Clinical utility of a single-item test for DSM-5 alcohol use disorder among outpatients with anxiety and depressive disorders

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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Residual alcohol use disorder symptoms after treatment predict long‐term drinking outcomes in seniors with DSM‐5 alcohol use disorder

Alcoholism Clinical and Experimental Research ◽

10.1111/acer.14722 ◽

2021 ◽

Author(s):

Silke Behrendt ◽

Alexis Kuerbis ◽

Barbara Braun‐Michl ◽

Randi Bilberg ◽

Gerhard Bühringer ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Dsm 5 ◽

Drinking Outcomes

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Effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2019-0177 ◽

2019 ◽

Vol 97 (8) ◽

pp. 781-785 ◽

Cited By ~ 2

Author(s):

M.S. Zastrozhin ◽

V.Y. Skryabin ◽

V.V. Smirnov ◽

E.A. Grishina ◽

K.A. Ryzhikova ◽

...

Keyword(s):

Alcohol Use ◽

High Performance ◽

Alcohol Use Disorder ◽

Depressive Disorders ◽

Rating Scale ◽

Correlation Coefficients ◽

Inverse Correlation ◽

Efficacy And Safety ◽

Cyp2d6 Activity ◽

Scale Scores

The objective of the study was to investigate the effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder who received mirtazapine. The study included 109 Russian patients who received mirtazapine at a dose of 30.0 [15.0; 45.0] mg per day. Genotyping of CYP2D6*4 (1846G > A, rs3892097) was performed using real-time polymerase chain reaction with allele-specific hybridization. The activity of CYP2D6 was evaluated by determining the concentration of endogenous substrate of the enzyme and its urinary metabolite — pinoline to 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline ratio, using high-performance liquid chromatography – mass spectrometry. The statistically significant differences between the scores on the Hamilton Depression Rating Scale (HAMD) in patients with different genotypes were revealed by day 16: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [1.0; 3.2] (p < 0.001), and for the The UKU Side Effects Rating Scale (UKU): (GG) 6.0 [6.0; 7.0], (GA) 8.5 [8.0; 10.0] (p < 0.001). The calculation of correlation coefficients between the differences in scale scores and metabolic rate showed the presence of statistically significant weak inverse correlation with the efficacy indicator evaluated by HAMD (r = −0.278, p < 0.05), but not by UKU (r = 0.274, p > 0.05). This study demonstrated that an increased CYP2D6 activity reduces the efficacy of treatment with mirtazapine.

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The etiology of DSM-5 alcohol use disorder: Evidence of shared and non-shared additive genetic effects

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2018.12.034 ◽

2019 ◽

Vol 201 ◽

pp. 147-154 ◽

Cited By ~ 1

Author(s):

Rohan H.C. Palmer ◽

Leslie A. Brick ◽

Yi-Ling Chou ◽

Arpana Agrawal ◽

John E. McGeary ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Genetic Effects ◽

Dsm 5 ◽

Additive Genetic Effects

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A data-driven method for identifying shorter symptom criteria sets: the case for DSM-5 alcohol use disorder

Psychological Medicine ◽

10.1017/s0033291718001551 ◽

2018 ◽

Vol 49 (6) ◽

pp. 931-939 ◽

Cited By ~ 2

Author(s):

Cheryl D. Raffo ◽

Deborah S. Hasin ◽

Paul Appelbaum ◽

Melanie M. Wall

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Short Form ◽

Data Driven ◽

Short Forms ◽

Dsm 5 ◽

Epidemiologic Survey ◽

Sas Macro ◽

Continuous Improvement Model ◽

Sum Scores

AbstractBackgroundAlthough the DSM is a widely used diagnostic guide, lengthy criteria sets can be problematic and provide the primary motivation to identify short-forms. Using the 11 diagnostic criteria provided by the DSM-5 for alcohol use disorder (AUD), the present study develops a data-driven method to systematically identify subsets and associated cut-offs that yield diagnoses as similar as possible to use all 11 criteria.MethodRelying on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), our methodology identifies diagnostic short-forms for AUD by: (1) maximizing the association between the sum scores of all 11 criteria with newly constructed subscales from subsets of criteria; (2) optimizing the similarity of AUD prevalence between the current DSM-5 rule and newly constructed diagnostic short-forms; (3) maximizing sensitivity and specificity of the short-forms against the current DSM-5 rule; and (4) minimizing differences in the accuracy of the short-form across chosen covariates. Replication is shown using NESARC-Wave 2.ResultsMore than 11 000 diagnostic short-forms for DSM-5 AUD can be created and our method narrows down the optimal choices to eight. Results found that ‘Neglecting major roles’ and ‘Activities given up’ could be dropped with practically no change in who is diagnosed (specificity = 100%, sensitivity ⩾ 99.6%) or the severity of those diagnosed (κ = 0.97).ConclusionsWith a continuous improvement model adopted by the APA for DSM revisions, we offer a data-driven tool (a SAS Macro) that identifies diagnostic short-forms in a systematic and reproducible way to help advance potential improvements in future DSM revisions.

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