scholarly journals Towards the characterization and validation of alcohol use disorder subtypes: integrating consumption and symptom data

2013 ◽  
Vol 44 (1) ◽  
pp. 143-159 ◽  
Author(s):  
K. M. Jackson ◽  
K. K. Bucholz ◽  
P. K. Wood ◽  
D. Steinley ◽  
J. D. Grant ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Model Comparison ◽  
Latent Class ◽  
Common Factor ◽  
Hybrid Approaches ◽  
Epidemiologic Survey ◽  
Alcohol Involvement ◽  
Best Fitting

BackgroundThere is evidence that measures of alcohol consumption, dependence and abuse are valid indicators of qualitatively different subtypes of alcohol involvement yet also fall along a continuum. The present study attempts to resolve the extent to which variations in alcohol involvement reflect a difference in kindversusa difference in degree.MethodData were taken from the 2001–2002 National Epidemiologic Survey of Alcohol and Related Conditions. The sample (51% male; 72% white/non-Hispanic) included respondents reporting past 12-month drinking at both waves (wave 1:n = 33644; wave 2:n = 25186). We compared factor mixture models (FMMs), a hybrid of common factor analysis (FA) and latent class analysis (LCA), against FA and LCA models using past 12-month alcohol use disorder (AUD) criteria and five indicators of alcohol consumption reflecting frequency and heaviness of drinking.ResultsModel comparison revealed that the best-fitting model at wave 1 was a one-factor four-class FMM, with classes primarily varying across dependence and consumption indices. The model was replicated using wave 2 data, and validated against AUD and dependence diagnoses. Class stability from waves 1 to 2 was moderate, with greatest agreement for the infrequent drinking class. Within-class associations in the underlying latent factor also revealed modest agreement over time.ConclusionsThere is evidence that alcohol involvement can be considered both categorical and continuous, with responses reduced to four patterns that quantitatively vary along a single dimension. Nosologists may consider hybrid approaches involving groups that vary in pattern of consumption and dependence symptomatology as well as variation of severity within group.

scholarly journals Multivariate GWAS elucidates the genetic architecture of alcohol consumption and misuse, corrects biases, and reveals novel associations with disease

2020 ◽  
Author(s):  
Travis T Mallard ◽  
Jeanne E Savage ◽  
Emma C Johnson ◽  
Yuye Huang ◽  
Alexis C Edwards ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Psychiatric Disorders ◽  
Alcohol Use Disorder ◽  
Association Studies ◽  
Genetic Correlations ◽  
Genome Wide Association Studies ◽  
Genetic Associations ◽  
Socioeconomic Outcomes ◽  
Alcohol Involvement

ABSTRACTGenome-wide association studies (GWASs) of the Alcohol Use Disorder Identification Test (AUDIT), a ten-item screener for alcohol use disorder (AUD), have elucidated novel loci for alcohol consumption and misuse. However, these studies also revealed that GWASs can be influenced by numerous biases (e.g., measurement error, selection bias), which have led to inconsistent genetic correlations between alcohol involvement and AUD, as well as paradoxically negative genetic correlations between alcohol involvement and psychiatric disorders/medical conditions. To explore these unexpected differences in genetic correlations, we conducted the first item-level and largest GWAS of AUDIT items (N=160,824), and applied a multivariate framework to mitigate previous biases. In doing so, we identified novel patterns of similarity (and dissimilarity) among the AUDIT items, and found evidence of a correlated two-factor structure at the genetic level (Consumption and Problems, rg=.80). Moreover, by applying empirically-derived weights to each of the AUDIT items, we constructed an aggregate measure of alcohol consumption that is strongly associated with alcohol dependence (rg=.67) and several other psychiatric disorders, and no longer positively associated with health and positive socioeconomic outcomes. Lastly, by performing polygenic analyses in three independent cohorts that differed in their ascertainment and prevalence of AUD, we identified novel genetic associations between alcohol consumption, alcohol misuse, and human health. Our work further emphasizes the value of AUDIT for both clinical and genetic studies of AUD, and the importance of using multivariate methods to study genetic associations that are more closely related to AUD.

The Role Of Alcohol Use Disorder And Alcohol Consumption In Suicide Attempts-A Secondary Analysis Of 1921 Suicide Attempts

2010 ◽  
Vol 25 (7) ◽  
pp. 414-420 ◽  
Author(s):  
S. Boenisch ◽  
A. Bramesfeld ◽  
R. Mergl ◽  
I. Havers ◽  
D. Althaus ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Suicide Attempts ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
High Risk Group ◽  
Older Individuals ◽  
Alcohol Involvement

AbstractBackgroundIt is not known how characteristics of suicide attempts vary with different forms of alcohol involvement. The aim of this study is to clarify the role of alcohol use disorder and acute alcohol consumption in suicide attempts.MethodsData on 1921 suicide attempts was gathered in a major German city over a 5-year period. Suicide attempts were categorised according to a diagnosis of alcohol use disorder and acute alcohol consumption at the time of the attempt. Group comparisons and multinomial logistic regression were used for statistical analysis.ResultsIn 331 suicide attempts (17%) an alcohol use disorder was diagnosed. Six hundred and twenty-two suicide attempts (32%) were committed with acute alcohol consumption. Suicide attempts by individuals with alcohol use disorder were more often committed by men, older individuals and as a recurrent attempt, independently of alcohol consumption at the time of the attempt. When alcohol was consumed in suicide attempts by individuals with alcohol use disorder, low-risk methods were used most often.ConclusionsIndividuals with a diagnosis of alcohol use disorder are a high-risk group for multiple suicide attempts and should be a target group for suicide prevention. Screening for suicidality should be a regular part of the clinical assessment in individuals with alcohol use disorder.

Nalmefene against alcohol use disorder: A report of one case

2017 ◽  
Vol 41 (S1) ◽  
pp. s866-s866
Author(s):  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
L. Sánchez Blanco ◽  
R. Landera Rodríguez ◽  
M. Gómez Revuelta ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Opioid Receptor ◽  
Treatment Option ◽  
Withdrawal Syndrome ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Family Relationship ◽  
Heavy Drinking ◽  
Alcohol Withdrawal Syndrome

IntroductionAlcohol consumption represents a significant factor for mortality in the world: 6.3% in men and 1.1% in women. Alcohol use disorder is also very common: 5.4% in men and 1.5% in women. Despite its high frequency and the seriousness of this disorder, only 8% of all alcohol-dependents are ever treated. One potentially interesting treatment option is oriented toward reducing alcohol intake.AimsTo describe one case who has improved his alcohol consumption after starting treatment with nalmefene, an opioid receptor antagonist related to naltrexone.MethodsA 35-year-old male with alcohol use disorder since 2001 came to our consult in November 2015. He was in trouble with his family and he had a liver failure. We offer a new treatment option with nalmefene 18 mg to reduce alcohol consumption.ResultsBefore to start nalmefene he drank 21 drinks/week. Six-month later, he decreased alcohol intake until 5 drinks/week with better family relationship and liver function. After starting nalmefene he complained of nausea, so we recommend to take the middle of the pill for next 7 days. After this time he returned to take one pill with good tolerance and no more side effects or withdrawal syndrome.ConclusionsNalmefene appears to be effective and safe in reducing heavy drinking and in preventing alcohol withdrawal syndrome due to its opioid receptor antagonism. This case suggests nalmefene is a potential option to help patients, who do not want or cannot get the abstinence, in reducing their alcohol consumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of Familial Alcohol Consumption on Alcohol Use Disorder, Depression, Anxiety, and Stress of University Students

2021 ◽  
Vol 11 (1) ◽  
pp. 67-73
Author(s):  
Keun-Young Ryu ◽  
Kwan-Woo Park ◽  
Min-Sun Kim ◽  
Hea-Jin Lee ◽  
song yi Paek ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
University Students ◽  
Alcohol Use Disorder

Unhealthy Alcohol Use

2019 ◽  
Author(s):  
Stephen R Holt ◽  
Joseph H. Donroe
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Genetic Factors ◽  
Physical And Mental Health ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Societal Norms ◽  
High Prevalence ◽  
Excessive Alcohol

Unhealthy alcohol use refers to a spectrum of alcohol consumption ranging from at-risk drinking to alcohol use disorder. It is associated with both a high cost to society and to individuals. Globally, alcohol is a leading cause of death and disability, and despite the high prevalence of unhealthy alcohol use, diagnosis, and treatment of alcohol use disorder remains disproportionately low. Risk for unhealthy alcohol use and alcohol related harms is multifactorial and includes genetic factors, gender, age, socioeconomic status, cultural and societal norms, and policies regulating alcohol consumption among others. Excessive alcohol use is associated with a myriad of poor physical and mental health outcomes, and screening for unhealthy alcohol use is universally recommended and effective. This review contains 1 figures, 2 tables, and 76 references.  Key Words: addiction, alcohol, cancer, diagnosis, drinking, liver disease, screening, stigma, use disorderImportant Advances

scholarly journals Make Mission Impossible Feasible: The Experience of a Multidisciplinary Team Providing Treatment for Alcohol Use Disorder to Homeless Individuals

2020 ◽  
Vol 55 (5) ◽  
pp. 547-553
Author(s):  
Tommaso Dionisi ◽  
Carolina Mosoni ◽  
Giovanna Di Sario ◽  
Claudia Tarli ◽  
Mariangela Antonelli ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Clinical Evaluation ◽  
Treatment Program ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Multidisciplinary Treatment ◽  
Social Reintegration ◽  
Multidisciplinary Treatment Program ◽  
Glutamyl Transpeptidase

Abstract Aim People experiencing homelessness are often excluded from treatment programs for alcohol use disorder (AUD). The goal of this study was to describe the impact of a multidisciplinary treatment program on alcohol consumption and social reintegration in individuals with AUD experiencing homelessness. Methods Thirty-one individuals with AUD experiencing homelessness were admitted to an inpatient unit for 5–6 days for clinical evaluation and to treat potential alcohol withdrawal syndrome. A group of volunteers, in collaboration with the Community of Sant’Egidio, provided social support aimed to reintegrate patients. After inpatient discharge, all patients were followed as outpatients. Alcohol intake (number drinks/day), craving and clinical evaluation were assessed at each outpatient visit. Biological markers of alcohol use were evaluated at enrollment (T0), at 6 months (T1) and 12 months (T2). Results Compared with T0, patients at T1 showed a significant reduction in alcohol consumption [10 (3–24) vs 2 (0–10); P = 0.015] and in γ-glutamyl-transpeptidase [187 (78–365) vs 98 (74–254); P = 0.0021]. The reduction in alcohol intake was more pronounced in patients with any housing condition [10 (3–20) vs 1 (0–8); P = 0.008]. Similarly, compared with T0, patients at T2 showed significant reduction in alcohol consumption [10 (3–24) vs 0 (0–15); P = 0.001], more pronounced in patients with any housing condition [10 (3–20) vs 0 (0–2); P = 0.006]. Moreover, at T2 patients showed a significant reduction in γ-glutamyl-transpeptidase [187 (78–365) vs 97 (74–189); P = 0.002] and in mean cell volume [100.2 (95–103.6) vs 98.3 (95–102); P = 0.042]. Conclusion Patients experiencing homelessness may benefit from a multidisciplinary treatment program for AUD. Strategies able to facilitate and support their social reintegration and housing can improve treatment outcomes.

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

2018 ◽  
Vol 49 (6) ◽  
pp. 931-939 ◽  
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.

Alcohol Use Disorder and Comorbid Depression: A Randomized Controlled Trial Investigating the Effectiveness of Supportive Text Messages in Aiding Recovery

2019 ◽  
Vol 54 (5) ◽  
pp. 551-558 ◽  
Author(s):  
Helen O’Reilly ◽  
Aisling Hagerty ◽  
Seamus O’Donnell ◽  
Aoife Farrell ◽  
Dan Hartnett ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Controlled Trial ◽  
Text Messages ◽  
Comorbid Depression ◽  
Randomized Controlled ◽  
Lower Alcohol ◽  
The Impact

This randomized controlled trial examined the impact of daily supportive text messages over a six-month treatment period on mood and alcohol consumption in individuals with a dual diagnosis of alcohol use disorder (AUD) and depression. Results highlighted mood benefits at 3-month and lower alcohol consumption at 6-month treatment points.

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