ABSTRACT
Background: Alcohol dependence is a global public health issue; it is a chronic and relapsing illness. Relapse is multifaceted by both neurobiological and psychosocial processes. The aim of the study was to examine the expressed emotions and coping among persons with alcohol dependence. Methodology: The study was descriptive and hospital-based. A purposive sampling technique was used. This study was conducted at the Centre for Addiction Psychiatry, CIP, Ranchi. The total sample size was 50. Twenty-five persons with alcohol dependence who relapsed within six months following treatment formed a study group. Another 25 persons with alcohol dependence who were abstinent for a minimum period of six months after treatment formed a comparative group. Ways of Coping Questionnaire and the Level of expressed emotions Scale were used, and informed consent was taken from the participants. Chi- square and independent sample 't' test, Pearson's correlation was used to analyse the data. Results: Mean age of relapsed patients was 35.3 years (S.D±7.6), and abstinent patients were 35.4 yrs. (S.D±6.8), years of education of relapsed patients was 12 yrs. ±2.63 and 11.6 yrs. ±3.26 in abstinent patients. A majority (60%) of relapsed patients were from rural background, 92% in the abstinent group were employed. 60% of abstinent patients had a family history of alcohol dependence. Abstinent patients had scored significantly high in all the domains of ways of coping. Relapsed patients had higher scores in perceived lack of emotional support, perceived irritability, perceived intrusiveness, and perceived criticism compared to abstinent patients Conclusion: The study provided further evidence that coping and perceived expressed emotions significantly influenced relapse among persons with alcohol dependence.
ABSTRACT
Objective: This case report highlights the success of community services and supported employment program that may be of help to a woman with chronic inhalant use to achieve a complete abstinence. Methods: We report the case of a 45 year old lady who chronically abused glue, presented after 10 years with substance induced psychosis and comorbid mood disorder. Results: Abstinent from inhalant dependence was achieved after series of home treatment services and supported employment program. Conclusion: Provision of acute community service and incorporating this patient in supported employment program contribute to her successful journey in achieving abstinence from inhalant dependence.
ABSTRACT
Objective To detect different activated patterns of heavy smokers in different states as well as between smokers and non-smokers. Methods Seventeen subjects including 12 heavy smokers and 5 non-smokers (controls) were examined with functional magnetic resonance imaging (fMRI) performing smoking-related olfactory cue tasks. The data were processed with SPM2. These different patterns were compared between the two groups. Results When smokers were exposed to the smoking olfactory cue in the abstinent state, activation was found on the left superior frontal gyrus (BA8, 9, 10, 11), left middle frontal gyrus (BA8, 10, 11, 46), left inferior frontal gyrus (BA9), left medial frontal gyrus (BA6, 8, 10,11), right superior frontal gyrus (BA10), right middle frontal gyrus (BA8, 9), right inferior frontal gyrus (BA45, 47), right medial frontal gyrus (BA9, 11), left callosal gyrus (BA24, 31), right callosal gyrus (BA24, 37), right middle temporal gyrus (BA21) and both sides of the thalamus and cerebellum. When smokers were exposed to the smoking olfactory cue in the satiated state, activation could be found on both sides of the prefrontal lobe and cerebellar hemisphere, while there was no activation on the other brain regions. No activation was found on the whole brain of the nonsmokers,except for a little small volume active points appeared in individual subjects, possibly caused by the picture noise. Conclusion The Limbic system (cingulate cortex, thalamus) and the prefrontal lobe play an important role in the cue-induced smoking craving approved from the new perspective of the olfactory. It is feasible to research smoking addicts' brain activation and the role of neural mechanisms using olfactory stimulation with clinical 1.5T MRI equipment.