionOur study provides insights into the potential contribution of interoceptive sensibility to the heightened risk of alcohol dependence. Specifically, impaired interoceptive sensibility may be associated with the development of alexithymia and emotional dysregulation, potentially rendering individuals more susceptible to alcohol craving. Interoceptive sensibility could serve as a prerequisite for the cultivation of positive emotional processing skills.

Current treatments for alcohol use disorders (AUD) have limited efficacy. Recently, Cannabidiol (CBD) has been examined in a multitude of clinical settings. Preclinical and clinical results suggest that CBD might be particularly well suited for the treatment of AUD and may reduce alcohol cue and stress-induced craving and alcohol seeking. This study aims to investigate this new pharmacotherapy with a particular focus on neurobiological and physiological indicators of craving. Methods: In this double-blind, within-subject, randomised, placebo-controlled, cross-over study, non-treatment seekers will be randomly allocated to three days of four 200 mg CBD gel capsules (800 mg/day) or placebo, with an 18-day washout period. Cognitive, clinical, and neuroimaging assessments will be completed during these three days. The CBD and placebo assessments will be compared. The primary outcomes are i) BOLD signal as a proxy for regional activity during a cue reactivity and a fear response task measured with functional magnetic resonance imaging (fMRI), ii) heart rate variability and skin conductance levels as a proxy for psychophysiological responses to alcohol stimuli. The secondary outcomes are: i) neurometabolite levels (γ-Aminobutyric acid, ethanol, glutathione, and glutamate + glutamine (combined signal)) using magnetic resonance spectroscopy (MRS); ii) functional connectivity using resting state fMRI (rsfMRI); iii) executive functioning task results; iv) clinical outcomes such as craving, anxiety, and sleep. Discussion: This study will improve the understanding of the mechanisms of action of CBD and provide early signals of efficacy regarding the therapeutic potential of CBD in the treatment of alcohol use disorder.ClinicalTrials.gov Identifier: NCT05387148.