[Differences by sex and income level in mortality from causes directly related to alcohol in Navarre, 1993-2017]. / Diferencias por sexo y nivel de renta en la mortalidad por causas directamente relacionadas con el alcohol en Navarra, 1993-2017.

BACKGROUND: Alcohol consumption is a risk factor for many health problems. Mortality from causes of death wholly attributable to alcohol consumption by sex and income level was studied and trends in the 1993-2017 period were analyzed in Navarre (Spain). METHODS: Deaths due to alcohol-induced mental disorders, dependence and abuse, alcoholic cardiomyopathy, alcoholic cirrhosis and other alcoholic liver diseases, and accidental alcohol poisoning were selected through codes ICD-9 and ICD-10. Annual income that determines copayment level was used as an indicator of socioeconomic status. Mortality rates adjusted to the European standard population were calculated using the direct method and joinpoint regression was used to evaluate the temporal trend. RESULTS: A total of 441 deaths were recorded in the population aged 35-79 years. It highlights liver cirrhosis as the most common cause (77,5%). Death rates in men were ten and five times higher than in women in 1993-1997 and 2013-2017 periods, respectively. Compared to men with incomes above 18,000 €, mortality rates were five times higher in the population with incomes below 18,000 €. No statistically significant changes were observed in the trend of mortality rates throughout the period studied. CONCLUSIONS: Mortality by causes of death wholly attributable to alcohol has not decreased in Navarre in the last three decades, it is higher in men than in women and in the population with lower incomes.

Psicosis etílica y mortalidad por todas las causas en Bielorrusia / Alcohol psychoses and all-cause mortality in Belarus

Antecedentes: La carga que representan los problemas relacionados con el alcohol en Europa Central y Oriental es la más alta del mundo. El nivel de consumo de alcohol en Bielorrusia se encuentra entre los más altos a nivel mundial, con un índice de consumo estimado de 14 litros de alcohol puro per cápita. Los desórdenes sociales, económicos y políticos experimentados en Bielorrusia durante los años que siguieron a la disolución de la Unión Soviética se han visto acompañados por un incremento sustancial de la mortalidad por todas las causas. Aunque el alcohol, en las antiguas Repúblicas Soviéticas, parece ser un contribuidor importante en la carga sobre dichas enfermedades, se han llevado a cabo pocas investigaciones sistemáticas sobre su impacto en la mortalidad por todas las causas en Bielorrusia. Objetivos: El objetivo del presente estudio es tratar este déficit particular en lo concerniente a la relación con la mortalidad total por alcohol utilizando datos a nivel agregado. Método: Las tendencias en la mortalidad por todas las causas y los índices de incidencia de la psicosis etílica (como sustituto del consumo de alcohol), desde 1970 hasta 2005, fueron examinados utilizando análisis de series temporales ARIMA para evaluar relaciones bivariables entre dos series temporales. Resultados: Los resultados del análisis de estas series temporales apuntan hacia una estrecha relación entre la mortalidad por todas las causas y los índices de psicosis etílica a nivel agregado. Conclusiones: Este estudio refrenda los hallazgos anteriores que sugieren la existencia de vínculos estrechos entre alcohol y mortalidad. Las conclusiones del presente estudio también apoyan la hipótesis de que el alcohol es un factor crucial enla crisis de mortalidad de Bielorrusia. Por lo tanto, el control del alcohol debe ser una prioridad clave en las políticas bielorrusas de salud pública

Background: The burden of alcohol-related problems in central and eastern Europe is the highest in the world. The level of alcohol consumption in Belarus is among the highest in the world, with an annual consumption rate estimated to be 14 litres of pure alcohol per capita. The social, economic and political turmoil that Belarus has experiences in the years following the dissolution of the Soviet Union has been accompanied by a substantial rise in all-cause mortality. Although alcohol seems to be an important contributor to the burden of disease in the former Soviet republics, little systematic research has been undertaken on its impact on all-cause mortality in Belarus. Aims: The aim of the present study was to address this particular deficit concerning the alcohol-total mortality relationship in Belarus by using aggregate-level data. Method: Trends in the all-cause mortality and alcohol psychoses incidence rates (as a proxy for alcohol consumption) from 1970 to 2005 were analyzed employing ARIMA time series analysis in order to asses bivariate relationship between the two time series. Results: The results of time series analysis suggest a close relationship between all-cause mortality and alcohol psychoses rates at the aggregate level. Conclusions: This study replicates the previous findings that suggested close link between alcohol and mortality. The outcome of present study also supports the hypothesis that alcohol is a crucial factor of mortality crisis in Belarus. Therefore, alcohol control must be a key priority for Belorussian public health policy

Estimates of harm associated with changes in Swedish alcohol policy: results from past and present estimates.

AIMS: (i) To compare actual developments of alcohol-related harm in Sweden with estimates derived prior to major policy changes in 1995 and (ii) to estimate the effects on consumption and alcohol-related harm of reducing alcohol prices in Sweden. DESIGN: Alcohol effect parameters expressing the strength of the relationship between overall alcohol consumption and different alcohol-related harms were obtained from ARIMA (Auto Regressive Integrated Moving Average) time-series analyses. MEASUREMENTS: Measures of Swedish alcohol-related mortality (liver cirrhosis, alcoholic psychosis, alcoholism and alcohol poisoning), accident mortality, suicide, homicide, assaults and sickness absence from 1950 to 1995. FINDINGS: Previous estimates of alcohol-related harm based on changes in alcohol consumption for the period 1994-2002 for Sweden were, in some cases (e.g. violent assaults and accidents), relatively close to the actual harm levels, whereas in other cases (e.g. homicides, alcohol-related mortality and suicide) they diverged from observed harm levels. A tax cut by 40% on spirits and by 15% on wine is estimated to increase total per capita alcohol consumption by 0.35 litre. This increase is estimated to cause 289 additional deaths, 1627 additional assaults and 1.6 million additional sickness absence days. CONCLUSIONS: The estimates of future changes in harm based upon even relatively modest increases in alcohol consumption produce considerable negative effects, with large economic consequences for the Swedish economy. The additional alcohol-related deaths, for instance, amount to more than half the number of yearly traffic fatalities in Sweden.

[Regional indices of alcoholic poisonings and alcoholic psychoses]. / Oblastnye pokazateli alkogol'nykh otravlenii i alkogol'nykh psikhozov.

Interrelations of phenomena preconditioned by alcohol consumption were the starting prerequisite of the case study. The annual lethality rates due the to alcohol poisonings (AP) and alcoholic psychosis (APS) morbidity were investigated in 77 Russia's regions during 1991-1999, when the alcohol consumption used to be dynamic in the country--a sharp growth in 1991-1994, a drop in 1995-1998, and a new increase in 1999. The correlation of studied phenomena was observed only in 33 regions. The ratio of AP level to APS level varied in different regions and during different time periods from 50-fold AP prevalence to 65-fold APS prevalence. The distribution of APS indices was normal, while the distribution of AP deviated from the norm towards a higher dispersion. Two etalons were made use of, i.e. one for AP and the other for APS, to assess the differences between the AP and APS indices. APS differed from the appropriate etalon by far less versus AP. A list of regions with respect for deviations of APS and AP indices was compiled. A conclusion was made to the extent that consciously or unconsciously the postmortem diagnoses of AP were concealed in a majority of Russia's regions; APS were not registered in full either. However, the latter reflect better the alcohol-related situation in regions versus AP.

Alcohol-related human losses in Russia in the 1980s and 1990s.

AIMS: The estimation of alcohol-related human losses in Russia in the 1980s and 1990s. DESIGN: The estimation was made by comparing changes in the total number of deaths and in specific categories, and alcohol consumption in Russia during this time. SETTING: The anti-alcohol campaign, launched in 1985, and the market reforms launched in 1992 were associated with large and rapid changes of alcohol-consumption in Russia. FINDINGS: In the early 1980s, the aggregate number of direct and indirect alcohol-related life losses was more than 500,000 per annum, or 32% of total deaths. Half of the alcohol-related human losses in Russia over the period studied were due to accidents, poisoning and violence. Following the anti-alcohol campaign and reduction in annual per capita alcohol consumption from 14.2 (1984) to 10.5 l (1986), mortality decreased from 1161.6 to 1054.0 per 100,000 of the population. It is estimated that from 1986 to 1991 the lives of 1.22 million people were spared; that is, 11.4% of the number of deaths expected without the anti-alcohol campaign. All categories of deaths were reduced with the exception of neoplasms, infectious and parasitic diseases. In the period of the so-called market reforms both alcohol consumption and mortality increased sharply. The total number of alcohol-related deaths for 1994 was 751,000 in the population, or 33% of all deaths (direct and indirect losses). In 1995 alcohol consumption started to decrease. A decrease in mortality was registered despite the sharp deterioration of the quality of life in the country. However, a new growth of total mortality, fatal alcohol poisonings and number of alcohol psychoses began in 1999-2000. CONCLUSION: The results of this study show the enormous scale of alcohol-related mortality in Russia. It has been revealed that alcohol-related deaths are at the top of the hierarchy of all premature deaths in the country. Decreasing alcohol consumption is an important means of decreasing total mortality in Russia.

Asociación entre consumo de vodka y tasa de mortalidad relacionada con el alcohol, a nivel agregado, utilizando series temporales / Aggregate-level time-series association between vodka consumption level and alcohol related mortality rate

Antecedentes: La asociación entre el nivel de consumo de alcohol per cápita y el índice de mortalidad relacionada con el consumo de alcohol está muy bien documentada. Tenemos muchos menos datos, sin embargo, sobre el efecto de una bebida específica de alcohol en el índice de mortalidad. Objetivo: Calcular el efecto de una bebida específica de alcohol en el índice de mortalidad relacionada con el consumo de alcohol (a causa de cirrosis hepática, intoxicación alcohólica, alcoholismo y psicosis alcohólicas) entre 1970 y 1999 fueron analizadas en relación con las tendencias en el nivel de consumo per cápita de diferentes tipos de bebidas alcohólicas, mediante el análisis de series temporales. Resultados: Dicho análisis demostró el efecto directa y estadísticamente significativo de los cambios en el consumo de vodka per cápita sobre los índices de mortalidad relacionada con el alcohol. Al mismo tiempo, apenas se observó la menor correlación entre el nivel total de consumo de alcohol y los diferentes tipos de índices de mortalidad vinculada al consumo de alcohol. Conclusión: Los resultados del presente estudio refuerzan la idea de que el índice de mortalidad vinculada al consumo de alcohol tiende a ser más sensible a los cambios experimentados en el consumo de vodka per cápita que al nivel total de consumo de alcohol. La principal evidencia que nos lleva a esta conclusión es la asociación probada y significativa ente los índices de mortalidad vinculados al consumo de alcohol y el nivel de consumo de vodka per cápita. El resultado de este estudio indica, asimismo, que la mortalidad por intoxicación alcohólica es un indicador preferente de los daños vinculados al alcohol en los países donde predomina el modelo reconsumo que persigue la embriaguez (AU)

Background: The association between alcohol consumption level per capita and alcohol-related mortality rate is well documented. Considerably less is known concerning beveragespecific effect of alcohol on mortality rate. Aim: To estimate the beverage-specific effect of alcohol on alcohol-related mortality rate. Measurements: Trends in different types of alcohol-related mortality rate (due to liver cirrhosis, poisoning by alcohol, alcoholism and alcoholic psychosis) from 1970-1999 in Belarus were analyzed in relation to trends in the level of different types of alcoholic beverages consumption per capita applying time series analysis. Results: The analysis demonstrated a positive and statistically significant effect of changes in vodka per capita consumption on alcohol-related mortality rates. At the same time, hardly any correlation is observed between the total level of alcohol consumption and different types of alcohol-related mortality rates. Conclusion: The results of present study give support to the idea that alcohol-related mortality rate tends to be more responsive to changes in vodka consumption per capita than in total level of alcohol consumption. The main evidence for this conclusion is that a positive and significant association between alcohol-related mortality rates and level of vodka consumption per capita was revealed. The outcome of this study also suggests that alcohol poisoning mortality is a preferable marker of alcohol-related harm in the countries with prevailing intoxication-oriented drinking pattern (AU)

Excess mortality related to alcohol and smoking among hospital-treated patients with psoriasis.

BACKGROUND: Psoriasis is seen as a disease that does not kill. However, it is associated with alcohol intake and smoking. Thus, there could be excess mortality due to causes related to alcohol intake and smoking among patients with psoriasis. DESIGN: A cohort was identified from the nationwide Hospital Discharge Register from January 1, 1973, through December 31, 1984, and mortality was followed up for 22 years by linkage with the Cause-of-Death Register, from January 1, 1973, through December 31, 1995. PATIENTS: A cohort of 3132 men and 2555 women admitted to inpatient treatment with psoriasis as the principal diagnosis. MAIN OUTCOME MEASURES: Date and underlying cause of death. RESULTS: We observed 1918 deaths in contrast to the 1211 deaths expected on the basis of the national mortality rates. The all-cause standardized mortality ratio (SMR) for men was 1.62 (95% confidence interval [CI], 1.52-1.71); for women, 1.54 (95% CI, 1.43-1.64). Among men, the highest SMRs were found for alcohol psychosis (8.91 [95% CI, 2.89-20.70]) and liver disease, ie, cirrhosis, fatty liver, and hepatitis (6.98 [95% CI, 5.34-8.96]). Among women, the highest SMR was found for liver disease (5.06 [95% CI, 2.70-8.65]). Excess mortality was high for all causes of death directly related to alcohol; the SMR for men was 4.46 (95% CI, 3.60-5.45); for women, 5.60 (95% CI, 2.98-8.65). CONCLUSIONS: Patients with moderate to severe psoriasis are at increased risk for death. Alcohol is a major cause for this excess mortality.

Predictors of mortality in alcoholic women: a 20-year follow-up study.

Very little is known about the factors that predict mortality in female alcoholics. This study investigates these predictors in 103 female alcoholics who were psychiatrically hospitalized between 1967 and 1968 and followed for over 20 years. The findings showed that age, benders, and/or delirium tremens, comorbidity, and 3-year posttreatment drinking status were associated with time to death. That older alcoholics and those with pathological drinking within 3 years after treatment had a significantly shorter time to death was not surprising. However, the association of benders with mortality indicated that women may be very sensitive to short periods of high concentrations of alcohol. Comorbidity also had an intriguing effect in that women with a history of depression were more likely to survive. The predictors of mortality in these female alcoholics differed from those of the male alcoholics in this sample. These differences will be discussed in future publications.

[Alcoholic delirium--a potentially life-threatening condition]. / Das Alkoholdelir--ein potentiell lebensbedrohlicher Zustand.

Full-blown alcoholic delirium is characterised by the symptoms of an exogenous psychosis and signs of vegetative dysregulation. Organic brain disease may initiate its development. The pathogenesis of the condition remains hypothetical. Therapeutic drugs of first choice have long been clomethiazole and benzodiazepines. Basic sedative treatment may be usefully supplemented by highly potent neuroleptic agents. This, together with improvements in intensive medical care, has reduced the mortality rate to 3 to 8%. Concomitant organic diseases may complicate and prolong the condition. A defective state is a possible outcome.

Proposal for a composite index of alcohol problems.

This study proposes constructing a composite index to measure the severity of alcohol problems in Canada. Composite summary indicators are used in many areas, particularly in economics where the Consumer Price Index is well known. The composite indexes developed for this analysis were constructed using the index number method. The indexes were based on the statistical series for alcohol consumption, alcohol morbidity, alcohol mortality and alcohol-related traffic offences in the ten provinces and cover the years 1975, 1980, 1985 and 1990. The selected statistical series were compared using both Spearman and the Pearson correlations. In addition, Kendall's coefficient of concordance was used to determine the degree of association among all the statistical series together. The initial results indicated that there were different provincial rankings for each of the four statistical series, demonstrating that in comparing provinces the ranking of the "alcohol problem" depends on the statistical series selected. The construction of a composite index can be an effective strategy for resolving these differences in the rankings. Provincial rankings for the composite indexes on the severity of alcohol problems were fairly consistent for each time period. In terms of general trends among the provinces, Prince Edward Island, Alberta, British Columbia and Saskatchewan had the highest composite indexes; Manitoba, Nova Scotia and Ontario the mid-range; and New Brunswick, Newfoundland and Quebec the lowest.

Mortality in alcohol-related diseases in Sweden during 1971-80 in relation to occupation, marital status and citizenship in 1970.

A new Swedish population register, created by linking Census data to the Cause of Death Registry and covering over 99% of the population, has been used to study the relationship between occupational category, marital status and citizenship in 1970 and mortality in closely alcohol-related diseases during 1971-1980 for the ages 25-64 years. Age-standardized rate ratios (SRR) have been computed for mortality in alcoholism, alcohol intoxication and alcohol psychosis ("AAA") and in liver cirrhosis. SRR-values for both diagnose categories and both sexes were higher than average among not gainfully employed (SRR = 3.71 among males and SRR = 1.96 among females in 1976-80 for "AAA"), among employees in the service sector, engine-drivers and unskilled workers and increased in liver cirrhosis among artists and authors. Among females there were smaller variations in mortality for occupational groups than among males. The SRR-values showed a tendency to be higher in 1976-80 than in 1971-75, probably due to health-related selection to some extent. The alcohol-related mortality was also increased among divorced, widows (SRR = 1.37 for "AAA" and 2.81 for liver cirrhosis in 1976-80) and widowers and among never married males. SRR was much higher among Finnish citizens in Sweden (SRR for "AAA" = 3.85 among males and 2.35 among females in 1976-80) than among males and females living in Finland (SRR for "AAA" = 1.13 among males and 0.36 among females) and also higher than among immigrants from other countries, summed (SRR for "AAA" = 0.62 among males and 0.64 among females).(ABSTRACT TRUNCATED AT 250 WORDS)

[Estimation of alcohol-related deaths in France in 1985]. / Nombre de décès attribuables à l'alcool, en France, en 1985.

The number of deaths attributable to alcohol in France during 1985 has been estimated from national death statistics, and from records attributable risks for each disease related to alcohol. The attributable risks for alcohol by sex and by disease were computed from the 1974 survey by the Institut Français d'Opinion Publique of a national sample of 981 adults on consumption of alcohol, and from the relative risk of death for alcohol drinkers estimated from epidemiological studies. The total number of deaths attributable to alcohol in the population aged 20 or more was 52,000 in 1985 (44,500 men and 7,500 women). Half of these deaths occurred before age 65. Nine percent of the overall mortality was attributable to alcohol (3 percent for women and 16 percent for men). This proportion was 28 percent for men between ages 45 and 64. Among these 52,000 deaths, 14,000 were due to liver cirrhosis or alcoholic psychosis, 16,500 to cancer, mainly from oral cavity, pharynx, larynx, esophagus, or liver, 8,900 to external causes of injury, 9,050 to cardiovascular disease, 550 to pneumonia, and 3,000 to ill-defined diseases.

[Observations on deaths in alcoholism]. / Observatii asupra deceselor în alcoolism.

The present study is an attempt to establish the death rate of alcoholic patients with their various psycho-organic complications. The study was done on cases of alcoholic patients hospitalized in our Clinic over the past three decades. Thus, if the mortality index in 46,591 psychic patients hospitalized between 1959 and 1988 was of 0.36%, in alcoholics (totalling 5,580 of all patients) the mortality index was of 1.97%. An analysis of these figures with the aid of the X-square method showed a p of less than 0.001, indicating a significant difference with a probability of over 99.90% between these two groups of patients.

Canadian trends in mortality from mental disorders, 1965-1983.

This report describes trends in the death rate for all mental disorders, presenile and senile dementia, and alcoholic psychoses and alcohol abuse/dependence in Canada for the period 1965-1983. It is demonstrated that overall there has been an increase in the death rate for each of these causes of mortality, both for males and females, and that in the case of presenile and senile dementia the increase has been particularly rapid. The older age groups appear to be contributing most to the observed changes. Conjectures are made as to the underlying reasons for the observed trends.

Alcohol availability, alcohol consumption and alcohol-related damage. I. The distribution of consumption model.

One of the major approaches to alcoholism prevention is referred to as the distribution of consumption model. This prevention model can be summarized as a causal model whereby the availability of alcoholic beverages has a direct causal effect on the aggregate level of alcohol consumption in the population and, in turn, an indirect effect on the incidence and prevalence of alcohol-related damage. This article summarizes an application of a statistical technique known as the analysis of linear structural relations (LISREL) to a set of Ontario data concerning alcohol availability, alcohol consumption and alcohol-related damage. Results substantiated the existence of specific causal paths consistent with the model. Several procedures for assessing the overall goodness-of-fit of the model suggested that it adequately fit the data. The results provide reasonable statistical evidence that government policies restricting the retail availability of alcoholic beverages will reduce the per capita rates of alcohol consumption and, in turn, reduce the level of alcohol-related mortality and morbidity in the general population.

Scotland's liquor licensing changes: an assessment.

The impact of the changes in Scotland's liquor licensing laws was assessed by comparing trends in alcohol related problems in Scotland with those in England and Wales. The study showed no appreciable effect on the level of alcohol related morbidity and mortality, though some improvements were noted in relation to the rates of convictions for drunkenness. The changes introduced since 1976 appeared to be popular and there was widespread perception that public drunkenness had become less common-place.

Has mortality related to alcohol decreased in Sweden?

In Sweden sales of alcohol dropped 17% from 1976 to 1982. Similarly, comparison of data from 1979 and 1982 shows that the mortality from cirrhosis of the liver declined appreciably, by 28% in men and 29% in women. During 1979-82 mortality from pancreatitis also declined noticeably, by 30% in men and 36% in women. By contrast, no decrease occurred in mortality from alcoholic psychosis, alcoholism, or alcohol intoxication. The decrease in mortality from cirrhosis of the liver and pancreatitis is probably explained by a decrease in the consumption of alcohol among an important subgroup of high consumers of alcohol. The lack of a decrease in mortality from alcoholic psychosis, alcoholism, and alcohol intoxication may be because such diagnoses are often made in socially deteriorated, more dependent alcoholic subjects who have not been able to reduce their consumption.

Stressful events, stressful conditions and alcohol problems in the United States: a partial test of Bales's theory.

Bales's theory that sociostructural factors that produce stress for members of a society increase the rate of alcoholism is examined to explain variations in the levels of alcoholism in the 50 states. Two types of social stress are conceptualized and measured at the state level: The first, the "life events" model, is based on life changes that require adaptation. An index is described in which (negative) personal life events in 15 categories (e.g., divorce and plant closings) are aggregated for each state using macro measures. The second model is based on the idea of chronic stressful conditions, and is measured through the Measure of Status Integration and the Index of Relative Opportunities. Alcohol-related problems are measured by death rates for cirrhosis, alcoholism and alcoholic psychosis, and by per capita alcohol consumption. Both stressful events and stressful conditions are correlated with all indicators of alcoholism at the state level, 19 of 20 correlations being in the theoretically expected direction. Correlations are enhanced when age, urbanicity, the percentage of Blacks, low income and education are controlled for. The three macro measures of stress taken together explain 27% of the variation in cirrhosis death rates, 14% of the variation in alcoholism and alcoholic psychosis death rates and 47% of the variation in alcohol consumption rates.