Search

Abstract Background Poor quality of sleep among alcoholics and persons undergoing alcohol withdrawal has been described as a possible cause of alcohol relapse. It has been suggested earlier that nitrous oxide gas has a significant effect on the signs of alcohol withdrawal syndrome (AWS) and thus might be expected to reduce sleep disturbance during withdrawal. The aim of the present study was to investigate sleep quality during alcohol withdrawal, to evaluate the correlation between sleep quality and the severity of AWS and alcohol craving, and to determine if nitrous oxide treatment does counteract withdrawal's effects on the quality of sleep. Voluntary patients (n = 105) admitted to the A-Clinic detoxification center with AWS were included in the study. The AWS patients were randomly assigned to one of the following 45-minute gas treatments: (1) nitrous oxide/oxygen; (2) normal air/O2; and (3) medical (normal) air. The study was single-blind by design. Sleep quality was assessed after these treatments during the inpatient period; sleep time, sleep efficiency and the fragmentation of sleep were recorded by wrist-worn actigraphs. Severity of AWS was evaluated by the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar) and that of alcohol dependence and craving by the Obsessive Compulsive Drinking Scale [OCDS] and the Severity of Alcohol Dependence Data (SADD) questionnaire. Results The fragmentation index and the time awake while in bed were both much above the reference values for the Finnish population. These values reflect the restless and disturbed night sleep of the subjects. The only statistically significant effects between the treatment groups were found in the correlations of CIWA-Ar (severity of AWS) scores, OCDS-scores (alcohol craving) and coffee consumption, all of which were positively associated with movement time and negatively with total sleep time and sleep efficiency. The sleep quality of patients treated with nitrous oxide gas did not differ from the sleep quality of those treated with normal air. Conclusions The severity of AWS and coffee consumption had the most significant negative impact on sleep quality. According to our results, nitrous oxide gas does not differ from placebo in its effect on sleep quality during alcohol withdrawal.

Background: Brief alcohol intervention (BI) is recommended for use in health care. However, too little is known about its use in everyday work. Objective: The aim of this study was to examine the activity of asking patients about alcohol use, offering them BI, and documenting these issues in physicians' and nurses' consultations as a part of everyday primary health care (PHC) work. Methods: All PHC workers (n = 104) of seven health care centers were asked to report information on 30 consecutive adult patients. Altogether, 78 PHC workers (75.0%) participated in this study and reported information on 2,047 patients. Results: A total of 1,112 (56.4%) patients had been asked about alcohol use at some point. According to the PHC workers, 115 (10.4%) of the patients who had been asked about alcohol use were risky drinkers. BI was offered to 103 (89.6%) risky drinkers. Alcohol-related documentation was found in 452 (42.0%) of the records of patients who had been asked about alcohol use. Discussion: The BI activity of PHC professionals is high if the patient is considered a risky drinker. However, the overall incidence of inquiry could be increased and alcohol-related documentation still remains low. [ABSTRACT FROM AUTHOR]

Background: Approximately half of patients suffering from a significant drug or alcohol related disorder also match the criteria of some other psychiatric disorder. Yet, little is known about comorbidity among substance misusing pregnant women. Aims: To estimate the prevalence of psychiatric diseases among mothers with substance misuse severe enough to end up in an assessment at a specialized addiction clinic and to compare their backgrounds to the controls. Methods: Between 1 June 2003 and 31 December 2005, the maternity clinics in Pirkanmaa health district were asked to refer mothers with possible substance misuse to Tampere University Addiction Psychiatric Clinic, where 119/217 patients were considered misusers. Of these, 49/119 (41.2%) participated in the whole study. At baseline, the assessment was made using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and at the end of the study, 6-12 months after delivery, with the Structured Clinical Interview for DSM-IV (SCID). The comparison group ( n = 74) filled a postal survey concerning their background and substance use. Results: 57% of substance misusing pregnant women had psychiatric illnesses; 6-12 months after delivery the number of substance use-related diagnoses was 40%. However, the number, spectrum and severity of psychiatric diagnoses were high in this group. Conclusions: Psychiatric comorbidity is common among substance misusing mothers. Their social situation is often very difficult and support needs vary a lot. In order to offer them best possible treatment, diagnosing these disorders should be a routine part of evaluation during pregnancy. [ABSTRACT FROM AUTHOR]