Recognition of a Person with Alcohol Dependence: A Community-based Survey

The huge majority of people with an alcohol dependence problem that is uncomplicated by serious mental illness or social chaos receive treatment in the community. Tackling Alcohol Together: The Evidence Base of a UK Alcohol Policy (Raistrick et al, 1999, chapter 9) provides strong evidence supporting the move towards briefer and community-based treatments, while at the same time recognising the need for intensive and in-patient treatments for people with more complicated problems. It follows that the traditional sequencing of care, which might be characterised as having four phases – assessing and engaging patients, detoxification, specific therapy and aftercare – is less tidy than it used to be. Detoxification is seen much more as a standalone procedure that should be undertaken when the patient is ready, rather than as a prerequisite of starting treatment. Of course, there are also instances where detoxification may be required as an expedience, for example during an unplanned admission into hospital, or where regular high levels of intoxication are a barrier to treatment. Equally, where the focus of treatment is on mental illness rather than alcohol dependence, then detoxification may well be viewed as a necessary first step.

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Parental alcohol dependence, socioeconomic disadvantage and alcohol and cannabis dependence among young adults in the community

European Psychiatry ◽

10.1016/j.eurpsy.2009.12.011 ◽

2011 ◽

Vol 26 (1) ◽

pp. 13-17 ◽

Cited By ~ 18

Author(s):

M. Melchior ◽

M. Choquet ◽

Y. Le Strat ◽

C. Hassler ◽

P. Gorwood

Keyword(s):

Young Adults ◽

Alcohol Dependence ◽

Intergenerational Transmission ◽

Substance Dependence ◽

Socioeconomic Disadvantage ◽

Community Based ◽

Cannabis Dependence ◽

Dsm Iv ◽

Parental Alcohol

AbstractWe tested the hypothesis that socioeconomic disadvantage exacerbates the intergenerational transmission of substance dependence. Among 3056 community-based young adults (18–22 years, 2007), the prevalence of alcohol dependence (WHO AUDIT, 5.8%) and cannabis dependence (DSM IV criteria, 7.3%) was doubled in the presence of combined parental alcohol dependence and socioeconomic disadvantage.

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Cognitive decline and mortality in a community-based sample of homeless and precariously housed adults: 9-year prospective study

BJPsych Open ◽

10.1192/bjo.2020.3 ◽

2020 ◽

Vol 6 (2) ◽

Cited By ~ 2

Author(s):

Kristina M. Gicas ◽

Andrea A. Jones ◽

Allen E. Thornton ◽

Anna Petersson ◽

Emily Livingston ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Alcohol Dependence ◽

Inhibitory Control ◽

Verbal Learning ◽

Study Entry ◽

Community Based ◽

Cognitive Ageing ◽

Risk Of Mortality

Background Homeless and precariously housed individuals experience a high burden of comorbid illnesses, and excess mortality. Cross-sectional studies report a high rate of cognitive impairment. Long-term trajectories have not been well investigated in this group. Aims To longitudinally assess risks for premature and/or accelerated cognitive ageing, and the relationship with early mortality in homeless and precariously housed people. Method This is a 9-year community-based study of 375 homeless and precariously housed individuals from Vancouver, Canada. Annual cognitive testing assessed verbal learning and memory, and inhibitory control. Linear mixed-effects models examined associations between clinical risk factors (traumatic brain injury, psychotic disorders, viral exposure, alcohol dependence) and cognitive change over 9 years. Cox regression models examined the association between cognition and mortality. Results Traumatic brain injury and alcohol dependence were associated with decline in verbal memory. Inhibitory control declined, independent of risk factors and to a greater extent in those who died during the study. Better inhibitory control was associated with a 6.6% lower risk of mortality at study entry, with a 0.3% greater effect for each year of life. For each one-point increase in the Charlson Comorbidity Index score at study entry, the risk of mortality was 9.9% higher, and was consistent across age. Adjusting for comorbidities, inhibitory control remained a significant predictor of mortality. Conclusions Findings raise the possibility of a premature onset, and accelerated trajectory, of cognitive ageing in this group of homeless and precariously housed people. Traumatic brain injury, alcohol dependence and cognition could be treatment priorities.

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Association of Attention-deficit Hyperkinetic Disorder with Alcohol Use Disorders in Fishermen

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_48_17 ◽

2017 ◽

Vol 08 (S 01) ◽

pp. S078-S082

Author(s):

Manoj Kumar ◽

Balaji Bharadwaj ◽

Pooja Patnaik Kuppili ◽

Gomathi Ramaswamy ◽

Gilbert Marie Majella ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Dependence ◽

Attention Deficit ◽

High Frequency ◽

Alcohol Use Disorder ◽

Adult Adhd ◽

Alcohol Use Disorders ◽

Hyperkinetic Disorder ◽

Community Based ◽

Harmful Use

ABSTRACT Introduction: Alcohol use is a widely prevalent problem and poses hazard during work for certain groups such as fishermen. Disorders such as Attention-Deficit/Hyperkinetic Disorder (ADHD) correlate with early onset and greater severity of alcohol use disorders. Aims: We planned to study the frequency of ADHD among fishermen in a fishing hamlet of southern India using adult ADHD self-reported scale (ASRS) and correlated with the severity of alcohol use disorder as evidenced by age at initiation of alcohol use, presence of harmful use, or dependence use as defined by Alcohol Use Disorders Identification Test (AUDIT). Subjects and Methods: This was a community-based interview using AUDIT questionnaire for severity of alcohol use and the ASRS to detect ADHD. Results: The prevalence of adult ADHD among fishermen in this study was 25.7% using the critical items of the ASRS. ADHD was about twice as likely in participants with dependence as those without dependence (odds ratio = 2.10). ADHD was also more likely in participants with onset of use before 30 years of age than others (25.1% vs. 15.4%) (P = 0.27). Discussion: We found a high frequency of alcohol use among fishermen (79.8%). However, only 9.9% had alcohol dependence which is higher than the general population (2.3%) in the region. Fishermen with alcohol dependence were twice as likely to have ADHD as those without alcohol dependence. Conclusion: In a community-based survey of fishermen, the prevalence of alcohol dependence was about 10%. The presence of alcohol dependence predicted a two times higher likelihood of ADHD among fishermen than those without alcohol dependence.

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