scholarly journals Ludwig van Beethoven—a psychiatric perspective

Author(s):  
Andreas Erfurth

SummaryBiographical accounts of famous artists usually try to relate the life story to the works (and vice versa). This gives the work a special “colour”, often the context for understanding for today’s recipients. This interrelation is complex and often judgmental, sometimes manipulative. Thus, medical (including psychiatric), characterological and psychodynamic assessments and interpretations must be made with great caution. Primary sources may be scanty and diagnostic concepts may have changed (Mozart died of hitzigem Frieselfieber [prickly heat fever]; in Hölderlin’s lifetime, schizophrenia or bipolar disorder did not yet “exist”). The attempt at a diagnostic classification often says more about the author and his time than about the artist (for example, the assessment of Robert Schumann’s or Friedrich Hölderlin’s mental illness). Against this background, elements of Ludwig van Beethoven’s biography are presented from a psychiatric perspective. In summary, Beethoven can be diagnosed with an alcohol use disorder. A pronounced hyperthymic temperament is likely to have had a clearly positive influence on the course of the disorder. In particular, no influence of the alcohol use disorder on the musical quality of the work can be proven. A clear episodic course of affective symptoms as in bipolar disorder is not demonstrable. The deafness caused a severe reduction in quality of life.

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 141
Author(s):  
Hwee Wee ◽  
Gweon-Young Kang

Addiction is related to aggression and quality of life. This study examined the relationship between these three factors according to occupation group in a mixed urban/rural area to better understand adult addiction problems. This study was a secondary data analysis of cross-sectional data collected by a 2017 regional survey of adults living in Gunsan City, South Korea. The survey included 500 people split into the unemployed (Group1), full-time homemakers (Group2), and primary (Group3), secondary (Group4), and tertiary (Group5) industry workers. Addiction problems and aggression were positively correlated (p < 0.01). Aggression and alcohol use disorder were correlated in Group3 (r = 0.31), Group4 (r = 0.34), and Group5 (r = 0.32), and aggression and smartphone addiction were correlated in Group2 (r = 0.39) and Group4 (r = 0.31). Problem gambling was correlated with aggression in Group5 (r = 0.39). A negative relationship between quality of life and alcohol use disorder occurred in Group1 (r = −0.36). According to the occupation group, the relationships between addiction problems, aggression, and quality of life were different. These findings suggest that addiction management for adults should be implemented in consideration of occupation groups.


2020 ◽  
Vol 12 (4) ◽  
pp. 69
Author(s):  
EunJu Song

Many patients with alcohol use disorder experienced insomnia or sleep disturbances. However, their sleep problems rarely addressed in the treatment process. It may prove beneficial if treatment programs should intend to help prevent the recurrence of alcohol use disorder by solving patients&rsquo; sleep-induced problems and accordingly include appropriate sleep interventions. The present study employed a descriptive design and conducted a cross-sectional survey to assess the relationship among sleep quality, score on the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), abstinence self-efficacy, and quality of life in inpatients with alcohol use disorders. Data were collected from June to August 2018, from 117 patients admitted to the psychiatric ward for alcohol-use patients in two mental hospitals in South Korea. Sleep quality was significantly correlated with the SOCRATES score (r = .247, p = .007) and quality of life (r = -.346, p = .001). However, it showed no relationship with abstinence self-efficacy (r = -.066, p = .477). These findings suggest that abstinence programs need to employ a comprehensive approach instead of primarily focusing on maintaining abstinence and cessation of alcohol use. However, both sleep disturbances and alcohol abstinence require patience and prolonged treatment. Thus, it is a challenge to design concrete interventions to address the sleep problems experienced by patients with alcohol use disorder.


2021 ◽  
Author(s):  
Najlaa Lahbairi ◽  
Alice Laniepce ◽  
Shailendra Segobin ◽  
Nicolas Cabé ◽  
Céline Boudehent ◽  
...  

Abstract Background. Health-related quality of life (HRQoL) is an important clinical outcome in Alcohol Use Disorder (AUD) and is considered as a relevant indicator of treatment success. While a better understanding of the factors affecting HRQoL would enable to adjust patients’ care to favour treatment outcome, the determinants of HRQoL in AUD remain unclear. This study aims at describing HRQoL in AUD patients and at identifying its best predictors. Methods. We included 53 recently detoxified patients with severe AUD (sAUD) and 38 healthy controls (HC). They underwent a cognitive assessment and filled in questionnaires concerning socio-demographics, alcohol history, sleep quality, depression, anxiety and impulsivity. Additionally, a HRQoL questionnaire especially designed for AUD patients (Alcohol Quality of Life Scale; AQoLS) was used.Results. sAUD patients reported that alcohol affects their HRQoL mainly in the “negative emotions”, “control”, “relationships”, and “sleep” domains. Compared to HC, they were impaired on episodic memory, working memory, executive functions, and processing speed tasks. They also reported lower sleep quality, higher depression, anxiety and impulsivity. No association was found between AQoLS total score and socio-demographics, cognitive performance, or sleep quality in patients. We found a significant correlation between HRQoL and depression/anxiety as well as impulsivity. Anxiety and impulsivity were indeed the only significant predictors of HRQoL, explaining 47.7% of the variance. Conclusions. Anxiety and impulsivity are crucial determinants of HRQoL in recently detoxified sAUD patients. Since anxiety and impulsivity are frequent issues in addiction and especially in AUD, they should be particularly considered by clinicians to favour treatment outcomes.


Author(s):  
Katie Witkiewitz ◽  
Henry R. Kranzler ◽  
Kevin A. Hallgren ◽  
Deborah S. Hasin ◽  
Arnie P. Aldridge ◽  
...  

Abstract Background The World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials. Objective The current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment. Design and Participants Secondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806). Measures Alcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment. Key Results One-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking. Conclusion AUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning.


2012 ◽  
Vol 14 (6) ◽  
pp. 659-666 ◽  
Author(s):  
Conor K. Farren ◽  
Kevin P. Hill ◽  
Roger D. Weiss

2020 ◽  
Author(s):  
Kristine Tarp ◽  
Sengül Sari ◽  
Anette Søgaard Nielsen

Abstract Background: In Denmark, there is a high prevalence of individuals suffering from alcohol use disorder (AUD). However, of these, only 10% seeks treatment. The aim of this study was to examine reasons not to seek treatment among people who suffer from AUD.Methods: Participants suffering from AUD were recruited among somatic as well as psychiatric in and outpatients. The study was qualitative, based on semi-structured individual participant interviews. The analysis was narrative.Results: The participant group consisted of two women and four men. Their average age was 58. The investigation indicated that the participants felt that alcohol added to their quality of life and that they enjoyed using it in social settings. Also, it seemed that there were two major groups of facilitating factors towards rehabilitation: health-related issues as well as relatives and relations. Finally, two major reasons for not seeking AUD treatment appeared: participants did not believe that it was a relevant offer for them and participants wanted to deal with their alcohol overuse issue themselves.Conclusions: In gaining an understanding of the reasons not to seek AUD treatment, we simultaneously gain an opportunity to adapt prevention campaign strategies and treatment offers to become even more inclusive towards people who may suffer from AUD but do not recognize and acknowledge a treatment need. Here, increased focus on several initiatives might contribute to a decrease of barriers to treatment-seeking and, thus, increase the proportion of people suffering from AUD who consider to and actually do seek treatment.


2021 ◽  
Vol 12 ◽  
Author(s):  
Heinz Grunze ◽  
Martin Schaefer ◽  
Harald Scherk ◽  
Christoph Born ◽  
Ulrich W. Preuss

Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40–70%, both for Bipolar I and II disorder, and with male preponderance. Alcohol use disorder and bipolarity significantly influence each other's severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity.


2021 ◽  
pp. 026988112199179
Author(s):  
Ben Sessa ◽  
Laurie Higbed ◽  
Steve O’Brien ◽  
Claire Durant ◽  
Chloe Sakal ◽  
...  

Background: 3,4-methylenedioxymethamphetamine (MDMA) therapy has qualities that make it potentially well suited for patients with addictions, but this has never been explored in a research study. We present data from the Bristol Imperial MDMA in Alcoholism (BIMA) study. This is the first MDMA addiction study, an open-label safety and tolerability proof-of-concept study investigating the potential role for MDMA therapy in treating patients with alcohol use disorder (AUD). Aims: This study aimed to assess if MDMA-assisted psychotherapy can be delivered safely and can be tolerated by patients with AUD post detoxification. Outcomes regarding drinking behaviour, quality of life and psychosocial functioning were evaluated. Methods: Fourteen patients with AUD completed a community alcohol detoxification and received an eight-week course of recovery-based therapy. Participants received two sessions with MDMA (187.5 mg each session). Psychological support was provided before, during and after each session. Safety and tolerability were assessed alongside psychological and physiological outcome measures. Alcohol use behaviour, mental well-being and functioning data were collected for nine months after alcohol detoxification. Results: MDMA treatment was well tolerated by all participants. No unexpected adverse events were observed. Psychosocial functioning improved across the cohort. Regarding alcohol use, at nine months post detox, the average units of alcohol consumption by participants was 18.7 units per week compared to 130.6 units per week before the detox. This compares favourably to a previous observational study (the ‘Outcomes’ study) by the same team with a similar population of people with AUD. Conclusions: This study provides preliminary support for the safety and tolerability of a novel intervention for AUD post detox. Further trials to examine better the therapeutic potential of this approach are now indicated.


2014 ◽  
Vol 29 (5) ◽  
pp. 282-287 ◽  
Author(s):  
N. Carmiol ◽  
J.M. Peralta ◽  
L. Almasy ◽  
J. Contreras ◽  
A. Pacheco ◽  
...  

AbstractBipolar disorder and alcohol use disorder (AUD) have a high rate of comorbidity, more than 50% of individuals with bipolar disorder also receive a diagnosis of AUD in their lifetimes. Although both disorders are heritable, it is unclear if the same genetic factors mediate risk for bipolar disorder and AUD. We examined 733 Costa Rican individuals from 61 bipolar pedigrees. Based on a best estimate process, 32% of the sample met criteria for bipolar disorder, 17% had a lifetime AUD diagnosis, 32% met criteria for lifetime nicotine dependence, and 21% had an anxiety disorder. AUD, nicotine dependence and anxiety disorders were relatively more common among individuals with bipolar disorder than in their non-bipolar relatives. All illnesses were shown to be heritable and bipolar disorder was genetically correlated with AUD, nicotine dependence and anxiety disorders. The genetic correlation between bipolar and AUD remained when controlling for anxiety, suggesting that unique genetic factors influence the risk for comorbid bipolar and AUD independent of anxiety. Our findings provide evidence for shared genetic effects on bipolar disorder and AUD risk. Demonstrating that common genetic factors influence these independent diagnostic constructs could help to refine our diagnostic nosology.


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