scholarly journals Depression and/or PTSD Comorbidity Affects Response to Antidepressants in Those With Alcohol Use Disorder

2022 ◽  
Vol 12 ◽  
Author(s):  
Peter J. Na ◽  
Elizabeth Ralevski ◽  
Oluwole Jegede ◽  
Aaron Wolfgang ◽  
Ismene L. Petrakis
Keyword(s):  
Depressive Symptoms ◽  
Alcohol Use ◽  
Significant Interaction ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Depression Scale ◽  
Diagnostic Group ◽  
Hamilton Depression Scale ◽  
Depression Group ◽  
Drinking Outcomes

Objective: Depression and post-traumatic stress disorder (PTSD) highly co-occur with alcohol use disorder (AUD). The comparative effects of noradrenergic vs. serotonergic antidepressants on drinking and depressive outcomes for those with AUD and co-occurring depression and/or PTSD are not well known.Methods: This study was an analysis of a randomized control trial of 128 patients with AUD who had co-occurring depression and/or PTSD. They were randomized to treatment with paroxetine vs. desipramine and naltrexone vs. placebo leading to four groups: paroxetine plus naltrexone, paroxetine plus placebo, desipramine plus naltrexone, and desipramine plus placebo. Outcomes were percent of drinking days, percent heavy drinking days, drinks per drinking day (Time Line Follow-back Method), and depressive symptoms (Hamilton Depression Scale). Groups compared were (1) depression without PTSD (depression group; n = 35), (2) PTSD without depression (PTSD group; n = 33), and (3) both depression and PTSD (comorbid group; n = 60).Results: There were no overall significant differences in drinking outcomes by medication in the entire sample, and no significant interaction when diagnostic groups were not considered. However, when diagnostic groups were included in the model, the interactions between time, diagnostic group, and medication (desipramine vs. paroxetine) were significant for percent drinking days (p = 0.042), and percent heavy drinking days (p = 0.036); paroxetine showed better drinking outcomes within the depression group, whereas desipramine showed better drinking outcomes in the PTSD and comorbid groups. Regarding depressive symptoms, paroxetine was statistically superior to desipramine in the total sample (p = 0.007), but there was no significant interaction of diagnostic group and medication. Naltrexone led to a decrease in craving but no change in drinking outcomes.Conclusions: The results of this study suggest that drinking outcomes may respond differently to desipramine and paroxetine depending on comorbid MDD and/or PTSD.

scholarly journals Alcohol Use Disorder and Depression in Patients with Alcohol-Related Seizures

2018 ◽  
Vol 72 (3) ◽  
pp. 177-183
Author(s):  
Normunds Sūna ◽  
Evija Gūtmane ◽  
Lelde Liepiņa ◽  
Anastasija Tomilova ◽  
Valdis Folkmanis
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Alcohol Use Disorder ◽  
Psychiatric Comorbidity ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Self Harm ◽  
Disorder Identification ◽  
Typical Day ◽  
Patients With Epilepsy

Abstract Both alcohol use disorder and depression are important aspects of health in the general population and among patients with epilepsy. Depression is the most prevalent psychiatric comorbidity in epilepsy, thereby increasing morbidity as well as mortality rate. From our experience, we can see that one third of epilepsy inpatients experience seizures that are alcohol-related. There have been no studies conducted in Latvia about alcohol use disorder and depression in patients with alcohol-related seizures (ARS) and epilepsy. We recruited 108 patients with ARS, 44 of whom had comorbid epilepsy. 75% of patients in our study had depression according to the Hamilton depression scale. Higher score in the Alcohol Use Disorder Identification Test was associated with thoughts of self-harm. Greater consumption of alcohol on a typical day when drinking was associated with a higher risk of alcohol dependence. Of patients without epilepsy, 60% received antiepileptic drugs (AEDs) and 17% even used 2–3 different drugs to overcome ARS. A large part of patients had not been warned by their physician that alcohol provokes seizures. Our data could help to identify greater suicidality risk and alcohol dependence risk cases in patients with ARS, as well as improve care for this group of patients in general.

scholarly journals Evaluation of the online-based self-help programme “Selfapy” in patients with unipolar depression: study protocol for a randomized, blinded parallel group dismantling study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rico Krämer ◽  
Stephan Köhler
Keyword(s):  
Depressive Symptoms ◽  
Depression Scale ◽  
Drop Out ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Online Interventions ◽  
Phone Calls ◽  
Self Help ◽  
Low Threshold ◽  
The Impact

Abstract Background Patients with mild to moderate depressive symptoms can have limited access to regular treatment; to ensure appropriate care, low-threshold treatment is needed. Effective online interventions could increase the supply of low-threshold treatment. Further research is needed to evaluate the effectiveness of online interventions. This study aims to evaluate the online-based self-help programme “Selfapy” on a sample of depressive subjects and compares the impact of the programme’s unaccompanied version with its therapeutic accompanied version. Methods A sample of 400 subjects that have a mild to severe depressive episode (Becks Depression Inventory - II and Hamilton Depression Scale) will be used. Subjects are randomly assigned to immediate access to an unaccompanied course (no support from psychologist via weekly phone calls), immediate access to an accompanied course (support from a psychologist via weekly phone calls) or a waiting list control group (access to the intervention after 24 weeks). The intervention will last for a period of 12 weeks. Depressive symptoms as a primary parameter, as well as various secondary parameters, such as life satisfaction, therapeutic relationships, social activation, self-esteem, attitudes towards Internet interventions and drop-out rates, are recorded at four different points in time: at baseline (T1), 6 weeks after the start of the intervention (T2), 12 weeks after the start of the intervention (T3) and 3 months after completion of the treatment follow-up (T4). Conclusion This randomized and controlled, blinded study will make use of a “dismantled” approach to adequately compare the accompanied and unaccompanied versions of the intervention. Positive and meaningful results are expected that could influence the acceptance and implementation of online interventions. Trial registration German Clinical Trials Register DRKS00017191. Registered on 14 June 2019

scholarly journals Trajectories of maternal depressive symptoms and offspring’s risk behavior in early adolescence: data from the 2004 Pelotas birth cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ana Beatriz Bozzini ◽  
Jessica Mayumi Maruyama ◽  
Tiago N. Munhoz ◽  
Aluísio J. D. Barros ◽  
Fernando C. Barros ◽  
...  
Keyword(s):  
Cohort Study ◽  
Depressive Symptoms ◽  
Alcohol Use ◽  
Maternal Depression ◽  
Risk Behavior ◽  
Birth Cohort ◽  
Depression Scale ◽  
Self Report ◽  
Birth Cohort Study ◽  
Maternal Depressive Symptoms

Abstract Background This longitudinal study explored the relationship between trajectories of maternal depressive symptoms and offspring’s risk behavior in adolescence contributing to an extremely scarce literature about the impacts of maternal depression trajectories on offspring risk behaviors. Methods We included 3437 11-year-old adolescents from the 2004 Pelotas Birth Cohort Study. Trajectories of maternal depressive symptoms were constructed using Edinburgh Postnatal Depression Scale (EDPS) from age 3 months to 11 years. We identified five trajectories of maternal depressive symptoms: “low” “moderate low”, “increasing”, “decreasing”, and “chronic high”. The following adolescent outcomes were identified via self-report questionnaire and analyzed as binary outcome –yes/no: involvement in fights and alcohol use at age 11. We used logistic regression models to examine the effects of trajectories of maternal depressive symptoms on offspring’s risk behavior adjusting for potential confounding variable. Results Alcohol use and/or abuse as well as involvement in fights during adolescence, were not significantly associated with any specific trajectory of maternal depressive symptoms neither in the crude nor in the adjusted analyses. Conclusion Alcohol use and involvement in fights at age 11 were not associated with any specific trajectory of maternal depression.

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.

scholarly journals Effectiveness of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

2021 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Family Therapy ◽  
Depression Scale ◽  
Small Sample ◽  
Post Treatment ◽  
Treatment Manual ◽  
Future Research ◽  
Hamilton Depression Scale ◽  
Treatment As Usual

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. Objective: To study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed by blinded evaluators at baseline and post-treatment with the Hamilton Depression Scale (HAMD). Self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks. Analyses were performed according to intent-to-treat principles. Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment. Conclusion: ABFT was not superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s small sample size, missing data, and implementation challenges. Continued efforts to improve treatment for MDD in outpatient clinics are warranted . Future research should examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings. Trial Registration: Clinicaltrials.gov identifier: NCT01830088 https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013

A 6-Month Randomized Trial of a Smartphone Application, UControlDrink, in Aiding Recovery in Alcohol Use Disorder

2021 ◽  
pp. 1-12
Author(s):  
Conor Farren ◽  
Aoife Farrell ◽  
Aisling Hagerty ◽  
Cliodhna McHugh
Keyword(s):  
Alcohol Use ◽  
Text Messaging ◽  
Alcohol Use Disorder ◽  
Positive Impact ◽  
Controlled Trial ◽  
Intervention Group ◽  
Heavy Drinking ◽  
Smartphone Application ◽  
Smartphone App ◽  
Control Group

<b><i>Background and Aims:</i></b> Alcohol use disorder (AUD) is a substantial problem, causing early death and great economic burden. Research has highlighted the potential positive impact of technological interventions, such as smartphone applications (app) in treatment of AUD. The aim of this study was to explore the effectiveness of a smartphone app, incorporating computerized cognitive behavioural therapy and text messaging support, on alcohol outcomes over 6 months in a post-rehabilitation setting. <b><i>Methods:</i></b> A total of 111 participants with AUD were recruited into this randomized controlled trial, following completion of a 30-day rehabilitation programme. The intervention group (<i>n</i> = 54) used the smartphone app “UControlDrink” (UCD) over 6 months with treatment as usual (TAU), and the control group (<i>n</i> = 57) received TAU. All subjects suffered from AUD as the primary disorder, with other major psychiatric disorders excluded. All intervention subjects used the UCD smartphone app in the treatment trial, and all subjects underwent TAU consisting of outpatient weekly support groups. Drinking history in the previous 90 days was measured at baseline and at 3- and 6-month follow-ups. Additional measurements were made to assess mood, anxiety, craving, and motivation. Results were analysed using intention-to-treat analyses. <b><i>Results:</i></b> Retention in the study was 72% at 3 months and 52% at 6 months. There was a significant reduction in heavy drinking days in the intervention group relative to TAU over the 6 months, <i>p</i> &#x3c; 0.02. <b><i>Conclusions:</i></b> The UCD smartphone app demonstrates a significant benefit to reducing heavy drinking days over a 6-month post-rehabilitation period in AUD.

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

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

Clinical Outcomes of the First 2 Years of Implementation of the Integrated Care Pathway for Concurrent Major Depressive Disorder and Alcohol Use Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S79-S79 ◽  
Author(s):  
A.V. Samokhvalov ◽  
S. Awan ◽  
B. Le Foll ◽  
C. Probst ◽  
P. Voore ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Alcohol Use ◽  
Depressive Disorder ◽  
Integrated Care ◽  
Alcohol Use Disorder ◽  
Care Pathway ◽  
Retention Rates ◽  
Major Depressive ◽  
Integrated Care Pathway

BackgroundBoth major depressive disorder (MDD) and alcohol use disorder are highly prevalent, often comorbid and cause significant socioeconomic burden. At CAMH, we have developed and integrated care pathway (ICP) to treat these disorders and evaluated its effectiveness in comparison to treatment as usual (TAU)MethodsChart review; descriptive statistics, c2 and t-tests, linear mixed effects models, Kaplan–Meier and log-rank analyses.ResultsOverall, 81 patients were enrolled into ICP. Comparisons of treatment retention rates between ICP patients and matched historical controls (n = 81) showed significantly lower dropout rate in ICP cohort (18.5% vs. 69.1%, P < 0.001, Fig. 1). The ICP patients demonstrated significant reduction in depressive symptoms severity (QIDS: 14.6 vs. 10.0, P < 0.001; BDI 26.3 vs. 16.2, P < 0.001), reduction in the amount of alcohol consumed weekly from 44.6 standard drinks at baseline to 12.6 (P < 0.001) by the end of treatment, which was significantly better compared to controls (56.9 vs. 25.2, P < 0.001), P = 0.014 (Fig. 2).ConclusionsThe ICP is a feasible approach to treatment of concurrent AUD and MDD with significantly higher retention rates than TAU. Patients demonstrate improvements on several levels including depressive symptoms, and changes in alcohol drinking patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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