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1.
Psychiatr Danub ; 32(Suppl 2): 273-280, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32970647

RESUMO

BACKGROUND: Researches to date had indicated that socioeconomic status is a strong predictor of health behavior but also it has two-way effect with alcohol use disorder. This study examines social factors and their impact on alcohol use disorder and places individual alcohol use in the context of the status and conditions in which people live. To determine the distribution and characteristics of social factor in patients with alcohol use disorder (AUD) in the area of the Tuzla Canton (TC) in the period 01.01.2011 - 31.12.2015, in relation to: age, sex, marital status, level of education, municipality of residence, home ownership status, family structure, employment status, and monthly monetary income. SUBJECTS AND METHODS: Retrospective research was conducted using a systematic sample of 1863 patients with AUD, using documentation from the Psychiatry clinic of the University Clinical Centre (UCC) and the protocols of Health Centres. RESULTS: The sample was composed 1808 (97.05%) men and 55 (2.95%) women; the ratio of men to women was 33:1. the ages of the patients in the sample were 54.4±9.79 years - men 54.49±9.74 years; women 51.45±10.94 years. Most of the men in the sample were married (71.1%) and most of the women were widowed (54.5%). The largest number of patients had elementary school education (66.5%), were unemployed (56.8%), with a monthly monetary income less than 300 convertible marks (KM) (62.2%), owned their own home (78.2%), and 36.1% of them lived with a partner or their own children. CONCLUSIONS: There are significantly more men being treated for AUD; most of them are married, and most of the women are widowed. The largest number of patients treated for AUD have elementary school education, are unemployed, have monthly monetary income less than 300 km, own their own house, and a little more than one third of them lived with their partner or their own children.


Assuntos
Alcoolismo/epidemiologia , Alcoolismo/psicologia , Adulto , Bósnia e Herzegóvina/epidemiologia , Emprego , Feminino , Humanos , Masculino , Casamento , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Socioeconômicos
2.
Psychiatr Danub ; 32(Suppl 2): 281-289, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32970648

RESUMO

The different personalities of alcoholics are expressed in the way they manifest certain traits of their personality. In addition to knowing the general and common characteristics of alcoholics, it is even more important for clinical practice to know the differences between them, thus allowing a personalized approach to each patient, as a unique personality. The division of the personalities of alcoholics may be viewed through the prism of seven perspectives: the disease perspective, the dimensional perspective, the cognitive-anxiety perspective, the behavioral perspective, the spiritual/transcendent perspective, the narrative and the systemic perspective. Each of these perspectives more clearly represents part of the personality of the alcoholic; together they give a clearer picture of the problem and accordingly offer different treatment options.


Assuntos
Alcoólicos/psicologia , Alcoolismo/psicologia , Personalidade , Ansiedade , Humanos
3.
J Addict Med ; 14(5): e264-e266, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32852316

RESUMO

INTRODUCTION: Patients with substance use disorder may be particularly vulnerable to withdrawal-related complications during the SARS-CoV-2 (COVID-19) pandemic. Limited availability of alcohol and other substances coupled with decreased accessibility to substance use treatment poses a substantial risk to this population. Isopropanol, the active ingredient in rubbing alcohol, is widely available; thus, it may be used in times of scarcity. CASE REPORT: We present a case of intentional isopropanol ingestion used as an ethanol surrogate within the setting of the COVID-19 pandemic. CONCLUSIONS: Toxic alcohol ingestions are imperative considerations on the differential for the intoxicated patient particularly during resource-limited times.


Assuntos
2-Propanol/administração & dosagem , Alcoolismo/psicologia , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Automedicação/psicologia , 2-Propanol/efeitos adversos , Administração Oral , Adulto , Betacoronavirus , Humanos , Masculino , Pandemias
4.
Cerebrovasc Dis Extra ; 10(2): 94-104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32854098

RESUMO

BACKGROUND AND PURPOSE: Rates of depression after ischemic stroke (IS) and myocardial infarction (MI) are significantly higher than in the general population and associated with morbidity and mortality. There is a lack of nationally representative data comparing depression and suicide attempt (SA) after these distinct ischemic vascular events. METHODS: The 2013 Nationwide Readmissions Database contains >14 million US admissions for all payers and the uninsured. Using International Classification of Disease, 9th Revision, Clinical Modification Codes, we identified index admission with IS (n = 434,495) or MI (n = 539,550) and readmission for depression or SA. We calculated weighted frequencies of readmission. We performed adjusted Cox regression to calculate hazard ratio (HR) for readmission for depression and SA up to 1 year following IS versus MI. Analyses were stratified by discharge home versus elsewhere. RESULTS: Weighted depression readmission rates were higher at 30, 60, and 90 days in patients with IS versus MI (0.04%, 0.09%, 0.12% vs. 0.03%, 0.05%, 0.07%, respectively). There was no significant difference in SA readmissions between groups. The adjusted HR for readmission due to depression was 1.49 for IS versus MI (95% CI 1.25-1.79, p < 0.0001). History of depression (HR 3.70 [3.07-4.46]), alcoholism (2.04 [1.34-3.09]), and smoking (1.38 [1.15-1.64]) were associated with increased risk of depression readmission. Age >70 years (0.46 [0.37-0.56]) and discharge home (0.69 [0.57-0.83]) were associated with reduced hazards of readmission due to depression. CONCLUSIONS: IS was associated with greater hazard of readmission due to depression compared to MI. Patients with a history of depression, smoking, and alcoholism were more likely to be readmitted with depression, while advanced age and discharge home were protective. It is unclear to what extent differences in type of ischemic tissue damage and disability contribute, and further investigation is warranted.


Assuntos
Afeto , Isquemia Encefálica/psicologia , Depressão/psicologia , Infarto do Miocárdio/psicologia , Readmissão do Paciente , Acidente Vascular Cerebral/psicologia , Tentativa de Suicídio , Fatores Etários , Idoso , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/epidemiologia , Bases de Dados Factuais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Feminino , Humanos , Masculino , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Alta do Paciente , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fumar/psicologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Fatores de Tempo , Estados Unidos/epidemiologia
6.
Public Health ; 185: 61-69, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32570147

RESUMO

OBJECTIVES: Alcohol is one of the most used and abused psychoactive substances by adolescents. We investigated influencing factors of risky and problem drinking in Korean female adolescents. STUDY DESIGN: The study design used is a cross-sectional modeling. METHODS: We used data from the 13th Korean Youth Risk Behavior Web-based Survey (KYRBS) conducted in 2017. KYRBS data were obtained from a stratified, multistage, clustered sample. Risky drinking was binge drinking and problem drinking was drinking with several conflicts association with alcohol consumption. RESULTS: Among 62,276 participants, the rates of current, risky, and problem drinking among all participants were 16.1%, 8.3%, and 6.1%, respectively. Although all of these rates were higher in males, risky and problem drinking rates among current female drinkers were higher than those of males (55.4 vs 48.5%, 38.9 vs 37.2%, respectively). Problem drinking was most strongly associated with risky drinking (adjusted odds ratio: 17.53 [95% confidence interval: 14.63-21.00]), similarly, risky drinking was most strongly associated with problem drinking in female current drinkers (17.76 [14.84-21.27]). Current smoking was the second strongest risk factor for risky and problem drinking in females (5.22 [3.92-6.95] and 2.93 [2.21-3.89], respectively). CONCLUSION: Many female adolescents in Korea drink alcohol in an unhealthy manner. The female risky and problem drinking rates among current drinkers were higher than those of males. Risky drinking and problem drinking was most significant influencing factor among females, reciprocally. Public education on abstinence in female adolescents is warranted.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Saúde Mental , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , República da Coreia , Fatores de Risco , Assunção de Riscos , Inquéritos e Questionários
8.
Aust N Z J Public Health ; 44(3): 201-207, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32364653

RESUMO

OBJECTIVE: To investigate factors associated with alcohol use in adolescents, with the focus on analysing the comorbidities between single-occasion harmful-drinking episodes with mental health issues and risk behaviours. METHODS: This study used data from the Young Minds Matter survey, designed to inform on the prevalence of the seven most common mental health disorders of children and adolescents. Logistic regression modelling was used to assess the odds of harmful drinking behaviour in young people aged 13-17 years in Australia. RESULTS: We found a strong association between single-occasion harmful drinking and mental health issues, which hold after controlling for sociodemographic characteristics. Young people with severe mental health issues within the past year were four times more likely to have been drinking at harmful levels in the past 30 days. CONCLUSIONS: Alcohol use can have adverse health effects among children and adolescents. Research has found a bidirectional association between alcohol use and mental health conditions where the presence of one issue almost doubles the risk of having the other issue. Implications for public health: The comorbidity between these issues suggests the need for strategies to integrate policies addressing mental health and alcohol use disorders in young people.


Assuntos
Comportamento do Adolescente/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Assunção de Riscos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Austrália/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Prevalência , Inquéritos e Questionários
9.
Aust N Z J Public Health ; 44(3): 186-192, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32459387

RESUMO

OBJECTIVE: To examine whether baseline measures of stress, life satisfaction, depression and alcohol use predict making or sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers. METHODS: We analysed data from the nationally representative quota sample of 1,549 Aboriginal and Torres Strait Islander adults who reported smoking at least weekly in the Talking About The Smokes baseline survey (April 2012-October 2013) and the 759 who completed a follow-up survey a year later (August 2013-August 2014). RESULTS: More smokers who reported negative life satisfaction, feeling depressed, higher stress or drinking heavily less often than once a week at baseline made a quit attempt between the baseline and follow-up surveys. In contrast, of these smokers who had made quit attempts between surveys, more who reported higher stress were able to sustain abstinence for at least one month; other associations were inconclusive. Conclusions and implications for public health: Health staff and Aboriginal and Torres Strait Islander smokers need not see being more stressed as an obstacle to quitting among Aboriginal and Torres Strait Islander people. Health staff should emphasise the benefits to mental health that come with successfully quitting smoking.


Assuntos
Alcoolismo/psicologia , Depressão/psicologia , Satisfação Pessoal , Fumantes/psicologia , Fumar/efeitos adversos , Estresse Psicológico/psicologia , Adulto , Alcoolismo/etnologia , Austrália/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Depressão/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Fumar/epidemiologia , Fumar/etnologia , Abandono do Hábito de Fumar/etnologia , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Estresse Psicológico/etnologia
10.
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
11.
J Stud Alcohol Drugs ; 81(2): 152-163, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32359044

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the costs and cost-effectiveness of two treatments for 101 alcohol use disorder patients and their intimate partners--group behavioral couples' therapy plus individual-based treatment (G-BCT), or standard behavioral couples' therapy plus individual-based treatment (S-BCT). METHOD: We estimated the per-patient cost of each intervention using a microcosting approach that allowed us to estimate costs of specific components in each intervention as well as the overall total costs. Using simple means analysis and multiple regression models, we estimated the incremental effectiveness of G-BCT relative to S-BCT. Immediately after treatment and 12 months after treatment, we computed incremental cost-effectiveness ratios (ICER) and cost-effectiveness acceptability curves for percentage days abstinent, adverse consequences of alcohol and drugs, and overall relationship functioning. RESULTS: The average per-patient cost of delivering G-BCT was $674, significantly less than the cost of S-BCT ($831). However, 12 months after treatment, S-BCT participants performed better on all outcomes compared with those in G-BCT, and the calculated ICER moving from G-BCT to S-BCT ranged from $10 to $12 across these outcomes. The current findings indicated that, except at very low willingness-to-pay values, S-BCT is a cost-effective option relative to G-BCT when considering 12-month posttreatment outcomes. CONCLUSIONS: As expected, G-BCT was delivered at a lower cost per patient than S-BCT; however, S-BCT performed better over time on the clinical outcomes studied. These economic findings indicate that alcohol use disorder treatment providers should seriously consider S-BCT over G-BCT when deciding what format to use in behavioral couples' therapy.


Assuntos
Alcoolismo/economia , Alcoolismo/terapia , Terapia Comportamental/economia , Análise Custo-Benefício , Terapia de Casal/economia , Parceiros Sexuais , Adulto , Alcoolismo/psicologia , Terapia Comportamental/métodos , Análise Custo-Benefício/métodos , Terapia de Casal/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia de Grupo/economia , Psicoterapia de Grupo/métodos , Parceiros Sexuais/psicologia
12.
BMC Public Health ; 20(1): 709, 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-32423398

RESUMO

BACKGROUND: Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of the development of alcohol related problems among individuals with elevated social anxiety. We investigated the moderation effect of difficulties in emotion regulation on the relationship between symptoms of social anxiety, coping and conformity motives and alcohol related problems. METHODS: In a sample of university students (N = 647) in South Korea, we examined whether cognitive (fear of negative evaluation), behavioral (social avoidance), and physiological symptoms (concerns over physiological symptoms) of social anxiety affect alcohol related problems with the mediation of coping and conformity motives. Furthermore, difficulties in emotion regulation were hypothesized to moderate each mediational path. RESULTS: Results showed that the fear of negative evaluation and concerns over physiological symptoms were associated with alcohol related problems with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by difficulties in emotion regulation. CONCLUSIONS: Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of social anxiety were related to alcohol related problems. In addition, individuals with high levels of difficulties in emotion regulation were prone to exhibit more alcohol related problems.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Ansiedade/psicologia , Regulação Emocional , Estudantes/psicologia , Adaptação Psicológica , Alcoolismo/psicologia , Medo , Feminino , Humanos , Masculino , Motivação , Negociação , República da Coreia , Comportamento Social , Universidades , Adulto Jovem
13.
PLoS One ; 15(4): e0231647, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32302340

RESUMO

Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.


Assuntos
Alcoolismo/psicologia , Depressão/psicologia , Comportamento de Busca de Ajuda , Relações Interpessoais , Suicídio/psicologia , Adulto , Alcoolismo/epidemiologia , Comorbidade , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Autorrelato/estatística & dados numéricos , Suicídio/prevenção & controle
14.
PLoS One ; 15(4): e0231158, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32255802

RESUMO

BACKGROUND: Large scale efforts to expand access to mental healthcare in low- and middle-income countries have focused on integrating mental health services into primary care settings using a task sharing approach delivered by non-specialist health workers. Given the link between mental disorders and risk of suicide mortality, treating common mental disorders using this approach may be a key strategy to reducing suicidality. METHODS AND FINDINGS: The Programme for Improving Mental Health Care (PRIME) evaluated mental health services for common mental disorders delivered by non-specialist health workers at ten primary care facilities in Chitwan, Nepal from 2014 to 2016. In this paper, we present the indirect impact of treatment on suicidality, as measured by suicidal ideation, among treatment and comparison cohorts for depression and AUD using multilevel logistic regression. Patients in the treatment cohort for depression had a greater reduction in ideation relative to those in the comparison cohort from baseline to three months (OR = 0.16, 95% CI: 0.05-0.59; p = 0.01) and twelve months (OR = 0.31, 95% CI: 0.08-1.12; p = 0.07), with a significant effect of treatment over time (p = 0.02). Among the AUD cohorts, there were no significant differences between treatment and comparison cohorts in the change in ideation from baseline to three months (OR = 0.64, 95% CI: 0.07-6.26; p = 0.70) or twelve months (OR = 0.46, 95% CI: 0.06-3.27; p = 0.44), and there was no effect of treatment over time (p = 0.72). CONCLUSION: The results provide evidence integrated mental health services for depression benefit patients by accelerating the rate at which suicidal ideation naturally abates over time. Integrated services do not appear to impact ideation among people with AUD, though baseline levels of ideation were much lower than for those with depression and may have led to floor effects. The findings highlight the importance of addressing suicidality as a specific target-rather than an indirect effect-of treatment in community-based mental healthcare programs.


Assuntos
Alcoolismo/terapia , Serviços Comunitários de Saúde Mental/organização & administração , Depressão/terapia , Atenção Primária à Saúde/organização & administração , Suicídio/estatística & dados numéricos , Adulto , Alcoolismo/diagnóstico , Alcoolismo/psicologia , Participação da Comunidade , Depressão/diagnóstico , Depressão/psicologia , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Suicídio/prevenção & controle
15.
PLoS Med ; 17(4): e1003056, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32302308

RESUMO

BACKGROUND: Both intimate partner violence (IPV) and alcohol misuse are highly prevalent, and partner alcohol misuse is a significant contributor to women's risk for IPV. There are few evidence-based interventions to address these problems in low- and middle-income countries (LMICs). We evaluated the effectiveness of an evidence-based, multi-problem, flexible, transdiagnostic intervention, the Common Elements Treatment Approach (CETA) in reducing (a) women's experience of IPV and (b) their male partner's alcohol misuse among couples in urban Zambia. METHODS AND FINDINGS: This was a single-blind, parallel-assignment randomized controlled trial in Lusaka, Zambia. Women who reported moderate or higher levels of IPV and their male partners with hazardous alcohol use were enrolled as a couple and randomized to CETA or treatment as usual plus safety checks (TAU-Plus). The primary outcome, IPV, was assessed by the Severity of Violence Against Women Scale (SVAWS) physical/sexual violence subscale, and the secondary outcome, male alcohol misuse, by the Alcohol Use Disorders Identification Test (AUDIT). Assessors were blinded. Analyses were intent-to-treat. Primary outcome assessments were planned at post-treatment, 12 months post-baseline, and 24 months post-baseline. Enrollment was conducted between May 23, 2016, and December 17, 2016. In total, 123 couples were randomized to CETA, 125 to TAU-Plus. The majority of female (66%) and a plurality of male (48%) participants were between 18 and 35 years of age. Mean reduction in IPV (via SVAWS subscale score) at 12 months post-baseline was statistically significantly greater among women who received CETA compared to women who received TAU-Plus (-8.2, 95% CI -14.9 to -1.5, p = 0.02, Cohen's d effect size = 0.49). Similarly, mean reduction in AUDIT score at 12 months post-baseline was statistically significantly greater among men who received CETA compared to men who received TAU (-4.5, 95% CI -6.9 to -2.2, p < 0.001, Cohen's d effect size = 0.43). The Data and Safety Monitoring Board recommended the trial be stopped early due to treatment effectiveness following the 12-month post-baseline assessment, and CETA was offered to control participants. Limitations of the trial included the lack of a true control condition (i.e., that received no intervention), self-reported outcomes that may be subject to social desirability bias, and low statistical power for secondary IPV outcomes. CONCLUSIONS: Results showed that CETA was more effective than TAU-Plus in reducing IPV and hazardous alcohol use among high-risk couples in Zambia. Future research and programming should include tertiary prevention approaches to IPV, such as CETA, rather than offering only community mobilization and primary prevention. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov (NCT02790827).


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/terapia , Terapia Cognitivo-Comportamental/métodos , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Alcoolismo/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem , Zâmbia/epidemiologia
16.
Psychopharmacology (Berl) ; 237(6): 1691-1707, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32285159

RESUMO

RATIONALE: Compared to the general population, adult Attention-Deficit / Hyperactivity Disorder (ADHD) is more prevalent in patients with Alcohol Use Disorder (AUD). Impaired behavioral inhibition is a common characteristic in both ADHD and AUD. Relapse risk is increased in patients with AUD and comorbid, untreated ADHD and in AUD patients with increased neural cue-reactivity. OBJECTIVES: In this study, we examined the interaction between neural correlates of behavioral inhibition and alcohol cue-reactivity with a hybrid imaging task. METHODS: Out of 69 adult study participants, we included n = 49 in our final analyses: Individuals had a diagnosis of either AUD (n = 13), ADHD (n = 14) or both (n = 5), or were healthy controls (HC; n = 17). The functional magnetic resonance imaging paradigm aimed to examine the combined effects of both an interference-inhibition task ("Simon-task") and an alcohol cue-reactivity task. Instead of segregating by diagnostic group, we pursued a dimensional approach in which we compared measures of AUD and ADHD severity, as well as the interaction of both, using multiple regression analyses. RESULTS: The four groups did not differ on the behavioral level on either the inhibition task or the alcohol cue-reactivity task. However, brain activation in frontal control and reward-related regions during completion of the combined tasks were related to ADHD and AUD severity (symptom load). During presentation of both alcohol cues and the inhibition task, participants with higher AUD and ADHD symptom load exhibited greater BOLD (blood oxygen level dependent) responses in subcortical reward-related regions. CONCLUSIONS: Our findings support the hypothesis that ADHD additionally diminishes inhibition ability in individuals with AUD. This may increase relapse risk when confronted with alcohol cues. Further, it is crucial for patients with comorbid AUD and ADHD to take into account not only reduced cognitive control over behavioral inhibition but also simultaneously heightened alcohol cue-reactivity.


Assuntos
Alcoolismo/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Sinais (Psicologia) , Inibição Psicológica , Rede Nervosa/diagnóstico por imagem , Adulto , Alcoolismo/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Condicionamento Psicológico/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa/métodos , Recompensa , Adulto Jovem
17.
AIDS Behav ; 24(11): 3083-3092, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32306211

RESUMO

African-American (AA) women are overrepresented among women with HIV (WWH). In the United States, psychiatric disorders are prevalent among WWH and associated with adverse outcomes. However, little research has examined psychiatric disorders among AA WWH. 315 AA women who were hazardous/heavy drinkers (HD) or moderate/non-drinkers (ND) were recruited from an HIV clinic in a study on alcohol use disorders. We compared sample prevalence of Axis-1 psychiatric diagnoses using the Structured Clinical Interview for DSM-IV with those from general population AA women in the National Comorbidity Survey-Replication (NCS-R). While 29.9% of general population AA women had any lifetime disorder, 66.9% of HD and 62.4% of ND WWH met criteria for a lifetime Axis-1 disorder. Specifically, lifetime PTSD and lifetime MDD were over threefold higher; current PTSD and current MDD respectively were 11-fold and threefold higher. PTSD was the most frequent comorbid diagnosis. HD and ND WWH did not differ in prevalence of psychiatric diagnoses despite significantly higher rates of substance use among HD women. Diagnostic evaluation and intervention for psychiatric disorders should be a priority in HIV medical care settings to improve health outcomes. Interventions should be tailored to address the particular stressors, challenges, and resiliencies among AA WWH.


Assuntos
Afro-Americanos/psicologia , Alcoolismo/psicologia , Infecções por HIV/tratamento farmacológico , Transtornos Mentais/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Alcoolismo/epidemiologia , Fármacos Anti-HIV , Baltimore/epidemiologia , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
18.
Compr Psychiatry ; 100: 152175, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32345436

RESUMO

BACKGROUND: Multiple developmental risk factors for Substance Use Disorders (SUDs) during young adulthood have been identified. In this investigation, we examined the impact of homelessness, foster care, and adverse childhood experiences (ACEs) prior to 12th grade on the development of three common SUDs during young adulthood-Alcohol Use Disorder (AUD), Tobacco Use Disorder (TUD) and Cannabis Use Disorder (CUD). Our hypothesis was that while both homelessness and ACEs are significant risk factors for young adult SUDs, foster care involvement might convey protection. METHODS: Using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health, measures of ACEs were derived from the CDC-Kaiser ACE study, and DSM-V SUD diagnoses were derived from items originally based on DSM-IV. SUD diagnoses were binned into "mild", "moderate", and "severe" groupings. Survey-based logistic models were used to estimate risks of SUDs while controlling for demographics. RESULTS: The results suggest that the experience of homelessness prior to 12th grade in addition to ACEs were significantly associated with the development in young adulthood of the most severe forms of AUD and TUD and all severity levels of CUD. Foster care was not associated with either risk or protection from SUDs. CONCLUSIONS: The experience of homelessness during development may be viewed as another detrimental ACE that is a risk factor for the most common SUDs in young adulthood. Given the magnitude of the current epidemic of homelessness in the U.S., these results should raise substantial concern.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Alcoolismo/epidemiologia , Criança Acolhida , Pessoas em Situação de Rua/estatística & dados numéricos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabagismo/epidemiologia , Adolescente , Adulto , Alcoolismo/psicologia , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Estudos Longitudinais , Masculino , Abuso de Maconha/psicologia , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/psicologia , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Tabagismo/psicologia , Adulto Jovem
19.
Clin Ter ; 171(2): e120-e129, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32141483

RESUMO

Alcohol use disorders (AUD) are among the most common and undertreated mental disorders in developed countries. The co-occurrence of psychiatric comorbidity and AUD has already been well documented. Moreover, alexithymia was found associated with heavy drinking and alcohol dependence. A large part of AUD individuals, between 45 and 67%, have been identified as alexithymics. Both psychiatric comorbidity and alexithymia can negatively impact the course of recovery from alcohol. Alcohol consumption has also been shown to significantly influence autonomic responses. Chronic use of alcohol may induce significant changes in heart rate variability, respiratory frequency, electrodermal activity and skin temperature. To date, only a few studies have comprehensively investigated the comorbidity of alexithymia in AUD individuals with dual diagnosis. Thus, the aim and also the novelty of the present investigation were to disclose in individuals with AUD the emotional and cognitive stress responses to selected physiological parameters measured by ProComp5 Infiniti™ encoder in AUD patients suffering alexithymia with or without concomitant dual diagnosis. Quite interestingly, in AUD subjects with concomitant dual diagnosis we found that the alexithymia elevated skin temperature, heart rate variability and decreased respiratory frequency. Alexithymia, if associated with the dual diagnosis condition in AUD individuals, can be considered as a further vulnerability factor to stressing factors, impacting psychosomatic processing and inducing alterations in physiological parameters. In this paper, we discuss the implications of these findings in the early treatment of alexithymic AUD individuals.


Assuntos
Sintomas Afetivos/psicologia , Alcoolismo/psicologia , Adulto , Sintomas Afetivos/complicações , Consumo de Bebidas Alcoólicas , Alcoolismo/complicações , Comorbidade , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
South Med J ; 113(3): 104-110, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32123923

RESUMO

OBJECTIVES: Personal health behavior can influence the academic development of healthcare students. This study was designed to evaluate the personal health behavior, including sleep time, of healthcare students at a large health sciences center. METHODS: An anonymous online survey based on standardized questionnaires about sleep, insomnia, depression, alcohol use, and exercise was sent to all of the healthcare students (including medical, nursing, pharmacy, graduate biomedical science, and allied health students) in the Texas Tech University Health Sciences Center graduate education programs in Lubbock. RESULTS: In total, 412 students replied to this survey. Their mean sleep duration during the weekday was 7.5 ± 1.2 hours; 16.5% were short sleepers (<7 hours) during weekdays; 33% of the students woke up "feeling tired or worn out" >15 days during the last month. Many students were either moderately or severely bothered by "the lack of energy" because of poor sleep, and 56.6% of students rated their sleep as either fair or poor. Approximately 35% of students had drinking patterns that qualified as hazardous drinking, 6.3% of students smoked, and 23% of students did not do even mild exercise during the week. Eighty-nine percent of students reported stress in their life, including family stress, job stress, financial stress, legal stress, and other stress. Thirty-five percent of students considered their health as either poor or fair. Approximately 50% of students did not expect any change in their situation during the next 3 to 6 months. CONCLUSIONS: Although most healthcare students report adequate sleep times, more than half of them rate their sleep as fair or poor. In addition, some have poor health habits, including excessive alcohol use. Health science centers should introduce programs to promote healthy behaviors and reduce stress in healthcare students.


Assuntos
Comportamentos Relacionados com a Saúde , Estudantes/psicologia , Adulto , Idoso , Alcoolismo/etiologia , Alcoolismo/psicologia , Depressão/etiologia , Depressão/psicologia , Exercício Físico/psicologia , Feminino , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Sono , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Texas , Universidades/organização & administração , Universidades/estatística & dados numéricos
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