ABSTRACT
Objective:To explore the differences in clinical characteristics and treatment outcomes between patients with type A and type B alcohol dependence, and to find the independent risk factors of relapse.Methods:Alcohol-dependent male patients attending the Addiction Medicine Center of Beijing Huilongguan Hospital from January 2018 to December 2020 were selected for the study and divided into type A alcohol-dependent group ( n=77) and type B alcohol-dependent group ( n=87). All patients were given acute detoxification treatment and were followed up after treatment on relapse to drinking. Differences in demographic and clinical data were compared between the two groups, and differences in treatment outcomes between the two groups at different time points over 3 months were compared. Patients were divided into relapse group and non-relapse group according to whether they drank again after 3 months. Logistic regression model was established to screen the risk factors of relapse of alcohol-dependent patients by SPSS 25.0 software. Results:There was no significant difference between the two types of patients in years of education, marital status, smoking status and working status(all P>0.05), but the proportion of co-residents( χ2=5.69, P=0.017) and the proportion of positive family history of alcoholism were significant difference between the two type of patients( χ2=13.32, P<0.001). There were statistically significant differences between the two types of patients in the onset time( t=-7.28, P<0.001), the first drinking age( t=-2.36, P=0.020), the proportion of drinking in the morning( χ2=7.83, P=0.005), psychotic symptoms( χ2=4.31, P=0.038), convulsions after withdrawal( χ2=5.30, P=0.021), and alcohol use disorder identification test(AUDIT) score( t=4.30, P<0.001). At the 4th and 8th weekend of the follow-up, there were statistically significant differences in drinking frequency(0(0, 3), 0(0, 0), Z=-4.13, P<0.001; 3(0, 3), 0(0, 3), Z=-4.42, P<0.001) and relapse rate (40(45.98%), 9(11.69%), χ2=22.92, P<0.001; 61(70.11%), 24(31.17%), χ2=24.82, P<0.001) between the two types of alcohol dependence patients after drinking again. After 12-week follow-up, there were statistically significant differences between the two types of alcohol-dependent patients in the interval of first drinking(20(7, 30)d, 88(38, 90)d, Z=-7.83, P<0.001), the cumulative duration of abstinence(4(0, 8)weeks, 12(4, 12)weeks, Z=-5.13, P<0.001), the cumulative rate of abstinence(71(81.60%), 25(32.47%), χ2=40.62, P<0.001), the frequency of drinking after abstinence(3(3, 3), 0(0, 3), Z=-5.54, P<0.001), and the reduction of daily average alcohol consumption( t=3.36, P<0.001). Logistic regression model showed that type B alcohol dependence ( OR=3.121, P=0.03, 95% CI: 1.12-8.72) and AUDIT score ( OR=1.498, P<0.01, 95% CI: 1.29-1.74) were the risk factors for relapse of alcohol-dependent patients. Conclusions:Patients with type A and type B alcohol dependence have obvious differences in clinical characteristics and treatment outcomes, and type B alcohol dependence is independent risk factor for relapse to drinking in alcohol-dependent patients, which validate the rationality and necessity of alcohol dependence subtypes.
ABSTRACT
Objective:To explore the causes of the maintenance of smoking behaviors in male patient with chronic schizophrenia.Methods:Totally 188 male,smoking patients with chronic schizophrenia,meeting with the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV),above 5-year course of disease,taken a steady dosage of antipsychotics for 3 months,and 61 healthy smoking men were collected according to the voluntary principles.The psychopathologic symptoms and the dependence of cigarette of all patients were as- sessed with the Positive and Negative Syndrome Scale (PANSS)and the Fagerstrom Test for Nicotine Dependence (FTND),the Russell's Smoking Motivation Questionnaire (SMQ)was used to investigate the causes for maintai-ning behaviors of smoking in patients and healthy controls respectively.Results:The sedative item scores of SMQ were lower in patient group than in the controls [3 (0,9)vs.6 (0,9),P <0.001],and other scores of subscales had no significant difference compared with control.Heavy dependence happened in patient group slightly less than health controls (2.7%vs.8.2%,P <0.05).The total scores of FTND were positively correlated with the doses of antipsychotics (chlorpromazine equivalent)(r =0.22,P <0.01).The scores of total (β=0.22),automatic (β=0.27)and sedative (β=0.37)items in patient group were less than controls (Ps <0.001)by multi-factors step-wise Linear regression analysis.Conclusion:Compared with general smokers,lower need for sedation,less heavy dependence and motivation in smoking patients might be correlated with the strict management for inpatients smok-ing,social-psychological factors and culture background in China.
ABSTRACT
Objective To understand the prevalence and distribution features of mild cognitive impairment(MCI)among elderly in Xinjiang Uygur and Han ethnic groups so as to provide evidence for etiological study and prevention. Methods From July 2007 to October 2008, according to the criteria of DSM-IV for MCI,a randomized, stratified and cluster sampling procedure was used in the Uygur and Han elder people aged ≥60 years in south Xinjiang, east Xinjiang and Urumchi region. Results A total of 2986 people were surveyed, including 1519 Uygur people and 1467 Han people, and 1435 males and 1551 females. (1) According to the age composition of national census in 2000, the total crude prevalence rate of MCI was 10.21%, and the total standardized prevalence rate of MCI was 10.58% in Uygur and Han elder people. In general Uygur and Han population, the crude prevalence rates of MCI were 9.61% and 10.84%, and the standardized prevalence rates of MCI were 10.29%and 10.86%, respectively. The prevalence of MCI was higher in Han population than in Uygur population, but there was no statistical difference(χ~2 = 1.225, P>0.05). (2) In males and females, the crude prevalence rates of MCI were 9.34% and 11.03%, and the standardized prevalence rates of MCI were 9.26% and 11.62%, respectively. There was no difference in prevalence rate between different sex populations(χ~2 =2.314,P>0.05). (3) In elder people aged 60～69, 70～79 and≥80 years, the MCI prevalence rates were 6.83%, 13.22% and 22.22% in Uygur population and 8.64%, 12.50% and 19.30% in Han population, respectively, and the prevalence rate of MCI was increased with aging in the two thnic roups(χ_(for trend)~2=34.753, 14.081, both P<0.05). (4)There were statistical differences in prevalence rates of MCI among different education levels, and it was decreased with enhancement of education levels in Uygur and Han population(χ_(for trend) = 14.785, 21.059, both P<0.05). Conclusions In Xinjiang Uygur and Han ethnic elderly people, the prevalence rates of MCI are significantly different among elderly with different ages and education levels, and it is increased with aging, but is decreased with enhancement of education levels.