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2.
Alcohol Alcohol ; 56(1): 42-46, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33150930

RESUMO

AIMS: We conducted a cross-sectional survey to estimate the prevalence and clinical manifestation of disulfiram ethanol reaction (DER) and isopropanol toxicity (IT) in patients with alcohol use disorders, on disulfiram. Alcohol-based hand rub contains either ethanol or isopropanol or both. COVID-19 pandemic has led to wide scale usage of sanitizers. Patients with alcohol use disorders, on disulfiram, might experience disulfiram ethanol like reactions with alcohol-based sanitizers. METHODS: We telephonically contacted 339 patients, prescribed disulfiram between January 2014 and March 2020. The assessment pertained to the last 3 months (i.e. third week of March to third week of June 2020). RESULT: The sample consisted of middle-aged men with a mean 16 years of alcohol dependence. Among the 82 (24%) patients adherent to disulfiram, 42 (12.3%) were using alcohol-based hand rubs. Out of these, a total of eight patients (19%; 95% CI 9-33) had features suggestive of DER; four of whom also had features indicative of IT. Five patients (62.5%) had mild and self-limiting symptoms. Severe systemic reactions were experienced by three (37.5%). Severe reactions were observed with exposure to sanitizers in greater amounts, on moist skin or through inhalation. CONCLUSION: Patients on disulfiram should be advised to use alternate methods of hand hygiene.


Assuntos
Dissuasores de Álcool/efeitos adversos , Alcoolismo/diagnóstico , Dissulfiram/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Etanol/efeitos adversos , Higienizadores de Mão/efeitos adversos , 2-Propanol/administração & dosagem , 2-Propanol/efeitos adversos , Adulto , Dissuasores de Álcool/administração & dosagem , Alcoolismo/tratamento farmacológico , Estudos Transversais , Dissulfiram/administração & dosagem , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Etanol/administração & dosagem , Higienizadores de Mão/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Tratamento de Abuso de Substâncias
3.
Nervenarzt ; 92(1): 57-65, 2021 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-32696076

RESUMO

So far few medications are approved for prophylactic treatment of alcohol dependence relapse. Apart from disulfiram, which is no longer marketed in Germany, the opioid antagonists naltrexone, nalmefene and the putative glutamate antagonist acamprosate are approved. In some other countries, baclofen and gamma-hydroxybutyrate (GHB) are licensed. Possible other drugs of interest for prophylaxis of alcohol dependence relapse are vareniclin, gabapentin, and topiramate, but so far none of them have received approval. In the light of the currently running revision of the German guidelines for the diagnosis and treatment of alcohol related disorders, an update on the pharmacotherapy of alcohol dependence is presented.


Assuntos
Dissuasores de Álcool , Alcoolismo , Acamprosato/uso terapêutico , Dissuasores de Álcool/uso terapêutico , Alcoolismo/diagnóstico , Alcoolismo/tratamento farmacológico , Alemanha , Humanos , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes , Taurina/uso terapêutico
4.
Cochrane Database Syst Rev ; 12: CD012921, 2020 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-33368213

RESUMO

BACKGROUND: Drug- and alcohol-related impairment in the workplace has been linked to an increased risk of injury for workers. Randomly testing populations of workers for these substances has become a practice in many jurisdictions, with the intention of reducing the risk of workplace incidents and accidents. Despite the proliferation of random drug and alcohol testing (RDAT), there is currently a lack of consensus about whether it is effective at preventing workplace injury, or improving other non-injury accident outcomes in the work place. OBJECTIVES: To assess the effectiveness of workplace RDAT to prevent injuries and improve non-injury accident outcomes (unplanned events that result in damage or loss of property) in workers compared with no workplace RDAT. SEARCH METHODS: We conducted a systematic literature search to identify eligible published and unpublished studies. The date of the last search was 1 November 2020. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, two other databases, Google Scholar, and three trials registers. We also screened the reference lists of relevant publications known to us. SELECTION CRITERIA: Study designs that were eligible for inclusion in our review included randomised controlled trials (RCTs), cluster-randomised trials (CRTs), interrupted time-series (ITS) studies, and controlled before-after (CBA) studies. Studies needed to evaluate the effectiveness of RDAT in preventing workplace injury or improving other non-injury workplace outcomes. We also considered unpublished data from clinical trial registries. We included employees working in all safety-sensitive occupations, except for commercial drivers, who are the subject of another Cochrane Review. DATA COLLECTION AND ANALYSIS: Independently, two review authors used a data collection form to extract relevant characteristics from the included study. They then analysed a line graph included in the study of the prevalence rate of alcohol violations per year. Independently, the review authors completed a GRADE assessment, as a means of rating the quality of the evidence. MAIN RESULTS: Although our searching originally identified 4198 unique hits, only one study was eligible for inclusion in this review. This was an ITS study that measured the effect of random alcohol testing (RAT) on the test positivity rate of employees of major airlines in the USA from 1995 to 2002. The study included data from 511,745 random alcohol tests, and reported no information about testing for other substances. The rate of positive results was the only outcome of interest reported by the study. The average rate of positive results found by RAT increased from 0.07% to 0.11% when the minimum percentage of workers who underwent RAT annually was reduced from 25% to 10%. Our analyses found this change to be a statistically significant increase (estimated change in level, where the level reflects the average percentage points of positive tests = 0.040, 95% confidence interval 0.005 to 0.075; P = 0.031). Our GRADE assessment, for the observed effect of lower minimum testing percentages associating with a higher rate of positive test results, found the quality of the evidence to be 'very low' across the five GRADE domains. The one included study did not address the following outcomes of interest: fatal injuries; non-fatal injuries; non-injury accidents; absenteeism; and adverse effects associated with RDAT. AUTHORS' CONCLUSIONS: In the aviation industry in the USA, the only setting for which the eligible study reported data, there was a statistically significant increase in the rate of positive RAT results following a reduction in the percentage of workers tested, which we deem to be clinically relevant. This result suggests an inverse relationship between the proportion of positive test results and the rate of testing, which is consistent with a deterrent effect for testing. No data were reported on adverse effects related to RDAT. We could not draw definitive conclusions regarding the effectiveness of RDAT for employees in safety-sensitive occupations (not including commercial driving), or with safety-sensitive job functions. We identified only one eligible study that reflected one industry in one country, was of non-randomised design, and tested only for alcohol, not for drugs or other substances. Our GRADE assessment resulted in a 'very low' rating for the quality of the evidence on the only outcome reported. The paucity of eligible research was a major limitation in our review, and additional studies evaluating the effect of RDAT on safety outcomes are needed.


Assuntos
Alcoolismo/diagnóstico , Traumatismos Ocupacionais/prevenção & controle , Detecção do Abuso de Substâncias/métodos , Aviação , Humanos , Análise de Séries Temporais Interrompida , Detecção do Abuso de Substâncias/estatística & dados numéricos
5.
Pan Afr Med J ; 36: 321, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193975

RESUMO

Introduction: the main aim of this study was to determine the prevalence and associated factors of alcohol use disorder (AUD) in patients with Multi-Drug Treatment-Resistant Tuberculosis (MDR-TB) compared with their non-tuberculosis control, and its association with disease pattern and associated medical comorbidities. Methods: MDR-TB patients (128) and their respective caregivers were interviewed in a treatment unit in Nigeria. Diagnosis of AUD was made using the Structured Clinical Interview for DSM-IV Axis I Disorder, information was obtained on the severity of the TB and associated health problems. Results: prevalence of AUD was (21.9%) and was significantly higher among cases than in controls (2.3%), p = 0.006. Severe TB, OR = 3.33 (1.56-6.83), hematological diseases, OR = 2.34 (1.06-4.33) and HIV/AIDS, OR = 3.01 (1.67-7.01) were the strongest predictors of AUD at 95% CI. Conclusion: AUD was highly prevalent in MDR-TB and was associated with certain medical comorbidities and increased severity of the illness.


Assuntos
Alcoolismo/epidemiologia , Cuidadores/estatística & dados numéricos , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adulto , Alcoolismo/diagnóstico , Estudos de Casos e Controles , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Tuberculose Resistente a Múltiplos Medicamentos/fisiopatologia , Adulto Jovem
6.
Artigo em Russo | MEDLINE | ID: mdl-33244959

RESUMO

OBJECTIVE: To identify characteristics of and possible differences in clinical and electroencephalographic parameters in patients with alcohol dependence with- and without comorbid affective disorders. MATERIALS AND METHODS: Ninety-five patients, including 74 with an established diagnosis of alcohol dependence and 21 with alcohol dependence and affective disorders, were examined. Duration of alcohol dependence and affective disorder (years), number of hospitalizations and suicidal attempts were analyzed as anamnestic data. Hamilton's anxiety and depression scale (HDRS), the Alcohol Use Disorders Identification Test (AUDIT), the General clinical impression scale (CGI-s) were used as psychometric tools. The study of bioelectric activity of the brain was carried out using a 16-channel encephalograph. The background electroencephalogram was recorded, the values of absolute spectral power and coherence of theta, alpha and beta rhythms were analyzed. RESULTS AND CONCLUSION: Patients with comorbidity of alcohol dependence and affective disorders have a significantly higher risk of suicidal behavior, a greater frequency of hospitalizations, higher levels of anxiety compared with patients without affective disorders. Electrophysiological data have shown that patients with comorbidity of alcohol dependence and affective disorders have higher values of spectral power of alpha-rhythm in all parts of the cerebral cortex (except for temporal lobes) and beta-rhythm in the occipital cortex, as well as an increase in interhemispheric coherence in all frequency ranges.


Assuntos
Alcoolismo , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Comorbidade , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Tentativa de Suicídio
7.
PLoS One ; 15(10): e0241268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33108388

RESUMO

In this paper, a total of 20 sites of single nucleotide polymorphisms (SNPs) on the serotonin 3 receptor A gene (HTR3A) and B gene (HTR3B) are used for feature fusion with age, education and marital status information, and the grid search-support vector machine (GS-SVM), the convolutional neural network (CNN) and the convolutional neural network combined with long and short-term memory (CNN-LSTM) are used to classify and discriminate between alcohol-dependent patients (AD) and the non-alcohol-dependent control group. The results show that 19 SNPs combined with academic qualifications have the best discrimination effect. In the GS-SVM, the area under the receiver operating characteristic (ROC) curve (AUC) is 0.87, the AUC of CNN-LSTM is 0.88, and the performance of the CNN model is the best, with an AUC of 0.92. This study shows that the CNN model can more accurately discriminate AD than the SVM to treat patients in time.


Assuntos
Alcoolismo/diagnóstico , Redes Neurais de Computação , Adulto , Fatores Etários , Alcoolismo/genética , Escolaridade , Feminino , Genótipo , Humanos , Modelos Lineares , Masculino , Estado Civil , Pessoa de Meia-Idade , Máquina de Vetores de Suporte , Adulto Jovem
8.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32968030

RESUMO

OBJECTIVES: Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent drinking, which we aimed to address by modeling dynamic changes in drinking throughout adolescence while adjusting for covariates. METHODS: Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over 5 annual follow-ups (mean age = 13.9 until 17.8 years). Regression models were used to determine whether child, parent, and peer factors at baseline (mean age = 12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD at the final follow-up (mean age = 18.8 years). RESULTS: We identified 4 classes: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Having more alcohol-specific household rules reduced risk of early-onset heavy drinking compared with late-onset moderate drinking (relative risk ratio: 0.31; 99.5% confidence interval [CI]: 0.11-0.83), whereas having more substance-using peers increased this risk (relative risk ratio: 3.43; 99.5% CI: 2.10-5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (odds ratio: 7.68; 99.5% CI: 2.41-24.47). CONCLUSIONS: Our study provides evidence that parenting factors and peer influences in early adolescence should be considered to reduce risk of later alcohol-related harm. Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm compared with recommended maximum levels of consumption (late-onset, moderate drinking).


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/etiologia , Consumo de Álcool por Menores/psicologia , Adolescente , Fatores Etários , Alcoolismo/diagnóstico , Austrália/epidemiologia , Intervalos de Confiança , Feminino , Humanos , Estudos Longitudinais , Masculino , Poder Familiar , Pais , Grupo Associado , Análise de Regressão , Fatores de Risco , Fatores Sexuais , Adulto Jovem
9.
Psychiatr Danub ; 32(Suppl 1): 146-149, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890379

RESUMO

BACKGROUND: In Belgium, 82% of the population consumes alcohol occasionally while 10% consume in a way that can be seen as problematic. On a European level, only 8% of the people who can be characterized as having Alcohol Use Disorder (AUD) would have consulted professional assistance in the past year. In this context, the KCE (Belgian Health Care Knowledge Centre) has addressed multiple recommendations to health professionals to reduce the "treatment gap" concerning the patients' care: (1) encourage screening and preventative interventions, (2) promote the acquirement of communicational and relational competences (3) develop collaborations between professionals. The objective of this article is to better understand their functioning. METHOD: We format a non-systematic literature review concerning these recommendations. RESULTS: The implementation of these Brief Interventions programs in primary care is relevant due to the moderately positive impact on the frequency and quantity of alcohol consumption but both the quality of the therapeutic relationship and collaboration with the care network would optimize Brief Interventions. The quality of the therapeutic relationship alone appears to have an impact on therapeutic outcome. CONCLUSION: Training concerning patient-professional relationship is necessary to maximize the effectiveness of BIs.


Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo , Atenção Primária à Saúde , Alcoolismo/diagnóstico , Bélgica , Humanos , Programas de Rastreamento
10.
Psychiatry Res ; 291: 113278, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32763540

RESUMO

Tobacco smoking is highly prevalent in patients with schizophrenia and alcohol dependence. The underlying neurobiology of nicotine addiction is complex. Rewarding effects of nicotine from cigarettes are associated, among others, with mu-opioid receptors encoded by the OPRM1 gene. The aim of the study was to evaluate the association between two OPRM1 gene polymorphisms, rs1799971 and rs510769, and tobacco smoking in Caucasian patients with schizophrenia, alcohol dependence, and healthy control subjects. The study included 1058 Caucasians (277 patients with schizophrenia, 359 patients with alcohol dependence, and 422 healthy control subjects), subdivided according to the nicotine dependence into smokers (i.e. current smokers) and non-smokers. A significant association was found between the GC haplotype (OPRM1 rs1799971 and rs510769) and smoking in healthy controls, but not in patients with schizophrenia and alcohol dependence. A nominal association was detected in all cases/controls, but this significance did not survive the correction for the multiple testing. This is the first study to reveal that nicotine dependence is associated with the GC haplotype of the OPRM1 rs1799971 and rs510769 in all subjects or specifically in healthy controls. These results did not confirm the strong connection between OPRM1 polymorphisms and nicotine dependence in schizophrenia or alcohol dependence.


Assuntos
Alcoolismo/genética , Estudos de Associação Genética/métodos , Haplótipos/genética , Receptores Opioides mu/genética , Esquizofrenia/genética , Adulto , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético/genética , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia
11.
Health Qual Life Outcomes ; 18(1): 276, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787865

RESUMO

BACKGROUND: Personality traits are related with risk of hazardous alcohol use and alcohol dependence. The Substance Use Risk Profile Scale (SURPS) measures personality traits associated with addictive substance abuse. We examined psychometric properties of the SURPS in Lithuanian population. MATERIALS AND METHODS: Two hundred forty-seven participants (mean age 37.22 ± 0.78 years), were recruited from the local community and from an inpatient addiction treatment centre. Internal consistency, stability, factor structure, content validity, and external validity of the SURPS were examined. Hazardous alcohol use was evaluated by Alcohol Use Disorder Identification Test (AUDIT). Alcohol dependence diagnosis was established by International Classification of Diseases - 10 (ICD - 10). We also performed gender analyses for associations of personality traits with alcohol dependence and hazardous use of alcohol. RESULTS: The SURPS scale demonstrated appropriate internal validity, good temporal stability, and adequate criterion validity and construct validity. The SURPS scores of hopelessness, anxiety sensitivity and impulsivity were higher in the alcohol dependence group than in the control group for both males and females. Impulsivity and sensation seeking were associated with hazardous alcohol use and these associations were more prevalent in females. CONCLUSIONS: Lithuanian translation of the SURPS scale was appropriate. The SURPS demonstrated good sensitivity for discriminating on alcohol dependence and was more sensitive for discriminating on hazardous alcohol use for females.


Assuntos
Alcoolismo/diagnóstico , Medição de Risco/normas , Adulto , Alcoolismo/psicologia , Estudos de Casos e Controles , Feminino , Humanos , Lituânia , Masculino , Pessoa de Meia-Idade , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Fatores Sexuais , Inquéritos e Questionários , Traduções , Adulto Jovem
12.
Rev Epidemiol Sante Publique ; 68(4): 215-225, 2020 Aug.
Artigo em Francês | MEDLINE | ID: mdl-32653261

RESUMO

BACKGROUND: The screening of patients who are at-risk drinkers, which means exceeding the thresholds defined by health authorities or associated with a specific situation (taking psychotropic drugs, having an organic pathology, driving a vehicle, drinking during pregnancy), represents a major issue in primary care. Few studies have offered perspective from the patients' standpoint. The main purpose of this study was to describe general practitioners at-risk drinking screening from their patients point of view. The secondary objective was to identify the factors associated with perception of satisfactory general practitioner knowledge about alcohol consumption. METHODS: A quantitative cross-sectional study was launched in 9 general practitioner offices over 6 months. Patients older than 18 were recruited to answer a questionnaire blinded from their general practitioner, indicating the level of their alcohol consumption and their perception regarding their general practitioner's screening methods. Descriptive, univariate and multivariate logistic regression analyses were performed. RESULTS: All in all, 445 patients were analyzed. Sixty-two at-risk drinkers were screened (13.9 %). Most of the patients declared they had not been interviewed about their alcohol consumption by their general practitioner either during initial consultations (86.1 %) or over time (83.3 %). Only 4.2 % of patients had previously initiated discussion about their consumption. Patients were not ashamed to talk about alcohol (99.2 %) and found their general practitioner to be competent on this topic (100 %). In multivariate analysis, independent factors associated with a good general practitioner knowledge about their patients' current consumption were the questions put forward by their general practitioner about alcohol consumption during their first visit (P<0.001) and during subsequent visits (P<0.001). CONCLUSION: This study showed a low general practitioner screening rate of their patients' at-risk drinking. Only a minority of patients, including at-risk drinkers, declared that their general practitioner was aware of their level of alcohol consumption. Screening could be improved by being systematized during initial consultations and regularly scheduled during subsequent visits, especially in at-risk situations.


Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo/diagnóstico , Clínicos Gerais , Programas de Rastreamento , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Alcoolismo/etiologia , Alcoolismo/prevenção & controle , Estudos Transversais , Diagnóstico Precoce , Feminino , Clínicos Gerais/estatística & dados numéricos , Comportamentos de Risco à Saúde , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários
14.
Psychiatry Res ; 290: 113171, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32526516

RESUMO

Little research has been conducted on posttraumatic stress disorder (PTSD) comorbidity among older adults regarding the description of PTSD in the 11th version of the International Classification of Diseases (ICD-11). This study sought to provide evidence of a dimensional model of psychopathology using the 'Hierarchical Taxonomy of Psychopathology' (HiTOP) model as a theoretical framework to explain patterns of ICD-11 PTSD comorbidity. Distinct patterns of ICD-11 PTSD comorbidity among a nationally representative sample (n = 530) of adults aged 60 years and older from the United States were examined using latent class analysis (LCA). Covariates associated with comorbidity classes were assessed through multinomial logistic regression. ICD-11 PTSD was highly comorbid with other psychopathologies. LCA results favoured a two-class solution. Class 1 (71.7%) was characterised by moderate probabilities for major depressive disorder and alcohol use disorder; Class 2 (28.3%) was characterised by a moderate-high probability of general psychopathology and was associated with lower social support, spousal/partner physical abuse, and history of attempted suicide. PTSD was highly comorbid with other disorders among older adults. Distinct patterns of PTSD comorbidity exist among this cohort and these findings can aid clinicians and researchers in understanding and predicting maladaptive responses to trauma and associated psychopathology.


Assuntos
Classificação Internacional de Doenças , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Idoso , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Comorbidade , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Classificação Internacional de Doenças/normas , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Tentativa de Suicídio/psicologia , Estados Unidos/epidemiologia
15.
Psychiatry Res ; 291: 113221, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32562935

RESUMO

A multitude of psychological and social factors likely contribute to the development and maintenance of addictive disorders. As different people develop different addictions, it is important to understand whether psychosocial factors are related differently to different types of addictive disorders. In this study, we examined the unique interaction of personality traits, family environment, and life events in predicting substance (drugs, alcohol) and behavioral (gambling, sex) addictive disorders, among 207 participants suffering from an addictive disorder and 79 controls. Results identified several psychosocial factors, including impulsivity and reported negative life events, that predicted all types of addictive disorders. There was also a unique prediction model for each addiction. Drug and alcohol use disorders were predicted by lower agreeableness and less intellectual-cultural family orientation, with alcohol use disorder further predicted by lower extraversion and higher family organization. Gambling disorder was predicted by a family with lower intellectual-cultural orientation and higher organization and control, whereas compulsive sexual behavior was predicted by lower extraversion and agreeableness and higher neuroticism, and by higher family control. These findings suggest that the complex interplay among psychosocial factors is manifested differently across addictive disorders and may thus have important implications for research, prevention, and intervention.


Assuntos
Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Autorrelato , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Alcoolismo/diagnóstico , Alcoolismo/psicologia , Comportamento Aditivo/diagnóstico , Feminino , Jogo de Azar/diagnóstico , Humanos , Comportamento Impulsivo/fisiologia , Masculino , Neuroticismo/fisiologia , Valor Preditivo dos Testes , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
16.
Rev Assoc Med Bras (1992) ; 66(3): 307-313, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520150

RESUMO

OBJECTIVE: To identify or use alcohol abuse and abuse in the IAMSPE elderly, through the application of AUDIT, socioeconomic characterization of the elderly, and problems associated with drinking and weight, if there is a relationship between depression and alcohol abuse. METHODS: This is a cross-sectional, exploratory, and descriptive study with a quantitative approach. One hundred elderly patients were interviewed to apply a socioeconomic form and to assess alcohol consumption from AUDIT. RESULTS: correlation between alcohol consumption and female gender (p = 0.021). Most of the participants were between 60 and 79 years old, were female, had a partner, had completed elementary school, had income and selected house, were retired and unemployed. CONCLUSION: In the present study, we found no correlation between alcohol abuse and depression; Only one correlation was found between male gender and higher alcohol abuse. However, a significant prevalence of moderate use of high alcohol was found (3.9% in women and 21.7% in men), i.e., it poses a risk to the health of the elderly.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Alcoolismo/epidemiologia , Fatores Etários , Idoso , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Alcoolismo/diagnóstico , Estudos Transversais , Transtorno Depressivo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários
17.
J Stud Alcohol Drugs ; 81(2): 125-134, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32359041

RESUMO

OBJECTIVE: Most studies linking physical victimization and substance use have focused on concurrent or temporally proximal associations, making it unclear whether physical victimization has a sustained impact on substance use problems. We examined the long-term associations between adolescent physical victimization and symptoms of substance use disorders in adulthood, controlling for intermediating victimization during young adulthood and several control variables. METHOD: Data were obtained from the Monitoring the Future Study (N = 5,291). Women and men were recruited around age 18 and surveyed biennially through age 30, and again at 35. Past-year physical victimization (threatened physical assaults, injurious assaults) was measured regularly from age 18 to 30. Alcohol and cannabis use symptoms (e.g., withdrawal, tolerance) were assessed at age 35. Controls were measured in adolescence (e.g., prior substance use) and young adulthood (e.g., marriage). Interactions examined whether associations varied by sex. RESULTS: When we controlled for adolescent substance use, adolescents who were threatened with injury or who sustained physical injuries as a result of violence had more alcohol use symptoms at age 35 than nonvictims. However, when victimization during young adulthood was statistically accounted for, only victimization during young adulthood was associated with age-35 alcohol use symptoms. The effects of young adult victimization, but not adolescent victimization, were stronger for women. Victimization was mostly unrelated to age-35 cannabis use symptoms. CONCLUSIONS: Adolescents who are threatened with physical assaults or injured by physical assaults have significantly more alcohol use symptoms in their mid-30s than nonvictimized adolescents, but these associations are completely explained by subsequent victimization during young adulthood.


Assuntos
Comportamento do Adolescente/psicologia , Alcoolismo/psicologia , Vítimas de Crime/psicologia , Abuso de Maconha/psicologia , Abuso Físico/psicologia , Abuso Físico/tendências , Adolescente , Adulto , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Abuso de Maconha/diagnóstico , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
18.
Compr Psychiatry ; 101: 152183, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32473383

RESUMO

BACKGROUND AND AIMS: The importance of personality characteristics in the diagnosis and treatment of gambling disorder (GD) and alcohol use disorder (AUD) is often highlighted in scientific literature. This study aimed to test predictions about the associations of temperament and character in chronic AUD patients with comorbid GD symptoms and without them. METHODS: Chronic AUD patients enrolled from an inpatient clinic were divided in two groups based on cluster analysis, AUD patients with (AUD + GD group: n = 30) and without (AUD group: n = 68) GD symptoms. Severity of GD symptoms and personality dimensions (Cloninger's Temperament and Character Inventory Revised, TCI-R) were assessed. Associations of tested variables were analysed with analysis of covariance, one-sample and independent sample t-tests. RESULTS: GD symptoms proved to be a clustering factor in terms of personality, where AUD + GD group expressed a more maladaptive personality profile. Compared to Hungarian normative TCI-R scores, both patient groups showed elevated levels of Harm Avoidance and Novelty Seeking with lower scores of Self-directedness, while the AUD + GD group scored lower on Persistence and Cooperation as well. The AUD + GD group reported significantly higher levels of Harm Avoidance, with lower scores of Reward Dependence compared to the AUD group. DISCUSSION: Comorbid GD symptom severity is an important factor in chronic AUD, where AUD patients with comorbid GD symptoms exhibited a more maladaptive personality constellation than singular AUD patients. These emphasize the need of special attention for comorbid GD symptoms in AUD, since treatment recommendations and prognosis for them may also differ.


Assuntos
Alcoolismo , Jogo de Azar , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Caráter , Jogo de Azar/epidemiologia , Humanos , Personalidade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade , Temperamento
19.
PLoS One ; 15(4): e0231022, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32255781

RESUMO

This study identifies how to screen for harmful alcohol use among gender minority (e.g., transgender and gender-expansive) people using brief screening methods and identifies which screening methods perform best among gender-expansive, transfeminine, and transmasculine subgroups, as screening recommendations are not currently available. Using 2018 Annual Questionnaire data from The PRIDE Study, area under the curve (AUC) values were compared to identify which screening methods ("4 or more" or "5 or more" drinks on one occasion in the past year, or one or more items from the Alcohol Use Disorders Identification Test [AUDIT]) best predicted (i) harmful alcohol use and (ii) one or more past year alcohol dependence symptoms or consequences. Among 1892 participants, "5 or more" drinks on one occasion (AUC ranges: 0.82-0.86) performed better than "4 or more" drinks (AUC ranges: 0.78-0.81) in predicting harmful drinking. The screening methods "4 or more" drinks, "5 or more" drinks, and the consumption items of the AUDIT (AUDIT-C) using a cutoff score of 3 all maximized sensitivity and specificity to predict alcohol dependence symptoms or consequences in gender minority people overall (AUC: 0.77-0.78). Screening for "5 or more" drinks on one occasion within the past year performed as well as or better than other screening methods to detect both harmful drinking and alcohol dependence-related symptoms or consequences. This single-item screening method can identify if more extensive alcohol use assessment is warranted with gender minority people.


Assuntos
Alcoolismo/diagnóstico , Programas de Rastreamento/métodos , Minorias Sexuais e de Gênero/psicologia , Adulto , Área Sob a Curva , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Minorias Sexuais e de Gênero/estatística & dados numéricos , Inquéritos e Questionários
20.
Rev Esc Enferm USP ; 54: e03553, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32236348

RESUMO

OBJECTIVE: To perform criterion validation of the Key Question in Portuguese for screening at-risk alcohol use among users of Primary Healthcare services. METHOD: This is a psychometric study conducted with users of a Primary Healthcare service located in the city of São Paulo, Brazil. Participants responded to the Key Question which was applied in conjunction with the Alcohol Use Disorders Identification Test-C for concurrent validation and measurement of psychometric properties. RESULTS: The sample consisted of 518 users. The Key Question presented 59% specificity and 99% sensitivity with respect to the Alcohol Use Disorders Identification Test-C in the general population. The accuracy was 81% in relation to this instrument. There was no influence of sociodemographic variables such as gender on the psychometric properties of the Key Question. CONCLUSION: The results indicate that the Key Question in Portuguese presented satisfactory psychometric qualities and suggest that its Portuguese version is as efficient for screening at-risk alcohol use as its reference standard, which subsidizes its use in Primary Healthcare.


Assuntos
Alcoolismo/diagnóstico , Programas de Rastreamento/métodos , Atenção Primária à Saúde , Inquéritos e Questionários , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Sensibilidade e Especificidade
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