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Background: The aim of this study is to study the change in motivation in patients with alcohol dependence syndrome (ADS).Design: 50 consecutive patients admitted for the treatment of ADS in a tertiary care hospital were evaluated. It was a cross sectional observational study.Methods: The study was done in a tertiary care hospital in the in-patient department of psychiatry. Structured performa for sociodemographic details. Psychiatric morbidity was assessed by structured clinical interview according to ICD10. SAD-Q (severity of alcohol dependence questionnaire) to assess severity of alcohol dependence. The assessment of motivation was done using the University of Rhode Island change assessment scale at baseline and after 10 days of admission. Data was evaluated keeping the aims and objectives in mind with appropriate statistical method using Statistical package social software (SPSS) version 21 and descriptive statistics was used. Chi square and Fisher exact test were used to assess the significance.Results: A total 64% were in pre-contemplation, 30% in contemplation and 6% were in action stage of motivation at baseline assessment. A significant change was seen in the levels of motivation towards contemplation and action stage after a brief hospital stay of 10 days. Motivation to change had a significant association with education and severity of alcohol dependence.Conclusions: Pharmacological and non-pharmacological treatment during a short hospital stay results in improvement in readiness for change in patients of alcohol dependence syndrome.
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Background: Alcohol dependence syndrome (ADS) and major depressive disorder are highly prevalent. Much less is known about the expectancy of alcohol use in depressed patients with ADS. Few studies had compared the expectancy of alcohol use in ADS patients with and without co-morbid depression. Assessing the above factors may help to formulate effective prevention strategies. This study was designed to assess the difference in expectancy of alcohol use and functioning in patients with ADS with and without co-morbid depression.Methods: The difference in expectancy of alcohol use in 96 alcohol dependent patients, of which 24 had co-morbid depression and 72 without co-morbid depression was studied using drinking expectancy questionnaire. In addition, we compared the difference in functioning between the two groups using GAF.Results: Prevalence of depression in alcohol dependent patients was 25%. ADS patients with co-morbid depression had less expectancy about alcohol use for sexual enhancement and had lower level of functioning compared to ADS patients without depression.Conclusions: Less expectancy on sexual enhancement in patients with ADS and co-morbid depression could be possibly due to reduced libido in depressed patients. The observed lower functioning in ADS patients with co-morbid depression despite no difference in severity of alcohol use may be possibly explained by the added burden of both the diseases.
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Background: Few studies have compared the pattern of alcohol use in Alcohol dependence syndrome (ADS) patients with and without co-morbid depression. Assessing the pattern may throw light into prevention of relapses more effectively in alcohol dependent patients with co-morbid depression. This study was undertaken to assess the difference in pattern of drinking of alcohol in patients with alcohol dependence with and without co-morbid depression.Methods: A descriptive comparative study was designed to compare the difference in pattern of alcohol use in alcohol dependent patients with co-morbid depression and without co-morbid depression. Severity of dependence on alcohol was assessed using Alcohol Use Disorders Identification Test (AUDIT). Drinking pattern was assessed using Timeline Follow back Calender and Drinking Pattern Questionnaire. The data were statistically analysed.Results: Total 96 alcohol dependent patients (24 had co-morbid depression and 72 without co-morbid depression) were included in the study. There were no significant differences in alcohol use in both the groups in terms of AUDIT scores, amount of drinking, abstinence days or binge drinking. More frequent drinking was observed in circumstances related to emotional, physiological, financial and children related situations in patients with co-morbid depression (p<0.05).Conclusions: Drinking circumstances like emotional, physiological, financial and children related situations require more attention while assessing, treating and aiming at relapse of prevention in ADS patients with co-morbid depression.
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Serious psychiatric conditions like schizophrenia, bipolar disorder, alcohol dependence syndrome lead to a great burden in care givers who adopt a variety of styles to cope with their family member’s illness. Burden perceived and coping styles used by spouses is quite different from other care givers given their close relationship with the patient. Little research is focused on spouses as an exclusive group for their assessment of burden & coping. The aim was to compare the burden and coping in spouses across three patient groups with schizophrenia, bipolar disorder and alcohol dependence syndrome.METHODSThis was conducted at Institute of Mental Health, Hyderabad with 180 spouses (30 male & 30 female) from patients of above three illnesses. After IEC approval and a written informed consent, the patient and spouse were interviewed with the semi-structured intake pro-forma to capture socio-demographic details of spouse, illness, marital, family & treatment history. After initial assessment of patient’s functional status using GAF scale; BAS, CCL, GHQ-12 instruments were administered on spouses to assess the burden of illness, coping styles and general health status. Data was analysed with SPSS 17.RESULTSAlcohol use and mental illness is high in families of patients with alcohol dependence reaching statistical significance. Nuclear families are high in schizophrenia group and in alcohol dependence group, substance use in spouses is high at 25 (52.1%) along with abuse of spouses at 19 (67.9%) which is statistically significant. On ANOVA & post hoc analysis, means of GHQ-12 in alcohol dependence group is higher than other groups while means of BAS is higher in alcohol dependence group showing high scores on BAS factor analysis.CONCLUSIONSBurden perceived by spouses of these three patient groups is significant. The coping styles used by spouses to handle the distress due to patient’s illness are many. A high global functioning score of the patient corresponds to good general health in the spouse. Proper psychosocial interventions when employed can help spouses deal better with burden and enhance coping styles.
ABSTRACT
Serious mental illnesses like schizophrenia, bipolar disorder, alcohol dependence syndrome lead to great burden in care givers who adopt a variety of methods to cope with their family member’s illness. Burden perceived and coping styles used by spouses is quite different from other care givers given their close relationship with the patient. Little research is focused on spouses as an exclusive group for the assessment of burden & coping. The aim was to study the socio-demographic profile, the burden and coping in the spouses of patients with schizophrenia, bipolar disorder and alcohol dependence syndrome.METHODSThis study was conducted at the Institute of Mental Health, Hyderabad, among 180 study participants including spouses (30 male & 30 female) from patient groups of the above three illnesses. After obtaining written informed consent, patient and spouse were interviewed with a semi-structured intake pro-forma to capture the socio-demographic details of spouse, illness, marital, family & treatment history. After initial assessment of patient’s functional status using GAF scale; BAS, CCL, GHQ-12 instruments were administered on spouses to assess the burden of illness, coping styles and general health status. SPSS 17 was applied to the data.RESULTSAlcohol use and mental illness is high in families of patients with alcohol dependence reaching statistical significance. Nuclear families are high in schizophrenia group and in alcohol dependence group, substance use in spouses is high at 25 (52.1%) along with abuse of spouses at 19 (67.9%) with statistical significance. Also, means of GHQ-12 in alcohol dependence group is higher than other groups while means of BAS is higher in alcohol dependence group.CONCLUSIONSBurden perceived by spouses of these three patient groups is significant. The coping styles used by spouses to handle the distress due to patient’s illness are many. A high global functioning score of the patient corresponds to good general health in the spouse. Proper psychosocial interventions when employed can help spouses deal better with burden and enhance coping styles.
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Alcoholism is one of the major health problems seen all over the world. The risk of relapse was estimated among 94 clients with alcohol dependence syndrome (ADS) who attended both in- and out-patient units of a tertiary care hospital. The tools used were the sociodemographic and clinical variables, Clinical Institute of Withdrawal Assessment Alcohol–revised (CIWA–Ar), Alcohol Use Disorder Identification Test (AUDIT), and Advanced Warning of Relapse (AWARE) scale. Out of the 94 clients, 63 (67.7%) were in the low-risk group for getting relapse, 26 (27.7%) were in the moderate-risk group, and 5 (5.3%) were in the high-risk group. Family history of alcohol use was significantly associated with the AWARE score (P < 0.05). Nicotine use was reported by 56 (59.6%) clients. Clients with a positive family history of alcohol use, disturbed sleep pattern, and higher total score (>20) of AUDIT scale were at higher risk of relapse.
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: Chronic pain and substance abuse are common problems with each having its own unique difficulties with partial response to treatment and poor outcomes. Relationship of chronic pain with alcohol dependence has not been explored unlike other substances specially opioids. This study aims to assess the prevalence and characteristic of chronic pain among respondents with alcohol dependence syndrome (ADS) and also attempts to explore the relationship of alcohol use and its effect on pain. Methods: A Cross-sectional prevalence study was carried out in outpatient services of Center for Addiction Medicine at National Institute of Mental Health and Neurosciences, Bangalore, India. Six hundred forty six subjects fulfilling the DSM IV diagnostic criteria for Alcohol Dependence Syndrome (ADS) were screened for chronic pain. The assessments included semi-structured proforma for demographic and clinical details, Brief pain inventory (BPI) and Severity of Alcohol Dependence Questionnaire (SADQC). Results: Chronic pain was prevalent in 118 (18 %) subjects with alcohol dependence syndrome with 49% of them reporting pain to be of severe intensity. Mean + SD (standard deviation) duration of pain in months was 26.2 + 33.7. Chronic pain was significantly more common among older patients. Majority of subjects (73.6 %) subjects reported use of alcohol for managing pain. Conclusions: Chronic severe pain either as a cause or effect of alcohol dependence is prevalent in such subjects. Efforts should be made to better understand and address the pain problems in this patient population. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.
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Alcohol is widely abused in contemporary social life, which has become a serious medical and social problem because it hurts human health and endangers public safety. Recent re-search has developed several active substances that can effective-ly improve or treat this syndrome via affecting the mesolimbic do-pamine nervous pathway to dampen rewarding effectiveness in-duced by ethanol. This paper reviews the progress in near-term studies of alcoholism-intervening agents, aiming at providing ref-erences for related mechanism exploration and drug development.
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Background – Alcohol dependence syndrome (ADS) is a medical disorder with some particular features resulting from a prolonged and heavy use of alcohol. When people with ADS present to a psychiatric service, they usually have developed other health problems. Objective – Since eastern Nepal has a heavy load of alcohol related problems, this hospital based descriptive study was carried out to observe psychiatric co-morbidity among inpatient-ADS cases. Method – In this cross sectional study of 60 consecutive inpatients, psychiatric co-morbidities were diagnosed according to the diagnostic criteria of ICD-10. Results – Mean age of the cases was 39.19 years, 75% were male and 90% were married. Three fourths used other substances besides alcohol; main being nicotine, opioid and cannabis. Eighty percent cases had one or other or more than one diagnosable psychiatric illness, including ICD-10 mental and behavioral disorders in 63% and personality problems severe enough to affect the course of substance use disorder in 48% of the total cases. The most common psychiatric disorder in ADS cases was anxiety disorders, followed by mood affective disorders, and psychotic illness. Among the personality problems, dissocial plus narcissistic, and anxious group were common. Conclusion – Psychiatric co-morbidity is common in people with alcohol dependence.
Subject(s)
Adult , Alcoholism/epidemiology , Alcoholism/psychology , Comorbidity , Diagnosis, Dual (Psychiatry) , Female , Humans , Male , Mental Disorders/etiology , Mental Disorders/psychology , Middle Aged , Inpatients , NepalABSTRACT
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Summary The main objective of this paper is to describe the way in which the Alcohol Dependence Syndrome is manifested, according to the criteria and indicators proposed by the DSM-IV, in a female sample that sought help at a treatment center due to alcohol consumption-related problems. A comparison was made with the results obtained in a previous 211-male-sample at the same treatment center. Method: This project is a case study in which a sample of 100 females was interviewed at the Clínica para Atención de Problemas Relacionados con el Alcohol (CAPRA) (Clinic for the Attention of Alcohol Related Problems) at the Hospital General de México (the main general hospital for patients who do not have social security benefits and come from different regions of the country including rural areas). The criteria for inclusion were: being aged 18 or over, female, having sought help for the first time (at these centers) due to alcohol problems and being physically and mentally able to answer the questionnaire correctly. Females that had previously been treated were included. However, one of the requisites was that they had to have drunk alcohol during the year before the interview to warrant recent and current consumption, regardless of being exposed to prior treatments, since the questionnaire includes the previous 12 months as a parameter. The instrument used to conduct this study was the Composite International Diagnostic Interview, Substance Abuse Module (CIDI-SAM). This instrument has been widely used with excellent results on various population samples in the U.S., as well as on the male population receiving treatment in Mexico. The instrument included the following sections: sociodemographic characteristics, amount and frequency of consumption; physical, psychological and social problems; symptoms of alcohol dependence, and pathways to health services. A few new sections were incorporated with specific characteristics for women, such as the effects of alcohol on women, alcohol consumption during pregnancy and nursing, partner's alcohol consumption and violent behavior in the couple and their associated risks. Results: The average age of the women interviewed was 47 years old, ranging from 22 to 91. Thirty-two percent were either married or living with a partner, 20% were divorced, 26% were widows and 22% were single. Seventy-four percent of them had children and they had 4.5 children in average. The average educational level was 4.7 years. Fifty-two percent of the respondents reported drinking alcohol every day and 19% almost every day (five or six days a week), with an average of 4.2 drinks per occasion (52% of the women reported having three to four drinks per occasion). The preferred reported beverage was «pulque¼ (28%), followed by beer (25%) and distilled beverages (21%). Other traditional drinks and «96° proof" alcohol also showed a significant percentage (20%). As for the Alcohol Dependence Syndrome, 50% of the women met the dependency criteria proposed by the DSM-IV, compared with 82% of the 211 men interviewed in the same center with a statistically significant difference (X2= 34.22; p = 0.000). Women with alcohol dependence syndrome presented an average of five symptoms. A more detailed analysis was carried out based on the severity of the dependence syndrome, measured by the number of reported symptoms (1-2, 3-4, 5-7). The most frequently reported symptom across all levels of severity was the presence of physical and/or psychological problems. In the group of non-dependent women (those who reported less than 3 symptoms), an important difference between men and women was observed. The most frequent symptoms reported by men, after the presence of physical and psychological problems, were withdrawal symptoms (34.2%) and loss of control (15.8%). In the case of the women, unsuccessful efforts to reduce alcohol intake (16%) and withdrawal symptoms (16%) appeared in the second place. The group of women with low dependence (three to four criteria reported) presented similar characteristics to those observed in the group of non-dependent women. In men with low levels of dependence, the most frequent symptom presented were: giving up or reducing activities (social, occupational or recreational) in order to drink and withdrawal symptoms. In the groups with the highest severity level (5-7 symptoms), differences between men and women were less evident. Conclusions: The most important differences in dependence symptoms between men and women are probably related to gender-specific cultural expectations and social norms regarding alcohol use. This situation is reflected in the type of symptoms presented more frequently in women and men. Women reported more symptoms related to unsuccessful efforts to reduce alcohol intake; whereas men presented symptoms related to the time spent drinking or recovering from the effects of alcohol and giving up or reducing activities (social, occupational or recreational) in order to drink. The information presented evidences the need to conduct more specific studies that take in consideration biological and psychological, as well as social conditions underlying female alcohol use in order to provide appropriate and effective treatment to meet their gender needs and expectations.