Predictors of Posttreatment Drinking Outcomes in Patients with Alcohol Dependence

2014 ◽  
Vol 21 (1) ◽  
pp. 19-30 ◽  
Author(s):  
Gerardo Flórez ◽  
Pilar A. Saiz ◽  
Paz García-Portilla ◽  
Francisco J. De Cos ◽  
Sonia Dapía ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Biological Markers ◽  
Relapse Prevention ◽  
Treatment Initiation ◽  
Positive Impact ◽  
Severity Index ◽  
Addiction Severity Index ◽  
Obsessive Compulsive ◽  
Timeline Followback

Aim: This cohort study examined how predictors of alcohol dependence treatment outcomes work together over time by comparing pretreatment and posttreatment predictors. Methods: A sample of 274 alcohol-dependent patients was recruited and assessed at baseline, 6 months after treatment initiation (end of the active intervention phase), and 18 months after treatment initiation (end of the 12-month research follow-up phase). At each assessment point, the participants completed a battery of standardized tests [European Addiction Severity Index (EuropASI), Obsessive Compulsive Drinking Scale (OCDS), Alcohol Timeline Followback (TLFB), Fagerström, and International Personality Disorder Examination (IPDE)] that measured symptom severity and consequences; biological markers of alcohol consumption were also tested at each assessment point. A sequential strategy with univariate and multivariate analyses was used to identify how pretreatment and posttreatment predictors influence outcomes up to 1 year after treatment. Results: Pretreatment variables had less predictive power than posttreatment ones. OCDS scores and biological markers of alcohol consumption were the most significant variables for the prediction of posttreatment outcomes. Prior pharmacotherapy treatment and relapse prevention interventions were also associated with posttreatment outcomes. Conclusions: The findings highlight the positive impact of pharmacotherapy during the first 6 months after treatment initiation and of relapse prevention during the first year after treatment and how posttreatment predictors are more important than pretreatment predictors.

scholarly journals The Study of Use of Obsessive–Compulsive Drinking Scale, For Craving in Alcohol-Dependent Patients: Relationship to Alcoholism Severity

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Neeli Uma Jyothi ◽  
Shaik.Faizan Ali ◽  
Mounica. Bollu
Keyword(s):  
Visual Analogue Scale ◽  
Alcohol Dependence ◽  
Analogue Scale ◽  
Severity Index ◽  
Addiction Severity Index ◽  
Obsessive Compulsive ◽  
Addiction Severity ◽  
Mini Mental Status Examination ◽  
Index Of Severity

Background: Many clinicians and researchers believe that “craving” an abusable substance is a central phenomenon related to addiction. Craving for alcohol appears to be intimately related to the loss of control over consumption and to compulsive alcohol use. Aim: To compare the scores of obsessive compulsive drinking scale with visual analogue scale, severity of alcohol dependence questionnaire and addiction severity index. Materials and Methods: Literate patients who met DCR-ICD-10 criteria for alcohol dependence syndrome were taken in the study and they must have been drinking alcohol daily till 1 week ago and the subjects were required to consume at least 6 standard drinks per day over the last month. Instruments used in this study were Obsessive Compulsive Drinking Scale – OCDS, Severity of Alcohol Dependence Questionnaire – SADQ, Addiction Severity Index – ASI ,Visual Analogue Scale – VAS, Mini Mental Status Examination – MMSE, Timeline Method – TL. Results: Among 40 patients, the mean age of these patients was 38 yrs (38.55+ 9.60). 95% of them were Hindus and 5 % Christians. 82.5 % were married. And 50% of patients have the income between Rs.15000-20000 per month. The correlation matrix of OCDS variables (OCDS-T,OCDS-O,OCDS-C),ASI-A,SADQ,VAS variables(G,F,I) and TL on all four follow-ups were measured. All correlations were positive and significant at p<0.001.obsessive compulsive drinking scale total score in 2 drinking outcome groups during 8 week treatment period was seen in which there is a difference between in two patient groups at baseline. i.e., abstinent group had lower score than relapse group. This difference was consistently observed between the groups over the entire period of follow-up. Conclusion: Craving was higher among those who relapsed than those who did not. Craving did predict high alcohol consumption and high index of severity at baseline and all through the follow-up.

scholarly journals Is alcohol dependence a mediator between alcohol consumption and alcohol-related problems? A study from a clinical population in Stockholm County

2003 ◽  
Vol 20 (2-3) ◽  
pp. 101-111
Author(s):  
Anders Romelsjö ◽  
Robin Room ◽  
Elisabeth Ellström
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Addiction Treatment ◽  
Social Problems ◽  
Addiction Severity Index ◽  
Clinical Population ◽  
Substantial Part ◽  
Stockholm County ◽  
Alcohol Dependence Syndrome ◽  
Alcohol Related Problems

Several studies have been done on the prevalence of the alcohol dependence syndrome, while other studies have focused on whether the dependence syndrome can be seen as a unity, or not. Few studies have analysed the association between alcohol consumption, the alcohol dependence syndrome (ADS) and alcohol-related problems. A main issue is to what extent an association between alcohol consumption and problems is explained by the dependence syndrome or by its sub-components (drinking despite a health problem, craving, impaired control, preoccupation with alcohol, withdrawal symptoms and increased tolerance). The purpose in this paper is to elucidate this issue in analyses of data from the health care-based clinical sample of the study “Women and Men in Swedish Addiction Treatment”, comprising comprehensive interviews of almost 1000 inpatients and outpatients in Stockholm County. These data cover e.g. alcohol and drug use, alcohol dependence (ICD-10) measured by the Composite International Diagnostic Interview (CIDI), the composite-scores part of the Addiction Severity Index (ASI), sociodemographics and alcohol-related problems. Three measures of alcohol-related problems were constructed covering health and psychological problems, self-defined social problems, and social problems defined by others. In these exploratory analyses of patients with alcohol dependence as a dominating problem, a series of logistic regression analyses were done. A substantial part of the association between the consumption measures and the three outcomes could be accounted for by measures of the ADS. The predictive power of the six criteria composing the ADS varied considerably for the different outcomes. The interpretation is not straightforward, not least as the alcohol dependence syndrome also includes items of alcohol-related problems.

The A1 allele of the DRD2 gene (TaqI A polymorphisms) is associated with antisocial personality in a sample of alcohol-dependent patients

2003 ◽  
Vol 18 (7) ◽  
pp. 356-360 ◽  
Author(s):  
G Ponce ◽  
M.A Jimenez-Arriero ◽  
G Rubio ◽  
J Hoenicka ◽  
I Ampuero ◽  
...  
Keyword(s):  
Family History ◽  
Personality Disorder ◽  
Alcohol Dependence ◽  
Antisocial Personality Disorder ◽  
Phenotypic Expression ◽  
Severity Index ◽  
Addiction Severity Index ◽  
Antisocial Personality ◽  
Drd2 Gene ◽  
Alcohol Dependent

AbstractBackground. –Presence of A1 allele of the DRD2 gene has been associated with a predisposition for alcoholism although there are limited data about its phenotypic expression in alcoholism.Objectives. –To determine the importance of the A1 allele in clinical variables of alcohol dependence.Methodology. –A sample of 103 alcohol-dependent males was studied. All patients were recruited consecutively from the general hospital and community settings. The diagnostics were made with the structured clinical interview for DSM-III-R (SCID); and the International Personality Disorder Examination (IPDE). Diagnosis of family alcoholism was made by direct interview or with the Research Diagnostic Criteria-Family History (RDC-FH). The Addiction Severity Index (ASI) and the Severity of Alcohol Dependence Scale (SADS) were used to assess alcohol dependence severity. Genotyping was done by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods.Results. –Approximately 39% of the sample carried the A1 allele (A1+ group). This group had higher prevalences of antisocial personality disorder (60% vs. 15.9%); and alcoholism family history (72.5% vs. 52.4%). Also A1+ had early onset alcohol abuse and more drinking problems. The presence of A1+ was the main factor to explain the diagnosis of antisocial personality disorder, but the weight of this factor was not sufficient to explain the complications assessed by the ASI.Conclusions. –Our results support the existence of an association between the A1 allele and factors resulting from dopaminergic deficiency, otherwise denominated reward deficiency syndrome.

scholarly journals Validation of an Online Version of the Alcohol Use Disorders Identification Test (AUDIT) for Alcohol Screening in Spanish University Students

2021 ◽  
Vol 18 (10) ◽  
pp. 5213
Author(s):  
Laura Ballester ◽  
Itxaso Alayo ◽  
Gemma Vilagut ◽  
José Almenara ◽  
Ana Cebrià ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
University Students ◽  
Alcohol Dependence ◽  
Online Survey ◽  
Alcohol Use Disorders ◽  
Alcohol Screening ◽  
Online Version ◽  
Timeline Followback ◽  
Identification Test

Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18–24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT’s Cronbach’s alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.

scholarly journals A Cross-sectional Study of Psychiatric Comorbidity and Severity of Addiction in Patients with Early- and Late-Onset Alcohol Dependence

2020 ◽  
Vol 42 (4) ◽  
pp. 334-340
Author(s):  
Anamika Das ◽  
Sujita Kumar Kar ◽  
Pawan Kumar Gupta ◽  
Pronob Kumar Dalal
Keyword(s):  
Alcohol Dependence ◽  
Early Onset ◽  
Late Onset ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Addiction Severity Index ◽  
Cross Sectional ◽  
Addiction Severity ◽  
Onset Group ◽  
Early Onset Group

Background: Alcohol use disorder is a serious health problem with high comorbidities. Early-onset alcohol use has been associated with greater impulsivity, increased severity of dependence, frequent alcohol withdrawal complications, externalizing symptoms, and antisocial behaviors. We aimed to evaluate the psychiatric comorbidities and severity of addiction in early- and late-onset alcohol dependence. Methods: This was a cross-sectional study. All patients fulfilling the diagnostic criteria of alcohol dependence as per International Classification of Diseases (10th edition) were included in it. Semi-Structured Assessment for Genetics of Alcoholism IV was applied to find the age of onset of dependence as per the lifetime frame and also to find comorbidities. Composite International Diagnostic Interview 3.0. was used to find other comorbidities. The severity of addiction was evaluated with Addiction Severity Index, 5th edition. All the sociodemographic and clinical parameters were compared between patients with the early- and late-onset alcohol dependence. Results: Out of the 112 patients screened, 57 met the selection criteria, 26 were with early-onset and 31 with late-onset alcohol dependence. The patients were all males. The patients with early-onset alcohol dependence had a higher family history (P = 0.006) and were nonearning (P = 0.002) in comparison to the group with late-onset dependence. The comorbidity among all patients was 59.6% and 84.2% in current and lifetime frames, respectively. It was significantly higher in the early-onset group, both for current (P = 0.015) and lifetime (P = 0.031) frames. On the domains of Addiction Severity Index 5th edition, the early-onset group had a more severe profile of addiction in all domains except the medical domain. Conclusion: Comorbidity is high among patients with alcohol dependence and is even higher for the early-onset group. The family history was higher in the early-onset group and they have more severe profile of substance use.

Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment

2015 ◽  
Vol 30 (1) ◽  
pp. 128-136 ◽  
Author(s):  
A.F.A. Schellekens ◽  
C.A.J. de Jong ◽  
J.K. Buitelaar ◽  
R.J. Verkes
Keyword(s):  
Anxiety Disorders ◽  
Alcohol Dependence ◽  
Severity Index ◽  
Addiction Severity Index ◽  
Late Relapse ◽  
Early Relapse ◽  
Addiction Severity ◽  
Character Inventory ◽  
Relapse Rates ◽  
Alcohol Dependent

AbstractIntroduction:Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized that co-morbid anxiety disorders would be particularly predictive for early relapse, but not late relapse.Subjects and methods:In a prospective design, male alcohol dependent patients (n = 189) were recruited from an inpatient detoxification clinic. Psychiatric diagnoses and personality traits were assessed using the Mini International Neuropsychiatric Interview for psychiatric disorders and the Temperament and Character Inventory. The addiction severity index was used to assess addiction severity and follow-up.Results:One year after detoxification, 81 patients (53%) relapsed and nine patients (7%) were deceased, due to alcohol related causes. Co-morbid anxiety disorder, marital status, addiction severity, in particular legal problems, and harm avoidance predicted relapse. Anxiety disorders specifically predicted early relapse.Conclusion:Alcohol dependence is a severe mental disorder, with high relapse rates and high mortality. Alcohol dependent patients with co-morbid anxiety disorders are particularly prone to relapse during the first three months of treatment. These patients may therefore require additional medical and psychological attention.

Group and Individual Change in the Treatment of Drug Addictions: A Follow-up Study in Therapeutic Communities

2010 ◽  
Vol 13 (2) ◽  
pp. 906-913 ◽  
Author(s):  
José Javier López-Goñi ◽  
Javier Fernández-Montalvo ◽  
Juan Carlos Menéndez ◽  
Fausto Yudego ◽  
Angel Rico García ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Treatment Program ◽  
Family Relationships ◽  
Family Relations ◽  
Severity Index ◽  
Addiction Severity Index ◽  
Reliable Change Index ◽  
Therapeutic Communities ◽  
Treatment Change

The pre-post treatment change of 112 patients in two therapeutics Spanish communities is described. The Addiction Severity Index (ASI) was used at intake and at the end of the treatment program. Results of the treatment program were evaluated by applying composite scores (CS) of the ASI, and the evolution of each patient was evaluated using the Reliable Change Index (RCI). 69.7% of the sample completed treatment, and 30.3% dropped out prematurely. At intake, the percentage of people who could improve in the different areas of the ASI ranged between 35.1% for alcohol consumption and 95.3% for family relationships. At the follow-up, the percentage of subjects who showed significant statistical improvements in the different areas varied between 7.9% in family relations and 66.7% in alcohol consumption. The percentage of patients who deteriorated was less than 10% for all variables. Implications for further research and clinical practice are commented upon.

Symptoms of Alcohol Dependence Predict Suicide Ideation Among Alaskan Undergraduates

Crisis ◽  
2016 ◽  
Vol 37 (3) ◽  
pp. 232-235 ◽  
Author(s):  
Christopher R. DeCou ◽  
Monica C. Skewes
Keyword(s):  
Depressive Symptoms ◽  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Suicide Ideation ◽  
Alcohol Problems ◽  
Future Research ◽  
Causal Mechanism ◽  
Students At Risk ◽  
The Relationship ◽  
Alcohol Related Problems

Abstract. Background: Previous research has demonstrated an association between alcohol-related problems and suicidal ideation (SI). Aims: The present study evaluated, simultaneously, alcohol consequences and symptoms of alcohol dependence as predictors of SI after adjusting for depressive symptoms and alcohol consumption. Method: A sample of 298 Alaskan undergraduates completed survey measures, including the Young Adult Alcohol Consequences Questionnaire, the Short Alcohol Dependence Data Questionnaire, and the Beck Depression Inventory – II. The association between alcohol problems and SI status was evaluated using sequential logistic regression. Results: Symptoms of alcohol dependence (OR = 1.88, p < .05), but not alcohol-related consequences (OR = 1.01, p = .95), emerged as an independent predictor of SI status above and beyond depressive symptoms (OR = 2.39, p < .001) and alcohol consumption (OR = 1.08, p = .39). Conclusion: Alcohol dependence symptoms represented a unique risk for SI relative to alcohol-related consequences and alcohol consumption. Future research should examine the causal mechanism behind the relationship between alcohol dependence and suicidality among university students. Assessing the presence of dependence symptoms may improve the accuracy of identifying students at risk of SI.

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