Attention-deficit hyperactivity symptoms and risk of alcohol use relapse.

AIM: Alcohol use disorder (AUD) is frequently accompanied by comorbid attention-deficit hyperactivity disorder (ADHD). Comorbid ADHD has been reported to increase the severity of AUD. We investigated whether ADHD severity also influences AUD relapse risk at baseline and after inpatient treatment. METHODS: In this study, 187 AUD patients admitted to Narimasu Kosei Hospital from October 2019 to March 2021 were included in the analysis. According to the Adult ADHD Self-Report Scale (ASRS), participants were divided into two groups: ASRS+ with ADHD characteristics (n = 43) and ASRS- with low/no ADHD characteristics (n = 144). Groups were compared for AUD relapse risk at the start of treatment (baseline) and before hospital discharge using the multidimensional Alcohol Relapse Risk Scale (ARRS). The change in relapse risk during hospitalization was also compared by assessment of the interaction between groups (ASRS+ vs. ASRS-) and time (at discharge vs. baseline). RESULTS: The total ARRS score and dimension subscores for stimulus-induced vulnerability and emotionality problems were significantly higher in the ASRS+ group at baseline and before discharge compared to the ASRS- group. There was a significant group × time interaction indicating less improvement of stimulus-induced vulnerability during inpatient treatment among the ASRS+ group compared to the ASRS- group. CONCLUSIONS: Our findings suggest that AUD patients with ADHD characteristics have a higher risk of relapse both at baseline and after inpatient treatment. Stimulus-induced vulnerability to relapse is less likely to improve with treatment in patients with ADHD characteristics.

[The Basic Act on Measures against Alcohol-related Health Harm and Role of General Psychiatrists--With focus on SBRIT and Deadly Triangle].

Japan has just enacted a national law for alcohol, that named "Basic Act on Measures Against Alcohol-related Health Harm". This article includes 5 topics; i) General psychiatrists have the roles and responsibilities in this law, ii) All psychiatrists need to know about alcohol-related health harm and alcohol-related problem, iii) Alcohol dependence is attributed to change of neurotransmitter in the brain, iv) Mood disorder is more likely to be complicated by alcohol dependence and/or hazardous drinking. Some of the patients with the above-mentioned complicated disease have alcohol-induced mood disorder, v) If the patient has alcohol-induced mood disorder, it will place priority on alcoholism treatment and will be important to quickly resolve with abstinence. Finally, the proposals are made as follows; i) Making a guideline, ii) Physicians skilled at SBIRT (Screening, Brief Intervention, and Referral to Treatment) should be qualified as a certifying physician, and having the qualification should allow reimbursing medical institutions for the alcohol related service provided.

[Alcoholism and regional strategy and collaboration].

The most part of an estimated alcohol dependence syndrome person has only a medical treatment of a complication in primary care medicine in Japan, and only about 5% is related to treatment. Therefore many intoxicated persons go to an emergency hospital, and a staff takes an excessive burden. Cooperation of various organizations is important to the police, fire fighting, polity and a self-help meeting as well as between the medical agencies to link non-healer to treatment. The law which does the health problem measure by alcohol behind schedule compared with foreign countries in 2013 is established, and it' s expected that cooperation will be developed from now on.

Influence of GIRK channel inhibition on relapse risk in Japanese alcohol-dependent inpatients.

We examined the influence of G-protein-activated inwardly rectifying K+ (GIRK) channel inhibition on relapse risk in Japanese alcohol-dependent inpatients. The participants included 11 patients who received GIRK inhibition treatment and 39 patients who did not receive GIRK inhibition treatment. The participants answered a questionnaire, including the Alcohol Relapse Risk Scale (ARRS) and a questionnaire about their experiences of stressful events 2 weeks after hospitalization (time 1) and completed follow-up questionnaires 45-60 days after the first rating (time 2). A significant interaction was found between group and time on positive expectancy for alcohol scores on the ARRS (F = 5.93, p = 0.02). The scores at time 2 were lower than that at time 1 in the GIRK inhibition treatment group (p = 0.004) but not in the non-GIRK inhibition treatment group. The results of the present study suggest that GIRK inhibition treatment may improve the positive expectancy for alcohol, a component of relapse risk. The present study suggests that the effects of GIRK inhibition treatment should be investigated further in future studies.