Correlation analysis of mental health conditions and personality of patients with alcohol addiction.

BACKGROUND: Alcohol addiction, or alcohol dependence, refers to a psychological state of strong craving for alcohol caused by drinking when both the drinking times and alcohol consumption reach a certain level. Alcohol addiction can cause irreversible damage, leading to mental illness or mental disorders, negative changes in their original personality, and a tendency to safety incidents such as committing suicide or violent attacks on others. Significant attention needs to be given to the mental health of alcohol addicts, which could reflect their abnormal personality traits. However, only a few papers on this issue have been reported in China. AIM: To investigate the correlation between mental health and personality in patients with alcohol addiction. METHODS: In this single-center observational study, we selected 80 patients with alcohol addiction as the research subjects, according to the criteria of the K10 scale to evaluate the mental health of patients with alcohol addiction, and divided these patients into four groups based on the evaluation results: Good, average, relatively poor and bad. And then analyzed the correlation between mental health conditions and personality characteristics from these four groups of patients. RESULTS: The average score of the K10 scale (Kessler 10 Simple Psychological Status Assessment Scale) in 80 patients with alcohol addiction was 25.45 points, the median score was 25 points, the highest score was 50 points, and the lowest score was 11 points. Pearson's analysis showed that the K10 score was positively correlated with the scores of these two subscales, such as the P-subscale and the N-subscale (P < 0.05). In contrast, the K10 score had no significant correlation with the scores from the E-subscale and the L-subscale (P > 0.05). CONCLUSION: The mental health conditions of patients with alcohol addiction are positively correlated with their personality characteristics.

Relationship between serum vitamin D and thyroid hormone profiles in male patients with alcohol dependence.

BACKGROUND: Alcohol dependence (AD) results in several medical problems including vitamin D deficiency and thyroid dysfunction. However, the relationship between these two complications remains unclear. The aim of the present study was to explore the relationship between serum vitamin D and thyroid hormone profiles in male patients with AD. METHODS: A total of 117 male patients with AD were enrolled. Vitamin D deficiency was defined as serum concentrations of the main circulating vitamin D, 25-hydroxy vitamin D [25(OH)D], below 50 nmol/L. The AD patients were divided into two groups accordingly: 46 patients with normal vitamin D levels (normal group) and 71 patients with vitamin D deficiency (deficiency group). The levels of thyroid hormone profiles including total triiodothyronine 3 (TT3), total thyroxine 4 (TT4), thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) between the two groups were compared. Correlation between the serum levels of 25(OH)D and thyroid hormone profiles was evaluated using simple correlation (Pearson's correlation) and multivariable analysis using linear regression models. RESULTS: The prevalence of vitamin D deficiency in male patients with AD is 60.7% (71/117; 95% confidence interval: 51.6-69.1%). Moreover, the serum levels of TT3 (t = -2.682, p = 0.009), TT4 (t = -2.033, p = 0.044), fT3 (t = -2.986, p = 0.003), and fT4 (t = -2.558, p = 0.012) in deficiency group were significantly higher than those in normal group. Post hoc power analyses showed that the power for fT3 was sufficient (power > 0.80). Furthermore, univariate analysis showed that the serum vitamin D levels were negatively correlated with the TT3 (r = -0.189, p = 0.044), fT3 (r = -0.350, p < 0.001), and fT4 (r = -0.198, p = 0.033) levels, while multivariate analysis indicated that only fT3 was independently related to the serum levels of vitamin D in male patients with AD. CONCLUSIONS: These results suggested that the serum vitamin D levels may be associated with fT3 in male patients with AD.

Effect of short-term mindfulness-based stress reduction on sleep quality in male patients with alcohol use disorder.

Background: Sleep disturbance is one of the most prominent complaints of patients with alcohol use disorder (AUD), with more than 70% of patients with AUD reporting an inability to resolve sleep problems during abstinence. Mindfulness-based stress reduction (MBSR) has been shown to improve sleep quality and as an alternative therapy to hypnotics for sleep disorders. Objective: The aim of the present study was to evaluate the effect of short-term MBSR on sleep quality in male patients with AUD after withdrawal. Methods: A total of 91 male patients with AUD after 2 weeks of routine withdrawal therapy were randomly divided into two groups using a coin toss: the treatment group (n = 50) and the control group (n = 41). The control group was received supportive therapy, and the intervention group added with MBSR for 2 weeks on the basis of supportive therapy. Objective sleep quality was measured at baseline and 2 weeks after treatment using the cardiopulmonary coupling (CPC). Indicators related to sleep quality include total sleep time, stable sleep time, unstable sleep time, rapid eye movement (REM) sleep time, wake-up time, stable sleep latency, sleep efficiency, and apnea index. These indicators were compared by an analysis of covariance (ANCOVA) between the two groups, controlling for individual differences in the respective measures at baseline. Results: The results showed that there were no significant differences in the age [t (89) = -0.541, P = 0.590), BMI [t (89) = -0.925, P = 0.357], educational status [t (89) = 1.802, P = 0.076], years of drinking [t (89) = -0.472, P = 0.638), daily intake [t (89) = 0.892, P = 0.376], types of alcohol [χ2 (1) = 0.071, P = 0.789], scores of CIWA-AR [t (89) = 0.595, P = 0.554], scores of SDS [t (89) = -1.151, P = 0.253), or scores of SAS [t (89) = -1.209, P = 0.230] between the two groups. Moreover, compared with the control group, the total sleep time [F (1.88) = 4.788, P = 0.031) and stable sleep time [F (1.88) = 6.975, P = 0.010] were significantly increased in the treatment group. Furthermore, the average apnea index in the patients who received MBSR was significantly decreased than in the control group [F (1.88) = 5.284, P = 0.024]. Conclusion: These results suggest that short-term MBSR could improve sleep quality and may serve as an alternative treatment to hypnotics for sleep disturbance in patients with AUD after withdrawal.

Alcohol dependence inpatients classification with GLM and hierarchical clustering integration using fMRI data of alcohol multiple scenario cues.

Alterations in brain reactions to alcohol-related cues are a neurobiological characteristic of alcohol dependence (AD) and a prospective target for achieving substantial treatment effects. However, a robust prediction of the differences in inpatients' brain responses to alcohol cues during the treatment process is still required. This study offers a data-driven approach for classifying AD inpatients undertaking alcohol treatment protocols based on their brain responses to alcohol imagery with and without drinking actions. The brain activity of thirty inpatients with AD undergoing treatment was scanned using functional magnetic resonance imaging (fMRI) while seeing alcohol and matched non-alcohol images. The mean values of brain regions of interest (ROI) for alcohol-related brain responses were obtained using general linear modeling (GLM) and subjected to hierarchical clustering analysis. The proposed classification technique identified two distinct subgroups of inpatients. For the two types of cues, subgroup one exhibited significant activation in a wide range of brain regions, while subgroup two showed mainly decreased activation. The proposed technique may aid in detecting the vulnerability of the classified inpatient subgroups, which can suggest allocating the inpatients in the classified subgroups to more effective therapies and developing prognostic future relapse markers in AD.

Exposure to Olfactory Alcohol Cues During Non-rapid Eye Movement Sleep Did Not Decrease Craving in Patients With Alcohol Dependence.

Background and Objectives: Cue exposure therapy (CET) has been used to reduce alcohol use, but the effect of CET during sleep on alcohol dependence (AD) is unclear. The present study examined the effect of repeated exposure to an olfactory stimulus during non-rapid eye movement (NREM) sleep on cue reactivity and craving in patients with AD. Methods: Thirty-five patients with AD were enrolled according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). All the subjects were randomly assigned to the experimental or control group. The experimental group was exposed to alcohol odor for 10 min during NREM sleep. The other group (controls) was exposed to water [control stimulus (CtrS)] for 10 min during NREM sleep. Demographic, alcohol-related, and clinical characteristics were collected at baseline. A cue-reactivity test was conducted before and after exposure to evaluate the effect of memory manipulation on acute response to an alcohol stimulus. Results: There were no significant time × group interactions according to the visual analog scale (VAS) score of craving intensity, skin conductance response (SCR), systolic blood pressure (SBP), and diastolic blood pressure (DBP; all p > 0.05). Two-way ANOVA showed significant main effects of time on SCR [F (1,33) = 4.453, p = 0.043], SBP [F (1,33) = 14.532, p = 0.001], DBP [F (1,33) = 8.327, p = 0.007], Craving-VAS [F (1,33) = 1.997, p = 0.167] in two groups. Conclusion: Exposure to olfactory alcohol cues during NREM sleep had no significant effect on alcohol craving in subjects with AD during hospitalization.

Depicting People in Visual Cues Affects Alcohol Cue Reactivity in Male Alcohol-Dependent Patients.

Cue reactivity is often used to study alcohol cues brain responses. Standardized image sets are used, but the effect of viewing people interacting with the alcohol drink remains unclear, which is associated with the factors of alcohol cues that influence the degree of response to alcohol stimuli. The present study used fMRI to investigate the reactivity of alcohol dependence (AD) inpatients to alcohol cues with or without human drinking behavior. Cues with a human interacting with a drink were hypothesized to increase sensorimotor activation. In total, 30 AD inpatients were asked to view pictures with a factorial design of beverage types (alcoholic vs. non-alcoholic beverages) and cue types (with or without drink action). Whole-brain analyses were performed. A correlation analysis was conducted to confirm whether the whole-brain analysis revealed cue-related brain activations correlated with problem drinking duration. The left lingual gyrus showed significant beverage types through cue type interaction, and the bilateral temporal cortex showed significant activation in response to alcohol cues depicting human drinking behavior. The right and left lingual gyrus regions and left temporal cortex were positively correlated with problem drinking duration. Sensorimotor activations in the temporal cortex may reflect self-referential and memory-based scene processing. Thus, our findings indicate these regions are associated with alcohol use and suggest them for cue exposure treatment of alcohol addiction.

Effects of Chronic Alcohol Use Disorder on the Visual Tilt Illusion.

Rationale: Among the serious consequences of alcohol use disorder (AUD) is the reduced ability to process visual information. It is also generally agreed that AUD tends to occur with disturbed excitation-inhibition (EI) balance in the central nervous system. Thus, a specific visual behavioral probe could directly qualify the EI dysfunction in patients with AUD. The tilt illusion (TI) is a paradigmatic example of contextual influences on perception of central target. The phenomenon shows a characteristic dependence on the angle between the inducing surround stimulus and the central target test. For small angles, there is a repulsion effect; for larger angles, there is a smaller attraction effect. The center-surround inhibition in tilt repulsion is considered to come from spatial orientational interactions between orientation-tuned neurons in the primary visual cortex (V1), and tilt attraction is from higher-level effects of orientation processing in the visual information processing. Objectives: The present study focuses on visual spatial information processing and explores whether chronic AUD patients in abstinence period exhibited abnormal TI compared with healthy controls. Methods: The participants are 30 male volunteers (20-46 years old) divided into two groups: the study group consists of 15 clinically diagnosed AUD patients undergoing abstinence from alcohol, and the control group consists of 15 healthy volunteers. The TI consists of a center target surround with an annulus (both target and annulus are sinusoidal grating with spatial frequency = 2 cycles per degree). The visual angle between center and surround is a variable restricted to 0°, ±15°, ±30°, or ±75°. For measuring the TI, participants have to report whether the center target grating orientation tilted clockwise or counterclockwise from the internal vertical orientation by pressing corresponding keys on the computer keyboard. No feedback is provided regarding response correctness. Results: The results reveal significantly weaker tilt repulsion effect under surround orientation ±15° (p < 0.05) and higher lapse rate (attention limitation index) under all tested surround orientations (all ps < 0.05) in patients with chronic AUD compared with health controls. Conclusions: These results provide psychophysical evidence that visual perception of center-contextual stimuli is different between AUD and healthy control groups.

Evidence of a Relationship Between Plasma Leptin, Not Nesfatin-1, and Craving in Male Alcohol-Dependent Patients After Abstinence.

The goal of this study was to determine whether the plasma leptin, nesfatin-1, cortisol, brain-derived neurotrophic factor (BDNF), and inflammatory cytokines could be used as potential biomarkers for the degree of craving in the alcohol-dependent patients after 1 month of abstinence. A total of 83 patients with alcohol use disorder (AUD) and 61 healthy subjects were assessed. Patients with AUD were selected from Department of Material Dependence, Anhui Mental Health Center, and subjects in the control group were selected from healthy volunteers. The Alcohol Urge questionnaire Scale (AUQ) was used to evaluate the extent of craving for alcohol, and the Michigan Alcoholism Screening Test (MAST), the Fagerstrom Test for Nicotine Dependence (FTND), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were also assessed in patients with AUD. Enzyme-Linked Immunosorbent Assay (ELISA) was used for the measurement of plasma leptin, nesfatin-1, cortisol, BDNF, Interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) levels. Compare with healthy controls, the average leptin, leptin/BMI, IL-6, CRP, and TNF-α levels in patients with AUD were significantly increased, while the BDNF levels were significantly decreased. Moreover, the partial correlational analysis showed that the AUQ scores of the alcohol-dependent patients were positively correlated with the plasma leptin levels (r = 0.613, P < 0.001), rather than nesfatin-1 (r = 0.066, P = 0.569) after controlling for age as covariate. Furthermore, plasma nesfatin-1 levels were found to be correlated with the SDS scores (r = 0.366, P = 0.001) in the AUD group. In addition, plasma leptin levels were positively associated with the plasma IL-6 (r = 0.257, P = 0.033), CRP (r = 0.305, P = 0.011), and TNF-α (r = 0.311, P = 0.009) levels, and negatively associated with the BDNF levels (r = -0.245, P = 0.042) in patients with AUD. These results suggest that plasma leptin, but not nesfatin-1, might be a potential biomarker for the degree of craving in alcohol-dependent patients after 1 month of abstinence, the mechanism of which might be related to the dysfunction of the inflammatory cytokines and BDNF levels.

Pharmacologic prevention of postoperative delirium after on-pump cardiac surgery: A meta-analysis of randomized trials.

BACKGROUND: Postoperative delirium is a prevalent and disabling mental disorder in patients undergoing on-pump cardiac surgery. There is some evidence that the use of pharmacological interventions may reduce the risk of developing of postoperative delirium. Therefore, the aim of this meta-analysis was to determine the effect of pharmacologic agents for the prevention postoperative delirium after cardiac surgery. METHODS: Randomized controlled trials (RCTs) were identified through a systematic literature search of electronic databases and article references up to October 2016. End points included incidence of postoperative delirium, severity of postoperative delirium, cognitive disturbances of postoperative delirium, duration of postoperative delirium, length of stay in intensive care unit (ICU) and hospital, and short-term mortality. RESULTS: A total of 14 RCTs with an aggregate of 14,139 patients were included. The results of the present meta-analysis show that pharmacologic agents significantly decrease postoperative delirium [relative risk (RR), 0.83; 95% confidence interval (95% CI), 0.75-0.91, P < .00001] and duration of postoperative delirium (RR = -0.37, 95% CI = -0.47 to -0.27, P < .00001) after on-pump cardiac surgery. In addition, subgroup analysis shows that dexamethasone and dexamethasone were associated with a trend toward a reduction in postoperative delirium (RR, 0.45; 95% CI, 0.30-0.66, P < .0001; RR, 0.80; 95% CI, 0.68-0.93, P = .003, respectively). However, our results fail to support the assumption that pharmacologic prophylaxis is associated with a positively reduction in short-term mortality, length of ICU, or hospital stay. CONCLUSION: This meta-analysis suggests that the perioperative use of pharmacologic agents can prevent postoperative delirium development in patients undergoing cardiac surgery. However, there remain important gaps in the evidence base on a few small studies with multiple limitations. Further large-scale, high-quality RCTs are needed in this area.

Excessive use of WeChat, social interaction and locus of control among college students in China.

In China, the number of college students using mobile phone based messaging and social networking applications like WeChat is increasing rapidly. However, there has been minimal research into the addictive nature of these applications and the psychological characteristics associate with their excessive use. There is also no published scale available for assessing excessive use of WeChat and similar applications. In the current study, we collected data from 1,245 college students in China (715 females) and developed the WeChat Excessive Use Scale (WEUS). We then assessed the relationship between excessive use of WeChat and excessive use of a social networking application-Weibo, problematic use of mobile phones, external locus of control, and social interaction skills. Our 10-item scale featured three factors, namely- "mood modification," "salience" and ''conflict"- critical factors in assessing different forms of addiction. The WEUS was found to be a reliable instrument in assessing excessive use of WeChat as it showed good internal consistency and correlated with other measures of problematic use social networking and mobile phone addiction. Our results showed that excessive users of WeChat are more likely to excessively use Weibo than they are to problematically use mobile phones. Our study also showed that greater excessive use of WeChat is associated with higher external locus of control and greater online social interaction skills. These results reveal that WeChat has unique and strong appeal among college students in China. Further, practitioners should consider dealing with malleable factors like locus of control and real life social skills in treating people with problematic messaging and social networking.

Delta coherence in resting-state EEG predicts the reduction in cigarette craving after hypnotic aversion suggestions.

Cigarette craving is a key contributor of nicotine addiction. Hypnotic aversion suggestions have been used to help smoking cessation and reduce smoking relapse rates but its neural basis is poorly understood. This study investigated the underlying neural basis of hypnosis treatment for nicotine addiction with resting state Electroencephalograph (EEG) coherence as the measure. The sample consisted of 42 male smokers. Cigarette craving was measured by the Tobacco Craving Questionnaire. The 8-minute resting state EEG was recorded in baseline state and after hypnotic induction in the hypnotic state. Then a smoking disgust suggestion was performed. A significant increase in EEG coherence in delta and theta frequency, and significant decrease in alpha and beta frequency, between the baseline and the hypnotic state was found, which may reflect alterations in consciousness after hypnotic induction. More importantly, the delta coherence between the right frontal region and the left posterior region predicted cigarette craving reduction after hypnotic aversion suggestions. This suggests that the functional connectivity between these regions plays an important role in reducing cigarette cravings via hypnotic aversion suggestions. Thus, these brain regions may serve as an important target to treat nicotine addiction, such as stimulating these brain regions via repetitive transcranial magnetic stimulation.

[Effects of methadone maintenance treatment on working memory in male heroin dependent patients].

OBJECTIVE: To explore the differences of working memory task performance between male patients with heroin dependence in methadone maintenance treatment (MMT) and healthy controls (HC). METHODS: A total of 42 heroin-dependent patients at Huainan City Psychiatric Hospital from May 2011 to October 2011 were compared with 31 gender- and age-matched HCs on such working memory tests as visual-space, visual-verbal and visual-face. Then the accurate rate and reaction time of the above tasks were between two groups. RESULTS: The participants with anxiety or depression were excluded. All MMT subjects were required to have negative urine toxicology screening tests. The accurate rate of verbal working memory of the patients was worse than that of HCs (83% ± 9% vs 89% ± 10%). And the difference was significant between two groups (t(71) = -2.631, P = 0.010). The accurate rate of visual-object and visual-spatial working memory showed no significant differences between two groups (P > 0.05). The differences in reaction time on these tasks showed no statistical significance between two groups (P > 0.05). In addition, the dose of methadone and the duration of MMT revealed no significant effects on the performance of working memory and executive functions. CONCLUSION: The disproportion impairment of patients on space, verbal and face working memory is probably due to the differential heroin-mediated injuries of encephalic regions. Methadone has no effect on working memory and executive functions in the patients with a history of heroin use during maintenance treatment intervention.