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1.
J Abnorm Psychol ; 128(8): 813-822, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31657596

RESUMO

Between-subjects literature has established that trait-like negative mood predicts coping motives, which predict alcohol-related problems and that trait-like positive mood predicts mood enhancement motives, which then predict alcohol consumption. However, there is considerable within-person variation in drinking motives, and the relationship between mood, motives, and alcohol outcomes must be more closely examined at a daily level. The current study used ecological momentary assessment (EMA) to measure mood, motives, alcohol use, and alcohol consequences in 101 college drinkers over a 15-day period. At the between-subjects level, positive mood predicted enhancement motives, which in turn predicted alcohol consumption and consequences. Negative mood predicted coping motives, which were associated with only alcohol-related consequences. At the within-subjects level, daily anxious and depressed mood were associated with endorsing coping motives, but coping motives were not associated with alcohol consumption or problems. Positive mood was associated with enhancement motives, which was associated with both daily alcohol consumption and problems. These results corroborate previous findings that enhancement motives are most predictive of outcomes in the college population and highlight the importance of considering within-subject variance in drinking motives. The relationships between mood, motives, and alcohol outcomes differ when examined as between-subjects versus within-subject constructs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Afeto/fisiologia , Consumo de Álcool na Faculdade/psicologia , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Relações Interpessoais , Motivação/fisiologia , Adolescente , Adulto , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Estudantes/psicologia , Universidades , Adulto Jovem
2.
Adv Exp Med Biol ; 1164: 73-87, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576541

RESUMO

The purpose of this review is to briefly summarize the roles of alcohol (ethanol) and related compounds in promoting cancer and inflammatory injury in many tissues. Long-term chronic heavy alcohol exposure is known to increase the chances of inflammation, oxidative DNA damage, and cancer development in many organs. The rates of alcohol-mediated organ damage and cancer risks are significantly elevated in the presence of co-morbidity factors such as poor nutrition, unhealthy diets, smoking, infection with bacteria or viruses, and exposure to pro-carcinogens. Chronic ingestion of alcohol and its metabolite acetaldehyde may initiate and/or promote the development of cancer in the liver, oral cavity, esophagus, stomach, gastrointestinal tract, pancreas, prostate, and female breast. In this chapter, we summarize the important roles of ethanol/acetaldehyde in promoting inflammatory injury and carcinogenesis in several tissues. We also review the updated roles of the ethanol-inducible cytochrome P450-2E1 (CYP2E1) and other cytochrome P450 isozymes in the metabolism of various potentially toxic substrates, and consequent toxicities, including carcinogenesis in different tissues. We also briefly describe the potential implications of endogenous ethanol produced by gut bacteria, as frequently observed in the experimental models and patients of nonalcoholic fatty liver disease, in promoting DNA mutation and cancer development in the liver and other tissues, including the gastrointestinal tract.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Carcinogênese , Citocromo P-450 CYP2E1 , Sistema Enzimático do Citocromo P-450 , Etanol , Acetaldeído/toxicidade , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Carcinogênese/efeitos dos fármacos , Carcinogênese/patologia , Citocromo P-450 CYP2E1/metabolismo , Sistema Enzimático do Citocromo P-450/metabolismo , Etanol/toxicidade , Humanos , Isoformas de Proteínas
3.
PLoS One ; 14(6): e0218469, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31216319

RESUMO

OBJECTIVE: Although there is evidence that Attention Deficit Hyperactivity Disorder (ADHD) symptoms are positively related to alcohol use and related problems among young adults, little research has examined the mechanisms that might explain this association. In response, this study examined the mediating effects of coping and enhancement drinking motives on the prospective associations between ADHD symptoms and alcohol outcomes. METHOD: Participants (N = 4,536) were young men from the Cohort Study on Substance Use Risk Factors. Measures of ADHD symptoms and those of drinking motives, heavy episodic drinking (HED) and alcohol use disorder symptoms were used from the baseline and 15-month follow-up assessments. RESULTS: Findings indicated that the associations of ADHD-inattention symptoms with alcohol use disorder (AUD) symptoms and with HED were partially and completely mediated through drinking motives, respectively, whereas drinking motives did not mediate the ADHD-hyperactivity/impulsivity-symptoms-alcohol outcomes associations. CONCLUSION: Results indicated that coping and enhancement motives partially explained the ADHD-inattention symptoms-subsequent alcohol outcomes association. These findings suggest that interventions targeting enhancement and coping motives may help prevent problematic drinking among young men with elevated ADHD-inattention symptoms.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Transtornos Relacionados ao Uso de Álcool/complicações , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Estudos de Coortes , Depressão/complicações , Depressão/epidemiologia , Etanol/efeitos adversos , Humanos , Comportamento Impulsivo/fisiologia , Masculino , Motivação/fisiologia , Estudos Prospectivos , Fatores de Risco , Estudantes , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adulto Jovem
4.
J Addict Med ; 13(1): 35-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30303888

RESUMO

OBJECTIVE: Despite high rates of alcohol use disorder (AUD) and alcohol-induced deaths among Native Americans, there has been limited study of the construct validity of the AUD diagnostic criteria. The purpose of the current study was to examine the validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) AUD criteria in a treatment-seeking group of Native Americans. METHODS: As part of a larger study, 79 Native Americans concerned about their alcohol or drug use were recruited from a substance use treatment agency located on a reservation in the southwestern United States. Participants were administered the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID for DSM-IV-TR) reworded to assess 11 DSM-5 criteria for AUD. Confirmatory factor analysis (CFA) was used to test the validity of the AUD diagnostic criteria, and item response theory (IRT) was used to examine the item characteristics of the AUD diagnostic criteria in this Native American sample. RESULTS: CFA indicated that a 1-factor model of the 11 items provided a good fit of the data. IRT parameter estimates suggested that "withdrawal," "social/interpersonal problems," and "activities given up to use" had the highest magnitude of discrimination. "Much time spent using" and "activities given up to use" were associated with the greatest severity. CONCLUSIONS: The current study provided support for the validity of the AUD DSM-5 criteria and a unidimensional latent construct of AUD in this sample of treatment-seeking Native Americans. IRT analyses replicate findings from previous studies. To our knowledge, this is the first study to examine the validity of the DSM-5 AUD criteria in a treatment-seeking sample of Native Americans. Continued research in other Native American samples is needed.


Assuntos
Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/etnologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Índios Norte-Americanos/etnologia , Escalas de Graduação Psiquiátrica/normas , Adolescente , Adulto , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Alcoolismo/diagnóstico , Alcoolismo/etnologia , Alcoolismo/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Sudoeste dos Estados Unidos/etnologia , Adulto Jovem
5.
Neuroscience ; 398: 144-157, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30481568

RESUMO

Many studies have implicated hippocampal dysregulation in the pathophysiology of alcohol use disorder (AUD). However, over the past twenty years, a growing body of evidence has revealed distinct functional roles of the dorsal (dHC) and ventral (vHC) hippocampal subregions, with the dHC being primarily involved in spatial learning and memory and the vHC regulating anxiety- and depressive-like behaviors. Notably, to our knowledge, no rodent studies have examined the effects of chronic ethanol exposure on synaptic transmission along the dorsal/ventral axis. To that end, we examined the effects of the chronic intermittent ethanol vapor exposure (CIE) model of AUD on dHC and vHC synaptic excitability. Adult male Long-Evans rats were exposed to CIE or AIR for 10 days (12 h/day; targeting blood ethanol levels of 175-225 mg%) and recordings were made 24 h into withdrawal. As expected, this protocol increased anxiety-like behaviors on the elevated plus-maze and successive alleys test. Extracellular recordings revealed marked CIE-associated increases in synaptic excitation in the CA1 region that were exclusively restricted to the ventral domain of the hippocampus. Western blot analysis of synaptoneurosomal fractions revealed that the expression of two proteins that regulate synaptic strength, GluA2 and SK2, were dysregulated in the vHC, but not the dHC, following CIE. Together, these findings suggest that the ventral CA1 region may be particularly sensitive to the maladaptive effects of chronic ethanol exposure and provide new insight into some of the neural substrates that may contribute to the negative affective state that develops during withdrawal.


Assuntos
Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Depressores do Sistema Nervoso Central/efeitos adversos , Etanol/efeitos adversos , Hipocampo/efeitos dos fármacos , Sinapses/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Expressão Gênica/efeitos dos fármacos , Quinases do Centro Germinativo , Hipocampo/fisiopatologia , Masculino , Proteínas Serina-Treonina Quinases/metabolismo , Ratos Long-Evans , Receptores de N-Metil-D-Aspartato/metabolismo , Sinapses/fisiologia , Transmissão Sináptica/fisiologia
6.
Psychiatry Res ; 271: 208-213, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30502556

RESUMO

People with alcohol use disorder (AUD) are at an increased risk for cardiovascular diseases (CVD). Physical fitness is a predictor of CVD and premature mortality. Currently, no existing measures of physical fitness used in the general population have been tested for validity and reliability in this vulnerable population. Therefore, we examined the reproducibility, feasibility and correlates of the Eurofit test battery in this population. From 32 men (age = 40.8 ±â€¯13.8years; illness duration = 10.2 ±â€¯10.3years; body mass index, BMI = 24.8 ±â€¯3.8) and 13 women (age = 41.9 ±â€¯12.1years; illness duration = 13.7 ±â€¯13.1years; BMI = 26.3 ±â€¯4.9) with AUD two trials of the Eurofit test, administered within one week, were analyzed. All patients also completed the International Physical Activity Questionnaire, the Positive Affect and Negative Affect Scale and Alcohol Use Disorders Identification Test. All Eurofit items showed good reproducibility with intraclass correlation coefficients ranging from 0.82 for the flamingo balance test to 0.97 for the standing broad jump and handgrip strength tests. Better performance on Eurofit test items was associated with younger age, a shorter illness duration, a lower BMI and higher physical activity levels. The current study demonstrates that the Eurofit test can be recommended as a reliable test for evaluating the physical fitness of inpatients with alcohol use disorder.


Assuntos
Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Teste de Esforço/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , Adulto , Transtornos Relacionados ao Uso de Álcool/complicações , Transtornos Relacionados ao Uso de Álcool/psicologia , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Exercício Físico , Teste de Esforço/métodos , Estudos de Viabilidade , Feminino , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Aptidão Física , Reprodutibilidade dos Testes , Medição de Risco/métodos , Fatores de Risco
7.
Psychol Addict Behav ; 33(2): 139-143, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30451511

RESUMO

Previous research has demonstrated a significant association between alcohol and aggression. However, the precise mechanisms underlying this relationship have yet to be fully elucidated. In the present study, we examined alcohol's effects on an attentional bias toward aggressogenic cues as the first step in a possible mediation model of alcohol-facilitated intimate partner aggression. More specifically, we tested an interactive effect of problematic alcohol use and acute alcohol intoxication on an attentional bias toward anger words. Participants in this study were 249 male and female heavy drinkers from the community with a history of past-year intimate partner aggression perpetration who participated in an alcohol-administration laboratory study assessing the effect of alcohol intoxication on cognitive biases. Multiple linear regression was used to test the proposed moderation model. Acute alcohol intoxication moderated the effect of problematic alcohol use on an attentional bias toward anger, with this effect being stronger for individuals in the alcohol compared to no-alcohol control condition. These findings suggest that problematic drinkers may be more likely to attend to aggressogenic stimuli while acutely intoxicated, relative to when they are sober. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Agressão/fisiologia , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Ira/fisiologia , Viés de Atenção/fisiologia , Violência por Parceiro Íntimo , Adulto , Intoxicação Alcoólica/fisiopatologia , Sinais (Psicologia) , Feminino , Humanos , Masculino , Modelos Estatísticos , Teoria Psicológica , Adulto Jovem
8.
Clin Liver Dis ; 23(1): 141-155, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30454828

RESUMO

Chronic alcohol use induces silent changes in the structure and function of the central and peripheral nervous systems that eventually result in irreversible, debilitating repercussions. Once identified, nutritional supplementation and cessation measures are critical in preventing further neurologic damage. The proposed mechanisms of neuronal injury in chronic alcohol abuse include direct toxic effects of alcohol and indirect effects, including those resulting from hepatic dysfunction, nutritional deficiencies, and neuroinflammation. Clinical manifestations include cerebellar ataxia, peripheral neuropathy and Wernicke-Korsakoff encephalopathy. Continued exploration of the pathophysiologic mechanisms may lead to the discovery of early interventions that can prevent permanent neurologic injury.


Assuntos
Transtornos do Sistema Nervoso Induzidos por Álcool/fisiopatologia , Alcoolismo/fisiopatologia , Transtornos do Sistema Nervoso Induzidos por Álcool/etiologia , Transtornos do Sistema Nervoso Induzidos por Álcool/metabolismo , Transtornos do Sistema Nervoso Induzidos por Álcool/psicologia , Transtornos Relacionados ao Uso de Álcool/metabolismo , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Síndrome Alcóolica de Korsakoff/etiologia , Síndrome Alcóolica de Korsakoff/metabolismo , Síndrome Alcóolica de Korsakoff/fisiopatologia , Síndrome Alcóolica de Korsakoff/psicologia , Neuropatia Alcoólica/etiologia , Neuropatia Alcoólica/metabolismo , Neuropatia Alcoólica/fisiopatologia , Alcoolismo/complicações , Alcoolismo/metabolismo , Alcoolismo/psicologia , Ataxia Cerebelar/etiologia , Ataxia Cerebelar/metabolismo , Ataxia Cerebelar/fisiopatologia , Humanos , Neurotransmissores/metabolismo
9.
Neuropharmacology ; 145(Pt A): 25-36, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29477298

RESUMO

Relapse remains the most prominent hurdle to successful rehabilitation from alcoholism. The neural mechanisms underlying relapse are complex, but our understanding of the brain regions involved, the anatomical circuitry and the modulation of specific nuclei in the context of stress and cue-induced relapse have improved significantly in recent years. In particular, stress is now recognised as a significant trigger for relapse, adding to the well-established impact of chronic stress to escalate alcohol consumption. It is therefore unsurprising that the stress-responsive regions of the brain have also been implicated in alcohol relapse, such as the nucleus accumbens, amygdala and the hypothalamus. Environmental enrichment is a robust experimental paradigm which provides a non-pharmacological tool to alter stress response and, separately, alcohol-seeking behaviour and symptoms of withdrawal. In this review, we examine and consolidate the preclinical evidence that alcohol seeking behaviour and stress-induced relapse are modulated by environmental enrichment, and these are primarily mediated by modification of neural activity within the key nodes of the addiction circuitry. Finally, we discuss the limited clinical evidence that stress-reducing approaches such as mindfulness could potentially serve as adjunctive therapy in the treatment of alcoholism. This article is part of the Special Issue entitled "Neurobiology of Environmental Enrichment".


Assuntos
Transtornos Relacionados ao Uso de Álcool/reabilitação , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Animais , Encéfalo/fisiopatologia , Meio Ambiente , Humanos , Estresse Psicológico/fisiopatologia , Estresse Psicológico/reabilitação
10.
Neuropsychopharmacology ; 43(9): 1915-1923, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29907878

RESUMO

Forced abstinence from chronic two bottle-choice ethanol drinking produces the development of negative affective states in female C57BL/6J mice. We previously reported that this disrupted behavior is acutely reversed by administration of ketamine 30 min-prior to testing. Here we assessed whether ketamine can be used as an inoculant against the development of abstinence- dependent affective disturbances. In parallel, we examined the impact of ketamine administration on long-term potentiation (LTP) in the bed nucleus of the stria terminalis (BNST), a region implicated in affective disturbances. We administered ketamine (3 mg/kg i.p.) to female C57BL/6J mice with a history of chronic ethanol drinking at either the onset, two, or 6 days- post-abstinence and observed its impact on affective behavior in the elevated plus maze (EPM), the Novelty Suppressed Feeding Test (NSFT), and the Forced Swim Test (FST). In addition, we assessed BNST synaptic plasticity with field potential electrophysiology two to 3 weeks into abstinence. We found that early abstinence was associated with disrupted behavior on the EPM. Ketamine administered at the onset of forced abstinence prevented both the deficit in early EPM behavior, and the delayed deficits in NSFT and FST. However, ketamine administered either two or 6 days post-abstinence failed to prevent the abstinence-induced affective disturbances. To begin to explore potential alterations in neural circuit activity that accompanies these actions of ketamine, we assessed the impact of ketamine administration at the onset of forced abstinence and measured LTP induction in the BNST. We find that early ketamine administration persistently increased the capacity for LTP within the BNST. These findings suggest a critical period at the onset of forced abstinence in which ketamine inoculation can prevent the development of affective disturbances, in part by enhancing plasticity within the BNST.


Assuntos
Transtornos Relacionados ao Uso de Álcool/complicações , Ketamina/farmacologia , Transtornos do Humor/tratamento farmacológico , Psicotrópicos/farmacologia , Núcleos Septais/efeitos dos fármacos , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Afeto/efeitos dos fármacos , Afeto/fisiologia , Transtornos Relacionados ao Uso de Álcool/tratamento farmacológico , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Animais , Modelos Animais de Doenças , Feminino , Potenciação de Longa Duração/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Transtornos do Humor/etiologia , Transtornos do Humor/fisiopatologia , Núcleos Septais/fisiopatologia , Síndrome de Abstinência a Substâncias/fisiopatologia , Síndrome de Abstinência a Substâncias/psicologia , Técnicas de Cultura de Tecidos
11.
Hum Psychopharmacol ; 33(3): e2657, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29676057

RESUMO

OBJECTIVES: Although sleep disturbances are prominent during alcohol withdrawal, less is known about the specific components of sleep that are disturbed prior to and during acute detoxification. This study aimed to determine whether specific sleep components are affected prior to and during acute detoxification and their relationship to psychological distress. METHODS: Twenty-nine participants were recruited from a residential detoxification service in Melbourne, Australia, and completed both subjective methods of sleep and distress, in addition to wearing an actigraphy device. RESULTS: Daytime dysfunction, sleep quality, and sleep disturbances were the components that were most disturbed in the month prior to admission, and poor sleep efficiency was detected during acute withdrawal using actigraphy. A significant association was found between sleep and psychological distress in this group. CONCLUSIONS: Specific disturbances in sleep are experienced prior to and during acute alcohol withdrawal, suggesting that tailored interventions may be effective in the treatment of sleep deficits during these periods.


Assuntos
Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Síndrome de Abstinência a Substâncias/fisiopatologia , Doença Aguda , Adulto , Idoso , Transtornos Relacionados ao Uso de Álcool/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/etiologia , Síndrome de Abstinência a Substâncias/complicações
12.
Epilepsy Res ; 143: 82-89, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29705654

RESUMO

PURPOSE: The aim of this study was to investigate the association between alcohol use and seizures in acutely hospitalized patients. We wished to study the extent of the problem as well as the clinical characteristics of people with various forms of alcohol-related seizures, including their drinking pattern. METHOD: After admission, a semi-structured interview took place with 134 consecutive patients (epilepsy 92, single seizures 42). Alcohol use was assessed by the Alcohol Use Disorders Identification Test (AUDIT) and by the number of alcohol units consumed during 6 days prior to the seizure. Sleep time was recorded during the previous 3 days and nights. A follow-up telephone interview covering the same weekdays was performed on a seizure-free day at least 4 weeks later. RESULTS: 28% of patients had AUDIT scores ≥8 (hazardous drinking); 22% in epilepsy, 43% in single seizures (p = .012). Non-focal seizures were increased in single seizures, suggesting a withdrawal mechanism. In the 58 epilepsy patients with social drinking (excluded hazardous drinking or excessive binging), the alcohol intake was not different prior to seizure compared to follow-up, downgrading the role of modest alcohol intake as a seizure precipitant in epilepsy. On the other hand, a high percentage of binge drinkers had epilepsy (57%), and in the subgroup of Idiopathic Generalized Epilepsy (IGE) even social drinking was associated with seizures. Seizures peaked on Sundays and Mondays. Less sleep prior to the seizure was associated with hazardous drinking. CONCLUSION: Alcohol is a major seizure precipitant in the context of hazardous drinking and withdrawal. In people with epilepsy, occasional binge drinking is associated with loss of seizure control. Social drinking is an uncommon cause of seizure breakthrough in predominantly focal epilepsy, but caution is warranted in IGE. Alcohol intake prior to a seizure is often accompanied by other triggers, such as sleep loss. Alcohol alone should not always be blamed.


Assuntos
Transtornos Relacionados ao Uso de Álcool/complicações , Convulsões/complicações , Adulto , Consumo de Bebidas Alcoólicas/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Estudos Cross-Over , Epilepsia/complicações , Epilepsia/fisiopatologia , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Convulsões/fisiopatologia , Sono
13.
Behav Pharmacol ; 29(5): 462-468, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29561290

RESUMO

Contingency management (CM) is associated with decreases in off-target drug and alcohol use during primary target treatment. The primary hypothesis for this trial was that targeting alcohol use or tobacco smoking would yield increased abstinence in the opposite, nontargeted drug. We used a 2 [CM vs. noncontingent control (NC) for alcohol]×2 (CM vs. NC for smoking tobacco) factorial design, with alcohol intake (through urinary ethyl glucuronide) and tobacco smoking (through urinary cotinine) as the primary outcomes. Thirty-four heavy-drinking smokers were randomized into one of four groups, wherein they received CM, or equivalent NC reinforcement, for alcohol abstinence, smoking abstinence, both drugs, or neither drug. The CM for alcohol and tobacco group had only two participants and therefore was not included in analysis. Compared with the NC for alcohol and tobacco smoking group, both the CM for the tobacco smoking group [odds ratio (OR)=12.03; 95% confidence interval (CI): 1.50-96.31] and the CM for the alcohol group (OR=37.55; 95% CI: 4.86-290.17) submitted significantly more tobacco-abstinent urinalyses. Similarly, compared with the NC for the alcohol and tobacco group, both the CM for smoking (OR=2.57; 95% CI: 1.00-6.60) and the CM for alcohol groups (OR=3.96; 95% CI: 1.47-10.62) submitted significantly more alcohol-abstinent urinalyses. These data indicate cross-over effects of CM on indirect treatment targets. Although this is a pilot investigation, it could help to inform the design of novel treatments for alcohol and tobacco co-addiction.


Assuntos
Abstinência de Álcool/psicologia , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Adulto , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Alcoolismo/fisiopatologia , Comportamento Aditivo/fisiopatologia , Comportamento Aditivo/psicologia , Etanol/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fumar/fisiopatologia , Tabaco/efeitos adversos , Tabagismo/fisiopatologia
14.
Br J Psychiatry ; 212(2): 67-68, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29436326

RESUMO

Alcohol-related dementia represents an underrecognised mental disorder with both clinical and public mental health aspects. There is considerable scope for improving its assessment within both mainstream and specialist mental health services, but ongoing challenges remain in ensuring its timely detection so that appropriate preventative and rehabilitative interventions can be applied. Declaration of interest None.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Demência , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Síndrome Alcóolica de Korsakoff/diagnóstico , Síndrome Alcóolica de Korsakoff/epidemiologia , Síndrome Alcóolica de Korsakoff/fisiopatologia , Demência/induzido quimicamente , Demência/diagnóstico , Demência/epidemiologia , Demência/fisiopatologia , Humanos
15.
Addict Behav ; 83: 123-129, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29428330

RESUMO

INTRODUCTION: Craving has been proposed as a major contributor to addiction relapse and the influence of mood on craving and substance use has been extensively documented. However, information is lacking concerning the extent to which the magnitude of these effects may vary according to different types of substances. The aim of the present study was to compare the prospective links between emotions, craving and substance use in four groups of patients beginning treatment for alcohol, tobacco, cannabis, or opiate addiction. METHODS: Ecological Momentary Assessment (EMA) was used over a two-week period. Data were analyzed using hierarchical linear modeling (HLM). RESULTS: 159 participants were recruited (67.3% male; M = 36.7 years). The average response rate to the EMA assessments was 83.1%. The findings confirmed the strong predictive role of craving intensity on substance use reported at the next assessment of the day among the alcohol (γ = 0.224; p = .018), tobacco (γ = 0.133; p = .013) and cannabis groups (γ = 0.266; p = .019), but not for opiates (γ = 0.098; p = .142). Craving intensity was itself predicted by greater anxious mood (γ = 0.108; p = 0,029) and event negativity (γ = 0.107; p = .003) among tobacco patients, lower sad mood among cannabis patients (γ = -0.248; p = 0,002), and lower event negativity among opiate patients (γ = -0.201; p = .002). CONCLUSION: While these results support the benefit of targeting craving in addiction treatment regardless of substance type, the substance-specific emotional risk factors for craving identified in this study may provide important insights for the development of personalized treatment strategies.


Assuntos
Afeto/fisiologia , Comportamento Aditivo/fisiopatologia , Comportamento Aditivo/psicologia , Fissura/fisiologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Feminino , Humanos , Masculino , Abuso de Maconha/fisiopatologia , Abuso de Maconha/psicologia , Transtornos Relacionados ao Uso de Opioides/fisiopatologia , Transtornos Relacionados ao Uso de Opioides/psicologia , Estudos Prospectivos , Tabagismo/fisiopatologia , Tabagismo/psicologia
16.
J Intellect Disabil ; 22(1): 5-17, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27555557

RESUMO

We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers. Participants ( N = 474) were divided into four groups based on IQ and severity of alcohol use-related problems. IQ was estimated using (a short form of) the Wechsler Adult Intelligence Scale third edition. Severity of alcohol use-related problems was assessed using the Alcohol Use Disorder Identification Test. Overall, there were no significant differences between light and problematic drinkers on estimated VIQ. Within the group without MBID, estimated PIQ was significantly lower. Estimated PIQ was not lower in problematic drinkers with MBID compared to light drinkers with MBID. The results are indicative of cognitive deficits in problematic drinkers without MBID. Screening for cognitive deficits with additional instruments is advised.


Assuntos
Consumo de Bebidas Alcoólicas/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Deficiência Intelectual/fisiopatologia , Inteligência/fisiologia , Adulto , Humanos , Masculino
17.
ACS Chem Neurosci ; 9(8): 1907-1916, 2018 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-29227676

RESUMO

Animal models are essential for understanding the biological factors that contribute to drug and alcohol addiction and discovering new pharmacotherapies to treat these disorders. Alcohol (ethanol) is the most commonly abused drug in the world, and as the prevalence of alcohol use disorder (AUD) increases, so does the need for effective pharmacotherapies. In particular, treatments with high efficacy in the growing number of female AUD sufferers are needed. Female animals remain underrepresented in biomedical research and sex differences in the brain's response to alcohol are poorly understood. To help bridge the gender gap in addiction research, this Review discusses strategies that researchers can use to examine sex differences in the context of several common animal models of AUD. Self-administration, two-bottle choice, drinking in the dark, and conditioned place preference are discussed, with a focus on the role of estrogen as a mediator of sex differences in alcohol-related behaviors.


Assuntos
Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Comportamento Aditivo/fisiopatologia , Modelos Animais de Doenças , Caracteres Sexuais , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/genética , Animais , Comportamento Aditivo/genética , Hormônios/metabolismo , Humanos
18.
Age Ageing ; 47(2): 248-254, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29088316

RESUMO

Background: alcohol consumption has many harmful health effects, but also benefits of moderate consumption on frailty have been reported. We examined this relationship longitudinally from midlife to old age. Methods: data of reported alcohol consumption in midlife (year 1974) and in old age (years 2000 and 2003) were available of a socioeconomically homogenous sample of 2360 men (born 1919-34, the Helsinki Businessmen Study). Alcohol consumption was divided into zero (N = 131 at baseline), light (1-98 g/week, N = 920), moderate (99-196, N = 593), and high consumption (>196, n = 716). Incidence of phenotypic frailty and prefrailty was assessed in 2000 and 2003. Alcohol consumption (reference 1-98 g/week, adjusted for age, body mass index and smoking) was related to frailty both longitudinally (from 1974 to 2000, and from 2000 to 2003) and cross-sectionally in 2000 and 2003. Results: during a 30-year follow-up, high consumption clearly decreased whereas lighter consumption remained stable. High consumption in midlife predicted both frailty (odds ratio = 1.61, 95% confidence interval = 1.01-2.56) and prefrailty (1.42; 1.06-1.92) in 2000, association with zero and moderate consumption was insignificant. Cross-sectionally in 2000, both zero (2.08; 1.17-3.68) and high consumption (1.83; 1.07-3.13) were associated with frailty, while in 2003 only zero consumption showed this association (2.47; 1.25-4.88). Conclusion: the relationship between alcohol and frailty is a paradox during the life course. High, not zero, consumption in midlife predicts old age frailty, while zero consumption in old age is associated with frailty, probably reflecting reverse causality.


Assuntos
Envelhecimento , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Idoso Fragilizado , Fragilidade/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Consumo de Bebidas Alcoólicas/fisiopatologia , Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Finlândia/epidemiologia , Seguimentos , Idoso Fragilizado/psicologia , Fragilidade/diagnóstico , Fragilidade/fisiopatologia , Fragilidade/psicologia , Avaliação Geriátrica , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Prognóstico , Medição de Risco , Fatores de Risco , Fatores de Tempo
19.
Brain Imaging Behav ; 12(2): 564-576, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28429160

RESUMO

Because adolescence is a period of heightened exploration of new behaviors, there is a natural increase in risk taking including initial use of alcohol and marijuana. In order to better understand potential differences in neurocognitive functioning among adolescents who use drugs, the current study aimed to identify the neural substrates of risky decision making that differ among adolescents who are primary users of alcohol or marijuana, primary users of both alcohol and marijuana, and controls who report primary use of neither drug. Participants completed the Balloon Analogue Risk Task (BART) while undergoing functional magnetic resonance imaging. Comparison of brain activation during risky decisions versus non-risky decisions across all subjects revealed greater response to risky decisions in dorsal anterior cinguate cortex (dACC), anterior insula, ventral striatum, and lateral prefrontal cortex. Group comparisons across non-using controls, primary marijuana, primary alcohol, and alcohol and marijuana users revealed several notable differences in the recruitment of brain regions. Adolescents who use both alcohol and marijauna show decreased response during risky decision making compared to controls in insula, striatum, and thalamus, and reduced differentiation of increasing risk in dACC, insula, striatum, and superior parietal lobe compared to controls. These results provide evidence of differential engagement of risky decision making circuits among adolescents with varying levels of alcohol and marijuana use, and may provide useful targets for longitudinal studies that explicitly address causality of these differences.


Assuntos
Encéfalo/crescimento & desenvolvimento , Encéfalo/fisiopatologia , Tomada de Decisões/fisiologia , Uso da Maconha/psicologia , Assunção de Riscos , Consumo de Álcool por Menores/psicologia , Adolescente , Transtornos Relacionados ao Uso de Álcool/complicações , Transtornos Relacionados ao Uso de Álcool/diagnóstico por imagem , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Mapeamento Encefálico , Tomada de Decisões/efeitos dos fármacos , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Abuso de Maconha/complicações , Abuso de Maconha/diagnóstico por imagem , Abuso de Maconha/fisiopatologia , Abuso de Maconha/psicologia , Testes Neuropsicológicos
20.
J Affect Disord ; 225: 201-206, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-28837954

RESUMO

OBJECTIVE: To assess prospectively the association of the number of past pregnancies on the evolution of bipolar disorder (BD). METHODS: Data were drawn from the 2 waves of the National Epidemiologic Study of Alcohol and Related Conditions (NESARC), a representative sample of the US population of 34,653 participants. All women diagnosed with BD were included. The number of children and BD's characteristics, i.e. BD type, age of onset, hospitalization and suicide attempt, and lifetime psychiatrics comorbidity were assessed at wave 1. Mood episode and BD's characteristics were also assessed at wave 2. RESULTS: In the sample of 1190 women with BD, 27% had no child, 17% had one, 25% had two 31% had three children or more. Women with at least two children were more likely to have BD I, to report hypomania and suicide attempt during the follow-up than women without child. Parity was not associated with other characteristics of BD, nor with the severity and course of the illness. LIMITATIONS: Not provide information on pregnancies not ending to a delivery. CONCLUSION: Parity is associated with a higher incidence of hypomania and suicide attempt during a 3-years follow-up in women with BD.


Assuntos
Transtorno Bipolar/fisiopatologia , Paridade/fisiologia , Adolescente , Adulto , Idoso , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Comorbidade , Transtorno Ciclotímico/fisiopatologia , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , Tentativa de Suicídio , Adulto Jovem
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