"Alcohol craving in patients diagnosed with a severe mental illness and alcohol use disorder: Bidirectional relationships between approach and avoidance inclinations and drinking": Correction to Schlauch et al. (2013).

BackgroundICD-10 includes a craving criterion for alcohol dependence while DSM-IV does not. Little is known about whether craving fits with or improves the DSM-IV criteria set for alcohol-use disorders.MethodData were derived from current drinkers (n=18 352) in the 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES), a nationally representative survey of US adults >17 years of age. The Alcohol Use Disorder and Associated Disabilities Interview Schedule was used to assess the eleven DSM-IV dependence and abuse criteria, and alcohol craving. Exploratory factor, item response theory, and regression analyses were used to evaluate the psychometric properties and concurrent validity of DSM-based alcohol disorder criteria with the addition of alcohol craving.ResultsThe past 12-month prevalence of craving was 1.3%. Craving formed part of a unidimensional latent variable that included existing DSM-IV criteria. Craving demonstrated high severity on the alcohol-use disorder continuum, resulting in an improved dimensional model with greater discriminatory ability compared with current DSM-IV criteria. Correlates of the diagnosis did not change with the addition of craving, and past 12-month craving was associated with prior alcohol dependence, depression, and earlier age of alcohol disorder onset among those with current DSM-IV alcohol dependence.ConclusionsThe addition of craving to the existing DSM-IV criteria yields a continuous measure that better differentiates individuals with and without alcohol problems along the alcohol-use disorder continuum. Few individuals are newly diagnosed with alcohol dependence given the addition of craving, indicating construct validity but redundancy with existing criteria.

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The Impact of Comorbid Conditions on Long-Term Patient-Reported Outcomes From Burn Survivors

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa090 ◽

2020 ◽

Vol 41 (5) ◽

pp. 956-962

Author(s):

Clifford C Sheckter ◽

Kevin Li ◽

Gretchen J Carrougher ◽

Tam N Pham ◽

Nicole S Gibran ◽

...

Keyword(s):

Mental Illness ◽

Alcohol Use ◽

Mental Component Summary ◽

Patient Reported Outcomes ◽

Alcohol Use Disorder ◽

Negatively Associated ◽

Risk Of Death ◽

Patient Reported ◽

The Impact

Abstract Preburn comorbidities increase the risk of death in the acute phase, and negatively impact quality of life among survivors. Investigations to date have only evaluated comorbidities as indices, limiting the ability to target conditions and develop strategies for risk reduction. Therefore, we aimed to evaluate the differential effects of specific conditions on long-term, patient-reported outcomes after burn injury. A prospectively maintained trauma registry was merged with a longitudinal database of patient-reported outcomes from a regional burn center from 2007 to 2018. Demographic data, injury-specific information, and the prevalence of 20 comorbidities were systematically documented. The impact of comorbidities on responses to Short Form-12/Veterans RAND 12 (SF/VR-12) health surveys at 6, 12, and 24 months postinjury was evaluated with generalized linear models. The merged dataset included 493 adult participants. Median age was 46 years (interquartile range, IQR 32–57 years), and 72% were male. Median burn size was 14% TBSA (IQR 5–28%). Seventy percent of participants had ≥1 comorbidity (median 1 comorbidity/participant; IQR 0–2 comorbidities). SF/VR-12 mental component summary scores at 6 and 12 months postinjury were negatively associated with mental illness (P < .001, P = .013). SF/VR-12 physical component summary (PCS) scores were negatively associated with smoking (P = .019), diabetes (P = .001), and alcohol use disorder (P = .001) at 6-month follow-up. Twelve-month SF/VR-12 PCS scores were negatively associated with prior trauma admission (P = .001) and diabetes (P = .042). Twenty-four-month SF/VR-12 PCS scores were negatively associated with mental illness (P = .003). Smoking, alcohol use disorder, and diabetes were associated with lower PCS scores 6 months after injury; diabetes persisted as a negatively associated covariate at 12 months. Mental component summary scores were negatively associated with mental illness 6 and 12 months postinjury. Integrated models of postdischarge comorbidity management need to be tested in burn patients.

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Prevalence and identification of alcohol use disorders among severe mental illness inpatients in Taiwan

Psychiatry and Clinical Neurosciences ◽

10.1111/j.1440-1819.2008.01909.x ◽

2009 ◽

Vol 63 (1) ◽

pp. 94-100 ◽

Cited By ~ 11

Author(s):

Ming-Chyi Huang ◽

Chuan-Hsun Yu ◽

Chun-Tse Chen ◽

Chiao-Chicy Chen ◽

Winston W. Shen ◽

...

Keyword(s):

Mental Illness ◽

Alcohol Use ◽

Severe Mental Illness ◽

Alcohol Use Disorders

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History of suicidality and alcohol craving trajectories during inpatient treatment for alcohol use disorder

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2020.107918 ◽

2020 ◽

Vol 209 ◽

pp. 107918

Author(s):

Roshni Janakiraman ◽

Joshua L. Gowin ◽

Matthew E. Sloan ◽

Melanie L. Schwandt ◽

Nancy Diazgranados ◽

...

Keyword(s):

Alcohol Use ◽

Inpatient Treatment ◽

Alcohol Use Disorder ◽

Alcohol Craving ◽

History Of

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Nutritional Ketosis as a Potential Treatment for Alcohol Use Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.781668 ◽

2021 ◽

Vol 12 ◽

Author(s):

Vikrant R. Mahajan ◽

Sophie K. Elvig ◽

Leandro F. Vendruscolo ◽

George F. Koob ◽

Valerie L. Darcey ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Ketone Bodies ◽

Alcohol Intoxication ◽

Nutritional Intervention ◽

Withdrawal Symptoms ◽

Energy Deficit ◽

Acetate Metabolism ◽

Brain Disorder ◽

Alcohol Craving

Alcohol use disorder (AUD) is a chronic, relapsing brain disorder, characterized by compulsive alcohol seeking and disrupted brain function. In individuals with AUD, abstinence from alcohol often precipitates withdrawal symptoms than can be life threatening. Here, we review evidence for nutritional ketosis as a potential means to reduce withdrawal and alcohol craving. We also review the underlying mechanisms of action of ketosis. Several findings suggest that during alcohol intoxication there is a shift from glucose to acetate metabolism that is enhanced in individuals with AUD. During withdrawal, there is a decline in acetate levels that can result in an energy deficit and could contribute to neurotoxicity. A ketogenic diet or ingestion of a ketone ester elevates ketone bodies (acetoacetate, β-hydroxybutyrate and acetone) in plasma and brain, resulting in nutritional ketosis. These effects have been shown to reduce alcohol withdrawal symptoms, alcohol craving, and alcohol consumption in both preclinical and clinical studies. Thus, nutritional ketosis may represent a unique treatment option for AUD: namely, a nutritional intervention that could be used alone or to augment the effects of medications.

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Impaired control in heavy drinking and its association with alcohol craving and alcohol use disorder severity

Salud Mental ◽

10.17711/sm.0185-3325.2020.021 ◽

2020 ◽

Vol 43 (4) ◽

pp. 151-157

Author(s):

Edén Sánchez ◽

Carlos S. Cruz Fuentes ◽

Corina Benjet ◽

María Elena Medina-Mora

Keyword(s):

Alcohol Use ◽

Alcohol Dependence ◽

Perceived Control ◽

Alcohol Use Disorder ◽

Latent Class ◽

Heavy Drinking ◽

Alcohol Craving ◽

Heavy Drinkers ◽

Impaired Control ◽

The Relationship

Introduction. Impaired control over drinking has been frequently cited in diverse theoretical descriptions regarding harmful alcohol use and is considered a DSM criterion for alcohol use disorder. Differences in the frequency of endorsement of impaired control have been viewed as a reflection of the severity of the problem. Moreover, it has been posited that the ability to place a limit on alcohol consumption may be mediated through enhanced craving. Objective. In this study, we addressed the relationship between impaired control, self-reported craving, and alcohol dependence severity among heavy drinkers. Method. We conducted a latent class analysis of impaired control dimensions (perceived control, failed control, and attempted control) of 208 heavy drinkers. To determine whether the identified classes could represent different forms of severity of the disorder, the best-fit model was contrasted with scores on the Alcohol Dependence Scale. Furthermore, we assessed the relationship between impaired control criteria (using the Impaired Control Scale [ICS]) with alcohol craving. Results. We identified a three-class solution based on impaired control severity. A graded increase of the craving scores and alcohol severity among the three classes was also identified. Only the ICS items comprising perceived control and partially those related to failed control, but not those evaluating attempted control, distinguished the gradient among the latent classes. Discussion and conclusion. This study provides further support of the proposal of a unidimensional continuum of severity among heavy drinkers and strengthens the theoretical relationship between impaired control and alcohol craving.

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