Occult Untreated Alcohol Use Disorder in a Patient with Recurrent Pituitary Macroadenoma

Alcohol use disorder (AUD) is a chronic relapsing and remitting psychiatric condition associated with adverse health outcomes. Although common, AUD is underdiagnosed, and treatment is often overlooked. At times of increased risk, such as the postoperative period, it is imperative to screen for and treat AUD to improve patient outcomes. Psychiatrists can play an important role in addressing AUD in this patient population through addiction psychiatry consultation services. We present the case of a patient with occult alcohol use disorder (AUD) leading to hospitalization in the setting of depressive mood symptoms and personality changes after a repeat pituitary macroadenoma resection and radiation five months earlier. AUD was noted months prior to hospitalization but was not addressed despite regular interactions with the healthcare system. Evaluation by addiction psychiatry specialists during hospitalization prompted recognition and treatment of AUD, resulting in cessation of alcohol use and resolution of mood symptoms and personality changes. The patient was discharged 3 days after admission and maintained abstinence from alcohol at two months postdischarge without recurrence of psychiatric symptoms.

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Sibling Alcohol Use Disorder Is Associated With Increased Risk for Suicide Attempt

Clinical Psychological Science ◽

10.1177/21677026211025041 ◽

2021 ◽

pp. 216770262110250

Author(s):

Mallory E. Stephenson ◽

Sara Larsson Lönn ◽

Jessica E. Salvatore ◽

Jan Sundquist ◽

Kenneth S. Kendler ◽

...

Keyword(s):

Alcohol Use ◽

Suicide Attempt ◽

Alcohol Use Disorder ◽

Cox Regression ◽

Population Based ◽

Swedish Population ◽

Sibling Pairs ◽

Increased Risk ◽

Using Data ◽

Shared Genetic

The association between having a sibling diagnosed with alcohol use disorder (AUD) and risk for suicide attempt may be attributable to shared genetic liability between AUD and suicidal behavior, effects of environmental exposure to a sibling’s AUD, or both. To distinguish between these alternatives, we conducted a series of Cox regression models using data derived from Swedish population-based registers with national coverage. Among full sibling pairs (656,807 males and 607,096 females), we found that, even after we accounted for the proband’s AUD status, the proband’s risk for suicide attempt was significantly elevated when the proband’s sibling was affected by AUD. Furthermore, the proband’s risk for suicide attempt was consistently higher when the sibling’s AUD registration had occurred more recently. Our findings provide evidence for exposure to sibling AUD as an environmental risk factor for suicide attempt and suggest that clinical outreach may be warranted following a sibling’s diagnosis with AUD.

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Healthcare utilisation prior to suicide in persons with alcohol use disorder: national cohort and nested case–control study

The British Journal of Psychiatry ◽

10.1192/bjp.2020.122 ◽

2020 ◽

Vol 217 (6) ◽

pp. 710-716

Author(s):

Casey Crump ◽

Alexis C. Edwards ◽

Kenneth S. Kendler ◽

Jan Sundquist ◽

Kristina Sundquist

Keyword(s):

Primary Care ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Large Population ◽

Healthcare Utilisation ◽

Case Control ◽

Increased Risk ◽

National Cohort ◽

Nested Case Control

BackgroundAlcohol use disorder (AUD) is common and associated with increased risk of suicide.AimsTo examine healthcare utilisation prior to suicide in persons with AUD in a large population-based cohort, which may reveal opportunities for prevention.MethodA national cohort study was conducted of 6 947 191 adults in Sweden in 2002, including 256 647 (3.7%) with AUD, with follow-up for suicide through 2015. A nested case–control design examined healthcare utilisation among people with AUD who died by suicide and 10:1 age- and gender-matched controls.ResultsIn 86.7 million person-years of follow-up, 15 662 (0.2%) persons died by suicide, including 2601 (1.0%) with AUD. Unadjusted and adjusted relative risks for suicide associated with AUD were 8.15 (95% CI 7.86–8.46) and 2.22 (95% CI 2.11–2.34). Of the people with AUD who died by suicide, 39.7% and 75.6% had a healthcare encounter <2 weeks or <3 months before the index date respectively, compared with 6.3% and 25.4% of controls (adjusted prevalence ratio (PR) and difference (PD), <2 weeks: PR = 3.86, 95% CI 3.50–4.25, PD = 26.4, 95% CI 24.2–28.6; <3 months: PR = 2.03, 95% CI 1.94–2.12, PD = 34.9, 95% CI 32.6–37.1). AUD accounted for more healthcare encounters within 2 weeks of suicide among men than women (P = 0.01). Of last encounters, 48.1% were in primary care and 28.9% were in specialty out-patient clinics, mostly for non-psychiatric diagnoses.ConclusionsSuicide among persons with AUD is often shortly preceded by healthcare encounters in primary care or specialty out-patient clinics. Encounters in these settings are important opportunities to identify active suicidality and intervene accordingly in patients with AUD.

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Maternal alcohol-use disorder is associated with increased risk of sudden infant death syndrome and infant death from other causes

Evidence-Based Nursing ◽

10.1136/eb-2013-101376 ◽

2013 ◽

Vol 17 (2) ◽

pp. 46-47

Author(s):

Katrine Strandberg-Larsen

Keyword(s):

Alcohol Use ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Alcohol Use Disorder ◽

Sudden Infant Death ◽

Sudden Infant ◽

Maternal Alcohol ◽

Increased Risk

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Increased risk of dementia in older female US veterans with alcohol use disorder

Addiction ◽

10.1111/add.15416 ◽

2021 ◽

Author(s):

Amber Bahorik ◽

Kirsten Bobrow ◽

Tina Hoang ◽

Kristine Yaffe

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Increased Risk ◽

Us Veterans

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Family alcohol use, rather than childhood trauma, is more likely to cause male alcohol use disorder: findings from a case-control study in northern China

BMC Psychiatry ◽

10.1186/s12888-021-03566-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xu Chen ◽

Yunmeng Pan ◽

Peiru Xu ◽

Yi Huang ◽

Nan Li ◽

...

Keyword(s):

Alcohol Use ◽

Childhood Trauma ◽

Emotional Abuse ◽

Alcohol Use Disorder ◽

Protective Factor ◽

Case Control Study ◽

Drinking Behavior ◽

Case Control ◽

Increased Risk ◽

Control Study

Abstract Objective To explore the influence of childhood trauma and family alcohol use on male alcohol use disorder. Methods We conducted a case-control study using Childhood Trauma Questionnaire (CTQ) and a structured interview involving 129 men with alcohol use disorder and 129 healthy male volunteers. The two groups were compared in terms of childhood trauma, parental drinking behavior, and attitudes toward childhood drinking. Results Patients showed higher scores of CTQ than controls on childhood trauma experiences, including on the subscales of physical abuse, emotional abuse, sexual abuse, and emotional neglect. Higher proportions of patients than controls had fathers who drank seven or more times a week, and had mothers who were opposed to childhood drinking. Conversely, a smaller proportion of patients than controls had fathers who opposed childhood drinking. Patients were more likely than controls to have been induced to drink as children. Logistic regression analysis identified three risk factors for alcohol use disorder: induced drinking during childhood [odds ratio (OR) 6.09, 95% confidence interval (CI) 2.56–14.51], the father’s weekly alcohol consumption during the respondent’s childhood (OR 4.40, 95%CI 2.94–6.58) and history of smoking (OR 3.39, 95%CI 1.48–7.77). Conversely, more years of education were a protective factor against alcohol use disorder (OR 0.88, 95% CI 0.78–0.99). Conclusions Men whose fathers drank frequently during their childhood and were encouraged to drink may be at increased risk of alcohol use disorder in adulthood. In fact these factors of family alcohol use appear to increase risk of alcohol use disorder among adult men more than exposure to childhood trauma does.

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Increased Risk of Mesenteric Ischemia in Patients With Alcohol Use Disorder

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2015.09.023 ◽

2016 ◽

Vol 91 (2) ◽

pp. 189-195 ◽

Cited By ~ 3

Author(s):

Chih-Wei Wei ◽

Yu-Chiao Wang ◽

Dong-Zong Hung ◽

Yu-Ting Chung ◽

Wei-Kung Chen ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Mesenteric Ischemia ◽

Increased Risk

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Disentangling Social-Genetic From Rearing-Environment Effects for Alcohol Use Disorder Using Swedish National Data

Psychological Science ◽

10.1177/0956797620931542 ◽

2020 ◽

Vol 31 (9) ◽

pp. 1140-1149

Author(s):

Jessica E. Salvatore ◽

Sara Larsson Lönn ◽

Jan Sundquist ◽

Kristina Sundquist ◽

Kenneth S. Kendler

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Extended Family ◽

Genetic Effect ◽

Psychological Consequences ◽

National Data ◽

Parental History ◽

Rearing Environment ◽

Environment Effects ◽

Increased Risk

Investigations of social-genetic effects, whereby a social partner’s genotype affects another’s outcomes, can be confounded by the influence of the social partner’s rearing environment. We used marital information on more than 300,000 couples from Swedish national data to disentangle social-genetic from rearing-environment effects for alcohol use disorder (AUD). Using observational and extended-family designs, we found that (a) marriage to a spouse with a predisposition toward AUD (as indexed by a parental history of AUD) increased risk for developing AUD; (b) this increased risk was not explained by socioeconomic status, the spouse’s AUD status, or contact with the spouse’s parents; and (c) this increased risk reflected the psychological consequences of the spouse having grown up with an AUD-affected parent (i.e., a rearing-environment effect) rather than a social-genetic effect. Findings illustrate that a spouse’s rearing-environment exposures may confer risk for AUD.

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The Epidemiology of Substance Use Disorders among the Adult Jewish Population in Israel

European Addiction Research ◽

10.1159/000513776 ◽

2021 ◽

pp. 1-9

Author(s):

Ruth Lev Bar-Or ◽

Ariel Kor ◽

Iman Jaljuli ◽

Shaul Lev-Ran

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Substance Use Disorders ◽

Jewish Population ◽

Alcohol Use Disorder ◽

Well Being ◽

Cannabis Use ◽

Cannabis Use Disorder ◽

Age Group ◽

Increased Risk

Introduction: Substance use disorders (SUDs) are a leading cause of morbidity and mortality worldwide, having a profound and global impact on health, well-being, safety, and productivity. Although traditionally the prevalence of SUDs in Israel has been estimated to be lower than those in high-income countries, estimates and characteristics of individuals with SUDs in the past decade are lacking. In this work, we explored the prevalence of SUDs among the adult Jewish population in Israel, per different classes of substances across sex, age group, and other sociodemographic factors. Methods: Data from an online representative sample of 4,025 respondents were collected, including the alcohol, smoking, and substance involvement screening test (ASSIST) metric and sociodemographic data. Results: We found that the most common SUDs were alcohol (10.5% [9.5–11.4]), cannabis (9.0% [8.2–9.9]), and sedative (3.6% [3.0–4.2]) use disorders. Alcohol-cannabis (3.2% [2.7–3.7]) and alcohol-sedative (1.04% [0.7–1.35]) were the most prevalent co-occurring SUDs. Among those with cannabis use disorder, the prevalence of alcohol use disorder was found to be 35.3% [30.4–40.2]. The estimated risk for alcohol use disorder was found to be inversely proportional to age, cannabis use disorder increased, peaked, and decreased with age, and that of sedative use disorder increased with age, particularly among women. While older individuals (in the 51–60 years of age group) were at lower risk (OR = 0.5 [0.3, 0.8]) compared to those <20 years of age for alcohol use disorder, they were at increased risk for sedative use disorder (OR = 3.1 [1.2, 9.7]). Conclusions: These findings represent substantially higher rates of SUDs in Israel than those previously reported and should affect resources allocated to addiction prevention and treatment. Further research on the role of gender, age, culture, and ethnicity in the propensity to develop SUDs is necessary for the development of more focused preventive and intervention measures. Focusing on non-Jewish populations in Israel and broadening the scope to include behavioral addictions should be addressed in future studies.

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Lack of Association between rs4680 Polymorphism in Catechol-O-Methyltransferase Gene and Alcohol Use Disorder: A Meta-Analysis

Disease Markers ◽

10.1155/2020/8850859 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Xin-Rong Jin ◽

Zhi-Qiang Zhao

Keyword(s):

Alcohol Use ◽

Subgroup Analysis ◽

Alcohol Use Disorder ◽

Meta Analysis ◽

Case Control Studies ◽

Knowledge Infrastructure ◽

Increased Risk ◽

Methyltransferase Gene ◽

Underlying Mechanisms ◽

Chinese National Knowledge Infrastructure

Background. The underlying mechanisms of alcohol use disorder (AUD) are regarded to be strongly associated with genetic factors. Although great efforts have been made to identify the association of rs4680 polymorphism in the catechol-o-methyltransferase gene and risk to AUD, the outcomes were still inconsistent. This study is aimed at exploring the association of rs4680 polymorphism and AUD by using a meta-analysis approach. Methods. Literature searching was undertaken across PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wanfang databases. We set the search period before February 20, 2020. We used the Review Manager 5.3 (RevMan 5.3) software to estimate the effect sizes in five genetic models. Results. In total, eighteen case-control studies and two cohort studies were included in this study. The merged results of overall population indicated there was no significant association between rs4680 polymorphism and AUD: V vs. M, OR = 1.02 , 95% CI 0.93-1.12, P = 0.70 ; VV vs. MM, OR = 0.99 , 95% CI 0.79-1.23, P = 0.92 ; VM vs. MM, OR = 0.91 , 95% CI 0.81-1.03, P = 0.15 ; VV+VM vs. MM, OR = 0.95 , 95% CI 0.80-1.13, P = 0.65 ; VV vs. VM+MM, OR = 1.04 , 95% CI 0.91-1.18, P = 0.57 . Subgroup analysis by gender suggested rs4680 polymorphism was marginally associated with an elevated risk to AUD among males (VM vs. MM, OR = 0.81 , 95% CI 0.67-0.98, P = 0.03 ). However, subgroup analysis by race and diagnosis did not support any significant association. Conclusions. The present study suggests that rs4680 polymorphism has no association with AUD in the overall population, but it has a weak association with AUD in males. Carriers of VM genotype in males appear to have an increased risk to AUD.

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